Biomechanics 2 Q & A | KevinRoot Medical
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Biomechanics 2 Q & A

  • Richard Blake

    Biomechanics 2 Q & A

     

    1. When you want to support forefoot varus deformities, yet not block first ray plantarflexion, how can you adjust the overall width of the orthosis (basically wider or narrower)?
    2. How does medial arch fill under the plastic help support the medial arch better than just the plastic?
    3. A patient with high degrees of pronation, and is 20 lbs overweight, how does the combination of thin plastic and medial arch fill work favorably when previous orthoses were deemed too hard?
    4. With heel, midfoot, or sesamoid pain, why would you err on the lab using minimal arch fill?
    5. Why is the Denton modification very important for the Inverted Orthotic Technique?
    6. When a patient presents with running related hip, pelvis, or low back pain, what would you first exam for biomechanically?
    7. As a podiatrist, what are the 5 problems that you can treat that helps a patient with low back pain?
    8. After making the orthotic shell, you can use the extrinsic rearfoot post to help invert a pronator more. After varus canting the rearfoot post, what must you apply under the front edge of the plate?
    9. What are the 2 types of Kirby skives?
    10. When you watch a patient walk, and see that they lean to one side, what is that called?

     

    Bonus Question: What is the Feehery Modification used for?





    Answers to the above Questions

     

    1. By narrowing the medial side until the lateral edge of the anterior platform
    2. 2 ways: the medial arch fill takes away some of the give to the plastic, and when that arch fill contacts the shoe itself, the shoe structure can help in the arch support.
    3. After dispense of the orthotic device, and feedback from the patient, if softness is needed, one third is standard removal of the medial arch fill as the initial attempt 
    4. Minimal arch fill on the mold or impression means higher arch support in the plastic. All 3 areas mentioned can be improved with a higher medial arch. There would be more support for the midfoot pain, and more weight transfer off the heel and ball of the foot.
    5. The Denton modification, also called a zero degree lateral frame fill, is a great way to stabilize the lateral column. With the Inverted Technique, especially if the goal is to invert the foot 3 or more degrees from vertical, this lateral column support helps prevent the foot from sliding too far laterally.
    6. From a podiatric biomechanical standpoint, limb length discrepancy is the first line of evaluation and treatment if found.
    7. The 5 areas to investigate and then possibly treat when a patient has low back pain are: limb length discrepancy, excessive pronation, excessive supination, excessive shock absorption, and tight hamstrings. 
    8. A forefoot varus post
    9. Medial heel (Kirby) skive and Lateral heel (Kirby) skive
    10. Limb Dominance

     

    Bonus Question: The Feehery modification is an intrinsic cuboid raise for lateral column stabilization or symptoms in that area.

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