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Custom Orthotics

Leather Balance Orthotics — Specifications

Length of Leather Orthotics

To Metatarsal Heads - Ends just proximal to metatarsal heads. Excellent where forefoot shoe room is limited. Can’t be used in cases requiring cushioning of pocketing of metatarsal heads because of its length. Not advisable in cases of a high degree of forefoot varus or severely pronated feet because of reduction of control and intolerability at the midtarsal area.

To Sulcus of Toes - Most common length prescribed; useful in most types of conditions. Protection for metaheads through the propulsive period of gait.

Full Length to End of Toes - Useful for protection of lesions at tibial aspect of proximal phalanx of hallux. Many doctors prefer this length for cases involving activities such as sprinting or ballet in which a great amount of time is spent at the propulsive period of gait. Also used for extra length needed for growth when leather orthotics are required for children.

Full Length with Levy Mold Crest - Traditionally used for heloma durum at distal aspect of toes. Levy mold crests can be added at time of construction or added later at your office. To add in the office, have the patient wear the orthotic for a couple of weeks. The toe pressure will cause indentations on the leather and can be used as an accurate guide for placement of 1/8’’ to 1/4’’ adhesive. Levy molds are also useful to prevent sliding forward on the orthotic encountered with very high heel raises. Remember, when using full-length, there has to be room at toe box to prevent irritation at dorsal aspect of toes.

Weight of Orthotic

Many different variations in thickness and width are available. The type used depends on the amount of shoe room available and the type of condition.

Thickness and Width

Very Thin, Very Light, Very Narrow - We recommend this for dress shoes. Very minimal functional control; used mostly for accommodations of lesions, such as pockets or pockets with metaraise for IPK. You may want to use this orthotic for dress, along with a regular weight leather orthotic or plastic orthotic for everyday use. When a very thin, very light, very narrow orthotic is desired, leather, cork fill-in, and celastic is an excellent material type.

Light and Narrow - Used when there is a possibility of a shoe-fitting problem. However, if an orthotic is too thin, especially when a heavy patient is involved, the effectiveness of the orthotic is reduced, thus compromising your treatment results. For example, a light orthotic will have a pocket too thin, in relation to a heavy patient’s weight, to transfer pressure from a metatarsal head. Also, when severe varus or valgus deformities are encountered, your balance wedging will provide less functional control.

Regular Weight - Normal thickness and width for the patient’s weight, activity, and sex.

Heavy Weight - Useful for overweight patients and severe deformities that require a leather orthotic, such as a high degree of forefoot valgus or very sensitive IPK’s where deep pockets are needed. These are made of thicker materials and firmer celastic. Remember that shoe room must be available for this orthotic. Orthotic Depth Shoe would be most useful here.