Hello All,
This is a question for my colleagues, my practitioners. I know we all have our own principles and school of thoughts. But I want to pose a discussion on what are people’s thought on UCBL/Pes Planovalgus orthotic stiffness choice.
Since exact rigidity needed to properly treat a diagnosis, is not something (exactly) is taught at school and is mainly anecdotal based on the patient’s body weight. My coworker and I differ is our opinion/treatment of pediatric kiddos regarding the choice of plastic/thickness. These are typically a personal choice of the practitioner and how they assume the patient will be able to tolerate and accept orthotic treatment. There is so many variables regarding one’s long term effectiveness such as natural biology, the patient’s compliance or age or comorbidities. I just want to discuss pediatric pes planus/PPV and do you believe its better to allow some movement of the foot/muscle activation at the expense of full alignment correction or do you try to achieve maximum tolerable correction and hope for (possible) long term alignment therapeutic correction?
I’m under the thought that Less is More. I prefer to do co-poly shells for my UCBL unless the child is 100 lbs or more. I feel that I still want the patient to have some movement to develop the intrinsic foot muscles.
From school I learn that it is preferrable for young children (I believe under the age of 5) to have flexible shoes to allow the child’s intrinsic foot muscles to develop. So why would I want to fully hold/reduce movement a child foot. I will admit my co-worker can correct a child’s alignment better with the polypro than I can necessarily with co-poly ( I will remade a device stiffness if I feel that my alignment correction is insufficient).
Maybe the discussion should be to use PP if the child is over 5 or over 100 lbs (at least for me). I just want to hear what my fellow colleagues are doing, and what their thoughts are.
I’m not saying there will be one correct way. But I feel this is how the List Serv should be better used at times.
Thank you,
Jennifer Wolbach LCPO
