Thursday, March 28, 2024

Orthotics for rigid flatfoot

Paula Pivko

Hi everyone I have a question regarding a friend of mine. He is 6’5 and weighs 390 so he is quite a big guy. He is 41 years old. He has rigid flatfeet with some ankle valgus, especially on the right side. I did not do a full evaluation but as far as I know he has full ROM and strength for dorsi and plantarflexion. He has arthritis, pain, and swelling in the right ankle. This flatfeet are not correctable and he has no arch. It is in my mind to make him a pair of UCBLs but given the pes planus, ankle valgus, plus his weight I don’t know if he would be able to tolerate this. My ideas are: UCBLs with polypro, with polyethylene, an orthotic with a cork/pelite material or recommend a SMO/AFO. I’ve had this issue with patients before and have done AFOs and UCBLs, but would like to get opinions from others on what works for them, especially since most of my patients with this issue have been little older ladies, not a 400 lb guy. He wants to be able to walk a school track to lose weight and improve his endurance. Thank you for your help as always. Paula Martinek, LPO

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