Current Pedorthics January-February 2017 | Vol.49, Issue 1 - Page 45

CEP The use of custom foot orthoses is a conventional therapy for a multitude of lower extremity pathologies. Patient satisfaction with these devices can be problematic and frustrating for both practitioner and patient. The underlying conflict lies with the amount of required correction not tolerated by the patient. The source of the complaint is frequently attributed to the orthoses itself, be it the amount of correction or arch height. The fact of the matter is that rarely is the orthoses the root of the problem. There is not too much correction, and the arch is not too high. The problem lies on the patient side of the equation if the form of untreated equinus deformity. DiGiovanni et al. described equinus as ankle joint dorsiflexion of less than 5° of ankle joint dorsiflexion with the knee extended.1 Proper evaluation technique is critical in this definition. Barouk and Barouk described the correct method to examine ankle joint dorsiflexion by either placing the hindfoot in a neutral position or in varus to eliminate dorsiflexion at the midfoot level allowing for primarily dorsiflexion to occur in the hindfoot while applying the proper amount of dorsiflexion force to the forefoot. 2 See figures 1-6 for correct deformity evaluation technique. Hill in his landmark article on the frequency of equinus made some fascinating comments on the relationship between equinus and orthoses. 3 I would like to look at some of these statements and address them individually. Read This Article, Take Survey to Earn Continuing Education Points The Pedorthic Footcare Association (PFA) offers Continuing Education Points (CEPs), approved by the American Board for Certification in Orthotics, Prosthetics & Pedorthics, Inc. (ABC) and the Board of Certification/Accreditation (BOC), via specially designated articles within Current Pedorthics magazine. To take advantage of the program, thoroughly read the adjacent CEU article and then visit: and click on the Continuing Education Opportunities tab to purchase the 10-question quiz associated with this article. CEP quizzes cost $25 for members and $50 for non-members. The quizzes are worth 1.0 Scientific or Business CEP, depending on the content. Successful completion of the quiz will result in 1.0 CEP reported directly to ABC and BOC at the end of each quarter. Look for additional CEP-eligible articles in future issues of the magazine; previous articles are available in the magazine archive at If you have any questions, contact PFA, at (229) 389-3440 or e-mail: “Treating apparent biomechanical problems that have an underlying equinus deformity with Current Pedorthics January/February 2017 43