In this practice-changing course – limited to six attendees, and held in off-season Telluride, Colorado – common developmental foot deformities are identified and described in terms of plane-based anatomical components. Musculoskeletal assessment procedures are reviewed as the findings lead the clinician to a systematic clinical decision-making process regarding orthotic design in terms of desired load-bearing foot and limb joint alignment, magnitude of segment enclosure, degrees of freedom provided or restrained, and posting options. Soft-tissue extensibility findings are also used in the documentation of the effects of assorted orthotic intervention strategies.
Lab sessions feature closely-supervised trials of several ankle and foot assessment procedures, with findings applied to orthotic posting and design. Materials will be provided for an introductory practice lab on undertaking on-site posting trials to preview effects of proposed orthotic modifications, and for a day of training in fabrication of 3 types of below-knee cast: plaster and SoftCast combination, FlexCast, and a removable footboard-Flexcast combination.
The content covered in this program includes the following topics:
- The emerging sciences of postural control acquisition and maintenance, including the role of the somatosensory system as it is currently understood in relation to load-bearing alignment of the torso, lower limbs, and feet.
- Foot and ankle functional anatomy, biomechanics, development, and pathomechanics in relation to body weight orientation over the base of support and to designing orthotic modifications to optimize foot development and function.
- Postural control deficits and body weight distribution on the foot in standing and walking as causative factors in contracture formation.
- Muscle and soft-tissue adaptation to chronic use of compensatory postural control mechanisms.
- An update on the role of spasticity in equinus deformity development.
- A review of conservative strategies for contracture reduction and management.
The kinesiology and pathokinesiology related to – and in support of – the safe and effective use of below-knee casts and a variety of orthotic interventions designed to improve postural alignment and control and to reduce developmental, flexible foot and ankle deformities that commonly develop in the presence of central nervous system dysfunction, hypotonia, and ligament laxity in childhood. Discussion of orthotic options includes Elaine Owen’s Tuned AFO/Footwear Combinations, heel lifting and weight-line training, orthotic posting and foot packaging principles and strategies, positioning, resting splints, stretching, and serial casting.
BONUS: Tutorial attendees are welcome to undergo Certified TheraTogs Fitter training and credentialing, after hours at no additional cost. This training is optional.