The high arch foot can be complicated to treat because sometimes it pronates too much.
In the high arch foot (pes cavus) the heel makes a steep angle to the arch and the forefoot has an even steeper angle to the ground. When it is off the ground the forefoot tends to be positioned lower than the heel, therefore when the foot is on the ground it needs to bend at the ankle to keep the body upright. This change in posture uses most of the normal extension (dorsiflexion) movement at the ankle. When this occurs, the foot pronates (which provides some dorsiflexion) as compensation. Pronation in this type of foot causes a significant increase in leg rotation.
And sometimes it supinates too much.
Within the forefoot the 1st metatarsal head (big toe joint) is sometimes positioned lower than the rest of the ball of the foot. As the 1st metatarsal hits the ground first the whole foot has to tilt towards the outer side (lateral) so that the rest of the forefoot sits against the ground. This raises the arch even higher and over supinates the foot. Over time this prevents normal pronation of the foot
Equiflex is a unique orthotic because it offers control of pronation or supination through Talar Made’s unique Integrated Posting System (IPS). A set of neutral, medial and lateral posts are provided free with each pair.
If the big toe joint is level with the rest of the forefoot, the high arch foot will tend to pronate too much. If the big toe joint sits lower than the rest of the forefoot the foot will tend to over supinate
For mild control select the neutral (0º) posts to fill the recesses on the underside of the orthotic. If more control is required select the 6mm heel elevator for the rearfoot post.
Rearfoot posts. As the arch rolls in during pronation, the heel (calcaneus) changes position and pressure falls on the inner (medial) side. Rearfoot posts are supplied to prevent this from happening. Choose 0º for mild control, 3º for moderate control and 5º medial posts for higher control.
Forefoot posts. Many feet that pronate excessively have a tendency for the forefoot to sit in a position, which is tilted inward (varus) when compared to the rearfoot. This encourages the inner (medial) border to roll down to the ground and cause further pronation. Forefoot posts are supplied to prevent this from happening. Choose 0º for mild control, 3º for moderate control and 5º medial posts for higher control.
Rearfoot posts. As the arch rises during supination, the heel (calcaneus) changes position and pressure falls on the outer (lateral) side. Rearfoot posts are supplied to prevent this from happening. Choose 0º for mild control, 3º for moderate control and 5º lateral posts for higher control.
Forefoot posts. Many feet that supinate excessively have a tendency for the forefoot to sit in a position, which is tilted outward (valgus) when compared to the rearfoot. This encourages the outer (lateral) border to roll down to the ground and cause further supination. Forefoot posts are supplied to prevent this from happening. Choose 0º for mild control, 3º for moderate control and 5º lateral posts for higher control.
Equiflex is designed to allow the forefoot to sit lower than the rearfoot and has a balancing support for the lesser metatarsals (2-5). This encourages an even distribution of pressure and reduces abnormal compensation of the ankle. A recess for the 1st metatarsal also encourages the medial column of the foot to work more efficiently.
Equiflex orthotics are manufactured from EVA (Ethylene Vinyl Acetate). They are available in two densities medium (45 Shore A) and firm (60 shore A). The top cloth material is impregnated with an anti-bacterial agent to reduce foot odour.
When selecting a model for your patient you should consider the severity of the condition, patient weight and activity level. Patients with moderate impact problems, average body weight and low or intermediate levels of activity are likely to need the medium density model. For patients requiring higher levels of control or for heavier patients with higher levels of activity choose the firm density.
Equiflex orthotics can be modified using the 0°, 3° or 5° medial or lateral posts. Please remember it may be necessary to offer different levels of control for each foot.
A wearing in period must always be allowed for in order to give the patient time to get used to the orthotic. However, it is not unusual to notice an immediate beneficial effect. It is important to review each patient as the level of control may need to be changed during the course of their treatment.
The length of time Equiflex orthotics last will vary between patients and this depends upon a number of factors including patient weight and activity level. However, around 6-8 months is the average, the products life will be maximised if they are cared for properly.
Yes, Equiflex orthotics can be changed between shoes. Equiflex are also suitable for use during athletic activities.
Equiflex orthotics should be cleaned regularly in order to prolong the product life expectancy. The best way to clean the devices is to gently sponge them with warm, soapy water and dry with a paper towel. Do not soak the product for long periods of time or dry artificially.
In some cases it may take from 4-6 weeks to derive the full benefit from Equiflex orthotics. If after this initial period symptoms continue it may be necessary to review the level of control by changing the posts. Patients should be advised that if their symptoms deteriorate they should attend at the earliest opportunity for reassessment.
|X Small||Small||Medium||Large||X Large||XX Large|
|UK||3½ – 4½||5 – 6||6½ – 7½||8 – 9||9½ – 10½||11 – 12|
|EURO||36 – 37||38 – 39||40 – 41||42 – 43||44 – 45||46 – 47|