The Patient

A 34-year-old female attended complaining of unilateral right-side forefoot pain. She is unable to modify footwear full time with work commitments and must wear a heeled shoe. She was diagnosed with Lesser Metatarsal Instability and secondary 3rd MTPJ capsulitis. Intrinsic muscle work was also supplied.

Prescribed Orthotic Type

Cobra Device – a hybrid shell style designed for high heels. Fore-foot posting options only. It is used for ladies’ dress shoes with heels that are higher than 3cm.

 

Lab Standard Description

  • Semi-flexible Polypropylene shell- to accommodate the shape of the shoe and allow bend.
  • Medium durometer EVA arch fill
  • Cobra grind- to accommodate high heels very slimline grind
  • 1.5mm Poron extension to sulcus- providing cushioning for the met heads
  • Micro-suede top and bottom cover- a thin top and bottom cover. Available in black, brown or beige.

Optional Specs and Posting, Additions and Modifications

Lesion accommodation: to 3rd met head made of EVA.

1.5 Nyplex bottom cover: to add more cushioning

Add 2mm Astroshock under the top cover- to add more cushioning

Metatarsal Pad (50%): used to off-load the prominent met heads. It is a Poron pad which is centred on the 3rd met, extending 3-4mm beyond distal edge of the shell. This positioning can be changed if specified in the order form and/or marked on the cast. By asking for it 50% they reduce the thickness by 50%, can be easier to tolerate and take up less room in the shoe.

The patient ordered a second pair to suit a specific pair of court shoes with a lower and thicker heel and a higher heel counter. The shoes were provided with the prescription to ensure fit.

 

Second Prescribed Orthotic Type

Flat Heel Cup Device: A modified slimline shell style with no heel cup. Suits most ladies slip-on casual and dress shoes with a low cut counter and heel height less than 3cm. No rear-foot angles possible on this device.

Lab Standard Description

Semi-rigid polypropylene shell-

0mm heel cup

Moderate slimline (hourglass) grind

Micro-suede top cover to mets

Optional Specs and Posting, Additions and Modifications

Metatarsal Pad– used to off-load the prominent met heads. It is a Poron pad which is centred on the 3rd met, extending 3-4mm beyond distal edge of the shell. This positioning can be changed if specified in the order form and/or marked on the cast. By asking for it 50% they reduce the thickness by 50%, can be easier to tolerate and take up less room in the shoe.

Narrow Shell grind to fit to shoes provided