Karl,

>(i) Is anyone using simple wedging for plantar fasciitis (ie. as discussed
above) on a regular basis for plantar fasciitis?

And this question will be a little controversial;

(iii) If the results are the same or better, why do we continue to use
expensive customised orthoses to treat this condition?<

If I feel through analysis of lesions, esp 5th mtpj cal, and shoe upper distortions that there is a Lateral COP displacement at propulsion I will make a temporary device usually with a slight heel raise, cut out for the first mtpj and a lateral/valgus forefoot wedge. I usually do this on the liner of the patients shoe.

Has this proved beneficial? Absolutely.

Do I make a custom CFO? Yes

Why? Because I want a device to be specific for that patient and be durable enough and effective in more than one pair of shoes. For the time and effort if would need to continue to replace the temporary device as it falls apart it is far more cost effective, in time and money, for a patient to receive the professionally manufactured custom device which will last  potentially for years.

I still believe clinically there is a need to reduce the STJ position which may have formed due to the influence of Patho dynamics but this would be conjecture and I have no evidence to suggest this is the case.

Regards

Graham



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