Thank you Steve.
Bruce
----- Original Message -----
From: "Steve Avil" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, April 19, 2004 11:29 AM
Subject: Re: MLA blisters in runners
> Hi Bruce,
> the material of choice is an EVA perhaps of medium density depending on
the
> weight of the patient.
> By lifting the small area under the navicular the front edge of the arch
is
> brought
> towards the heel posteriorly taking the high point of the posting in the
> arch away from the foot, hopfully eliminatng the contact/friction which
has
> caused the blistering.
>
> I'm not sure if increasing the calc pitch is the same but I feel it should
> have a similar effect, haven't tried it, might do.
>
> kind regards
>
> steve
>
> > -----Original Message-----
> > From: A group for the academic discussion of current issues in podiatry
> > [mailto:[log in to unmask]]On Behalf Of Bruce Williams
> > Sent: 19 April 2004 14:24
> > To: [log in to unmask]
> > Subject: Re: MLA blisters in runners
> >
> >
> > Steve;
> > Interesting response. Could you explain the raise under the
navicular
> > more clearly? What material do you use? How high, and wide is the
raise?
> > How thick?
> > Also, would this be akin to increasing the calcaneal pitch angle?
> > Sincerely;
> > Bruce Williams
> >
> > ----- Original Message -----
> > From: "Steve Avil" <[log in to unmask]>
> > To: <[log in to unmask]>
> > Sent: Monday, April 19, 2004 6:00 AM
> > Subject: Re: MLA blisters in runners
> >
> >
> > > Hello Jacqui and all,
> > >
> > > sorry to come to this late I have been away.
> > > I have read the entries re blistering. I do find this but it
> > doesn't cause
> > > too many problems. It occurs usually in those orhtoses which
> > tend to have
> > > higher density materials in the arch.
> > > I have found that using semi rigid orthoses can cause blistering of
the
> > long
> > > arch particularly behind the 1st Mpjt. I usually reduce the
> > orthoses , by
> > > millimetres,
> > > at the point of blistering, from the underside of the orthoses, which
> > tends
> > > to sort out the problem.
> > > I have pondered that the long arch must elongate on the orthoses,
which
> > > doesn't match it, as the heel lifts. With the elongation of the
> > > arch(dorsiflexion of the first met) there is friction between the pt
and
> > the
> > > orthoses.
> > > I have tried changing covering materials which has helped sometines
made
> > it
> > > worse.
> > > A small raise under th navicular can also help, which I believe
> > stops the
> > > elongation. I believe it allows the first met to adopt a more
> > plantarflexed
> > > position and miss the need to elongate at the propulsive phase.
> > > Hope these thoughts are of use.
> > > So far they have worked in my practice.
> > >
> > > kind regards
> > >
> > > steve avil
> > > Northampton School of Podiatry
> > >
> > >
> > >
> > > > -----Original Message-----
> > > > From: A group for the academic discussion of current issues
> > in podiatry
> > > > [mailto:[log in to unmask]]On Behalf Of Jacqui Baggaley
> > > > Sent: 14 April 2004 13:18
> > > > To: [log in to unmask]
> > > > Subject: Re: MLA blisters in runners
> > > >
> > > >
> > > > Bart
> > > >
> > > > Many thanks for your tip. I use semi flexible polypropylene
orthoses
> > > > and see a lot of marathon runners and triathletes who do Ironman
> > > > distance i.e. with a half or full marathon at the end. They
obviously
> > > > get very sweaty but also get blisters when they are training at the
> > > > individual events. Sometimes the blisters occur under the
> > navicular or
> > > > more distal up the 1st MPJ, regardless of whether the orthotic has a
> > > > full length top cover/ extension. I even get blisters myself
> > when I run
> > > > sometimes and was interested in Bruce Williams theory that the
medial
> > > > control in the running shoes may be the cause and be creating
> > a Fhl type
> > > > problem. I certainly wear a anti pronatory type shoe with my
> > orthotics.
> > > > I previously got anterior shin pain with a neutral shoe and the same
> > > > orthoses.
> > > >
> > > > Regards
> > > > Jacqui
> > > >
> > > > Jacqui Baggaley
> > > > Trinity Chiropody & Podiatry Clinic
> > > > 196 Ferry Road
> > > > Edinburgh EH6 4NW
> > > > Tel W 0131 476 9889
> > > >
> > > > -----Original Message-----
> > > > From: A group for the academic discussion of current issues
> > in podiatry
> > > > [mailto:[log in to unmask]] On Behalf Of Bart Van Gheluwe
> > > > Sent: 13 April 2004 10:01
> > > > To: [log in to unmask]
> > > > Subject: Re: MLA blisters in athletes
> > > >
> > > > Hello Jacqui,
> > > >
> > > > The blister problem you described is a familiar one to us when
using
> > > > non-rigid insoles with soft materials.
> > > > With our patient, this has mainly to do with the nature of the soft
> > > > insole
> > > > material, the quantity of sweat produced and the skin
> > sensibility of the
> > > > patient`s foot.
> > > > My colleague podiatrists mostly get the blister problem solved by
> > > > covering
> > > > the insoles with what we call "goat skin". It is a vey thin and
light
> > > > leather like covering . It is even not necessary to cover the whole
> > > > insole
> > > > with it, just the medial area where the blisters occur.
> > > > Hope this may be of nay help.
> > > > Regards,
> > > > Bart
> > > >
> > > > *******************************************************************
> > > > Bart Van Gheluwe
> > > > Laboratory of Biomechanics
> > > > Vrije Universiteit Brussel -Fac. LK
> > > > Vakgroep BIOM
> > > > Pleinlaan 2, 1050 Brussel, Belgium
> > > > Tel.: 02/629.27.33 (31)
> > > > Fax: 02/629.27.36
> > > > *******************************************************************
> > > >
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