VASYLI ORTHOTIC ADDITIONS
In addition to our wide range of orthotics, we offer products—such as wedges and heel raises—to address specific problems, such as a forefoot valgus abnormality or equinus condition.
VASYLI FOREFOOT POSTING
FOREFOOT VARUS:
To manage forefoot varus with an orthotic addition, first measure the forefoot varus angle. This is where the plantar plane of the forefoot is inverted relative to the plantar plane of the rearfoot when the subtalar joint is in neutral.
If the angle of the forefoot varus is 4 degrees, the forefoot would be posted at 4 degrees under the plantar metatarsal area with the thickest part of the wedge proximal to the first metatarsal head.
FOREFOOT VALGUS:
If the foot has a forefoot valgus abnormality, measure the angle—where the plantar plane of the forefoot is everted relative to the plantar plane of the rearfoot (ground) when the subtalar joint is in neutral.
If the angle of forefoot valgus is 6 degrees, the forefoot should be posted at 6 degrees under the plantar metatarsal area with the thickest part of the wedge proximal to the fifth metatarsal head.
IMPORTANT: Forefoot wedging techniques as noted above are based on an “ideal rearfoot” with no deformity.
VASYLI REARFOOT POSTING
When a rearfoot varus is present, extra wedging is occasionally needed to enhance the controlling aspect of the device you are using. A rearfoot varus is defined as the combination of the subtalar neutral and tibial varum components, which is the neutral calcaneal stance position (NCSP).
Position the foot in the NCSP.
Wedge the rearfoot to the NCSP angle, using the suitable rearfoot wedge.
VASYLI rearfoot wedges have a 2-degree or a 4-degree inclination and are made from firm (red) density EVA for maximum effect and long-term wear.
Wedging becomes important when dealing with any pronatory condition. Rearfoot wedging itself is necessary to change the timing of the pronatory phases and to help control the level of excessive pronation present in most of these conditions.
Most wedging occurs on the medial aspect of the calcaneus to increase inversion at the subtalar joint, and reinstate the structural integrity of the foot and alignment of the lower limb. Although the device helps to relieve the stress that pronatory disorders tend to cause, we have found that patients benefit greatly from having the orthotic device wedged at an appropriate angle to increase the level of effect.
For smaller sizes (SK, K, XS) the rearfoot wedge (RVR) may require trimming. Align the wedge with the start of the arch profile. Trim rear of wedge.
VASYLI HEEL LIFTS AND MET RAISE
HEEL LIFTS
In certain circumstances, the patient may need the addition of a heel lift to reduce stress on the Achilles tendon or lower leg structures, or to address equinus conditions, for example. In the case of an anatomical limb-length discrepancy, a heel lift may be applied under the device on the short side.
These lifts are placed at the back and center of the device, extending forward until finishing under the tarsal area. They are available in thicknesses of 4mm, 6mm, and 8mm in small, medium, and large.
A combination of these lifts can be used to obtain higher thicknesses. However, it’s doubtful that a thickness of more than 8mm could be used in most modern footwear.
METATARSAL RAISE (MET DOME):
Some patients suffer from forefoot problems such as metatarsalgia, interdigital neuritis, or neuromas. Although some of these problems are controllable with the use of foot devices, occasionally the metatarsal area needs extra lift to further support the structure.
The metatarsal raise is placed on top of the device and its front lip fits flush on the end of the orthotic. It is usually placed in the center of the device to lift the middle 3 metatarsals, but it can be shifted slightly to the lateral or medial side of the device midline for extra support of the 4th metatarsal or 2nd metatarsal.