Pathology Prescripti on Guide
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5 STEP
Complete 5 Step Pathology Prescripti on FormDownload Pathology Prescripti on Form from www.talarmadecustom.comALTERNATIVELY CALL 01246 268456 OR EMAIL [email protected] TO REQUEST AN ORDER PAD
Customised prescripti on is developed, including:- ORTHOTIC DESIGN- CORRECTIVE ADDITIONS & CUSHIONING- TOP COVER
Delivery ServiceYour orthoti cs are dispatched within 10 working days
Your clinical informati on is assessed by Clinical Experts including: - FOOT TYPE - CLINICAL TESTS- PATHOLOGY
- ORTHOTIC TYPE- CLINICAL PHOTOS/VIDEO (IF SUPPLIED)
Orthoti c Manufacture
STEP 1
STEP 3
STEP 5
STEP 2
STEP 4
MODULAR ORTHOTICKS™ PRO HOW TO ORDER
POWERED BY DOLA ORTHOTICS
PRACTICE NAME PRESCRIBER
PATIENT NAME WEIGHT SHOE SIZE (UK)GENDER
M<60kg 60-90kg >90kg F
DATE
GENERAL COMFORT AND PREVENTATIVE TREATMENT
KNEE/LEG PATHOLOGY
LOWERLIMB/ANKLE
REARFOOT PATHOLOGY
MIDFOOT PATHOLOGY
FOREFOOTPATHOLOGY
OTHERPLEASE SPECIFY
RANGE OF MOTION NWB
ORTHOTIC AIM
ORTHOTIC TYPE
CLINICAL TESTS
ANTERIOR KNEE PAIN
MEDIAL KNEE PAIN
LATERAL KNEE PAIN
CUBOID SYNDROME
LISFRANC INJURY
ACHILLES TENDINOPATHY
ANKLE EQUINUS
ANTERIOR IMPINGEMENT SYNDROME
FLEXOR HALLUCIS PATHOLOGY
GASTROC/SOLEUS PATHOLOGY
1ST MPJ INJURY
5TH METATARSAL INJURY
CORNS/CALLUS
FRIEBERGS OSTEOCHONDRITIS
FUNCTIONAL HALLUX LIMITUS
HALLUX RIGIDUS
CALCANEAL APOPHYSITIS: SEVERS DISEASE
CHRONIC PLANTAR HEEL PAIN: PLANTAR FASCIITIS
FAT PAD SYNDROME
PERONEAL PATHOLOGY
ILIOTIBIAL BAND (ITB)
OS GOOD SCHLATTERS
PATELLO-FEMORAL SYNDROME
MIDTARSAL JOINT SPRAIN
NAVICULAR PATHOLOGY
GENERAL PRONATED
POLYPROPYLENE ORTHOTIC
EVA ORTHOTIC
3D PRINTED ORTHOTIC
ORTHOTICK PRO - FULL LENGTH
ORTHOTICK PRO - 3/4 LENGTH
CUSTOM CUSTOMISED PREFAB
GENERAL SUPINATED NEUTRAL
PAEDIATRIC OUTTOEING
PAEDIATRIC INTOEING
PAEDIATRIC TOE WALKING
PLANTAR FASCIA PATHOLOGY
LATERAL ANKLE SPRAINS
PERONEAL TENDON PATHOLOGY
SHIN SPLINTS: ANTERIOR
SHIN SPLINTS: POSTERIOR
TIBIALIS ANTERIOR PATHOLOGY
HAV (BUNIONS)
METATARSAL STRESS FRACTURE
METATARSALGIA (CAPSULITIS / BURSITIS)
NEUROMA: INTERDIGITAL NEURITIS
PLANTAR PLATE INJURY
SESAMOID INJURY
PLANTAR CALCANEAL BURSITIS
RETROCALCANEAL BURSITIS
TARSAL TUNNEL SYNDROME
TIBIALIS POSTERIOR PATHOLOGY
ANKLE MIDTARSAL JOINT (MTJ) 1ST METATARSOPHALANGEAL JOINT (1ST MPJ)SUBTALAR JOINT (STJ)
EVERSIONINVERSION>10°
<10°
MOBILE
RESTRICTED
>65°
20° - 65°
<20°
>10°
<10°
>20°
<20°
PATHOLOGY PRESCRIPTION FORMCUSTOM AND PRO-PREFAB
FOOT TYPE ARCH HEIGHTCALCANEUS POSITION MSRT FORCE
SUPINATED
NORMAL
PRONATED
LOW
NORMAL
HIGH
INVERTED
VERTICAL
EVERTED
LOW
NORMAL
HIGH
RESTING STANCE POSITION
ORTHOTICK PRO LITE - 3/4 LENGTH SLIMLINE
HOW TO ORDER
Tell us about your patient and we will design, customise and send you the orthotic you need. Complete our Pathology Prescription Form...
Download Form from www.talarmadecustom.com
PRACTICE NAME PRESCRIBER
PATIENT NAME WEIGHT SHOE SIZE (UK)GENDER
M<60kg 60-90kg >90kg F
DATE
GENERAL COMFORT AND PREVENTATIVE TREATMENT
KNEE/LEG PATHOLOGY
LOWERLIMB/ANKLE
REARFOOT PATHOLOGY
MIDFOOT PATHOLOGY
FOREFOOTPATHOLOGY
OTHERPLEASE SPECIFY
RANGE OF MOTION NWB
ORTHOTIC AIM
ORTHOTIC TYPE
CLINICAL TESTS
ANTERIOR KNEE PAIN
MEDIAL KNEE PAIN
LATERAL KNEE PAIN
CUBOID SYNDROME
LISFRANC INJURY
ACHILLES TENDINOPATHY
ANKLE EQUINUS
ANTERIOR IMPINGEMENT SYNDROME
FLEXOR HALLUCIS PATHOLOGY
GASTROC/SOLEUS PATHOLOGY
1ST MPJ INJURY
5TH METATARSAL INJURY
CORNS/CALLUS
FRIEBERGS OSTEOCHONDRITIS
FUNCTIONAL HALLUX LIMITUS
HALLUX RIGIDUS
CALCANEAL APOPHYSITIS: SEVERS DISEASE
CHRONIC PLANTAR HEEL PAIN: PLANTAR FASCIITIS
FAT PAD SYNDROME
PERONEAL PATHOLOGY
ILIOTIBIAL BAND (ITB)
OS GOOD SCHLATTERS
PATELLO-FEMORAL SYNDROME
MIDTARSAL JOINT SPRAIN
NAVICULAR PATHOLOGY
GENERAL PRONATED
POLYPROPYLENE ORTHOTIC
EVA ORTHOTIC
3D PRINTED ORTHOTIC
ORTHOTICK PRO - FULL LENGTH
ORTHOTICK PRO - 3/4 LENGTH
CUSTOM CUSTOMISED PREFAB
GENERAL SUPINATED NEUTRAL
PAEDIATRIC OUTTOEING
PAEDIATRIC INTOEING
PAEDIATRIC TOE WALKING
PLANTAR FASCIA PATHOLOGY
LATERAL ANKLE SPRAINS
PERONEAL TENDON PATHOLOGY
SHIN SPLINTS: ANTERIOR
SHIN SPLINTS: POSTERIOR
TIBIALIS ANTERIOR PATHOLOGY
HAV (BUNIONS)
METATARSAL STRESS FRACTURE
METATARSALGIA (CAPSULITIS / BURSITIS)
NEUROMA: INTERDIGITAL NEURITIS
PLANTAR PLATE INJURY
SESAMOID INJURY
PLANTAR CALCANEAL BURSITIS
RETROCALCANEAL BURSITIS
TARSAL TUNNEL SYNDROME
TIBIALIS POSTERIOR PATHOLOGY
ANKLE MIDTARSAL JOINT (MTJ) 1ST METATARSOPHALANGEAL JOINT (1ST MPJ)SUBTALAR JOINT (STJ)
EVERSIONINVERSION>10°
<10°
MOBILE
RESTRICTED
>65°
20° - 65°
<20°
>10°
<10°
>20°
<20°
PATHOLOGY PRESCRIPTION FORMCUSTOM AND PRO-PREFAB
FOOT TYPE ARCH HEIGHTCALCANEUS POSITION MSRT FORCE
SUPINATED
NORMAL
PRONATED
LOW
NORMAL
HIGH
INVERTED
VERTICAL
EVERTED
LOW
NORMAL
HIGH
RESTING STANCE POSITION
ORTHOTICK PRO LITE - 3/4 LENGTH SLIMLINE
04 www.dolaorthoti cs.com/5step
STEP 1. TYPE + SIZE
SIZE
SK MK LK
XXS XS SM L
XLXXL
EU
25 - 2728 - 3132 - 3435 - 3738 - 3940 - 4142 - 4344 - 4647 - 49
50+
MENS
US UK US UK US UK
- - ---
7 - 8 9 - 10
11 - 12 13 - 14
15+
- - ---
6 - 7 8 - 9
10 - 11 12 - 13
14+
WOMENS
---
5 - 6 7 - 8
9 - 10 11 - 12
---
---
3 - 4 5 - 6 7 - 8
9 - 10 ---
KIDS
8 - 10K11 - 13K
1 - 3J4 - 5J6 - 7J
-----
7 - 910 - 12 13 - 23 - 45 - 6
-----
* Pro Lite: XXS - L only
Select a Size:The Orthoti cks Pro range is available in 10 sizes.
Select Type:
PRO FULL LENGTH - Full length orthoti c - Suitable for shoes with removable insoles
PRO 3/4 LENGTH - 3/4 length orthoti c- Requires less shoe space than the full length version - Suitable for most standard footwear without removable insoles
PRO LITE- 3/4 length low profi le design- Specifi cally designed for HARD TO FIT footwear including ballet fl ats, court shoes, high heels, low profi le football boots and even fl ipfl ops and sandals.
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Orthoti cks PRO 5 Step Process 05
STEP 2. FOOT TYPE
Mild
PronatedRight Foot
Moderate
Neutral Right Foot
Severe
SupinatedRight Foot
Determine a Foot Type:
Determine the Level of Problem:
MEDIAL LATERAL MEDIAL LATERALMEDIAL LATERAL
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06 www.dolaorthoti cs.com/5step
STEP 3. PATHOLOGY
GENERAL• Comfort• Preventi on• Performance
LOWER BACK / HIP & KNEE / LEG• SIJ• Sciati ca• Anterior Knee Pain - Patello Femoral Joint - Patella• Lateral Knee Pain - Ilioti bial Band (ITB) - Lateral Collateral Ligament (LCL) - Lateral Knee Joint• Medial Knee Pain - Adductor - Medial Collateral Ligament (MCL) - Medial Knee Joint
LOWERLIMB / ANKLE• Achilles Tendonopathy• Ankle Equinus• Anterior Impingement Syndrome• Gastroc/Soleus Pathology• Lateral Ankle Sprains• Peroneal Tendon Pathology• Shin Splints: Anterior• Shin Splints: Posterior• Tibialis Anterior Pathology
KIDS FEET• Flat Feet• Osgood Schla� ers / Sinding - Larsen• Calcaneal Apophysiti s: Severs• Paediatric Ou� oeing• Paediatric Intoeing• Paediatric Toe Walking
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Orthoti cks PRO 5 Step Process 07
FOREFOOT / MIDFOOT / REARFOOT
• 1st MPJ Injury• 5th Metatarsal Injury• Corns/Callus• Friebergs Osteochondriti s• Functi onal Hallux Limitus• Hallux Rigidus• HAV (Bunions)• Metatarsal Stress Fracture• Metatarsalgia (Capsuliti s / Bursiti s)• Neuroma: Interdigital Neuriti s• Plantar Plate Injury• Sesamoid Injury
• Cuboid Syndrome• Lisfranc Injury• Midtarsal Joint Sprain• Plantar Fascia Pathology
• Chronic Plantar Heel Pain: Plantar Fasciiti s• Fat Pad Syndrome• Plantar Calcaneal Bursiti s• Retrocalcaneal Bursiti s• Tarsal Tunnel Syndrome• Tibialis Posterior Pathology
FOREFOOT MIDFOOT REARFOOT
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08 www.dolaorthoti cs.com/5step
STEP 4. CLINICAL TESTS
ANKLE RANGE OF MOTION NWB
1ST METATARSOPHALANGEAL JOINT (1st MPJ) RANGE OF MOTION NWB
TESTAnkle joint dorsifl exion and plantar fl exion
RESULTSDorsifl exion range is greater than or less than 10°
TEST1st MPJ plantarfl exion and dorsifl exion
RESULTS1st MPJ dorsifl exion range is above 65°, between 20° - 65° or below 20°
SUBTALAR JOINT (STJ) RANGE OF MOTION NWB
TESTSubtalar joint inversion (supinati on) and eversion (pronati on)
RESULTSInversion (supinati on) range is greater than or less than 20o
Eversion (pronati on) range is greater than or less than 10o MEDIAL LATERAL
HEEL BISECTION
LEG BISECTION
RIGHT FOOT 20˚ INVERTED10˚ EVERTED
MIDTARSAL JOINT (MTJ) RANGE OF MOTION NWB
TEST• Midtarsal Inversion and Eversion• Midtarsal Adducti on & Abducti on• Midtarsal Dorsifl exion & Plantarfl exion
RESULTSMidtarsal joint is mobile or restricted
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Orthoticks PRO 5 Step Process 09
CALCANEUS POSITION RESTING STANCE POSITION
ARCH HEIGHT RESTING STANCE POSITION
MANUAL SUPINATION RESISTANCE TEST (MSRT) RESTING STANCE POSITION
JACKS TEST SAGITTAL PLANE
The position of the calcaneus in the patients normal stance
The height of the medial longitudinal arch in the patients normal stance
TESTThe amount of force required to supinate the foot
RESULTSLow, moderate or high amount of force is required to supinate the foot
TESTAssess the activation, range of motion available and force required for 1st MPJ dorsiflexion while weight bearing. Tests the function of the windlass mechanism
RESULTSLow force or high force required to dorsiflex the 1st MPJThe 1st MPJ has a high or low range of motion
HOW TO VIDEOS - See the test at www.dolaorthotics.com/5step
Everted / Pronated (right foot)
Vertical / Neutral (right foot)
Inverted / Supinated (right foot)
Low Arch Normal Arch High Arch
LUNGE TEST SAGITTAL PLANE
TESTFunctional range of ankle joint dorsiflexion in stance
RESULTSThe foot is greater than or less than 10cm from the wall
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10 www.dolaorthoti cs.com/5step
STEP 5. TOP COVERS
Durafi t™
Luxurious, breathable microfi bre with the appearance of genuine leather. Our most popular top cover as it has excellent performance properti es for sports, everyday, business and general use.
Black (Smooth)
Black (Semi Perf.)
Marine / Navy (Semi Perf.)
Bronze (Smooth)
Blue (Semi Perf.)
Orange (Semi Perf.)
Cocoa (Smooth)
Camel (Semi Perf.)
Silver (Semi Perf.)
Skin (Smooth)
Cream (Semi Perf.)
Skin (Semi Perf.)
Anthracite (Semi Perf.)
Lime (Semi Perf.)
Stone (Semi Perf.)
Beige (Semi Perf.)
Magenta (Semi Perf.)
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Orthoti cks PRO 5 Step Process 11
Diabeti c Anti Shear Stone Grey
Diabeti c Anti Shear nora® Lunatec Moti on 10Extremely so� , shock absorbing top cover with excellent shear force absorpti on.Used for pressure relief in pati ents with Diabetes and joint diseases like rheumatoid arthriti s.
ANTI SHEAR NORA® LUNATEC MOTION 10New type of EVA material absorbs shearing forces and has extremely so� cushioning properti es.
ANTI SHEAR NORA® LUNATEC MOTION 10New type of EVA material absorbs shearing forces and has extremely
Available on all custom and prefab opti ons from DOLA
Also available in sheets from www.talarmadecustom.com
Black Blue Red Lime Green Black/Grey Blue Swirl
Natural Yellow Purple Pink Lime Swirl Pink Swirl
EVACombining the perfect blend of cushioning, comfort and performance. This thin, high performance material is suitable for almost all applicati ons including sports, comfort and general use.
www.talarmadecustom.com
Bespoke range of foot ortho�csCustom
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www.talarmadecustom.com
TalarMade Ltd.Springwood House, Foxwood Way, Foxwood Industrial Park, Chesterfi eld, Derbyshire, United Kingdom S41 9RN
Tel: +44 (0)1246 268 456 | Fax: +44 (0)1246 268 648
DISCLAIMER: The informati on and recommendati ons provided in this manual are general in nature and do not replace the need for professional assessment. Including thorough history, physical examinati on, clinical diagnosis and other treatment modaliti es. The results of treatment directed testi ng including strapping and padding; and the results of applicable tests can be used to determine if your pati ent could benefi t from orthoti c therapy and to guide the design features of your custom orthoti c.
Bespoke range of foot ortho�csCustom
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