Leg Length Discrepancy (LLD)
Leg length difference causes pelvic instability. Anatomical leg length discrepancies (ALLD) must be documented by taking appropriate x-ray films. Functional leg length discrepancies (FLLD) are typically caused by hyperpronating feet.
Posture Control Insoles™ provide excellent correction for FLLD. Heel lifts are helpful when the ALLD is relatively small. If the ALLD requires correction in excess of 6-8mm, it is recommended to build up the full length of the outsole.
Cavus Feet (Ultra high “peaked” arches).
First Metatarsal Deficit (FMD) measuring less than 6-8 mm.
Patients who have deformities from birth, injuries, or have had surgical procedures that clearly drive lower extremity function may not benefit from wearing PCIs. A substantial (5.0mm or more) discrepancy between right and left FMD should cause the provider to further investigate the cause of the discrepancy.
Postural changes from wearing PCIs may cause pain in patients who have had recent surgery. Be conservative with surgical patients: Start them in 3.5mm insoles.
If the patient has TMJ problems (clicking, grinding), neck and shoulder muscles may contribute to locking the pelvis. Attending to the TMJ and muscle problems will enhance the benefit of wearing PCI’s.
Muscle problems can become self perpetuating. Self perpetuating muscle problems may render PCIs less effective if not resolved.
PCIs may add foot and gait comfort for obese people, but because of their weight distribution, may be less effective in improving upper body posture.
PCIs will benefit over 90% of your patients.