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CLINICAL CORNER WITH DR. RICHIE
Richie Brace® or Custom Foot Orthotic
for Adult Acquired Flatfoot?
Clinicians often debate whether the initial treatment of the Adult Acquired Flatfoot (AAF) should start with custom foot orthotic therapy or should proceed directly with a custom Richie Brace®.
While foot orthoses can be effective in the early stages of AAF, they become less effective when key ligaments in the midfoot have ruptured including the spring ligament.
A quick and easy test to detect rupture of the midfoot ligaments is the “single foot heel rise” test.
If a patient has difficulty or inability to perform a heel raise with full weight on one foot (see image) they have significant instability of the midfoot joints which cannot be controlled with simple foot orthoses. The Richie Brace® would be the best option in this situation because it controls tibionavicular rotation when the spring ligament is attenuated.
Dr. Richie is a Clinical Associate Professor at the California School of Podiatric Medicine. He has authored many original articles published in peer-reviewed medical journals as well as several chapters in respected textbooks of foot and ankle surgery. Dr. Richie recently published his own textbook titled Pathomechanics of Common Foot Disorders.
Dr. Richie is a Fellow and Past President of the American Academy of Podiatric Sports Medicine and is a Fellow of the American College of Foot and Ankle Surgeons. Dr. Richie designed and launched the Richie Brace(R) line of custom ankle-foot orthoses in 1996 which are now distributed in seven countries around the world.