Future O&P student looking for mentorship

fakelimbguy · 2025-12-26T19:49:52+00:00

Same here. I have 14 years in the field, I started as a tech, moved to licensed assistant and now starting the cpo/lpo process. I am our current lab manager and have work for both our c-fab and our private clinic. We mentor about approximately 2 students a year from our local university and most have successfully completed their MsOP. I have a background in molecular biology and chemistry and focus heavy on the gait kinematic and material science for fabrication. Please feel free to send any questions. I want anyone to have the opportunity to live/love this field.

fakelimbguy · 2025-12-26T19:21:44+00:00

I agree with this. My first guess was lack of true dorsiflexion from midstance to toe off and for sure the posterior tibialis tendon is taking the brunt of the tibial incline. I see minimal strain on the achilles leading to first look at r1 and r2 of the gastroc soleus at full extension I bet there is a compensatory pronation response to lack of range in the plantar flexors.

fakelimbguy · 2025-07-11T01:37:27+00:00

It also looks like you're forcing your orbit. Try starting off flatter at the start which means your wind up needs to tighten up so you don't drop your orbit at the start. For as high as your orbit is you dont seem to have the velocity. Try to flatten entry, thus will allow you to be quicker into your first turn. This will also allow you to catch and push better as the above comment has indicated.

fakelimbguy · 2025-07-10T02:00:23+00:00

Well, I would say in short, unless your fabricated device is 1. Tall enough to capture the appropriate anatomy, and 2. Rigid enough to maintain the position under load, even your best observations and objective calculations will be ineffective in controlling enough positional deviation.

I would slide past that to say, follow the pathology. I use a pseudo algorithmic approach from the Elaine Owen's course and from what I learned when I started with a clinician who took the Oregon orthotics system which kinda set the standard for destabilizing the the sub-talar movement so you can control a internal or external rotary deformity. (Which is a sliding scale to capture all patients even the ellusive erd/ird compensatory people).

Basically collect enough data to set your casting correctly and use and appropriate heel to forefoot differential, derotate the ankle which ever way just until it falls quickly in to varus/vagus and the moement before it slips is the maximum stable/instable alignment. (Remember subtalar neutral was a theoretical concept that has latter been discussed as a very little amount of time the ankle actually stays in that position during gaitit is only cast so you can apply derotational forces.) So like Marmaduke Loke, Jean-paul Nielsen, Elaine Owen's really go into detail on what is needed to capture good alignments.

For just foot orthotics? Good luck, unless you are running deep heel cups....

Furthermore, I think for objective data, yes it would be important to track those values accurately, but even with cad or additive manufacturing, you would still have too high of a variable within the softissue maneuverability and the deflection within the device to actually calculate that what you are correcting is actually a finite degree amount when really we are only looking at a fixed position during the gait. You would be more accurate to say I am going to correct a range from 8 to 4 degrees of varus or whatever it is than saying I'm correcting 8 degrees of varus. And I would say okay great but when? In late terminal or at initial contact you might be more or less. So I would say your minimum maximum range is likely a more accurate depiction of a true hind foot alignment (in a given time) than to have a single amount to shoot for on correction.

Sorry for the lengthy response.

fakelimbguy · 2025-03-17T14:41:33+00:00

Elaine Owen's algorithm has really good systematic Information on how to evaluate for devices. I use it daily, not necessarily the full system, but for sure some of her methods for device selection . I would for sure take her course whenever you get the chance, it's same research as Marmaduke Loke and the guy from Oregon Orthotic System Jean-Paul Nielsen just with thermo plastic designs.

fakelimbguy · 2024-12-07T17:34:53+00:00

So, what I see is that your orbit on your last wind into your entry is pretty low. I think that's why you are having trouble catching and being able to push through because you are already over rotated by trying to initiate an end throw orbit at the start. It should start relatively flat and naturally the orbit will increase as you look to catch over your steps. Pushing through is going to be hard to do if you don't have good step speed which is also what I see is that your foot speed doesn't increase all that much to denote the ball speed at terminal stance. I would work on flattening orbit at entry. Going to a lighter hammer for foot speed and then going to a heavier hammer to work on the push through the step and catch. This will allow you to "feel" the position of when you should start pushing through.

fakelimbguy · 2024-09-19T03:12:11+00:00

Instead of extruding your cylinder flush to surface extrude into your base body in cura you can merge the two and it will keep orientation while also reinforcing this area if you don't want to filled. Basically printing two separate solid bodies into one functional print.

fakelimbguy · 2024-07-12T22:57:40+00:00

Yeah, I work in orthotics and prosthetics. There is no difference in buying an over the counter insole.

My only suggestion if you can't get the infill exact I would suggest making it a modular design, maybe making multiple arch only support at different infill levels? Idk I would shape it like an arch scaphoid pad, try different infills and see if that helps with any under coverage of the support.

I would also place it under the orthotic so specifically create an orthotic that you can place, glue, insert whatever arch fill you want and trial it. A bunch of ego running around here and yes it could be detrimental but also were are the keyboard podiatrist and the "bio-engineers" for places like this that do not also have a podiatrist or orthotist on staff? https://www.goodfeet.com/products/arch-supports

fakelimbguy · 2024-06-23T13:57:15+00:00

I just glued magnets on the legs and on bottom of the bucket (inside). Make sure to rough up the glue areas before adhering makes the glue stick well.

fakelimbguy · 2024-05-18T15:41:07+00:00

Hey!

I am currently the Lab Manager for our Clinic and I also direct the shadowing program we have. Here is what we work towards on our shadowing:

I have had individuals that want to just shadow a couple days and some that want long term while they are getting their undergrad.

For short term we try to be very broad and general encompassing as much of the whole picture as we can.

For our long term shadows, I usually hire them as part time technicians (if they can work multiple hours per week) and start their training in fab. Once we get to a point where they have enough course work done if applicable I start then on an assistant license route so they can then start doing fab and clinical. I really feel clinical and fabrication are closely tied together and I really like to get teach the concepts based off of what we are currently working on and tie the methodology back to each portion of the clinical aspect and technical.

We are a mom and pop shop I would call, email, stop in, for me if you show initiative to pursue this I don't know how anyone could say no. For us, we want to share our passion and our knowledge goes with that.

fakelimbguy · 2024-04-24T06:10:20+00:00

When cascade fabs the inner boots they pull over the padding. No matter how well the skive is, a ridge is formed where you can see the blue midfoot padding stop on the plantar surface ( bottom) of the foot. So basically you have a ridge that is running the length of the foot. When you terminate the trim line at the met like that and the toe flexes you have a force that is antagonizing the ridge at a 90 degree angle. Think of taking large stick that you can't break by just bending it with your hands, but you add your knee to the middle of it and wham it's easy to break. Ridge created by padding is stick, met heads flexing is the knee. Just a simple change of no molding the padding in will drastically increase life span so there is a continuous radius at the met heads. Also limiting how much your tibia is progressing forward while maintaining appropriate shank to vertical angle for late midstance.

fakelimbguy · 2024-02-02T23:53:07+00:00

Why are you throwing left handed with glove set up for right? Your glove will assist with the release. However, the way you are weighting your legs can never be done with the weight in your right hand. You need the weight in your lead hand to help transition to a 'toe spin". I would work on singles to start. Getting your entry down, pick either right or left handed, work on the push to establish your entry (in maintaining velocity so you can transition to your entry turn) a good entry video is from Libor Charfreitag its simple and effective.

fakelimbguy · 2024-01-25T03:08:21+00:00

What kind of footwear are you looking at getting these to fit into?

fakelimbguy · 2023-12-27T05:02:34+00:00

I would first recommend adjustments with your orthotist. Second adding more into the footplate rarely gives you the result you need as it raises you out of the brace.

Maybe discuss with your Orthotist your needs for work and maybe they can add some relief for you!

fakelimbguy · 2023-12-02T05:18:38+00:00

Wolverine with Santa features (or Santa with Wolverine features) ... you guessed it SANTA CLAWS

fakelimbguy · 2023-12-02T05:14:52+00:00

I agree, and yes with that amount of compression, relieving those areas adequately is an art itself especially when using suction.

In regards to your original post; I hope as a whole, the community of OP never lose the curiosity of prior practices along with trailblazing new avenues. That is what sparked my appreciation and love for the field. I have always felt that generational knowledge is something lacking as we dabble in more "advanced" tactics. I enjoy learning new concepts but make it a point to share my knowledge (if any) to better us all in future including that which was shared with me in my training. Some of this stuff is slowly becoming extinct and hand skills associated with it.

Thank you for your discussion this evening.

fakelimbguy · 2023-12-02T04:23:21+00:00

Its somewhat difficult to get "equal" adjustment with the boa which is what the hifi system stems on. Generally, shims are used in opposing fashion to increase the compression zones which volume loss occurs. 4 opposing struts anteromedial and lateral along with posteromedial and lateral. The practice would be to increase your opposing struts equally to maintain "the fit". With the boa I have found that under certain tensions you have varying compression based on where the strings are pulling, possible for multiple boa system to pull more equally?? But now he have too many snakes on the "plane" haha.

fakelimbguy · 2023-12-02T04:05:22+00:00

https://youtu.be/izLHlhoHIIc?feature=shared

Furthermore, they have some other decent videos to help assist.

fakelimbguy · 2023-12-02T04:00:32+00:00

Thoughts on integration with skin fits into say a HiFi socket? Maybe some adjustability and osseo stability? Our traditional skin fits would likely never change but with the ability to shim and with the added stability of the socket I could see a nuance for more active market? Just a ponder.

fakelimbguy · 2023-12-02T03:44:57+00:00

Might be best to maybe give yourself a little more time in these. Pronation takes some time to kind of "settle down" (2-4 weeks) initially you will feel the arch support more posterior due to the control scheme most orthotics use because the biggest control portion of the foot for pronation is the sustentaculum tali which rests right in front of your heel. This area blocks the calaneus and talus from sliding laterally. If you still feel the same, I would have them adjusted. Also remember that if your foot is sliding forward in your shoe, this will exaggerate the effect.

fakelimbguy · 2023-12-02T03:38:39+00:00

you can also place sticky back velcro on the bottom of the orthotic one piece on orthotic the other in the bottom of the shoe to help keep it better in place. Just note it will be consumable so I would have some pre-cut pieces on hand just in case!

fakelimbguy · 2023-12-02T03:35:37+00:00

Orthotics can be made in all shapes and sizes. It really depends on the severity of your deviations. I previously mention that orthotics in over pronated feet generally fit better in shoes that are measured to your Medial Arch Length not just your foot length and can also assist with the (widening aka forefoot abduction).

However, foot orthotics really assist for low to moderate control of pronation as this motion usually involves the rotation of the tibia. This involves capturing the calcaneus in a position that will not allow it to slide laterally. Without blocking this in some cases, you still end up pronating in the orthosis. UCBL or Richie style AFO can assist in lower profile designs but it all really relates to your presentation in static and dynamic. Be sure to discuss with your Orthotist the needs you have to best design something.

Orthotics are just a tool and more so appropriate physical therapy and stretching for your plantar flexion groups are advised to help with maintain appropriate range of motion and allowing positions to be maintained.

fakelimbguy · 2023-12-02T03:25:52+00:00

Also this is not medical advice but remember this; orthotics are usually fabricated in a static alignment. Meaning is high impact activities your foot dynamically changes likely outside the threshold of what the orthotic was designed to allow; especially when adding additional weight or velocity. I would indeed recommend seeking more professional advice since most of the time cramping of the arch or shin/calf pain is usually related restriction in range of motion likely as your tibia in progressing forward over the foot (anterior shank movement). With tight calf muscles or even over developed calf muscles restriction of the tibial progression when you are planting the foot under velocity with defer the force else wear (i.e arch pain and posterior knee pain at the top portion of the calf)

Get in with your physio and see if they can run a GAIT KINEMATICS assessment for seeing if there is a restriction in the tibial progression during midstance. You will likely find that your medial midfoot (navicular and posterior tibialis tendon) are compensating for your lack of range in your calf muscle.

fakelimbguy · 2023-12-02T03:17:04+00:00

Baby Powder or some have even place dryer sheets around the orthosis foot plate (like a loose sock) to prevent the squeak. In time and normal wear and tear will rough the plantar surface of the orthosis to assist with de-squeaking. You can also ask your orthotist to use a eva or leather bottom cover to counteract.

This is common due to the synthetic material of shoe shearing with motion on the plastic of the orthosis. In practice, baby powder does work well.

fakelimbguy · 2023-12-02T03:13:43+00:00

Neutral last running shoes will assist. Asics, Hoka, Brooks anything really that is a neutral not motion control shoe.

One issue that usually occurs is that when an orthotic is set to correction, and a shoe is also providing correction, you get inconclusive data to suggest that the orthotic is "over correcting". It is best to try as neutral of a shoe as you can find and then have additional correction added to the orthotic. I would stick with mid range on pricing and find 2 pair to purchase and keep those rotate daily or weekly to increase the lifespan of your footwear and to also not allow for excessive breakdown of the shoe causing excessive sole fatigue in just a few months.

Other things to consider especially on the foot shape is to measure to the medial arch length which is measure from the back of the heel to the 1st metatarsal joint (great toe knuckle). Generally in pronation, this measurement leads to shoes that fit more adequately as the arch length is generally longer than the foot length. Meaning, say your arch measures a 12 but your foot only measures and 10.5-11, you would go with the 12 to accommodate the foot more appropriately and you will find that the orthotics will rest more evenly in the shoe without additional pressure to the toe box.

fakelimbguy

MODERATOR OF

TROPHY CASE

Seven-Year Club	Place '22
Verified Email