Re: Heel Lifts

[Guest guest]

Go to:

www.gwheellift.com

Jamey Dyson, D.C.

Salem

> Listers,

>

>

>

> Does any one here know where I can get some plain old-fashioned

cork or

> rubber heel lifts? I don't see them in the Meyer Distr. Catalogue

and

> they have vanished from the journals I get.

>

>

>

> Thanks.

>

>

>

> Terry Petty ,D.C.

[Guest guest]

Heel lifts-Meyer2005 catalog, page 303 has both cork and rubber.

(I just ordered some)

Bruce Chaser

"Terry Petty, D.C." wrote:

Listers,

Does

any one here know where I can get some plain old-fashioned cork or rubber

heel lifts? I don’t see them in the Meyer Distr. Catalogue and they have

vanished from the journals I get.

Thanks.

Terry

Petty ,D.C.

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[Guest guest]

I was taught in my post-grad orthopedics diplomate course many moons ago that you don’t go over half the femoral head ht difference….also in 1990 I listened to a Namey, MD good guy pro-chiropractic his brother is an osteopath at the American Back Society meeting in SanFran…CA who said the final determinate is the “good housekeeping rule/test” I thought to myself what? (btw the guy was funny as heck) He said before you put a patient in a heel lift toss a magazine on the floor have them first step on it with the long leg side and ask them how that feels….answer awkward…..then do the same on the short leg side….if they say it feels good or better then go ahead and disperse the heel lift. Alternatively if even when placed on the short leg side and the patient says “that feels wrong,” “that feels weird,” “I don’t like how that feels..” Etc., Etc., Doc Namey said never give’em a heel lift….I’ve done this every since with positive outcomes…..Vern Saboe From: [mailto: ] On Behalf Of g macdonaldSent: Wednesday, February 01, 2012 6:28 PMSubject: Heel Lifts Hi Gang,I have a question about heel lifts. If a patient has a confirmed 10mm trochanteric difference from L to R (as measured digitally on x-ray), what would be the corresponding mm heel lift. My options are 3, 5, 7 and 9 mm. I trust this is not a guess but some kind of formula about the amount of deficiency and the appropriate amount of lift.Thank you in advance.Garreth MacEugene

[Guest guest]

Well I just had a scanogram done after my hip replacement. New hip made leg 2.2 cm longer so heel loft won't do. Dr. Stonebrink said anything over 1/2" needed to lift whole foot not just heel. Agree??Connected by DROID on Verizon Wireless Heel Lifts Hi Gang,I have a question about heel lifts. If a patient has a confirmed 10mm trochanteric difference from L to R (as measured digitally on x-ray), what would be the corresponding mm heel lift. My options are 3, 5, 7 and 9 mm. I trust this is not a guess but some kind of formula about the amount of deficiency and the appropriate amount of lift.Thank you in advance.Garreth MacEugene

[Guest guest]

Agreed…..must have the shoe shop add it to the heel….Vern Saboe From: caughlindrc@... [mailto:caughlindrc@...] Sent: Wednesday, February 01, 2012 8:40 PMvsaboe; 'g macdonald'; Subject: RE: Heel Lifts Well I just had a scanogram done after my hip replacement. New hip made leg 2.2 cm longer so heel loft won't do. Dr. Stonebrink said anything over 1/2 " needed to lift whole foot not just heel. Agree??Connected by DROID on Verizon Wireless Heel Lifts Hi Gang,I have a question about heel lifts. If a patient has a confirmed 10mm trochanteric difference from L to R (as measured digitally on x-ray), what would be the corresponding mm heel lift. My options are 3, 5, 7 and 9 mm. I trust this is not a guess but some kind of formula about the amount of deficiency and the appropriate amount of lift.Thank you in advance.Garreth MacEugene

[Guest guest]

Jamey, Garreth.... Wouldn't you want to correct the sacral tilt before figuring the mms? SunnySunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com CC: To: docgumby30@...From: drjdyson1@...Date: Wed, 1 Feb 2012 18:46:20 -0800Subject: Re: Heel Lifts

Garreth,I recommend doing a measurement at the sacral base where you figure out how much the sacral base is tipped left or right out over the femur heads. Base your heel lift on that difference, not the height of the femur heads. It's hard to describe how to do the measurement without showing you.Another way to get close is to measure the sacral base to horizontal and however many degrees it is tipped, you double the number for the height of heel lift in mm.Jamey Dyson, DCOn Feb 1, 2012, at 6:27 PM, g macdonald wrote:

Hi Gang,I have a question about heel lifts. If a patient has a confirmed 10mm trochanteric difference from L to R (as measured digitally on x-ray), what would be the corresponding mm heel lift. My options are 3, 5, 7 and 9 mm. I trust this is not a guess but some kind of formula about the amount of deficiency and the appropriate amount of lift.Thank you in advance.Garreth MacEugene

[Guest guest]

Sunny,I've never seen a sacral tilt correct from adjusting or blocking as seen on a pre-post x-ray. If you can show me that it can be corrected, I'd be interested. My understanding of biomechanics is that it is not possible.JameyOn Feb 2, 2012, at 8:28 AM, Sunny Kierstyn wrote:Jamey, Garreth.... Wouldn't you want to correct the sacral tilt before figuring the mms? SunnySunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com CC: docgumby30@...From: drjdyson1@...Date: Wed, 1 Feb 2012 18:46:20 -0800Subject: Re: Heel LiftsGarreth,I recommend doing a measurement at the sacral base where you figure out how much the sacral base is tipped left or right out over the femur heads. Base your heel lift on that difference, not the height of the femur heads. It's hard to describe how to do the measurement without showing you.Another way to get close is to measure the sacral base to horizontal and however many degrees it is tipped, you double the number for the height of heel lift in mm.Jamey Dyson, DCOn Feb 1, 2012, at 6:27 PM, g macdonald wrote: Hi Gang,I have a question about heel lifts. If a patient has a confirmed 10mm trochanteric difference from L to R (as measured digitally on x-ray), what would be the corresponding mm heel lift. My options are 3, 5, 7 and 9 mm. I trust this is not a guess but some kind of formula about the amount of deficiency and the appropriate amount of lift.Thank you in advance.Garreth MacEugene

[Guest guest]

I want to see a standing pre-x-ray showing a sacral tilt of about 5 degrees. Then correct it with whatever method you use. Then show me a standing post-x-ray film of the level sacrum. The x-rays must be done correctly so there is no pelvic rotation which could create projection distortions. Also, the person cannot be in an acute antalgic state either.I don't think it is possible. You might be able to get a couple mm's of movement out of the sacrum, but the SI joints just don't move that much. JameyOn Feb 2, 2012, at 8:40 AM, Sunny Kierstyn wrote:Yet I do it every day .... you want only x-ray listings, is that the hangup? skSunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com Subject: Re: Heel LiftsFrom: drjdyson1@...Date: Thu, 2 Feb 2012 08:35:50 -0800CC: docgumby30@...; skrndc1@...Sunny,I've never seen a sacral tilt correct from adjusting or blocking as seen on a pre-post x-ray. If you can show me that it can be corrected, I'd be interested. My understanding of biomechanics is that it is not possible.JameyOn Feb 2, 2012, at 8:28 AM, Sunny Kierstyn wrote:Jamey, Garreth.... Wouldn't you want to correct the sacral tilt before figuring the mms? SunnySunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com CC: docgumby30@...From: drjdyson1@...Date: Wed, 1 Feb 2012 18:46:20 -0800Subject: Re: Heel LiftsGarreth,I recommend doing a measurement at the sacral base where you figure out how much the sacral base is tipped left or right out over the femur heads. Base your heel lift on that difference, not the height of the femur heads. It's hard to describe how to do the measurement without showing you.Another way to get close is to measure the sacral base to horizontal and however many degrees it is tipped, you double the number for the height of heel lift in mm.Jamey Dyson, DCOn Feb 1, 2012, at 6:27 PM, g macdonald wrote: Hi Gang,I have a question about heel lifts. If a patient has a confirmed 10mm trochanteric difference from L to R (as measured digitally on x-ray), what would be the corresponding mm heel lift. My options are 3, 5, 7 and 9 mm. I trust this is not a guess but some kind of formula about the amount of deficiency and the appropriate amount of lift.Thank you in advance.Garreth MacEugene

[Guest guest]

HI again,So I read all of what was said....here is a bit more on the films.Sacral Base angle 2 degrees down on the left. Iliac crest down 9.3 mm on the left, and as stated before, 10 mm low hip (trochanter) on the left. All left, left, left.....I started with a 3 mm lift and went after the pelvis and sacrum..........Garreth MacEugene Hi Gang,I have a question about heel lifts. If a patient has a confirmed 10mm trochanteric difference from L to R (as measured

digitally on x-ray), what would be the corresponding mm heel lift. My options are 3, 5, 7 and 9 mm. I trust this is not a guess but some kind of formula about the amount of deficiency and the appropriate amount of lift.Thank you in advance.Garreth MacEugene

[Guest guest]

Is the lumbar spine convex to the left also?Jamey Dyson, DCOn Feb 2, 2012, at 12:42 PM, g macdonald wrote:

HI again,So I read all of what was said....here is a bit more on the films.Sacral Base angle 2 degrees down on the left. Iliac crest down 9.3 mm on the left, and as stated before, 10 mm low hip (trochanter) on the left. All left, left, left.....I started with a 3 mm lift and went after the pelvis and sacrum..........Garreth MacEugene Hi Gang,I have a question about heel lifts. If a patient has a confirmed 10mm trochanteric difference from L to R (as measured

digitally on x-ray), what would be the corresponding mm heel lift. My options are 3, 5, 7 and 9 mm. I trust this is not a guess but some kind of formula about the amount of deficiency and the appropriate amount of lift.Thank you in advance.Garreth MacEugene

[Guest guest]

Garreth - there is not nearly enough information given to answer your question correctly. It first needs to be known whether the films were taken weight bearing, and if so, was the patient absolutely positioned correctly. Knees locked, glutes solidly against the bucky, about 15 degrees internal rotation, and feet exactly parallel. Central ray need be as close as possible to the femur heads. Magnification and distortion can be such that the measurements are worthless. Since the difference is greater than 5 mm, an equally accurate film needs to taken at the knee joints. I personally do not feel good about unleveling knees more than about 5 mm. It is hard to make bad knees feel good again. Then you must know if the lumbar spine has a functionally correct adaptation to the

short lower extremity. A scoliosis that is convex to the side of the short LE makes for a good lift candidate, no scoliosis can be ok. One going concave to the short LE will hurt the patient. Start with 3 mm for 2 weeks if the above parameters are met, then increase to 5 mm, then 7 mm, then 9 mm in two week intervals. Have the patient keep the one from the time before, in case the new height is uncomfortable. As far as I'm concerned there is no formula - if the patient has a 10 mm discrepancy and is actually a good candidate - go to the full 1 cm. The 9 mm is only for 2 weeks. If it feels ok, then have a shoe repair person either: create a full length crepe type insert for the shoe, or build up the outside of the shoe. Don't let them simply have a 9 or 10 mm heel lift. Rocker bottomed toward the sole is a good idea. Impress on the patient that this is a life sentence. In all the shoes,

all the time.The angle of the sacral base is irrelevant to the anatomical lengths of anyones lower extremities. You cannot change the angle in an adult no matter what you do. Greg From: g macdonald <docgumby30@...> < > Sent: Wednesday, February 1, 2012 6:27 PM Subject: Heel Lifts

Hi Gang,I have a question about heel lifts. If a patient has a confirmed 10mm trochanteric difference from L to R (as measured digitally on x-ray), what would be the corresponding mm heel lift. My options are 3, 5, 7 and 9 mm. I trust this is not a guess but some kind of formula about the amount of deficiency and the appropriate amount of lift.Thank you in advance.Garreth MacEugene