As the title states, this is my current challenge. I had a patient today with a hx of pes planus and plantar fascitis. She is a young, healthy female who has had bilateral plantar fasciotomies approximately 10 years ago. She developed scar tissue and had a second surgery to remove it in 2003. She has been in pain since. She has had every modality you can think of to treat inflammation and scar tissue with no resolution. She is currently back in PT and was referred to me for new foot orthotics.

Her biggest complaint is pain in the medial arch, where the majority of the scar tissue has developed. Consequently, she walks on the outside of her feet most of the time. I am going to attempt to make foot orthotics that will allow for relief medially but give support and alignment to the foot/ankle. I took an impression in foam with her seated and am still thinking about how to proceed. I welcome feedback but also stay tuned for the results!