Limb Length Discrepancy Following Total Hip Joint Replacement Surgery Treated With Heel Lifts

Limb lengthening is not uncommon after a total hip replacement and may cause subjective problems for patients. A study of 150 total hip replacements reveals 144 limbs were lengthened. Due to patient complaints, 40 (27%) required a Heel Lift on the unoperated side to gain satisfactory gait pattern. ClinOrthoRelatRes78Jul-Aug;(134):135-8.

Make sure to ask your post-op patients about their gait and dispense proper heel lifts from Atlas Biomechanics after a total hip replacement surgery.

BIOMECHANICS OF THE SHORT LIMB:
1. Supination of the subtalar joint.
2. External rotation of the tibia.
3. External rotation of the knee.
4. Abnormal patella tracking.
5. Pelvic Tilt.
6. Shifting of the center of gravity to the short side.

BIOMECHANICS OF THE LONG LIMB:
1. Pronation of the subtalar joint.
2. Internal rotation of the tibia and the knee.
3. Abnormal patella tracking.
4. Vaulting over the hip joint.

GAIT EVALUATION OF THE UNEQUAL LIMB LENGTH:
1. Center of gravity shifted to the short side.
2. Unilateral early heel lift.
3. Pelvic Tilt.
4. Shoulder drop.
5. Unilateral subtalar pronation.
6. Unilateral shoe wear (lateral heel).
7. Abnormal knee rotation and patella tracking.

Atlas Biomechanics produces a full line of cork and Eva/rubber heel lifts.

Teri Green
Atlas Biomechanics

1/4" Heel Lift for Unequal Limb Length

Heel lifts are inexpensive, easy to use medical device that is used to treat Unequal Limb Length, Achilles Tendonitis, and Short Limb.

Atlas Biomechanics manufactures heel lifts in the United State in Rubber Cork or EVA/Rubber blend. They are lightweight, durable and comfortable.

For the best alignment, place the heel lift under the shoe's insole. This will allow the heel lift to sit firmly at the bottom of the shoe. When the shoe lift is under the insole there is optimum control and comfort.

Atlas Biomechanics heel lifts are firm and true to size. There is a slight softening of the shoe lift with use.

Customer Practice Studies for 6 mm 1/4" Heel Lifts (surveying our practitioners)

-Achilles Tendonitis: 63% use the 6 mm (1/4 inch) heel lift to treat.
-Limb Length Discrepancy: 57% also use the 6 mm (1/4 inch) heel lift to treat.

Professional Grade 1/4 inch ( 6 mm ) Heel Lifts

*10 lifts bulk pack
*6mm (1/4 inch) shoe heel lift
*Comfortable natural base
*Long lasting risers

* 1/4" heel lifts with double-sided tape to hold into the shoe
*Treat unequal limb length, achilles tendonitis
*Made in the USA

Sizes: Small 2" (5.1cm) width, Medium 2 1/2" (6.4cm) width, Large 3" (7.4cm) width

Teri Green
Atlas Biomechanics

Atlas Biomechanics : How to Use Budin Splint for Crooked Hammertoes

Atlas Biomechanics : How to Use Budin Splint for Crooked Hammertoes: Budin Splints gently encourages proper toe alignment *Soft toe loop for control fit and comfort *Adjustable single loop hammertoe straig...

How to Use Budin Splint for Crooked Hammertoes

Budin Splints gently encourages proper toe alignment
*Soft toe loop for control fit and comfort
*Adjustable single loop hammertoe straighteners per pack.
*These Budin splints for hammertoes are made to protect and realign hammertoes and cushion ball of the foot
*Hammer toe pads align crooked or overlapping toes
*Relieves pain from corns, hammertoes, and metatarsalgia
*Washable and reusable.
*Helps lift and straighten hammer toes.
*Reduces pressure at tips and tops of hammertoes.
*Caution diabetics and patients with poor circulation because they may overtighten the loop.
*Use in place of corn pads
*Fits right or left foot
*Double layer  medical memory foam base cushions ball of the foot (metatarsal pad)

How to use Budin splint.

-Loose toe loop
-Budin splint cushion base is placed on the bottom of the foot
-Fit the loop over the hammertoe you want to realign
-Gently pull the toe loop of the Budin Splint to hold hammertoe

Teri Green
Atlas Biomechanics

Atlas Biomechanics : How to use Hammertoe Corn Stick On Foot Pads

Atlas Biomechanics : How to use Hammertoe Corn Stick On Foot Pads: Hammertoes are crooked toes that are caused by tight shoes, tendon misalignment, trauma and abnormal foot structure. When the toe's join...

How to use Hammertoe Corn Stick On Foot Pads

Hammertoes are crooked toes that are caused by tight shoes, tendon misalignment, trauma and abnormal foot structure. When the toe's joint (knuckle) rubs on the shoe a the skin gets irritated and a corn can form. By padding the joint, one can help prevent the painful corn from occurring.

How to use Hammertoe Corn Stick On Foot Pads

+ apply corn pad to a clean and dry foot
+ position corn pad so that the opening is placed around the affected corn
+ remove the corn pad for at least 5 hours per day or night to allow skin the breathe
+ after use each day, remove corn pad gently by slowly peeling it away from the skin
+ do not place corn pad on open skin.
+ if irritation, discomfort or any problems discontinue use and notify your physician

By padding the joint with a corn pad, one can help prevent the painful corn from occurring.

Teri Green
Atlas Biomechanics

Atlas Biomechanics : Gel Hammer Toe Crutch, Hammertoe Straightener Spli...

Atlas Biomechanics : Gel Hammer Toe Crutch, Hammertoe Straightener Spli...: Gel Hammer Toe Crutch, Hammertoe Straightener Splint The gel hammertoe crutch is a splint that elevates and straightens crooked digits. Th...

Atlas Biomechanics : Puncture Resistant Steel Insoles

Atlas Biomechanics : Puncture Resistant Steel Insoles: Puncture resistant steel insoles from Atlas Biomechanics are designed to prevent nails and other sharp metal objects from cutting into the ...

Atlas Biomechanics : Gel Foot Pad Cushions, How to make them last for m...

Atlas Biomechanics : Gel Foot Pad Cushions, How to make them last for m...: Gel foot pad cushions can be re-used and stay sticky for months. The gel used in Atlas Biomechanics foot pad cushions are designed to be sel...

Atlas Biomechanics : Steel 1/2 Stabilizer Plate Rigid Insoles, Half Len...

Atlas Biomechanics : Steel 1/2 Stabilizer Plate Rigid Insoles, Half Len...: Steel 1/2 Stabilizer Plate Rigid Insoles, Half Length Stabilizer / Insole Plates to Limit Fore-Foot, Metatarsal Joints & Turf Toe Us...

Atlas Biomechanics : Cork 12mm (1/2") Heel Lifts

Atlas Biomechanics : Cork 12mm (1/2") Heel Lifts: Cork 12mm (1/2") heel lifts were designed to correct limb length discrepancy. Atlas Biomechanics is the only USA company manufacturing...

Atlas Biomechanics : 6mm ( 1/4" ) Heel Lift is the Most Prescribed Shoe...

Atlas Biomechanics : 6mm ( 1/4" ) Heel Lift is the Most Prescribed Shoe...: Achilles tendonitis is frequently treated with heel lifts. Per our in-house survey with Atlas Biomechanics prescribing in shoe heel lifts, t...

Atlas Biomechanics : Atlas Biomechanics : 6mm ( 1/4" ) Heel Lift is the...

Atlas Biomechanics : Atlas Biomechanics : 6mm ( 1/4" ) Heel Lift is the...:  Achilles tendonitis is frequently treated with heel lifts. Per our in-house survey with Atlas Biomechanics prescribing practitioners, the 6...

Atlas Biomechanics : Steel Shank Shoe Inserts for Forefoot Injuries

Atlas Biomechanics : Steel Shank Shoe Inserts for Forefoot Injuries: Steel full stabilizer plate rigid insoles, half-length, and full length are used to stiffen the shoe's insole. This will limit the range...

Atlas Biomechanics : Heel Lifts in Ice Skates

Atlas Biomechanics : Heel Lifts in Ice Skates: Some ice skaters have the sensation that their heels are lifting out of their skates and the general feeling that it does not fit properly. ...

Atlas Biomechanics : How to Use a Re-usable, Stick On Foot Gel Pad

Atlas Biomechanics : How to Use a Re-usable, Stick On Foot Gel Pad: Self Adhesive, Reusable Gel Stick On Foot Pads Soft gel cushions are superior in reducing pressure while providing comfort to the foot. Th...

Atlas Biomechanics : Avantages of an Adjustable Heel Lift

Atlas Biomechanics : Avantages of an Adjustable Heel Lift: Adjustable heel lifts have numerous advantages over conventional heel shoe elevator lifts. 1. Leg Length Discrepancies: allows exact adju...

Atlas Biomechanics : Steel Insole Plate for Treatment of a Morton’s Toe...

Atlas Biomechanics : Steel Insole Plate for Treatment of a Morton’s Toe...: A steel plate insole can be beneficial in treating a Morton’s Toe. When the second toe is longer than the big toe, it is called Morton’s Toe...

Atlas Biomechanics : 8 Degree Varus/Valgus Heel Wedge, Cork Rubber

Atlas Biomechanics : 8 Degree Varus/Valgus Heel Wedge, Cork Rubber: Varus/Valgus Heel Wedges can be used for pronation or supination problems of the foot and ankle. Heel Wedges are designed to help align the...

Atlas Biomechanics : Semmes Weinstein Monofilament Wire 5.07 10g Neurop...

Atlas Biomechanics : Semmes Weinstein Monofilament Wire 5.07 10g Neurop...: According to the American Diabetes Association, all patients with diabetes should be screened for loss of protective sensation in their feet...

Atlas Biomechanics : 1/2″ heel lifts are a common size for patients wit...

Atlas Biomechanics : 1/2″ heel lifts are a common size for patients wit...: 1/2″ heel lifts are a common size for patients with unequal limb length. A short leg can be caused by many reasons. Post hip or knee replace...

Atlas Biomechanics : 1/4" (6 mm) Heel Lifts

Atlas Biomechanics : 1/4" (6 mm) Heel Lifts: Heel lifts are inexpensive, easy to use medical device that is used to treat Unequal Limb Length, Achilles Tendonitis, and Short Limb.  At...

Atlas Biomechanics : SHORT LEG SYNDROME (UNEQUAL LIMB LENGTH)

Atlas Biomechanics : SHORT LEG SYNDROME (UNEQUAL LIMB LENGTH): The presence of limb length discrepancy is usually associated with pelvic or lumbar misalignment. The short leg may be FUNCTIONAL, ANATOMI...

Atlas Biomechanics : Functional Short Leg and Heel Lifts

Atlas Biomechanics : Functional Short Leg and Heel Lifts: A functional short leg (FSL) is a common type of leg-length inequality is a result of rotational patterns of the pelvis and hips. It can a...

Atlas Biomechanics : How to Perform a Semmes Weinstein Neuropathy Skin ...

Atlas Biomechanics : How to Perform a Semmes Weinstein Neuropathy Skin ...: How to Perform a Semmes Weinstein Neuropathy Skin Test 1. Have the patient in a sitting position with shoes and socks off. 2. Explain to...

Atlas Biomechanics : PPT Self-Adhesive Heel Lift Cushion 1/4" Pad for H...

Atlas Biomechanics : PPT Self-Adhesive Heel Lift Cushion 1/4" Pad for H...: PPT heel lift cushion pads are a versatile footpad with many uses. PPT is also called poron and is an excellent material for cushioning, an...

Atlas Biomechanics : Indications of the Spring Steel Insoles- Full Stee...

Atlas Biomechanics : Indications of the Spring Steel Insoles- Full Stee...: Indications of the Spring Steel Insoles- Full Steel Stabilizer Plates - Problems requiring a Rigid or Semi-Rigid footbed - Turf Toe - Ha...

Atlas Biomechanics : Custom Fitting a Heat Moldable Plastic Heel Cup Pr...

Atlas Biomechanics : Custom Fitting a Heat Moldable Plastic Heel Cup Pr...: Custom Fitting our Heat Moldable Heel Cup Protector -Place heel cup protector inside the shoe with the star down and forward. -Most peop...

Atlas Biomechanics : Atlas Biomechanics : Limb Length Discrepancy and H...

Atlas Biomechanics : Atlas Biomechanics : Limb Length Discrepancy and H...: Atlas Biomechanics : Limb Length Discrepancy and Heel Lifts : Heel lifts are an inexpensive treatment option for limb length discrepancy and...

Atlas Biomechanics : Limb Length Discrepancy and Heel Lifts

Atlas Biomechanics : Limb Length Discrepancy and Heel Lifts: Heel lifts are an inexpensive treatment option for limb length discrepancy and Achilles tendonitis. A short leg can cause many different pa...

Custom Fitting a Heat Moldable Plastic Heel Cup Protector

Custom Fitting our Heat Moldable Heel Cup Protector

-Place heel cup protector inside the shoe with the star down and forward.
-Most people wear it over the sock.
-Place plastic heel cup protector in warm/hot water.
-Plastic heel protector will become pliable.
-With the heel protector in the shoe, step into it.
-Allow to custom mold for 2 minutes.
-Remove from the shoe and let plastic set for 10 minutes.
-The plastic heel protector should feel like a second skin, if not just remold it.

Uses for Plastic Heel Cup Protectors;
-Heel Spur
-Plantar Fat Pad Atrophy
-Ankle Injuries
-Shin Splint
-Lower Back

Teri Green
Atlas Biomechanics

Indications of Steel Insoles- Full Steel Stabilizer Plates

Indications of the Spring Steel Insoles- Full Steel Stabilizer Plates

- Problems requiring a Rigid or Semi-Rigid footbed
- Turf Toe
- Hallux Limitus / Hallux Rigidus
- Forefoot Pain
- Metatarsalgia
- Cuboid Syndrome
- Freiburg's Infraction
- Bunionectomy
- Foot Stability Post-op
- Shin Splints

Steel Stabilizer / Insole Plates to Limit Fore-Foot, Metatarsal Joints & Turf Toe

- Used to stiffen the sole of the shoe.
- Limits Range of Motion of the Forefoot and Midfoot.
- Makes shoe Non-Flexible.
- Extremely thin steel stabilizer plate insole, 1/8" thick.
- Comfortable and durable felt top cover.
-These steel insole plates are constructed to Limit Dorsiflexion at the metatarsal joints.
- Immobilizes toe joint to prevent it from bending during walking and sports.

Steel insoles are also used for puncture resistant shoe shank insoles.

Teri Green
Atlas Biomechanics

PPT Self-Adhesive Heel Lift Cushion 1/4" Pad for Heel Spur and Unequal Limb Length Discrepancy

PPT heel lift cushion pads are a versatile footpad with many uses. PPT is also called poron and is an excellent material for cushioning, and shock absorption.

One of its many uses is to cushion a painful heel spur. Remove the paper backing and place in the rear of the shoe. The PPT heel cushion will provide shock absorption when the heel stricks the floor.

Another use of the PPT heel cushion is to treat uneven limbs. The thickness is 1/4" ( 6 mm ) and provides a lift to the short leg.

Also, many medical practitioners will use our PPT heel lift cushion pads to treat Achilles tendonitis. Many people with Achilles tendonitis will have a short tendon and by placing the pad in the shoe it will relieve stress on the Achilles.

So a PPT heel lift cushion pads have many uses for the foot patient.

Teri Green
Atlas Biomechanics 

How to Perform a Semmes Weinstein Neuropathy Skin Test

How to Perform a Semmes Weinstein Neuropathy Skin Test

1. Have the patient in a sitting position with shoes and socks off.
2. Explain to the patient that you’re screening/testing for neuropathy (loss of skin nerve feeling).
3. Touch the Semmes-Weinstein nylon monofilament wire to the patient’s arm to show what the touch feels like.
4. Tell the patient to respond “Yes” each time he or she feels the pressure of the 5.07 monofilament wire on the foot during the exam.
5. Tell the patient to shut their eyes during the exam.
6. Hold the monofilament wire perpendicular to the patient’s foot. Press it against the foot, increasing the pressure until the monofilament bends into a C shape. (The patient should sense the monofilament by the time it bows.)
7. Hold the monofilament in place for about 1 second. Press the monofilament to the skin so it buckles at one of two times as you say “Time one” or “Time two.” Have the patient identify at which time he or she was touched. Randomize the sequence of applying the filament throughout the examination.
8. Locations for testing: On both feet, use the first, third, and fifth metatarsal heads and plantar surface of the distal hallux and third toe. Avoid callused areas.
9. Record response on foot screening form with “+” for Yes and “–” for No.

Teri Green
Atlas Biomechanics

Functional Short Leg and Heel Lifts

A functional short leg (FSL) is a common type of leg-length inequality is a result of rotational patterns of the pelvis and hips. It can also be affected by misalignments or torsional movement in the knee, ankles, and feet.

Limb Length Discrepancy and Heel Lifts

In many cases of a functional short leg, as evidenced by radiographic study, the use of heel lifts has been shown to help eliminate musculoskeletal deficiencies and improve patient outcomes. Providing support for the short limb with a heel lift is important when recognizing the functional short leg because providing a lift will likely diminish the associated sacroiliac subluxations.

Look at and palpate the iliac crests and the greater trochanters to see if they are of unequal height. Finally, look and palpate the lumbar spine. A typical postural distortion for a short leg will create lumbar scoliosis whose convexity moves toward the side of the FSL.

After you have measured your patient’s actual leg-length discrepancy, it is always safe to under correct. The classic rule of thumb is to cut the LLI in half and then start with the appropriate-sized heel lift.

Proceed to a 3 mm (1/8") heel lift and have the patient wear this for two weeks. Then re-evaluate.
Proceed to a 6 mm (1/4") heel lift or 9 mm (3/8") heel lift only if necessary. Use the two-week break-in period as indicated above. Then re-evaluate.

From a practical standpoint, it is very important to be able to confidently determine if someone truly has a short leg due to anatomy or functionality and to use a heel lift if need be.

Teri Green

Atlas Biomechanics

SHORT LEG SYNDROME (UNEQUAL LIMB LENGTH) Biomechanics of the Short Limb

The presence of leg length discrepancy is usually associated with pelvic or lumbar misalignment. The short limb may be FUNCTIONAL, ANATOMICAL, or a COMBO of both. Studies have found that the majority of patients presenting to our offices are functional, but a growing number seen are anatomical, the result of post hip or knee replacement surgeries. Many of these can be corrected within shoe heel lifts. You need an understanding of unequal limb length biomechanics before prescribing a heel lift from Atlas Biomechanics.

FUNCTIONAL SHORT Limb:
1. The sacroiliac joint that is misaligned causing the sacral base to drop to one side.
2. Flexion or Extension with one of the iliac bones out of its normal anatomical position.
3. Posterior Tibial Tendon Dysfunction causing the subtalar joint to overpronate, effectively shorting the limb.

ANATOMICAL SHORT Limb:
1. Hip or knee replacement surgery.
2. Polio.
3. Congenital, birth injuries and infections to the growth plates.
4. Fractures.

BIOMECHANICS OF THE SHORT Leg:
1. Supination of the subtalar joint.
2. External rotation of the tibia.
3. External rotation of the knee.
4. Abnormal patella tracking.
5. Pelvic Tilt.
6. Shifting of the center of gravity to the short side.

BIOMECHANICS OF THE LONG LIMB:
1. Pronation of the subtalar joint.
2. Internal rotation of the tibia and the knee.
3. Abnormal patella tracking.
4. Vaulting over the hip joint.

GAIT EVALUATION OF THE UNEQUAL LIMB LENGTH:
1. Center of gravity shifted to the short side.
2. Unilateral early heel lift.
3. Pelvic Tilt.
4. Shoulder drop.
5. Unilateral subtalar pronation.
6. Unilateral shoe wear (lateral heel).
7. Abnormal knee rotation and patella tracking.

Atlas Biomechanics produces all of our heel lifts in the USA.

Shoe Heel Lifts come in small, medium and large. They are manufactured from either EVA/Rubber or Cork/Rubber blend.

Heights are:
1/8 inch (3 mm) heel lift 
1/4 inch (6 mm) heel lift   
3/8 inch (9 mm) heel lift 
1/2 inch (12 mm) heel lift 
and
Adjustable Heel Lift with Built-in Heel Wedge  

Teri Green
Atlas Biomechanics