Practice Pearl # 1 (ORTHOTIC BLANKS) A heat molded thermoshell orthotic blank from Atlas Biomechanics, www.atlasbiomechanics.com lets the practitioner mold the orthotic directly to the patient's foot without having to cast or send out to a lab. Atlas Biomechanics eliminates the middle man, you produce a more accurate device and receive greater profit. Our heat moldable orthotic blank is billable under code L3030. The orthotic blank is completely heat moldable from a heat gun in about 2 minutes. Direct molding to the patient's foot can be accomplished in either full or partial weight bearing. You control the orthotic fabrication process, not some lab. The thin profile (1.3mm) allows it to fit in most any shoe (including heels, flats, gym shoes, ski boots, and hockey skates) and the 4 degree rear foot post allows for greater control and stability. Atlas Biomechanics and over 300,000 heat molded custom orthotic patients are proud of this orthotic.

Piriformis Syndome Biomechanical issues must be addressed to provide long term relief. These include, adding a heel lift on the shorter side, eliminating abnormal pronation issues with an orthotic is imperative. Addressing the pronation issue will ensure that the rotary forces transmitting up the leg will be correct and not place abnormal shearing on the pelvis and piriformis muscle. Therefore a custom orthtotic and heel lift is needed with piriformis syndrome.

L3030 Orthotic A true L3030 direct contact custom orthotic is molded directly to the patient's foot, not from an impression. Our heat molded orthotic blanks at Atlas Biomechanics www.atlasbiomechanics.com meet HCPCS DME code L3030. Our thermoplastic shells become moldable in about 2 minutes of heating with a heat gun. Direct contact allows more control of the orthotic fabrication process. Great for plantar fasciits and heel spurs. Heat molded, direct contact custom orthotics from Atlas Biomechanics meets the code DME L3030.

Orthotic Profit Center Over 300,000 pairs of Atlas Biomechanics www.atlasbiomechanics.com heat molded, direct contact, custom orthotic blanks are currently being used by patients. Surveys of our practitioners reveal a 31% conversion rate to direct contact, heat molded orthotics when discussed with their patients.

Heel Lift Study 798 patients with chronic and therapy resistant low back and or unilateral hip symptoms were examined for leg length inequality. 89% of these patients were found to have a leg length inequality. Most of their pain was on the side with the longer lower extremity. When correcting the leg length inequality with a heel lift, the majority of the cases had a permanent and mostly complete alleviation of symptoms. Spine1983Sep;8(6):643-51. Atlas Biomechanics offers a complete line of heel lifts, most sold in wholesale packs.

Skin Adhesive When taping patients you should have an adhesive base on the skin to help secure the tape, under- wrap and elastic-wrap. Our Q.D.A. Taping Base is a quick drying adhesive (Q.D.A.) that also reduces tape friction blisters and makes your taping job last longer. Atlas Biomechanics offers Q.D.A. tape adhesive base in wholesale packs.

Limb Length Discrepancy and Related Problems Following Total Hip Joint Replacement Surgery 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.

Effect of Leg Length Discrepancy on Spinal Motion During Gait Study in Japan focused on the effects of leg length discrepancy on the motion of the normal spine during gait in healthy volunteers who wore a heel raising device and to evaluate the effect of leg length discrepancy on the changes in curvature of the normal spine. The results showed an asymmetrical lateral bending angle of the thoracic spine was 4 degrees in the heel-raising gait and about 3 degrees in normal gait. The lateral bending angle of the lumbar spine was 8 degrees in the heel-raising gait and was 6 degrees in the normal gait. The conclusion of the study reveals that patients who have leg length discrepancy are at greater risk of developing spinal disorders and therefore, treatment for leg length discrepancy with a heel lift from Atlas Biomechanics may be helpful in preventing degenerative spinal changes. Spine(Phil,PA76)2003Nov1;28(21):2472-6.

Nitrile Exam Gloves are Better than other Gloves Studies have shown that Nitrile Exam Gloves from Atlas Biomechanics www.atlasbiomechanics.com offer superior protection when compared to latex or vinyl gloves. Many toxic chemicals are permeable through latex and vinyl. Nitrile is more durable and resistant to puncture holes than the average rubber glove. Nitrile is also a safe option for those who have an allergy to latex. Our Nitrile Exam Gloves at Atlas Biomechanics are only 6.99 per box of 100. www.atlasbiomechanics.com

Preventing Tape Contact Dermatitis Tape Contact Dermatitis is from irritation and moisture due to nonporous tape. To prevent tape contact dermatitis one must use a porous latex free athletic tape such as Cramer 950 Porous Athletic Tape which is latex free, zinc oxide coated and porous. www.atlasbiomechanics.com offers the Cramer 950 Porous Athletic Tape in our taping and wrapping section.

Functional Limb Length Discrepancy: The presence of a limb length discrepancy or short limb is usually associated with pelvic or lumbar spine misalignment. Limb length discrepancy is usually functional, but may be anatomical (hip or knee replacement surgery). Musculoskeletal conditions that may aggraviate the functional short limb are a misalignment of the sacroiliac joint causing it to drop or a rotation of the hip bones out of normal position. Functional limb length discrepancy is usually accompanied by compensatory changes in the back such as thoraco lumbar bending (scoliosis) and lumbar rotation. A heel lift from atlas biomechanics, www.atlasbiomechanics.com and manual therapy my achieve leg length equality and resolve symptoms.

Ski Orthotics and Ski Biomechanics: The typical down hill skier's lower extremities never goes through a complete gait cycle. They ideally should have limited pedal mechanics between midstance and the beginning of propulsion, with the knee in flexion during the entire contact phase. When initiating a turn a skier will maintain their control by directing the downhill knee medially and transferring the load into the foot over the inside edge. This is done by internally rotating their tibia, causing a closed kinetic chain pronation of the foot, which transfers the pressure through the boot onto the ski edge. In ski boots subtalar joint supination and pronation are responding to knee function. With ski orthotics the goal is to control the knee function by supporting the foot anatomy. A custom heat moldable ski orthotic from Atlas Biomechanics, www.atlasbiomechanics.com allow the skier to turn quicker and with more power. The skier will have a more efficient transfer of energy and will have decreased overall foot and knee fatigue. A ski orthotic from can make you a better skier. Teri Green, www.atlasbiomechanics.com

Heel Lifts Can Relieve Low Back Pain with Limb Length Discrepancy A study done at the Sackler Medical School in Israel showed how heel lifts can help relieve chronic low back pain patients with limb length discrepancy. They divided patients with chronic low back pain and limb length discrepancy into two groups. One group received a heel lift and manual therapy and the other just received manual therapy without the heel lift. The group who received the heel lift had a significant reduction of back pain when compared to the group without the lift. Their conclusions are that a heel lift reduces chronic low back pain and functional disability in patients with lower limb length inequality. And that heel lifts are a simple, noninvasive, and inexpensive therapeutic treatment that can be added to the treatment of chronic low back pain. www.atlasbiomechanics.com

TRIPLE V HEEL LIFT, VARUS/VALGUS AND VARIABLE height adjustable, was developed by Atlas Biomechanics with doctors and physical therapists input. The triple V heel lift has 3 removable rubber layers, 3 mm (1/8 inch) each to achieve proper correction of the short leg in limb length discrepancy. What makes us unique is the bottom layer has a varus or valgus correction option. Peel off one half of the layer to correct subtalar inversion or eversion. Most short legs of limb length discrepancy have a inversion of the subtalar joint. The Triple V Heel Lift corrects this. Atlas Biomechanics

Heat Moldable Orthotics Fabrication Tips Heat molded, direct contact orthotic blanks from Atlas Biomechanics should be comfortable before the patient leaves the office. Here are some pearls we have received from our practitioners over the years:

1. Reheat the orthotic shell to modify if the arch is too high or low before the patient leaves the office.
2. Slow break in period, 2 hours per day wearing the orthotic device, adding 2 hours each additional day.
3. During break in period, if the heat mold orthotic device is uncomfortable, remove, wait 2 hours and resume break in period.
4. Have the patient return for a check up in 10 days. Always to alittle modification on the orthotic blank, patients like the extra care.
5. Put the heated orthotic shell under the shoe's insole and have the patient stand on it to mold, it will get a good impression and not a hot foot.
6. Usually the dress orthotics will work in high heels up to 2 inches.
7. Use double sided tape to hold the heat mold orthotic in place or place the orthotic device under the shoe's insole, especially for the sports orthotic.
8. Hold the subtalar joint in neutral postition while pressing down onto the orthotic.

Those are some of the tips we have received from our practitioners regarding our heat molded, direct contact orthotic blanks from Atlas Biomechanics

Results of our Heat Mold Orthotic Survey: Atlas Biomechanics sends out annual surveys to all of our practitioners who fabricate our Heat Moldable, Direct Contact Orthotics. This year we sent out 587 forms and received 214 back. Here are the results: Practitioners state that they have a 31% rate of conversion of patients to orthotics when discussing it. 78% of practitioners fabriacte the heat moldable orthotic in direct contact with partial weight bearing. Medical assistants do 32% of the fabricating. Reheating to fine tune the orthotic is 12% with most lowing the arch. Private labeling of the orthotic with their name and phone number is 59%. The mean price charged for non insurance billed, cash for one pair of heat mold, direct contact custom orthotic is $196, with the price range of $73-327. Practitioners who charge the insurance companies, 96% use code L3030, with their mean reimbursement from the insurance carrier of $154, with range of $78-327. Number of orthotics fabricated per day is mean of 1.4, with range of 0.2-4.3. Teri Green, Atlas Biomechanics

Atlas Biomechanics is excited to announce that we are now producing 9 mm heel lifts in small, medium and large. Atlas Biomechanics is one of the leading producers of in shoe heel lifts in the US. Teri Green

6 mm heel lift (1/4 inch heel lifts) are now our most asked for in shoe heel lift, per our production and sales team. The 6 mm heel lift just took over as the most popular from the 3 mm heel lift. www.atlasbiomechanics

Achilles Tendonitis is one of the most common diagnosis given when doctor's are prescribing our heel lifts. The 6 mm shoe lifts are the most common dispensed for achilles tendonitis. View 3 mm, 6 mm and 9 mm heel lifts.

Valgus Heel: A heel in valgus is when the arch collapses (pronation) and as a result the calcaneal bone (heel) is in eversion. The subtalar joint that controls eversion and inversion. Supporting the arch and subtalar joint with a heat moldable custom orthotic can control valgus heel.

Foot products now manufactured by Atlas Biomechanics are Corn Pads, Callus Pads, Adjustable Crest Pads, Metatarsal Pads (including Sesamoid and Dancer's). These foot pads treat foot callus, corns on feet, hammertoes, sesamoiditis, dancer's injuries and metatarsalgia. These prevent hammertoe, foot callus and corns on feet, not callus remover.

Prevent hammertoe, corns on feet with toe pads such as adhesive corn pads and adjustable crest pads. Hammertoe pain can be decreased by wearing these foot products.

Metatarsal Pads may help women wear high heels with out pain. It can also help runners with foot pad pain. Barefoot walking can aggreviate the ball of your feet. Metatarsalgia is ball of the foot pain, usually caused by ill fitting shoe, decreased fat pad, arthritis and biomechanical problems. Metatarsal pads can alleviate the pain in the ball of your feet by padding the feet to cushion the feet. http://www.atlasbiomechanics.com/foot_pads_s/1871.htm

Dancer's / Sesamoid Pads treat Sesamoiditis and Ball of Foot Pain. Dancer's pads (also called Sesamoid pads) are foot pads that off load the first MPJ (big toe) joint, sesamoids and the ball of the foot. The reason it is called a dancer's pad is because your typical dancer is on her ball of the foot often and her sesamoid bones and or first MPJ joint can become inflamed. This foot pad off loads the pressure from the big toe joint and sesamoids to the pad thus decreasing pain. Atlas Biomechanics dancer's / sesamoid pads come in medial grade adhesive felt, foam and reusable gel.

Heel Lifts Treat Achilles Tendinitis. Achilles tendonitis is a common injury for both athletes and high heel shoe wearers. The gastroc-soleus (calf) muscle blends into a thick tendon called the achilles and attaches into the back to the heel (calcaneus). The Achilles Tendon allows for raising of the heel and pushing off during gait. Achilles Tendinitis is very common. The athlete over does a physical activity that the tendon is not used to. There can be a sudden increase in intensity, distance or amount of the activity. The Achilles can also be aggravated by the tendon being tight, over pronation, ill fitting shoes and worn out athletic gear. Another common reason for Achilles Tendinitis is when a woman continually wears high heels. The tendon over time will shorten since the foot is continually in a downward (plantarflexed) position. When the same woman then wears flats or goes barefoot, the Achilles is in a more stressed and shortened position. An abnormal pull on the tendon can cause it to become inflamed (Achilles Tendonitis). One that should be on everyone's list is an in shoe heel lift. A simple and inexpensive shoe lift is a medical device placed in the back of a shoe to lift the calcaneus bone slightly. This lifting of the heel riser will very slightly take the stress off the already tight Achilles Tendinitis. This is usually enough to allow the tendon to heal. When a heel lift is used in the shoe, it will increase the propulsion length of the Achilles during gait. The most common heel lift for Achilles Tendonitis is the 6 mm (1/4 inch) heel lift.

Tube Foam (pedi foam) to Make Custom Foot Pads: Tube foam are soft cushion sleeves that are tubular. This makes them great toe pads and bunion shields. All one has to due is place a proper sized tube foam over a digit to measure. Mark the foam and with scissors cut off a piece. For better placement, cut the tube foam a little longer than the toe and make a small cut perpendicular to the edge. This will allow the tube foam to stay in place better. Bunion shields or splints can also be fabricated in a similar way. Measure how long you want the tube foam over the bunion, taking in account that the toe will be the place holding it in place. Cut the tube foam after marking the length needed. Then cut perpendicular from the edge up to where the toe begins. Trim to fit. Metatarsal pads are made the same way.

3 Layer Foam Toe Separators are now being offer. Our Toe Separators allow air flow to the affect skin area and provides a secure cushion to protect and realign painful crooked toes. Great as a bunion splint and to prevent soft corns with hammertoes. Our 3 layer foam toe separator is in our toe separator section.

Morton's Neuroma Pad. Morton's neuroma is a painful pinched nerve on the ball of the foot. Patients say it feels like a pebble in their shoe or shooting pain from the ball of the foot to the toes. To off load and relieve pressure on the pinched Morton's neuroma, wearing a metatarsal pad on the bottom of the foot can help greatly. Morton's neuroma pads come in felt, foam and reusable gel.

Gel Corn Pads are reusable, self sticking hammertoe corn cushions produced by Atlas Biomechanics. For those with sensitive skin or don't want to constantly reapply felt or foam corn pads, these foot pads are the answer. Our gel corn pads come as a 9 corn cushion pack. Produced in the US of medical grade gel to prevent and cushion painful toe corns.

Gel Metatarsal Pads are reusable, self sticking, medical grade ball of the foot pads. These gel metatarsal pads are great for Morton's neuroma, metatarsalgia and sesamoiditis. Gel metatarsal pads are long lasting, comfortable and off load painful ball of the foot areas. Many patients use our gel metatarsal pads as a callous pad to prevent and cushion calluses.

Metatarsal Pad Sleeve is our newest gel metatarsal pad that is built into an elastic sleeve. Just slip on the sleeve to have a medical gel on the ball of the foot. The metatarsal gel pad elastic sleeve treats Morton's neuroma, Sesamoiditis, calluses and metatarsalgia. We produce our metatarsal pad sleeve here in the US from medical grade materials.

Dancer's Pad / Sesamoid Pad in medical grade adhesive felt is now being produced from Atlas Biomechanics. Our dancer's / sesamoid pads are designed and produced here in the US. Off load, cushion and protect painful 1st MPJ area (sesamoid) pain. These dancers pads / sesamoid pads work well with runners, workers who stand a lot and anyone with sesamoiditis. Sesamoiditis pads come in either right or left foot. Sesamoiditis affects dancers, athletes and people who stand a lot.

DigiStrip is a elastic strip (48") long with 1/2 medical grade gel coated. Cut your own corn pads, toe separators and tube foam and save money in the process. http://www.atlasbiomechanics.com/digistrip_p/digistrip.htm.

Gel Toe Comb is made from medical grade gel. Our gel toe comb separators, cushions and lifts toes. These gel toe combs act like a foam toe separator, corn pad and buttress ( crest ) pad all in one. Gel Toe Pad.

Felt Arch and Spur Support from Atlas Biomechanics is made of medical grade felt here in the USA. Our felt arch support provides great longitudinal arch control. Soft, lightweight and economical. The felt arch support comes in 1 arch support pair, 5 arch support pair and 25 arch support pair cases.

3 Layer Foam Toe Separatorsre produced here in the USA. The 3 layer foam toe separators come in small, medium and large. The denser center layer provides cushion while the softer outer layers provide air flow to the skin. So skin will not be moist as with other toe separators. 3 layer foam toe separator

Toe Separator with Loop are toe spreaders made of silicone gel with a toe ring to hold them in place. The stretchy material provides comfort and control. Our Toe Separators with Toe Loop are made in the USA. http://www.atlasbiomechanics.com/loop_toe_separator_p/p-1loop.htm

Bunion Pad with Built in Toe Separator: Realign Big Toe while Cushioning Bunion, Medical Grade Silicone Gel, Bunion Pad cushions and protects the boney bunion bump. Toe Separator realigns big toe. Right or Left interchangeable, Separates 1st and 2nd toes, Prevents 1st and 2nd toes from rubbing against one another, Encourages proper toe alignment of the big toe, one size fits all and Eases bunion pain. Bunion Pad with Built in Toe Separator

Dancer's Pads, Reusable and Self Sticking: Atlas Biomechanics produces medical grade dancer's / sesamoid pads that will off load painful sub 1st MPJ and sesamoiditis. These USA made gel pads are durable, light weight and can be used over and over again. The key is not to have oil or lotion on the foot. Click here to learn more about our Dancer's / Sesamoid Pads

NailZyme All Natural Enzyme Infused Fungal Nail Revitalizer: Thins, Lightens, Softens & Easier to Cut Nails. Most people see a difference with in 2-3 weeks of using NailZyme. Active Ingredients: Natural Enzymes ( Protease, Lipase, Amylase, Lactase, Cellulase & Bromelain ) Infused into: Jojoba Oil, Tea Tree Oil, Peppermint Oil and Sesame Oil. NailZyme comes in 1 oz dropper bottle. Usually lasts for approximately 1 month of treatment. click here for more info