BraceBlogger O&P Podcast #33 - Government Policy Influence - Click Here

A reading from the January 2018 Edge Magazine "Policy Influence and Clinical Realities" auuthored by Richard W. Miller, CO, FAAOP.

NAAOP - National Association for the Advancement of Orthotics and Prosthetics - Website Click Here

AAOP - American Academy of Orthotists & Prosthetists - Website Click

BIPA - Click Here for Information
Medicare Orthotics and Prosthetic Improvement Act 2017 - Click Here

O&P Alliance - Click Here


LCD - Click Here

BraceBlogger O&P Podcast #31 MIPS: What Is It for O&P? - Click Here

A full reading of an article in the January 2018 of The O&P Edge written by Phil Steven's, MEd, CPO, FAAOP concerning "Medicare's Strategy to Reimburse for Value Over Volume".

MIPS (Merit-Based Incentive Payment System) - Click Here

CMS Quality Payment Program - Click Here

SA Ignite (Execution Management Specialists of MIPS)- Click Here

Podcast #30 O&P Documentation Part 3 (Final) - Click Here

Final reading from the January 2018 Edge Magazine "How to Hit the Mark with Documentation" by Maria St. Louis-Sanchez msantray@yahoo.com

Podcast #29 O&P Documentation Part 2 - Click Here

Part 2 of a reading from an article authored by Maria St. Louis-Sanchez in the January 2018 The O&P Edge magazine (pg. 24). "How to Hit the Mark With Documentation" 


msantray@yahoo.com

Podcast #28 O&P Documentation Part 1 - Click Here

A reading from the January 2018 issue of the The O&P Edge authored by Maria S. Louis-Sanchez.

Podcast #26 Click Here

1. Industry Review . - "Adaptive Prothetics Opens Third Office" , "FTC Challenges Ottobock, Freedom Merger" pg.14

2.Advertisement - Engineered Silicon Products pg. 15

3. Sports: "30th Annual Hartford Ski Spectacular" pg.16

4. Advertisement - Revo Labs pg. 16

Sesamoiditis Question for Clyde from Patrick / NYC

Hello Clyde , I have a question for you. I sustained a sesamoid injury in both feet last year as a result of doing squats with heavy weights in barefeet (very stupid). MRI and xrays do not show fractures. The diagnosis is inflammation of the sesamoid area/big toe joint. I've been experimenting with various types shoes and inserts (i.e. wide forefoot, stiff sole, rocker bottom, certain combinations thereof as it is not easy to find). 

I have a couple of questions about your XL Blades because I am trying to figure out how they differ from other carbon fiber inserts that I have purchases, such as from Return To Play, and MyFootShop.com.

I hope you do not mind indulging me.

One of the problems I have with the plates I've tried is they are so unforgiving. Stiffness is the goal, yes, but I have noticed that with this injury, I get a lot of stinging in the underside of the great toe joint especially when coming into contact with hard surfaces such as uncarpeted floor in barefoot (which I try not to do). I have placed carbon inserts into my shoes and used off-weighting materials like dancers pads, and cut holes in the insoles that sit on top of the carbon plate, but I still notice that when I walk and turn certain ways, depending on the shoe I am in, my foot "catches" on the plate in the sesamoid area and creates a sudden jolt of stinging. I have noticed in pictures of your plate that the big toe area seems to be depressed, it hangs a bit lower than the surface of the rest of the plate. Is that done so that the 1st metatarsal area is off-weighted even more and to prevent pressure from the carbon insert hitting the bottom of the toe joint like I have experienced? The other carbon inserts I have do not have that depressed area, so it makes me wonder if yours would work better.

The other questions I have is related to how I have trouble finding shoes that actually allow for the carbon plates to sit in. A lot of shoes do not have a flat surface/footbed area, so a flat stiff insert doesn't sit flat, it sort of bounces around since it is not coming into contact with the full surface of the footbed. I have a pair of New Balance 928 Walking shoes and they have a flat footbed on the inside, so the insert seems to work well in those, whereas in many shoes, especially something like an Oxford (like I need for the office), they do not, since there is curvature in the footbed in many Oxfords. I was wondering if that made sense to you, and if in your experience you have found that certain types of shoes work with your inserts better. I am guess also that with the stiffness, a rocker sole is going to make a more comfortable insert, since without the rocker, it is difficult to walk with a stiff insert. The challenge is also extra-depth, since adding the inserts underneath an existing insole and any additional padding makes for a very tightly packed shoe. That's a challenge I've had with other carbon inserts.  Extra depth, WITH a flat internal footbed, are not easy to find.

Anyway, if you would kindly consider my concerns as I determine whether or not it would be worthwhile for me to pursue your XL Blade, I would greatly appreciate it. It's been quite a challenge, and I"m sure you have heard these concerns from other clients. I have great respect for your field.

Thank you very much

Patrick M.

New York City

415.XXX.XXXX

Hello Patrick, Thanks for the question.

All my X1 Blade structural designs are tailored to specific applications (sesamoiditis being one) using a combination of mediums: composites (carbon fibers both bidirectional and unidirectional and glass),  a unique low coefficient of friction film, and compression resistant polyethalene foams. Unlike a "carbon fiber plate" that is uniform in density and stiffness (like a rigid dinner plate) the X1 Blade orthotic varies in density and flexibilty. We achieve this by varying the fiber orientations along the laminate structure in three zones - rear, mid, and forefoot. This variable design allows for a more natural foot motion.

The X1 Blade for sesamoiditis ingredients are:

1) 3 Flex Zones (TriFlex) - 1) Rearfoot  -fexible and padded for heel strike 2) Midfoot - flexible so as

X1 Blade for Sesamoiditis

not to restrict ankle motion during activity 3) Forefoot - stiff minus with a 2mm drop under great toe lined with low friction film (ShearBan).

2) Rocker Shape to encourage a more natural gait and fit the curvature of a standard shoe shape. A flat "carbon fiber plate" is only good for children who are toe-walkers. It will to get them into a more natural heel toe toe gait. As you have found it is very difficult to walk normally with a stiff flat "carbon fiber plate" in your shoe. There is a biomechanical reason for that!
3) Medial Toe Wedge - The 2mm drop under the great toe creates a 1mm medial wedge that shifts some of the ground force off the 1st MTP (sesamoids) to the 2 through 5 met heads during weight-bearing.
4) 2mm poyethalene foam (compression resistant) - added to forefoot zone to shift more ground force from 1st MTP to mets 2 through 5.
5) Specs: Weight: Usually 1+ ounce depending on the shoe size.  Thinness: from 1mm to 2mm in thinness depending on the flexibility zone.

The shoe issue. What I say is:  if you decide to order an X1 Blade for your sesamoiditis when you get it try it without an insert in the shoe to see if it will work for you and if so deal with the shoe issue last.

Patrick, I have made several of these  X1 Blades for sesamoiditis (usually for athletes) with a 100% money back satisfaction guarantee, and so far I have never gotten one back. 

ABC Badge

So I would say give it a try! 

Clyde Peach, CO
indianabrace.com

Hallux Rigidus: X1 GoBlade #7485 to Thomas in Knoxville, TN 6/13/17

Thomas's X1 GoBlade Runner Model #7485

Order Taken: WebSite Order 6/13/17 / Shipped 6/14 /17
Carrier: USPS Priority Mail
PA: Thomas R./ Knoxville, TN
RX: Clyde's X1 GoBlade for Great Toe Pain Left
DX: Hallux Rigidus
ICD-10-CM Billing Code : M20.22
Plan: Fabricate TriZone X1 GoBlade #7485 men's size 10 left with StifFlex midfoot (zone 2) for unrestricted ankle motion during hiking. Create 2mm great toe (zone 3) and heel relief (zone 1) pockets. Maintain extra kick rocker shape forefoot (zone 3) for assisted natural toe off. Pad heel (zone 1) with 3mm blue/black Colorfoam for heel strike relief to prevent plantar fasciitis. Cover great toe relief zone 3 with ShearBan to prevent blistering during hiking activity. Specs: thickness and weight of X1 GoBlade #7485 - (0.0405 ") thin! - 1.064
oz light!
SKU: RTLDEEPF128L

ABC BADGE

Country of Origin: Made in USA / Indianapolis, IN by Clyde Peach, CO
Sport: hiking
Comments: I will be using the  X1 GoBlade in my hiking boot. thanks. Thomas/Knoxville, TN
Website: www.indianabrace.com
Contact: Call: 800-253-6217 Text: 317-445-1475 Email: clyde.peach@gmail.com
Practitioner: Clyde Peach, CO - ABC Certified Orthotist #1321
American Board for Certification in Orthotics and Prosthetics

Broken Nose Mask: Question from Ivona / handball

Dear Clyde

Hoosier Facemask LDP Black

My name is Ivona B. I heard about your webpage and I am in need of a mask for my broken nose. That is why I am writting this email.

I am a handball player and my nose was broken during a match. I went to surgery and got it fixed, but now I need a mask to play safely. I have a few questions about your masks.

Firstly, do I need to send measures of my nose and head so you can make a personalised mask or are all mask generic?

Secondly, do you have information on whether your masks are recognized and allowed by the European Handball Federation?

And thirdly, do you do delivery worldwide or is your delivery in the USA only?

I am looking forward to your answer.

Thank you in advance.

Best regards,

Ivona B.

Hello Ivona - All my masks are one-off by measurements. I ship masks all over the world. I do not know EHF rules pertaining to masks for a broken nose. Clyde Peach, CO

Hallux Rigidus: Clyde's X1GoBlades #7460 & 7461 to Bill in Bridgeport, WV

Order Taken: WebSite Order 5/9/17 ----- Shipped 5/10/17 USPS Priority Mail
PA: Bill D./ Bridgeport, WV
RX: Clyde's X1 GoBlade for Great Toe Pain - Bilateral
DX: Hallux Rigidus
ICD-10-CM Billing Code : M20.22

Bill's X1 GoBlade #7460 & 7461

Plan: Fabricate X1 GoBlade #7460 #7461
men's size 9 right and left with StifFlex midfoot for unrestricted ankle motion during normal walking. Create .03" great toe and heel relief pockets. Maintain rocker shape forefoot for natural toe off. Pad heel with1/8" perf plastizote for heel strike relief to prevent plantar fasciitis. Cover great toe relief zone with ShearBan to prevent blistering during running activity. Specs: thickness and weight of X1
GoBlade #7460 and #7461 - (1/25") thin - 1.150 oz light / Style: RTL+ F127RT / RTL+ F127LT
Sport: running
Comments: Clyde - I have an artificial joint in my left great toe trying to prevent that in my right. Run about 20K per week and want to continue.
Website: www.indianabrace.com
Blog: braceblogger.blogspot.com
Contact: Call: 800-253-6217 Text: 317-445-1475 Email: clyde.peach@gmail.com
Practitioner: Clyde Peach, CO - ABC Certified Orthotist #1321
American Board for Certification in Orthotics and  Prosthetics

BraceBlogger Podcast #18 - Click Here

3/16/17 - In this episode of the BraceBlogger podcast, Clyde Peach shares a historical SOAP note concerning orthotic intervention for a 8 year old male. The article is from the  last half of the February 2017 O&P News concerning the HHS 2017 Work Plan for O&P. the advertisement is about the Ossur Rebound Dual knee brace.

3/6/17 O&P Historical Progress Note 3/14/2001

O&P SOAP Note Historical - Bilateral Total-Contact Insoles / Bunionectomy w Hammertoes

2/27/17 - O&P Historical Progress Note - Orthotics

BraceBlogger PodCast #16 2/25/17 - Click Here

O&P SAMPLE SOAP NOTE & PROGRESS NOTE

Podcast #14 - O&P Under Seige by Allied Health Article

1/25/17 - In this episode of the BraceBlogger podcast, Clyde Peach, CO #1321 shares an interesting article written for the January 2017 O&P Edge concerning an "O&P Certification Pathway for Allied Health Professionals page 64. Authors: Jeff Arnette, CPO/L, BOCP; Brandon Arnette, BOCPO; and Michael Arnette, BOCPO/L all practitioners at Progressive Prosthetics & Orthotics, Tulsa, Oklahoma. Michael Arnette can be reached at michael.progressive@gmail.com. - CLICK HERE

Podcast #10 1/2/17 - Click Here - TLSO , ABC, MobilitySaves.org

SOAP NOTE - TLSO

ARTICLE - ABC Practitioner Changes

AD - MobilitySaves.org

Podcast # 8 12/15/16 - Click Here / Bilateral AFO's, WillowWood Leadership, VQ OrthoCare

PodCast # 8 Details
1. SOAP NOTE - Parapodium User
2: NEWS: Leadership Passes at Ohio WillowWood
3:AD: VQ OrthoCare

Podcast #7 - Scleroderma, Body Heat Generates Electricity, Endolite