Rx template

Adult-Acquired Flatfoot (PTTD)

A failing posterior tibial tendon lets the arch collapse and the heel drift into valgus. The orthotic's job is aggressive, comfortable pronation control that the patient will actually wear all day.

Style
¾-length or full-length, firm build
Density map
Firm throughout (≈55–60A); this is a control device first

All corrections are intrinsic: the varus geometry is modeled into the heel seat and arch while the printed base stays flat, so strong control doesn't come with a wedge-shaped device rocking in the shoe.

What you'll see

  • Progressive arch collapse, usually unilateral first
  • “Too many toes” sign and a valgus heel from behind
  • Pain and swelling along the posterior tibial tendon
  • A weak or painful single-leg heel raise
  • A still-flexible deformity in the early stages

The modifier package

Medial Heel SkiveThe workhorse: a deep skive for a strong supination moment
Rearfoot PostVarus posting built into the heel seat
Medial ArchFull-contact support under the collapsing arch
Medial ReinforcementKeeps the arch from bottoming out under load
Heel Cup DepthA deep cup holds the calcaneus in the corrected position

Worth considering

Sustentaculum TaliFocal support directly under the talar head

Clinical note

This template is for flexible (early-stage) deformity. A rigid flatfoot, or one that fails to correct on exam, needs imaging and a bracing or surgical conversation, not a stronger insole.

Every template is a starting prescription, not a constraint. Each parameter stays fully editable in Rx Studio before you send the order.

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