Orthotic Selector – Dola Orthotics

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ORTHOTIC SELECTOR

Orthotic Selector

WHO IS YOUR PATIENT?

Gender *

Weight *

Shoesize *

Shoesize (Mens US) *

Shoesize (Womens US) *

Activities

Footwear Type

WHAT IS YOUR PATIENT'S PRESENTING COMPLAINT?

Click here to see Common Conditions Library

General Comfort and Prevention

General Pronated

General Supinated

Neutral

Knee/Leg Pathology

Anterior Knee Pain

Medial knee pain

Lateral knee pain

Iliotibial Band (ITB)

Os Good Schlatters

Patello-Femoral Syndrome

Paediatric Outtoeing

Paediatric Intoeing

Paediatric Toe Walking

Lowerlimb / Ankle

Achilles Tendonopathy

Ankle Equinus

Anterior Impingement Syndrome

Extensor Tendonopathy

Flexor Hallucis Pathology

Gastroc/soleus Pathology

Lateral Ankle Sprains

Peroneal Tendon Pathology

Shin Splints: Anterior

Shin Splints: Posterior

Tibialis Anterior Pathology

Rearfoot Pathology

Calcaneal Apophysitis: Severs Disease

Chronic Plantar Heel Pain: Plantar fasciitis

Fat Pad Syndrome

Peroneal Pathology

Plantar Calcaneal Bursitis

Retrocalcaneal Bursitis

Tarsal Tunnel Syndrome

Tibialis Posterior Pathology

Midfoot Pathology

Cuboid Syndrome

Lisfranc Injury

Midtarsal Joint Sprain

Navicular Pathology

Plantar Fascia Pathology

Forefoot Pathology

1st MPJ Injury

5th Metatarsal Injury

Corns/Callus

Friebergs Osteochondritis

Functional Hallux Limitus

Hallux Rigidus

HAV (Bunions)

Lesser Digital Deformities

Metatarsal Stress Fracture

Metatarsalgia (Capsulitis / Bursitis)

Neuroma: Interdigital Neuritis

Plantar Plate Injury

Sesamoid Injury

WHAT ARE THE RESULTS OF YOUR CLINICAL TESTS?

Click here to view our clinical tests videos

Range of Motion NWB

Ankle

Subtalar Joint (STJ) Inversion

Subtalar Joint (STJ) Eversion

Midtarsal Joint (MTJ)

1st Metatarsophalangeal Joint (1st MPJ)

Resting Stance Position

Foot Posture Index

Calcaneus Position

Arch Height

MSRT Force

Sagittal Plane Assessment

Lunge Test

Jacks Test Force

Jacks Test Range

VIEW RECOMMENDATIONS

Recommendation Orthoticks Pro

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Recommendation Orthoticks Poly

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ADDITIONS TO CONSIDER

Please Note: Use of additions is optional and should be guided by clinical testing. The following additions are for your consideration.

Top Cover Strips

Poron Strips

Rearfoot Post

Wedge Strip - Rearfoot Varus

Wedge Strip - Rearfoot Valgus

Heel Raise

Mortons Extension

Reverse Mortons Extension

Forefoot Wedge - Varus

Forefoot Wedge - Valgus

Arch Cookie

Metatarsal Dome

Metatarsal Bar

Cuboid Pad

Arch Reinforcement

Medial Heel Skive (MHS)

Lateral Heel Skive (LHS)

Pl Fascial Groove (PFG)

Poron Heel Pad

Poron Horse Shoe Pad

Poron Forefoot Extension

1st Met Cutout

Sesamoid Pad

Device may require tapering

COMPLETE FOR COPY OF RECOMMENDATION (OPTIONAL)

Patient Name

Email

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