This is the part 3 of a series that should be read in order.
Key Points: What is a B2 orthotic device?
What type of impressions can you use to design a B2 device?
Besides just the Shape of the image, what can a B2 device be used for
(since it is not achieving Root Balancing?
What is the typical Gold Standard Orthosis?
Are B1 and B2 orthotic devices based on intrinsic or extrinsic modifications?
The second type of the myriad of Balanced Orthoses is called B2. These are shaped based orthoses, not to be used for Root Balancing. This is the image or impression captured by non-Root criteria. These impressions can be non weight bearing, semi-weight bearing, or fully weight bearing. The image can also be captured by a digital scanner. Therefore, it can be a non-neutral suspension cast, puddle cast, or foam box. They can produce incredibly stable orthoses. And, as with the subtalar neutral suspension casts, these images can be used in every orthosis listed when classical Root Balancing, in your mind, will not accomplish what you are trying to achieve, or you are not trained in Root casting/scanning positions. Typically, these are the feet that need more pronation correction, more supination correction, more medial/lateral instability correction, more cushion (or shock absorption), and less hallux limitus or better sagittal plane facilitation. If you look at the list below of corrective foot orthoses, only 3 have to have a B1 device (B1, B1P, and B1S).
Here we are back briefly to your Gold Standard (and Dr. Feldman’s Go-To Orthosis). Your Gold Standard, your most used orthosis, is typically B1 or B2. Therefore, your Gold Standard is a Balancing and Supporting orthosis. You are either using Root Balancing (B1) or concerned about the Shape of the Impression (B2) in designing your orthoses. Your Gold Standard does not change with different topcovers, with or without metatarsal pads, accommodations, or extrinsic rearfoot posts. Your Gold Standard is typically based on the intrinsic shape of the foot you capture. That will be B1 or B2 as I have discussed. Changing the basic material or arch height does not change your Gold Standard. Your Gold Standard is not changed even with huge material shifts, like plastic to EVA, but when you attempt to change the function of the device (like intrinsically adding a Kirby Skive to your device). Your Go-To device is changed away from Balancing to a device that you are trying to make it better for pronators, better for supinators, better for medial/lateral instability, better for shock absorption, and better for sagittal plane function (than your Go-To device will give you).
Review of all the Orthotic Types Being Presented
Corrective Orthotic Devices
↓
- Balancing (B): (B1 and B2)
- Pronators (P): BP, P1, P2, P3, P4, P5, and P6
- Supinators (S): BS, S1, S2, S3
- M/L Instability (M): BML, ML1, ML2, ML3, ML4, ML5, and ML6
- Shock Absorption (C): BC, C1/C2, C3/C4/C5, C6, and C7
- Sagittal Plane (H): BH, H1, H2, and H3
