This is part 17 of a series that should be read in order.
Key Points:
- Introduction to the Hannaford Device
- Typical patient selection for these devices
- Review of the 8 types based on plastic, EVA, or plastazote frames
The Shock Absorption Orthosis (continued)
Today I am finishing the topic of the devices that are designed for the primary function of shock absorption, and I have highlighted those that also provide more stability. The last 2 devices will be C6 and C7 named after their inventor, Dr. David Hannaford. The Hannaford device is not presently provided by KevinRoot Medical (although we are working on a design that should be very very close), but its place in this category is undeniably powerful. For patients with poor fat pad, severe heel pain, chronic shock related joint pains up to the low back, stress fractures in the foot, leg and thigh, insensitivity to plastics, and more. I have attached a blog post outlining the manufacturing process. I would read a few of the detached. Every lab technician standing for many hours each day should figure out how to make themselves a Hannaford device. Hint! LOL
Here is a summary of the 8 types of shock absorbing devices.
Shock Absorption ( C): BC, C1/C2, C3/C4/C5, C6, and C7
BC: Balanced Device (B1 or B2) with additional cushioning material
C1: Material that you used to make B device is changed to softer and more flexible, like lowering thickness of the polypropylene or changing polypropylene to sub-ortholen (™)
C2: Not only is the plastic softer, with more flexibility, less rigidity in the rearfoot post is used, by either softer density or intentional increased motion applied
C3: Basic material change to standard EVA on same mold with full frame fill
C4: EVA product with half EVA frame fill
C5: Basic EVA product with softer material and 1/2 EVA frame fill
C6: Hannaford full length 2 Layer Plastazote Design with firm white Plastazote (pressed against non-corrected mold)
C7: Hannaford full length 2 layer Plastazote Design with soft white Plastazote (pressed against non-corrected mold)
So let’s dive deeper into the Hannafords.
C6: The next 2 types of devices use plastazote, a plastic foam from polyethylene, part of the EVA family (3rd cousin?). Whereas it is not memory foam per se, by using the softest durometer (15) against the skin, you definitely get a molding of the patient’s foot. The union of 15 and 25 durometer plastazote was introduced in 1987 by podiatrist, Dr. David Hannaford. He had spent 2 years treating runners in Eugene, Oregon, and developed what is called “The Hannaford Orthotic Device”. I personally have utilized this device in my running community for 35 + years with fantastic results. This is a full length orthotic device with the shock absorbing qualities of a diabetic insert on steroids. I could not practice Podiatry well without using this device over 25% of all my orthotic devices. If your lab wants to make them, I can send a powerpoint presentation to them. And, you can immediately find info on my Podiatry blog: drblakeshealingsole. My top 6 uses, to only name a few, are:
- Poor Fat Pad
- Hypersensitive Feet (Nerve component)
- Intolerance to Plastic
- Knee, Hip and Back Pain
- Stress Fractures in Lower Extremity
- Severe Heel Pain
C6 uses 15 durometer plastazote against the skin, and 25 durometer as a base. As the insert compresses 30% over the first month, a 3rd layer of 60 durometer black plastazote is added plantarly for more stability. The initial 2 sheets are 1/2 inch pink 15 durometer full length and 1/2 inch 25 durometer sulcus length, glued together and then pressed. Typically, after grinding into shape, a leather topcover is applied. A 3rd layer of 1/8 inch black plastazote (60 durometer) can be used after the Hannaford has molded and has about 30% volume for better shoe fit.
Prescription for C6 Device (this will be changed once KRM is ready):
- Positive image is only shape of foot uncorrected
- 1/2 inch 15 durometer pink plastazote full length of shoe
- 1/2 inch 25 durometer white plastazote sulcus length
- 25 mm Heel Cups
- Wide as Foot
- Leather Full Length top cover
- Send with 60 durometer 1/8 inch black plastazote orthotic length to be applied later
C7 only uses 15 durometers for both layers, and rarely ever a 3rd layer. These are yearly redoes, and are for patients with severe shock issues and poor plantar fat pads.
Prescription for C7 Device (this will be changed once KRM is ready):
- Positive image is only shape of foot uncorrected
- 1/2 inch 15 durometer pink plastazote full length of shoe
- 1/2 inch 15 durometer white plastazote sulcus length
- 25 mm Heel Cups
- Wide as Foot
- Leather Full Length top cover
In summary, I have presented 3 classes of shock absorbing/cushioning devices that should be in your toolkit. BC, C1, and C2 use plastic as their base and definitely most podiatrists know about these. C3, C4, and C5 use EVA (ethyl vinyl acetate) as their base. These have been in the world of Orthotists and Pedorthists. C6 and C7, designed by Dr. David Hannaford, and called “Hannafords”, are made of plastazote material and are a full length device.
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
