Well, the long awaited laptop has arrived. I can now happily multitask again, reading some nerdy article while typing away in a Word document AT THE SAME TIME! I didn’t think this was a big deal until I couldn’t do it anymore. I tell ya, there are some things an Ipad just won’t do.

Anyway, today’s topic is UCBL style foot orthotics. For the past few weeks I’ve been making them like they are going out of style. The term UCBL stands for University of California Berkley Labs, where the UCBL was first developed.

There is a bit of a debate about what constitutes a UCBL foot orthotic. The definition is shaky. People market a wide variety of foot orthotics as UCBLs. Here are some pictures to give you an idea:

UCBLs

The general consensus is that a UCBL foot orthotic is made out of a rigid material such as plastic or carbon fiber. It is usually molded to a model of the patient’s foot (but it is possible to purchase prefabricated UCBLs). The side of the UCBL are deep, cupping the heel and extending up around the edges of the foot. The UCBL usually ends just before the Metatarsal Heads of the foot. See the green lines in the picture below.

UCBL trimlines
The purpose of a UCBL foot orthotic is to control and aggressively correct the foot. UCBLs are most often used for people who pronate severely, often because of flexible flat foot (also called Pes Planus) or because their Posterior Tibial Tendon is ruptured or damaged.

FlatFoot-Figure-2
UCBLs are usually prescribed when nothing else will work. They are bulky and hard to fit into shoes. I’ve been told that they are an absolute bear to break in. They are hard and unforgiving and have to be made absolutely right otherwise they will cause rubbing and blisters and skin irritation. Speaking from a Pedorthist’s point of view, they are a pain in the neck to make.  So why haven’t UCBLs gone extinct with the dinosaur? And furthermore, why have I made so many of them in the past few weeks? Because if they are done right, they work wonders. UCBLs operate under what I like to call the “captive audience” premise.
Have you ever been at a social event and gotten cornered into talking to a really annoying person? You use sophisticated strategies to get out of the situation. At the first possible excuse you put some distance between yourself and the talker, then you rope some other innocent bystander into the conversation. Then you see someone across the room you have to run over and greet. Whew. Disaster averted.

Well, your feet do similar things. Sort of. If you have a really flat or collapsed arch and then you stick an orthotic with an  aggressive arch support underneath it, your foot is just going to slide off to the side in an effort to escape the uncomfortable situation. This leaves your shoes looking like this:

ripped out lateral side

And your arch is no better off than it was before.
A UCBL grabs both sides of your feet, holding your arch against the support with the help of your shoe. This forces your foot to adapt to the shape of the UCBL. Whether it likes it or not. To return to the awkward talker analogy – it’s as if the talker were seated next to you on a long airplane flight. You can’t get away!

talker

I warned you earlier that UCBLs are unpleasant to get used to. (Like an obnoxious conversationalist). But give them time, and your feet will adapt to the situation. If you had bad enough alignment to warrant needing a UCBL in the first place, you will begin to notice an improvement after wearing them for about 1 week. At the end of two weeks, you should be able to forget you are wearing them. And you should be able to see a positive change in the arch, ankle, knee and back pain that first prompted you to ask your doctor for a prescription for foot orthotics.

As for the annoying talker, I’m sorry – there’s nothing I can do about that. At least your feet won’t hurt while you are listening to his long winded story about his latest UFO conspiracy theory.

Picture sources:
http://www.delatorreop.com/orthotic-devices/all-devices/foot-orthotic-orthopedic-ucbl-220/
http://jmorthotics.com/products-childrens.php

http://www.footeducation.com/acquired-adult-flatfoot-deformity-posterior-tibial-tendon-dysfunction

http://www.thequadrastepsystem.com/ls.html

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