Heel Cups - Supramalleolar Orthoses (SMO)/UCBL
Custom Suprmalleolar orthoses (SMOs)/ University of California Biomechanics Laboratory (UCBLs) are beneficial for treatment of many medical conditions and injuries. Sometimes UCBLs are referred to as heel cups.
These conditions can be (but are not limited to):
- Subtalar Instability
- Flexible Calcaneal (heel) Deformities
- Neuromuscular Impairment
- Cerebral Palsy
- Hypermobility
- Drop Foot/ Dorsiflexion Weakness
- Peripheral Neuropathy
- Multiple Sclerosis
- Cerebral Vascular Accident (CVA)/Stroke
- Amyotrophic Lateral Sclerosis (ALS)
- Diabetes
- Charcot Marie Tooth Disease (CMT)
- Guillain Barré Syndrome
- Tibialis Posterior Dysfunction
- Osteoarthritis
Anatomy and Biomechanics of SMO & UCBL |
There are two bones in the lower leg and 26 bones in the foot that create many joints. There are many
muscles, tendons, ligaments and nerves in the foot and ankle. There are two ankle joints:
The foot can be broken into three parts:
Arches of the foot:
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Goals of SMO & UCBL Treatment |
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Design of SMO & UCBL |
A Certified Orthotist will assess the foot and ankle and take a 3-D cast/mould of the foot and ankle if needed. This can be performed with the patient in a prone position or in a seated position. The Certified Orthotist will ensure the foot and ankle are in a corrected position and the subtalar joint will be in neutral.
Certified Orthotists can accomplish corrections to the foot with intrinsic and extrinsic modifications. Intrinsic modifications are changes made to the positive mold of the foot and ankle. Extrinsic modifications are accommodative padding added to SMO/UCBL orthosis Examples of accommodative padding:
There are a variety of SMO/UCBL designs. The Certified Orthotist will determine which design is best for treatment based on individuals’ needs and goals. Articulating SMOs will have ankle joints. All SMOs have straps to help ensure correct application of the orthosis.
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SMO & UCBL Application |
SMOs/UCBLs work best when used within a neutral shoe with an appropriate heel counter. SMOs/UCBLs can be switched between shoes. It is best to remove the insole of the shoe to allow space for the orthosis. |
Living with SMO & UCBL (follow up) |
The corrections provided by the orthosis may take some time to get used to. The SMO/UCBL should not be painful; however, it is not uncommon to feel some initial discomfort. The break-in period should not last more than two weeks. If you experience rubbing or blisters, please book an appointment with your Certified Orthotist for immediate attention. If you are experiencing pain after two weeks please book a follow up appointment with your Certified Orthotist. It is always recommended to book a follow up appointment with your Certified Orthotist if you experience any changes in condition (pain, growth). The Certified Orthotist can determine what changes need to be made or make recommendations for alternative treatment. Custom SMO/UCBL orthoses can often be modified or refurbished. The Certified Orthotist can reassess to determine the course of treatment with you. |
Funding for SMO & UCBL |
Alberta Aids to Daily Living (AADL) does provide funding for custom SMOs/UCBLs for Alberta Residents with valid Alberta Healthcare. AADL will pay 100% for the cost for Alberta Residents over the age of 65. AADL will pay 75% of the cost for Alberta Residents under the age of 65. A prescription from a physician is required. There is coverage for persons with low income.
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