Which wedge is indicated for cases of extreme pronation?

The indication for using a medial wedge in cases of extreme pronation is based on the biomechanical principles of foot alignment and weight distribution. Pronation refers to the inward roll of the foot during normal motion, which can lead to various foot-related issues if it becomes excessive (extreme pronation).

A medial wedge, when placed under the foot, serves to correct this pronation by shifting weight laterally, thereby encouraging a more neutral or stable alignment of the foot and ankle. It effectively counters the over-pronation by helping to realign the subtalar joint and the structures of the foot. This correction is crucial because excessive pronation can lead to problems not just in the foot, but also in the knees and hips due to altered biomechanics during gait.

In the context of the other options: a lateral wedge would typically be used for supination or to provide additional support on the outside of the foot; a rigid wedge may not provide the necessary dynamic support needed for a condition characterized by excessive motion like pronation; and a SACH (Solid Ankle Cushioned Heel) foot is primarily used in prosthetic applications to provide shock absorption, but does not directly address the problem of excessive pronation.

Thus, the medial wedge is specifically designed to