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:: home : our specialty : |
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Orthotics |
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Orthotics are a relatively new innovation. Originally they were referred to as
"arch supports". Now they have a more descriptive name. It has only been 30 years or so since they came into common use. Prior to that time "orthopedic"
work on feet was primarily performed by making alterations to shoes. You used to see some really strange looking additions to shoes in an effort to get
the foot to function correctly. A Pedorthists job is to evaluate and assess the biomechanics of the foot and then create an interface between the foot and the ground, minimizing the effects of the faulty structure. Ordinarily this device simply slips inside the shoe. Aggressive orthotic therapy is much more effective and much more comfortable.
When orthotic therapy first came into common use it was appealing to many practitioners because it was deemed "easy." You didn't have to have all the
heavy and dirty equipment that had previously been used to make and to modify shoes. All one needed to do was to have your patient step into a foam box
to make an impression of the foot, fill it with plaster, heat and shape plastic over the plaster, trim and put it in the shoe -- and collect your fee.
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Unfortunately that methodology is still taught and practiced by many. This method can improve many minor problems with the feet but most bio-mechanical problems and issues call for aggressive orthotic therapy. That is where we shine! Given our training, experience and background and since all the work is performed here in our facility we can be aggressive to the limit. We thrive on fixing problems.
There are an abundance of practitioners that dispense orthotics: Podiatrists, Physical Therapists, Chiropractors, Sports trainers, Physicians and Pedorthists. With rare exception the practitioner is only dispensing the orthotic. They are not prepared or trained to complete the work of pedorthics in "the design, manufacture, modification and fit of footwear." Yet, this is an integral part of successful pedorthics.
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In nearly every case the practitioner makes an impression of the foot, then sends it to an outside lab for fabrication. The tech who makes the orthotic has never seen the foot he is fabricating the orthotic for and simply makes the devices from molds sent by the practitioner according to boxes checked on an order form. Typically an evaluation of the effectiveness of the orthotics is never performed but rather the orthotics are handed to the patient with instructions to wear them. Even if an evaluation is made seldom does the practitioner have the materials, tools or equipment to make any alterations.
I mentioned a verus deformity but there are dozens of structural situations/conditions which can cause issues with the feet; a couple are tibial varum (bowed legs), Pes cavus (high arches,) leg-length discrepancy and on an on. The feet are the foundation of the body. When the foundation of a home or building settles unevenly it can cause all kinds of problems within the building: floors creak, walls and ceilings crack, doors won't close, cabinets won't stay closed and on. When the foundation of the body is off there are also problems within the structure; ankle pain, knee pain, Ilio-tibial pain
up the outside of the thighs or in the gleut, hip pain, low back pain, sometimes even muscle imbalance in the shoulders and neck.
That does not happen here! I personally perform the initial evaluation and recommend a plan of action to my patient. I personally make the impressions
of the feet. I do the lab work and fabricate the orthotic. I dispense the orthotics, fitting them to the shoes and the feet. So, the same person who has
held the feet and examined them and heard the concerns of the patient is the same person in the lab doing the plaster molds and sculpting the orthotics.
I then work with the patient to evaluate if the devices are doing the best possible correction to care for the concerns of the feet and the body. Since I have made
the orthotics it is no big deal to make adjustments. Our mind set is one of fixing problems and achieving the maximum improvement possible. Many pedorthists
are conservative in their practices because they don't want to do follow-up and can't make alterations. We can be aggressive because we have the materials on
hand and it is a simple matter to de-tune a little.
Our roots are in footwear so we are capable of performing the "design, manufacture, modification and fit of footwear" part of the definition of a Pedorthist.
Only a tiny percentage of pedorthists in this country deal in anything more than orthotics, or off-the-shelf footwear. We shine especially well with those
patients who need a little shoe work in addition to the orthotic work. It is no big deal to add a rocker sole to improve gait or add a little height to a heel
to compensate for a leg-length discrepancy, or whatever is needed.
Often an individual with a foot problem will find themselves in the care of a professional who practices "simple" pedorthics. They dispense a pair of
orthotics that just don't do the job. The patient receives little or no benefit from the orthotic and concludes that orthotics are not a viable solution.
You can even order orthotics through the mail. There are firms that will send you a foam box that you step into capturing an imprint of your feet. You mail
the box back and they make you a pair of orthotics from that imprint. There is just one problem, it doesn't work. Stepping into the foam box usually captures
your foot making the offending bio-mechanical motion. Your foot is captured making the wrong motion-not the correct motion. They have no way to make a correct
orthotic from an incorrect form. You must manipulate the foot to capture the proper position for the mold and then fabricate the orthotic to support the foot
in that position.
Orthotic therapy is a wonderful thing. Not only is it very effective and relatively painless but it is easy to modify as the foot evolves. As the years roll
around and the body changes it is a simple matter for the orthotics to evolve as well. Surgery has its place but once it's done there is no going back. You
lose the luxury of a little more, little less, or "I wish I hadn't done that." |
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