A while back I blogged about 5 rants regarding custom-made foot orthotics. Now another rant that comes to mind is can anyone prescribe them? In the interest of this blog we are only going to look at custom-made foot orthoses either from a cast or electronic scan.
Podiatrists, orthotists, prothetists, physiotherapists, chiropractors, osteopaths, sports trainers, medical doctors, and orthopaedic surgeons are prescribing custom built orthotic devices. Some with the appropriate training and necessary clinical reasoning skills to do so, and some without.
So what is an orthotic?
“Orthotics (Greek: Ορθός, ortho, “to straighten” or “align”) is a specialty within the medical field concerned with the design, manufacture and application of orthoses. An orthosis (plural: orthoses) is “an externally applied device used to modify the structural and functional characteristics of the neuromuscular and skeletal system”
An orthotic may be used to:
- Control, guide, limit and/or immobilize an extremity, joint or body segment for a particular reason
- To restrict movement in a given direction
- To assist movement generally
- To reduce weight bearing forces for a particular purpose
- To aid rehabilitation from fractures after the removal of a cast
- To otherwise correct the shape and/or function of the body, to provide easier movement capability or reduce pain
The prescription of orthotics combines the knowledge of anatomy and physiology, pathophysiology, and biomechanics. Orthotics can cause damage if used incorrectly. This is where we excel at Border Podiatry Centre.
“All podiatrists come out of Podiatry school convinced it is their God given right to prescribe orthoses. But the reality is very few are properly equipped to do so. Historically I have been absolutely shocked at how few people can even take an accurate negative cast. And that, is why we now have 3D scanners. Taking casts is difficult. It requires thought and skill and technique. Taking a scan is much easier, and it is available to anyone, anywhere. But, it still requires great skill and technique, and it MUST have the backing of a full biomechanical evaluation and gait study. The scan is just an electronic version of a cast. On its own, it is of little or no relevance”. – Simon Bartold
At Border Podiatry Centre, we are 110% committed to have a detailed understanding of the anatomy and physiology, pathophysiology, and biomechanics; how to assess the feet and body to prescribe orthotics; know how the body might react to the orthotics we prescribe and are prepared to put the time, effort and thought into following it up. We have trouble shooting strategies as to what to do if things go wrong.
Please, please, please ensure your clinician knows what they are doing and why when assessing and prescribing for orthotics. Ask questions. Ask heaps of questions. I can assure you the Podiatrists at Border Podiatry Centre know exactly what to do and why they do it and can answer any questions you may have.
Thanks and praise must go to Simon Bartold for some inspiration and his amazing up to date research also.