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Why, why, why???

Posted by David J. on 10/04/00 at 14:23 (029775)

Can someone please tell me why Pods continue to use the hard fiberglass etc, orthodics? I was told that I would get used to them after a few weeks. Guess what, it has been two months. A friend of mine had a pair made recently which are pretty firm, but are not made out of the fiberglass. I'm thinking about contacting the guy that made his to find out what the material is. Does anyone have a clue who would know before I ask him?

Re: Why, why, why???

Nancy N on 10/04/00 at 14:42 (029776)

This is an excellent question--my first orthotics were 'built' on pre-molds, and my pod attached padding in the right places until we got the fit right (my insurance would not pay for the custom orthotics, so we tried this chewing-gum-and-duct- tape method). They were wonderful, and then the problem came back. My PT suggested that maybe the orthotics were aggravating the problem, so I stopped wearing them for a while. Eventually that didn't seem to help, either, so I finally gave in (new insurance company) and got the 'real' ones. But they are hard as rocks and I still think they do more harm than good. The arches also feel very high and I can't imagine standing on them for any length of time, even if my PF was gone. I was told they would be 'semi-flexible' but it doesn't look that way. I do a lot of acting and used to do choral singing, which really requires the standing time, and I don't see any way to wear these things for a concert. I haven't worn them since about the beginning of August, and it will take a seriously persuasive doctor to get me back into them. The soft $10 ArchMates I've seen in catalogs look a lot more foot-friendly than my $300 orthotics.

Re: Why, why, why???

Dr. Biehler on 10/04/00 at 18:05 (029789)

Orthotics have been made out of all kinds of materials over the years. Hammered out metal ones made by hand used to be a favorite. The rohador ( a plastic) were great but polluted the area where they were made. The polyurathane have now taken over this role. They are great when control is needed to change the biomechanics and are easy for the labs to make. I think my favorites are made out of leather. They take several days to make and the labs don't like to spend the time. They can be combined with rubber butter which is a combination of rubber and cork. These are very confortable and can be easily ground down and adjusted to the individuale foot for comfort. Dr. B.

Re: Why, why, why???

wendyn on 10/04/00 at 19:50 (029796)

I think one of the reasons they keep using them is because they don't realize how many people have trouble with them. They assume that if they give someone orthotics and that person goes away, then that person is happy. Often that person goes away, gets fed up with the orthotics and then throws them in the garbage.

Re: Why, why, why???

Denise E on 10/05/00 at 06:17 (029820)

David, I just got my orthotics last week on Sept. 27. They felt wonderful the first day and I am already wearing them all day. They take a lot of pressure off my heal. They were custom made by my POD who took casts of my feet.

The brand is called Langer. When I picked them up I asked my POD whether they were rigid. He told me they were semi-rigid (maybe that is why they are comfortable). He also said if I were heavier (I'm under 100 lbs), he would have ordered me rigid because if I had addtional weight it would wear down a semi-rigid pair too soon.

I'm beginning to think after reading all the postings that maybe PODs ought to start everyone on semi-rigid orthotics regardless of weight so that they would be easier to get accustomed to. Even if this measns that in some cases they might have to be replaced sooner in someone who is much heavier.

Even though my orthotics are semi-rigid, they still feel pretty firm, so I can imagine how hard the rigid orthotics must feel.

If you want the phone number and address of the Langer Biomechanics Group, let me know.

Re: Why, why, why???

Richard C.Ped on 10/05/00 at 08:13 (029822)

Hi David,
To make a great pair of orthosis, I use a type of rubber called EVA. I have found that this material works best for me and the patients I see. I have spoken with many DPMs as well as the major orthopaedic clinic here and let them see the difference between the EVA and many other materials. They like the EVA. I can get a better, more intamate fit, that will not break down easily, but will provide comfort as well. I will, in severe cases, start someone out with a softer orthosis, until they become comfortable wearing it. To avoid a second charge (most insurance companies will only pay for one pair per year, if at all), I will grind the posting (the firm part) from the bottom, reshape the shell using the casts I made, then add a more firm EVA posting to the orthosis. I charge a small fee for the materials and labor, but as I said, it keeps the patient from having to pay for another pair. Look up the Board For Certification in Pedorthics web page to find a Pedorthist, or C.Ped, in your area, and ask him or her about different materials that can be used.
Richard

Re: Why, why, why???

john a on 10/05/00 at 10:43 (029838)

You mentioned 'rubber butter', a cork/rubber combination. Can that be bought somewhere? I am interested in trying to mold my own arch support. I'm even considering getting one of those 'super ball construction kits', thinking that this hard rubber stuff might be good for making an arch. Also considered silicone caulk. And Bob Ray mentioned 'liquid polyurethane'. Where do you get that? Ideally, I would like a heat-softened rubber putty-like compound that can be repeatedly softened and molded to suit. Does that exist?

Re: Why, why, why???

Dr. Zuckerman on 10/05/00 at 19:45 (029893)

Now you know the Why. The answer is going to see experts like Richard C. Ped . I still don't understand the why with hard plastic except in children with excessive pronation and ligaments that are really loose. They never taught me in foot school to use the hard plastic.

Re: Dr. Z...You are to kind! eom

Richard C.Ped on 10/06/00 at 08:14 (029924)

eom

Re: Dr. Z...You are to kind! eom

Pauline on 10/06/00 at 13:03 (029937)

David,
Maybe your really one of us, you know the ones who cannot wear orthotics. I personally don't think they are the answer to everyones PF problems. If they hurt take them out---what are you gaining from your pain???. I often wonder if you depend on orthotics for support
how do you ever tell your arch it's time to support itself. When you have back pain they don't sell you a back brace for you to wear for the rest of your life. They try to strengthen the abdominal area and the muscles around your back to help provide support. Like peanuts being the universal food for zoo animals, I think orthotics have become the universal foot treatment. Neither being correct.

Re: Above posting should be Re: Why, Why, Why

Pauline on 10/06/00 at 13:05 (029938)

Sorry I made another mistake in posting. Just human that way.

Re: Pauline, you make a good point and I agree

Kim B. on 10/07/00 at 12:04 (030000)

I can not, will not, wear painful orthotics, inserts or anything of that kind. I've tried them, I do not like them, and cannot benefit from something that causes me more pain. I continue to beleive that you can get proper arch support from something less rigid than plastic and fiberglass. Why wear down the natural padding in the heel? Elderly people suffer from padding that has worn down over the years, why rush to get less of somthing that can't be replaced? I vote for firm, soft support. Rigid does not work for everyone and not for me.

Kim B.

P.S. Yes, Dr. Z is a kind man, we are lucky to have him around. And, Mrs. Z is kind to share him with us. I hope he lets her shop a lot!

Re: Why, why, why???

Nancy N on 10/04/00 at 14:42 (029776)

This is an excellent question--my first orthotics were 'built' on pre-molds, and my pod attached padding in the right places until we got the fit right (my insurance would not pay for the custom orthotics, so we tried this chewing-gum-and-duct- tape method). They were wonderful, and then the problem came back. My PT suggested that maybe the orthotics were aggravating the problem, so I stopped wearing them for a while. Eventually that didn't seem to help, either, so I finally gave in (new insurance company) and got the 'real' ones. But they are hard as rocks and I still think they do more harm than good. The arches also feel very high and I can't imagine standing on them for any length of time, even if my PF was gone. I was told they would be 'semi-flexible' but it doesn't look that way. I do a lot of acting and used to do choral singing, which really requires the standing time, and I don't see any way to wear these things for a concert. I haven't worn them since about the beginning of August, and it will take a seriously persuasive doctor to get me back into them. The soft $10 ArchMates I've seen in catalogs look a lot more foot-friendly than my $300 orthotics.

Re: Why, why, why???

Dr. Biehler on 10/04/00 at 18:05 (029789)

Orthotics have been made out of all kinds of materials over the years. Hammered out metal ones made by hand used to be a favorite. The rohador ( a plastic) were great but polluted the area where they were made. The polyurathane have now taken over this role. They are great when control is needed to change the biomechanics and are easy for the labs to make. I think my favorites are made out of leather. They take several days to make and the labs don't like to spend the time. They can be combined with rubber butter which is a combination of rubber and cork. These are very confortable and can be easily ground down and adjusted to the individuale foot for comfort. Dr. B.

Re: Why, why, why???

wendyn on 10/04/00 at 19:50 (029796)

I think one of the reasons they keep using them is because they don't realize how many people have trouble with them. They assume that if they give someone orthotics and that person goes away, then that person is happy. Often that person goes away, gets fed up with the orthotics and then throws them in the garbage.

Re: Why, why, why???

Denise E on 10/05/00 at 06:17 (029820)

David, I just got my orthotics last week on Sept. 27. They felt wonderful the first day and I am already wearing them all day. They take a lot of pressure off my heal. They were custom made by my POD who took casts of my feet.

The brand is called Langer. When I picked them up I asked my POD whether they were rigid. He told me they were semi-rigid (maybe that is why they are comfortable). He also said if I were heavier (I'm under 100 lbs), he would have ordered me rigid because if I had addtional weight it would wear down a semi-rigid pair too soon.

I'm beginning to think after reading all the postings that maybe PODs ought to start everyone on semi-rigid orthotics regardless of weight so that they would be easier to get accustomed to. Even if this measns that in some cases they might have to be replaced sooner in someone who is much heavier.

Even though my orthotics are semi-rigid, they still feel pretty firm, so I can imagine how hard the rigid orthotics must feel.

If you want the phone number and address of the Langer Biomechanics Group, let me know.

Re: Why, why, why???

Richard C.Ped on 10/05/00 at 08:13 (029822)

Hi David,
To make a great pair of orthosis, I use a type of rubber called EVA. I have found that this material works best for me and the patients I see. I have spoken with many DPMs as well as the major orthopaedic clinic here and let them see the difference between the EVA and many other materials. They like the EVA. I can get a better, more intamate fit, that will not break down easily, but will provide comfort as well. I will, in severe cases, start someone out with a softer orthosis, until they become comfortable wearing it. To avoid a second charge (most insurance companies will only pay for one pair per year, if at all), I will grind the posting (the firm part) from the bottom, reshape the shell using the casts I made, then add a more firm EVA posting to the orthosis. I charge a small fee for the materials and labor, but as I said, it keeps the patient from having to pay for another pair. Look up the Board For Certification in Pedorthics web page to find a Pedorthist, or C.Ped, in your area, and ask him or her about different materials that can be used.
Richard

Re: Why, why, why???

john a on 10/05/00 at 10:43 (029838)

You mentioned 'rubber butter', a cork/rubber combination. Can that be bought somewhere? I am interested in trying to mold my own arch support. I'm even considering getting one of those 'super ball construction kits', thinking that this hard rubber stuff might be good for making an arch. Also considered silicone caulk. And Bob Ray mentioned 'liquid polyurethane'. Where do you get that? Ideally, I would like a heat-softened rubber putty-like compound that can be repeatedly softened and molded to suit. Does that exist?

Re: Why, why, why???

Dr. Zuckerman on 10/05/00 at 19:45 (029893)

Now you know the Why. The answer is going to see experts like Richard C. Ped . I still don't understand the why with hard plastic except in children with excessive pronation and ligaments that are really loose. They never taught me in foot school to use the hard plastic.

Re: Dr. Z...You are to kind! eom

Richard C.Ped on 10/06/00 at 08:14 (029924)

eom

Re: Dr. Z...You are to kind! eom

Pauline on 10/06/00 at 13:03 (029937)

David,
Maybe your really one of us, you know the ones who cannot wear orthotics. I personally don't think they are the answer to everyones PF problems. If they hurt take them out---what are you gaining from your pain???. I often wonder if you depend on orthotics for support
how do you ever tell your arch it's time to support itself. When you have back pain they don't sell you a back brace for you to wear for the rest of your life. They try to strengthen the abdominal area and the muscles around your back to help provide support. Like peanuts being the universal food for zoo animals, I think orthotics have become the universal foot treatment. Neither being correct.

Re: Above posting should be Re: Why, Why, Why

Pauline on 10/06/00 at 13:05 (029938)

Sorry I made another mistake in posting. Just human that way.

Re: Pauline, you make a good point and I agree

Kim B. on 10/07/00 at 12:04 (030000)

I can not, will not, wear painful orthotics, inserts or anything of that kind. I've tried them, I do not like them, and cannot benefit from something that causes me more pain. I continue to beleive that you can get proper arch support from something less rigid than plastic and fiberglass. Why wear down the natural padding in the heel? Elderly people suffer from padding that has worn down over the years, why rush to get less of somthing that can't be replaced? I vote for firm, soft support. Rigid does not work for everyone and not for me.

Kim B.

P.S. Yes, Dr. Z is a kind man, we are lucky to have him around. And, Mrs. Z is kind to share him with us. I hope he lets her shop a lot!