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orthotics - attention richard c.

Posted by iris on 10/23/00 at 16:57 (031081)

ear richard,
could you please explain the difference between using the foam box vs the plaster impression procedure for producing orthotics? what would encourage a doctor to use one procedure rather than the other? thank you very much for your reply.
iris

Re: orthotics - attention richard c.

kATHY on 10/23/00 at 19:02 (031090)

The pedorthist I used casted me with the foam box, I've loved my orthotics from day one but am going back tomarrow for some slight adjustments. Richard is it possible to wear down orthotics in 3-4 weeks

Re: orthotics - Iris and Kathy

Richard C.Ped on 10/24/00 at 08:38 (031136)

Iris: Foam box -vs- casting is pretty much a preference decision. I like the foam box because you can get a great impression (IF USED CORRECTLY) and is a very 'clean' procedure. I will use other means if there is a physicial problem involved. This would include any kind of fracture or pain in the patient's foot, leg, or knee. I always ask the patient if he/she has any pain in these areas before I begin work. If so, I would use the heated wax system. If there are no problems involved, I prefer using foam. It is quick and easy (IF USED CORRECTLY). Sorry about the 'used correctly' repetition, but that is a point that I must stress. I hope that answers your question. My coffee has not kicked in yet. If you need more information, please do not hesitate to ask me. I am more than happy to help. :-)
Kathy: Yes, some inserts can actually break down within a few weeks. It all depends on the material that was used and how that material was ground or sanded. One of the most frustrating things I see here is the patient's current orthotics from another C.Ped. There are places that will, for some reason, grind way to much from the arch area. They will also grind the bottom of the inserts round or curved. What this does is greatly decrease the arch support. I grind the bottom flat, and fit the insert to the patient's shoes. The insert must be interfaced with the shoe to work properly, and no, the inserts will not fit all shoes. If you take softer materials and add too much ground away from the arch, you get an insert that will break down within a few weeks. If you have the hard plastic stuff (you guys know how I feel about that) it more than likely will not fit your foot to begin with. Breakdown can also depend on the person's weight, and foot type, high arched or flat foot.
I hope this helps.
Richard

Re: orthotics - Iris and Kathy

davidb on 10/24/00 at 09:05 (031139)

Fitting othotics into shoes has always been a problem for me. I've had the best luck with P.W. Minor, which makes extra-depth shoes designed to fit orthotics. I'm currently using a fiberglass orthotic, which my pedorthist was able to attach to the padded insert in the P.W. Minor shoes. Unfortunately, P.W. Minor shoes aren't available in your typical shoe store.

Re: orthotics - choosing shoes

Richard C.Ped on 10/24/00 at 10:05 (031141)

PW makes great shoes. When trying on shoes in a store, I will remove the current insole (if possible) and put my custom insert in the shoe to see if there is enough room for my toes. I can usually look at the toe box and tell if there will be enough room or not, but some shoes can be tricky. I love New Balance shoes. I wear them to cut grass as well as playing volleyball. I know that my full length insert will fit those. My Rockport dress shoes do not have enough room for the full length, so I have to wear a 3/4. You can check with your insurance company to see if they cover shoes for your diagnosis. If so, ask your physician if he/she can write an RX for the shoes. Again, PW makes great shoes, but they are expensive.
Richard

Re: Re:finding pw minor shoes

iris on 10/29/00 at 17:35 (031588)

i am not aware of where to find pw minor shoes. cost has not stopped me from purchasing mephisto, haflingers, dansko etc. is there a website where locations are listed?
thank you for your help.

Re: orthotics - attention richard c.

kATHY on 10/23/00 at 19:02 (031090)

The pedorthist I used casted me with the foam box, I've loved my orthotics from day one but am going back tomarrow for some slight adjustments. Richard is it possible to wear down orthotics in 3-4 weeks

Re: orthotics - Iris and Kathy

Richard C.Ped on 10/24/00 at 08:38 (031136)

Iris: Foam box -vs- casting is pretty much a preference decision. I like the foam box because you can get a great impression (IF USED CORRECTLY) and is a very 'clean' procedure. I will use other means if there is a physicial problem involved. This would include any kind of fracture or pain in the patient's foot, leg, or knee. I always ask the patient if he/she has any pain in these areas before I begin work. If so, I would use the heated wax system. If there are no problems involved, I prefer using foam. It is quick and easy (IF USED CORRECTLY). Sorry about the 'used correctly' repetition, but that is a point that I must stress. I hope that answers your question. My coffee has not kicked in yet. If you need more information, please do not hesitate to ask me. I am more than happy to help. :-)
Kathy: Yes, some inserts can actually break down within a few weeks. It all depends on the material that was used and how that material was ground or sanded. One of the most frustrating things I see here is the patient's current orthotics from another C.Ped. There are places that will, for some reason, grind way to much from the arch area. They will also grind the bottom of the inserts round or curved. What this does is greatly decrease the arch support. I grind the bottom flat, and fit the insert to the patient's shoes. The insert must be interfaced with the shoe to work properly, and no, the inserts will not fit all shoes. If you take softer materials and add too much ground away from the arch, you get an insert that will break down within a few weeks. If you have the hard plastic stuff (you guys know how I feel about that) it more than likely will not fit your foot to begin with. Breakdown can also depend on the person's weight, and foot type, high arched or flat foot.
I hope this helps.
Richard

Re: orthotics - Iris and Kathy

davidb on 10/24/00 at 09:05 (031139)

Fitting othotics into shoes has always been a problem for me. I've had the best luck with P.W. Minor, which makes extra-depth shoes designed to fit orthotics. I'm currently using a fiberglass orthotic, which my pedorthist was able to attach to the padded insert in the P.W. Minor shoes. Unfortunately, P.W. Minor shoes aren't available in your typical shoe store.

Re: orthotics - choosing shoes

Richard C.Ped on 10/24/00 at 10:05 (031141)

PW makes great shoes. When trying on shoes in a store, I will remove the current insole (if possible) and put my custom insert in the shoe to see if there is enough room for my toes. I can usually look at the toe box and tell if there will be enough room or not, but some shoes can be tricky. I love New Balance shoes. I wear them to cut grass as well as playing volleyball. I know that my full length insert will fit those. My Rockport dress shoes do not have enough room for the full length, so I have to wear a 3/4. You can check with your insurance company to see if they cover shoes for your diagnosis. If so, ask your physician if he/she can write an RX for the shoes. Again, PW makes great shoes, but they are expensive.
Richard

Re: Re:finding pw minor shoes

iris on 10/29/00 at 17:35 (031588)

i am not aware of where to find pw minor shoes. cost has not stopped me from purchasing mephisto, haflingers, dansko etc. is there a website where locations are listed?
thank you for your help.