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Mixed Bag: orthotics evaluation, PT, etc.

Posted by Nancy S. on 10/26/00 at 15:51 (031370)

Hi, today was quite a foot day.
Had PT -- I like my new therapist -- but she is concerned that since I'm taking a trip starting mid next week, I'll miss two PT appts., and my orthotics won't be ready for two weeks. She wanted me to use crutches from now until I get the orthotics, esp. since I might walk more while away. She showed me how to use them -- I still walk, weight-bearing, but use the crutches to keep some of the weight off my tendons. She also showed me exactly what height to get (so that you can still fit 2 or 3 fingers between the top of the crutch and the armpit, and are using your arm muscles more and not doing anything to screw up the shoulders etc.). I've never had any upper-body problems and felt comfortable when I tried it, so I'll be using them for two weeks. I had to rent some, for $15; didn't want to buy when this is so temporary.
Then I went for my orthotics evaluation and casting by a board-certified orthotist. WHAT a difference between this experience and getting them from my ex-pod! I must thank Richard -- thank you, Richard! -- because I had your post with me, studied it before I went in, and showed parts of it to him when I had a question or whatever. And I asked LOTS of questions. (Boy do I see what a dolt I was when I first got PF and went to the pod and didn't ask enough questions and was too quiet when he didn't answer what questions I did have.) This guy answered everything, in great detail.
He used the foam box mould method, saying he does plaster only for very specific reasons (such as a foot fracture, when no pressure should be applied), and he did it exactly as Richard described to me. When I asked about the different materials used for the orthotics themselves, he hauled them all out and explained each kind to me and what conditions he uses them for. He also told me why he's using what for mine.
Mine will be full-length (unless I decide later I want him to make them shorter, which I don't think I will), sturdy foam material, with semi-rigid posting. After examining my feet, he said that I over-pronate (which I never knew -- no one else ever checked), and that my arches with no weight on them are fairly normal but when I stand up they collapse! This means that the orthotics may need several adjustments -- he wants to start with the full arch support my feet call for when semi-weight-bearing, and then grind down from there if the arch feels like too much when I'm on my feet. (Adjustments are no charge for 60 days.) He was very helpful about what kinds of shoes/boots to wear them in -- even how to lace up for the best support.
He gave me so much info. that I can't post it all. I'll just say that he answered every question I asked way beyond the call of duty and was totally respectful and happy to educate a curious patient. As I left, the lab door was open and there he was, working away.
Oh, two other tidbits: (1) I showed him my old hard orthotics from the ex-pod and he said he's still waiting to hear a reason or excuse for someone to make those things for someone like me. (He makes them on extremely rare occasions, such as for a 425-pound guy who wouldn't be helped by any other kind.) (2) He said you don't necessarily have to pass up the $90 boots or shoes for the $190 ones -- many good ones are made that don't carry a fancy label. 'You know where the extra $100 goes for the fancy label?' he said. 'In the pocket of Michael Jordan or Tiger Woods. You are paying for their advertising.' He gave me preprinted sheets on what to look for in shoes/boots -- how to analyze a pair according to my problems.
Ok, I think that's it. Hope this is helpful to someone. I'm going to go sit in the backyard for a while -- it's 70 degrees, fading but still beautiful colors out there. Think I'll drink it in before the sun goes down.
Good day, all --
Nancy

Re: Mixed Bag: orthotics evaluation, PT, etc.

Barbara TX on 10/26/00 at 16:59 (031385)

You have a wonderful evening Nancy... the fall colors out east were a sight to behold when I took my cruise through Amish country. By the way, I am thinking about having some Amish craftsman whittle me a pair of orthotics. It seems simpler than all this foot madness. I wonder, to the Dutch have less pf because of their wooden clogs? B.

Re: Mixed Bag: orthotics evaluation, PT, etc.

Beverly on 10/26/00 at 22:15 (031416)

Nancy,

Glad you had a good experience getting fitted for orthodics. I hope they work for you. Do you know the difference between rigid and semi-rigid? My last set, the temp's, were going to be rigid. But as you know, they didn't agree with me in the temporary form so I didn't get them.

Good Luck,
Beverly

Re: Mixed Bag: orthotics evaluation, PT, etc.

Julie F on 10/27/00 at 06:22 (031428)

Nancy, it sounds as though you're glad you're giving orthotics another go! What a good experience you had: the orthotist sounds excellent. I can't believe you won't have better luck this time - just keep getting adjustments made if you need to. Even if they are all right, and are going to be comfortable in the end, they will probably take some getting used to at first.

One thing that struck me from your post is the enormous value of being well informed. You know so much more now than when you went to your first pod, so you can get much more out of a meeting with anyone you consult. You weren't a dolt the first time, it was just early days and you didn't have the knowledge. I noticed the same thing the other day when I saw Ron. The first time I saw him six weeks ago I couldn't really take in all he told me (he talks fast, which doesn't help). On Wednesday we had a 'discussion between equals' (well, more or less): I had lots of questions, and understood pretty well everything he said in answer to them. Knowledge really is power. Hurray for Richard orthoses-wise - and everyone on this board.

I'm astonished your first guy never checked you for over-pronation. It should have shown up in a gait analysis - did he do onw?. No wonder you went off him, and good that you did!

The crutches sound a good idea for now. I hope you enjoyed the sunset!

All the best, Julie

Re: Mixed Bag: orthotics evaluation, PT, etc.

Richard, C.Ped on 10/27/00 at 08:27 (031438)

That is wonderful!!! It sounds like you found someone who really cares about his patients and the quality of his work. Yea!! Let me know if you have any other questions. I will be glad to give you plenty of ammunition to use. Thanx for the kind words. It has made my day, and it is only 9:15 am. I do not know where you live, but I went camping last week at the base of Mount Mitchell in North Carolina. Man oh man the colors!! WOW!
Richard, C.Ped

Re: Mixed Bag: orthotics evaluation, PT, etc.

Richard, C.Ped on 10/27/00 at 08:33 (031440)

Barbara TX: It is funny you should mention the Amish. When I first started classes for Pedorthics at Ball State, we actually had an Amish fellow in our class. I don't know if he went on to become a C.Ped, but it was pretty cool talking with him. He lives somewhere in Ohio. He had the hat, blue shirt,dark blue pants and the beard without the mustache.
Richard

Re: Mixed Bag: and "The Point of Belief"

Nancy S. on 10/27/00 at 10:52 (031449)

It's so true that being well informed when you go in makes all the difference. You know what your questions are, and the person takes you seriously. I'll never again be a dolt in this kind of situation (unwittingly, that is -- haha). My hopes are high for the new orthotics, I have to admit it -- I tried to keep them down, but they won't stay there!
Richard, you ARE the reason I was well enough informed!
I don't think I know enough to answer Beverly's above question very well, though: Can you explain the difference between a rigid and semi-rigid orthotic? I didn't pay much attention to the orthotist's rigid explanation, because I knew I wasn't getting them and was so relieved that I wasn't getting them and my head was swimming!
By the way, I'm in Maine, Richard. The colors in North Carolina are probably better now than they are here. But I still love them, even muted. My friends think I'm nuts because I keep flowers around for weeks after they're dead.
Last night I kind of fell into a dreamlike state out in the backyard; it was almost dark and I was sleepy, and the phrase 'The Point of Belief' popped into my mind, and then I half dreamed/daydreamed that I was writing a book with that title. I can't stop thinking about it.
Julie, to answer your question from another thread, I have kept journals most of my life. I had so many that my brother titled them 'I Remember Everything.' About 15 years ago, I began to feel I was writing in my journal so much that I was forgetting to live! So now I do it only in phases -- and I think this should be one of them. Thanks for the reminder, I salute you.
Nancy

Re: Mixed Bag: and "The Point of Belief"

Richard, C.Ped on 10/27/00 at 11:40 (031456)

Orthotic material....let's see....first you have soft or flexible. These are used basicaly as accommodative orthotics. You are not trying to use the insert as any means of correction, but just comfort. This material will 'bottom out' quickly. Next, there is semi-rigid or semi-flexible. These are use to make a somewhat accommodative orthosis, but will also provide more functional support. They do not bottom out as quickly. Lastly, you have the rigid. This material is used primarily to make functional orthotics. Mostly made out of the plastic stuff. You can also measure material by durometers. The lower the number, the softer the material. I use a 40 durometer EVA as a semi-flexible posting for my diabetic patients, along with a tri-lam shell for extra protection. Quick orthosis anatomy: the shell is what you stand on, and the posting is what gives the orthtic the control. I use a 55-65 durometer posting for my athletic type patients. Hope this helps. Enjoy the colors!
Richard

Re: Mixed Bag: orthotics evaluation, PT, etc.

Barbara TX on 10/26/00 at 16:59 (031385)

You have a wonderful evening Nancy... the fall colors out east were a sight to behold when I took my cruise through Amish country. By the way, I am thinking about having some Amish craftsman whittle me a pair of orthotics. It seems simpler than all this foot madness. I wonder, to the Dutch have less pf because of their wooden clogs? B.

Re: Mixed Bag: orthotics evaluation, PT, etc.

Beverly on 10/26/00 at 22:15 (031416)

Nancy,

Glad you had a good experience getting fitted for orthodics. I hope they work for you. Do you know the difference between rigid and semi-rigid? My last set, the temp's, were going to be rigid. But as you know, they didn't agree with me in the temporary form so I didn't get them.

Good Luck,
Beverly

Re: Mixed Bag: orthotics evaluation, PT, etc.

Julie F on 10/27/00 at 06:22 (031428)

Nancy, it sounds as though you're glad you're giving orthotics another go! What a good experience you had: the orthotist sounds excellent. I can't believe you won't have better luck this time - just keep getting adjustments made if you need to. Even if they are all right, and are going to be comfortable in the end, they will probably take some getting used to at first.

One thing that struck me from your post is the enormous value of being well informed. You know so much more now than when you went to your first pod, so you can get much more out of a meeting with anyone you consult. You weren't a dolt the first time, it was just early days and you didn't have the knowledge. I noticed the same thing the other day when I saw Ron. The first time I saw him six weeks ago I couldn't really take in all he told me (he talks fast, which doesn't help). On Wednesday we had a 'discussion between equals' (well, more or less): I had lots of questions, and understood pretty well everything he said in answer to them. Knowledge really is power. Hurray for Richard orthoses-wise - and everyone on this board.

I'm astonished your first guy never checked you for over-pronation. It should have shown up in a gait analysis - did he do onw?. No wonder you went off him, and good that you did!

The crutches sound a good idea for now. I hope you enjoyed the sunset!

All the best, Julie

Re: Mixed Bag: orthotics evaluation, PT, etc.

Richard, C.Ped on 10/27/00 at 08:27 (031438)

That is wonderful!!! It sounds like you found someone who really cares about his patients and the quality of his work. Yea!! Let me know if you have any other questions. I will be glad to give you plenty of ammunition to use. Thanx for the kind words. It has made my day, and it is only 9:15 am. I do not know where you live, but I went camping last week at the base of Mount Mitchell in North Carolina. Man oh man the colors!! WOW!
Richard, C.Ped

Re: Mixed Bag: orthotics evaluation, PT, etc.

Richard, C.Ped on 10/27/00 at 08:33 (031440)

Barbara TX: It is funny you should mention the Amish. When I first started classes for Pedorthics at Ball State, we actually had an Amish fellow in our class. I don't know if he went on to become a C.Ped, but it was pretty cool talking with him. He lives somewhere in Ohio. He had the hat, blue shirt,dark blue pants and the beard without the mustache.
Richard

Re: Mixed Bag: and "The Point of Belief"

Nancy S. on 10/27/00 at 10:52 (031449)

It's so true that being well informed when you go in makes all the difference. You know what your questions are, and the person takes you seriously. I'll never again be a dolt in this kind of situation (unwittingly, that is -- haha). My hopes are high for the new orthotics, I have to admit it -- I tried to keep them down, but they won't stay there!
Richard, you ARE the reason I was well enough informed!
I don't think I know enough to answer Beverly's above question very well, though: Can you explain the difference between a rigid and semi-rigid orthotic? I didn't pay much attention to the orthotist's rigid explanation, because I knew I wasn't getting them and was so relieved that I wasn't getting them and my head was swimming!
By the way, I'm in Maine, Richard. The colors in North Carolina are probably better now than they are here. But I still love them, even muted. My friends think I'm nuts because I keep flowers around for weeks after they're dead.
Last night I kind of fell into a dreamlike state out in the backyard; it was almost dark and I was sleepy, and the phrase 'The Point of Belief' popped into my mind, and then I half dreamed/daydreamed that I was writing a book with that title. I can't stop thinking about it.
Julie, to answer your question from another thread, I have kept journals most of my life. I had so many that my brother titled them 'I Remember Everything.' About 15 years ago, I began to feel I was writing in my journal so much that I was forgetting to live! So now I do it only in phases -- and I think this should be one of them. Thanks for the reminder, I salute you.
Nancy

Re: Mixed Bag: and "The Point of Belief"

Richard, C.Ped on 10/27/00 at 11:40 (031456)

Orthotic material....let's see....first you have soft or flexible. These are used basicaly as accommodative orthotics. You are not trying to use the insert as any means of correction, but just comfort. This material will 'bottom out' quickly. Next, there is semi-rigid or semi-flexible. These are use to make a somewhat accommodative orthosis, but will also provide more functional support. They do not bottom out as quickly. Lastly, you have the rigid. This material is used primarily to make functional orthotics. Mostly made out of the plastic stuff. You can also measure material by durometers. The lower the number, the softer the material. I use a 40 durometer EVA as a semi-flexible posting for my diabetic patients, along with a tri-lam shell for extra protection. Quick orthosis anatomy: the shell is what you stand on, and the posting is what gives the orthtic the control. I use a 55-65 durometer posting for my athletic type patients. Hope this helps. Enjoy the colors!
Richard