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othotic

Posted by paula on 2/01/02 at 09:14 (072174)

docs or anyone , is there a very well respected college for othotists? now that another 1500 dollars have been throw away on the latest ice scraper and adjusting it is just so very much discouraged at this point i would like to call them and maybe a professor there would know the best of the best orthotists.

Re: othotic

Ed Davis, DPM on 2/01/02 at 18:47 (072245)

$1500????? What type of orthotic did you get for that price? It would need to be diamond studded or have a 18k gold inlay for that price.
Ed

Re: othotic

paula on 2/01/02 at 19:26 (072253)

it's a plastic afo with a hinge and it goes up my calf. and it's got velcro that is falling off after one month and it feels like a torture device, but dr ed, 1500 dollars is nothing, i've denuded a large part of my retirement, everything i've worked for and i'm 55. i have a closet full of orthotic devices, and the foot and ankle surgeons and pods and therapists of atlanta are all partying in the tropics on my dollar i suppose. the plastic thing was for post tib. dysfuncion. not one of my device makers knew what a post or wedge was, let alone anything else that is supposed to go in an orthotic device. i'm so beyond depressed there aren't words for it. do you know a good orthotic college or two? i think i'll call and see if the instructors there know anyone here. i really have no idea what my next move should be .

Re: othotic

Ed Davis, DPM on 2/02/02 at 16:55 (072309)

I am not really familiar with the programs at schools for orthotists and prosthetists. I still cannot imagine what you recieved for $1500.

I cannot put a guarantee on a device which I dispense but I will everything possible to make sure that it works--repairing, modifying and remolding it till it does. One remedy for depression is to take action. I would demand that they make good on the device or at least provide a partial refund if they cannot.

If PTTD is present, is it on both feet? Have any of the doctors stated if it is stage 2 or 3?

I realize that I am far away but a plane ticket to Seattle is far less expensive than what you have paid. I would be happy to examine you, let you know what device I would recommend (provided that there is a device that would work--there usually is), then proceed to fabricate or have the device fabricated for you. You would pay me ONLY if the device is successful. (I would not make such an offer if I was not fairly confident about being successful). I may ask you to change shoegear to a stable running shoe such as the New Balance 1121 in order to enhance the action of the orthotic, would give you the names of local shoe dealers or pedorthists which you would need to obtain on your own. Occasionally we may want to combine some shoe modifications, performed by the pedorthist with the orthotic. I would also ask that you bring as many of the prior devices along as possible (two reasons--to see why they did not work and to see if they are modifiable).
Regards,
Ed

Re: othotic

BG CPed on 2/02/02 at 18:20 (072331)

That is a great offer Dr Ed. I also have a feeling you may fix her. It irks me to no end to hear this same story 2 times a week. The program at Northwestern Chicago may be a source, they have what I feel is the best program for Orthotists and Pedorthists. I am not sure if Mrs. Cotterman is still there, she may be able to get you some names. They are located in the Med School downtown not at the Evanston campus. I would think that they have some links on a website. Dr Ed offer sounds like a plan

Re: othotic Then I must have really been robbed

Donna SL on 2/02/02 at 19:28 (072336)

If you think $1500.00 is a lot, between the last two pods I saw they charged close to $11,000 for several pairs of failed orthotics, and adjustments, and got paid for most of it from my insurance company. I'm also responsible for 20% in copays. They don't contain any diamonds, or gold in them either.

Donna

Re: othotic

paula on 2/02/02 at 20:55 (072352)

dr ed i have seriously considered consulting with you for a while now. pttd is in both feet. terrible in one, worse in the other. i am the person who lost all her muscles in a muscle wasting syndrome, which has been corrected. , what i'm left with is severe pttd and a rehabilitation that can't get started till i get support for the post tib. i bought a therapy pool and need a plastic orthotic for now, to start walking with water up to my shoulders, since i have to start bearing weight slow. as i understand it, you, as a podiatrist, would be making an orthotic that is not plastic. so i reckon i must wait till i'm walking on land before i come to you. as i understand it i need an orthotist, with plastic things and heat guns? for now so i can get a plastic orthotic for the pool. the stage of pttd i'm in is anyone's guess. more than one doc said it's impossible to tell cause i can't stand up for the many toe test and the raise on toe test. time is wasting and my muscles will die of disuse and i need a plastic orthotic that works. this is beyond tragic.

Re: p.s.

paula on 2/02/02 at 21:08 (072356)

dr ed, i know you would be the best. the folks who live in your area are lucky. r ped thank you for the name of that school . i will call them monday. it will be refreshing to find an orthotist who has ever heard of a post or wedge. let alone anyghting more complex.donna, your experience sounds all too familiar. i have been throwing money at clowns for a year and a half. it would have been less time consuming, easier and cheaper to enroll in orthotic school myself and then take a piece of plastic and bite it into the correct orthotic.

Re: Paula

elliott on 2/02/02 at 23:46 (072377)

Look, I've had disagreements with you on this board over questioning those who come on here pushing their wares. But feeding off the injured, sick and elderly is big business; they know that crowd is desperate and susceptible. They rooked you. Such a device should cost maybe a few hundred, not well over a thousand. (Try and insist on at least a partial refund. If you make enough of a stink, you might get somewhere.) Sounds like this is not the first time sometihng like this has happened to you either. If you'd question them more beforehand and do a little shopping around too, you'd spend a lot less. I'm really sorry for your situation, but I do believe that too.

I'm not sure I understand why you can't find a competent doc to figure out what you have, and if it's PTTD, what stage you're in. If it surely is PTTD and it surely is an advanced stage, even ankle fusion allowing you to walk would be far more preferable than a life in a wheelchair. (BTW, did you have an MRI? What kind of health insurance do you have?) Are you in Atlanta? There must be competent docs there. Can't you ask around a lot about doctors? If you really can't find anyone, that trip out to Seattle to see Dr. Ed, in a wheelchair if necessary, is sounding all the more wiser and cheaper. Southwest has some pretty cheap flights these days. I can recommend a good doc in Baltimore too if that's more convenient.

--

Re: p.s. Paula

Donns SL on 2/03/02 at 01:57 (072382)

Paula,

I was thinking the same thing. Ater throwing so much money away over the years I'm seriously thinking about taking orthotic fabrication, and cped courses even if I only make them for myself initialy. I would have done it already if I didn't have to go out of state. For the price of a pair of orthotics, with several adjustments you could buy most of the equipment needed to produce them, and have the luxury of experimenting with what feels right to you.

Donna

Re: orthotic

Julie on 2/03/02 at 02:43 (072383)

Paula

I hope you'll give Dr Ed's kind offer some clear, serious thought - and make the trip to Seattle to consult with him. It would be more than worth the journey on the chance that he will see a way to cut through the complexity of your problems and point you towards a way out of them. At the very least you'll get a fresh look, by a doctor who has proved again and again that he knows his stuff.

In your shoes, I'd have no hesitation: I'd go.

Re: p.s. Paula

Carole C in NOLA on 2/03/02 at 07:50 (072391)

From what my pedorthist told me, her years of experience taught her more than she learned in school. Still, I think the C.Ped. after someone's name is a must.

Carole C

Re: p.s. Paula

paula on 2/03/02 at 09:35 (072399)

thank you all for your input. it is obvious from this board that dr ed is a great pod and a great human. i have and will consider makeing the trek to the guru. however i will first try calling the orthotic college in northwestern and getting an orthotist here in atlanta cause i must start with a plastic afo to begin in the pool. once i start walking on land i would want no one but dr ed to make my orthotic. as i understand it he makes a different orthotic, not a plastic thingy. pods make orthotics that go in shoes but not in water, orthotists make plastic thingies that support the ankle and post tib in a more hugging way, and i'm not sure what c peds do. tell me if i'm wrong about this. also in order to afford a plane ticket, a hotel room and staying long enuf to get it ?dgusted over a period of time, i would have to wait for another c.d. to mature and that's a few months away. i am broke. elliot, thank you for your caring post. these plastic afo's with hinges all seem to run about 750 apiece as far as i can tell. what is the difference between a c ped and an orthotist with those plastic afos?
it is good to know dr ed is out there for me and for the rest of us and i'm sure i'll be showing up at his place at some point of this rehabilitation, but right now i need a plastic afo that works. dr ed, if you think i've got this sequence wrong please let me know either here or at my email address.

Re: donna, i hear you

paula on 2/03/02 at 09:41 (072400)

donna, i have actually rigged something that works better than my zillions of orthotics. so i can only imagine how ggod a professional afo would be for me if i found the right person to make it. i have to have inner ankle support right now cause of the post tib, so when i walk in the pool i have a rube goldberg set up with canvas ankle brace, ace bandages, heel lifts, birkenstocks that should not be in water. and my zillion expensive orthotic devices enjoy sitting by the side of the pool as they smirk at me. so i understand your desire to learn how to do this yourself. give me some tupperware and a heat gun and i'll probably rig a plastic afo that works better than the useless one i have

Re: dr ed and c ped

paula on 2/03/02 at 10:01 (072408)

well the riff above my response to donna was a confusing right brain paragraph. let me try to be more coherent. what is the different brands of orthotics that are made my pods, by orthotists by c peds? who or what makes the plastic ones that go in water? i must start walking in water. also, i cannot put my legs in a vertical straigh+ walking position at this time even with wa+er up to my nose, without heel lifts, ankle supports arch support. or it tears at my post tib.

Re: donna, i hear you

paula on 2/03/02 at 10:02 (072410)

donna, i have actually rigged something that works better than my zillions of orthotics. so i can only imagine how ggod a professional afo would be for me if i found the right person to make it. i have to have inner ankle support right now cause of the post tib, so when i walk in the pool i have a rube goldberg set up with canvas ankle brace, ace bandages, heel lifts, birkenstocks that should not be in water. and my zillion expensive orthotic devices enjoy sitting by the side of the pool as they smirk at me. so i understand your desire to learn how to do this yourself. give me some tupperware and a heat gun and i'll probably rig a plastic afo that works better than the useless one i have

Re: p.s. Paula

paula on 2/03/02 at 10:02 (072411)

thank you all for your input. it is obvious from this board that dr ed is a great pod and a great human. i have and will consider makeing the trek to the guru. however i will first try calling the orthotic college in northwestern and getting an orthotist here in atlanta cause i must start with a plastic afo to begin in the pool. once i start walking on land i would want no one but dr ed to make my orthotic. as i understand it he makes a different orthotic, not a plastic thingy. pods make orthotics that go in shoes but not in water, orthotists make plastic thingies that support the ankle and post tib in a more hugging way, and i'm not sure what c peds do. tell me if i'm wrong about this. also in order to afford a plane ticket, a hotel room and staying long enuf to get it ?dgusted over a period of time, i would have to wait for another c.d. to mature and that's a few months away. i am broke. elliot, thank you for your caring post. these plastic afo's with hinges all seem to run about 750 apiece as far as i can tell. what is the difference between a c ped and an orthotist with those plastic afos?
it is good to know dr ed is out there for me and for the rest of us and i'm sure i'll be showing up at his place at some point of this rehabilitation, but right now i need a plastic afo that works. dr ed, if you think i've got this sequence wrong please let me know either here or at my email address.

Re: Orthotists and C.Ped's

Carole C in NOLA on 2/03/02 at 10:43 (072415)

Paula, a C.Ped is a Certified Pedorthist. That means an orthotist that deals with problems that involve the feet.

One of the C.Ped's on this board says that a C.Ped. is like a pharmacist for the feet. After you get the diagnosis from the doctors and/or podiatrists, a C.Ped. can make the orthotic that will help you.

I haven't ever seen a podiatrist, because I took a prescription from my regular rheumatologist straight to the C.Ped. he recommended, who did a wonderful job for me. From what I gather from reading this board, some podiatrists make their own orthotics rather than sending the patient to a C.Ped with a prescription. I don't really know if or why the materials might differ between a podiatrist vs a C.Ped.

Carole C

Re: p.s. Paula

elliott on 2/03/02 at 10:47 (072416)

Dr. Ed is great; I wish he were closer to home too. One reservation is that orthotics often need a few adjustments later on, and you can't keep flying out just for that. Also, he can't monitor your progress in person either.

Do you have insurance (HMO? FFS?) If so, what does it cover? If not, what can you get?

One note: I too have at least some sort of problem at least involving my PT tendon. I've noticed that a bicycling shoe, which has a superstiff and thick ball and seems to rise from heel to ball, allows me to walk more or less painfree (although you can't walk too fast in them). I'm not telling you to buy a cycling shoe, but you may want to try one on in a bike shop and try and take a few steps. Just a wacko idea of my own (and no, I don't own stock in bike shoe companies :-)).

To get freebie information, you may want to go to a web searcher like hotbot.com and type in buzz words like

afo posterior tibial.

Doing so and I found not only info on AFOs, but also the three stages of PTTD spelled out:

http://www.myfootshop.com/detail.asp?Condition=Posterior%20Tibial%20Tendon%20Dysfunction

---

Re: one more thing

elliott on 2/03/02 at 12:21 (072424)

Dr. Ed claims that the orthotics made by Northwest Podiatric (nwpodiatric.com) are just about the best in the world. I am considering ordering a pair myself. If you go to that site, click on orthotics, and then click on the doctor search, it brings up those in your area who prescribe them. Hopefully there's a correlation between competency and being on that list. Curious if you've seen any of those DPMs. Here are the ones listed for Atlanta:

ATLANTA FOOT CARE CENTER
3312 PIEDMONT RD. #160
ATLANTA, GA, 30305
(404) 233-7151

NOONAN PODIATRY GROUP, P.C.
3312 PIEDMONT RD # 510
ATLANTA, GA, 30305
(404) 233-2424

---

Re: one more thing

Dr. Zuckerman on 2/03/02 at 12:42 (072426)

Hi

I am not familiar with these DPM. The sucess of the orthosis has to do with
the biomechanical examination and the casting of the orthosis. The lab is what comes last. Without a good cast the orthosis was going to turn out fair to poor. what you can do is have your feet casted near you and then tell the DPM to order them from Northwest Podiatric. I have also heard the are pretty good.

Re: Paula, orthotist/cped confustion

Donna sL on 2/03/02 at 14:01 (072431)

Hi Paula,

You may need to take some orthotist courses also to help bend that tupperware into the proper position. Until then you should keep trying to find at least a certified orthotist to develop the right AFO. They are trained in bracing all parts of the body. An orthotist is not a cped, but can have a cped cert in addition to being an orthotist. Orthotist require extensive training, and certification, and require at least a 4 year college degree in that subject. A cped is only trained in foot orthosis, and shoe modifications, and the initial training required for certification is usually only a couple of weeks if that.

These links may help you find a certified orthotist, or at least check to see if whom you are dealing with is certified.

http://catalog.aopanet.org/membersdir/Default.cfm

http://www.oandp.com/facilities/

This link gives a little info about certified orthotist

http://www.aopanet.org/aboutaopa/index.html

If you plug in 'afo' some info comes up that may be of interest to you.

http://www.oandp.org/

http://www.oandp.com/

Do you have any large teaching hospitals in your area that have an Orthotics, and prothetics department, and are experienced with your condition?

If I see anything else that is helpful, I'll add it later.

Donna

Re: one more thing

Carole C in NOLA on 2/03/02 at 14:38 (072438)

Elliott, if you are right then it's a good thing she doesn't live in New Orleans. They don't list ANY doctors in Louisiana, at all!!!

I suspect that their list of good, competent doctors is less than exhaustive. Louisiana is not a third world country! It only tries to be. lol

Carole C

Re: try again

elliott on 2/03/02 at 14:56 (072444)

You made the same mistake I first made. You must still click on State at left even though you clicked on Louisiana at right (I hope their orthotics are designed better than their user-unfriendly web site). :-) So they do indeed have Louisiana!

Here are the doctors nearest you...

--------------------------------------------------------------------------------
Name:
Address:

Phone: DRS. L. BARONNE & N. MCGEE
2848 S. UNION ST.
OPELOUSAS, LA, 70570
(337) 942-7567

--------------------------------------------------------------------------------
Name:
Address:

Phone: JARED REEVES, D.P.M.
2106 N. 7TH ST #111
WEST MONROE, LA, 71291
(318) 325-0183

--------------------------------------------------------------------------------
Name:
Address:

Phone: KENNETH QUICK, DPM
804 HEAVENS DR. # 204
MANDEVILLE, LA, 70471
(985) 845-0505

--------------------------------------------------------------------------------
Name:
Address:

Phone: QUI LE, D.P.M.
5215 ESSEN LANE STE #1
BATON ROUGE, LA, 70809
(225) 757-8808

--------------------------------------------------------------------------------
Name:
Address:

Phone: ROBERT KIRTON, D.P.M.
105 E. REYNOLDS DR D
RUSTON, LA, 71270
(318) 255-3234

Now about Loiusiana being a third world country...

Re: try again

Carole C in NOLA on 2/03/02 at 15:22 (072450)

Thanks, Elliott! NW Podiatrics doesn't think we're a third world country after all, or they wouldn't list our doctors.

And here in New Orleans, we are making great strides at pulling ourselves up out of third world country status through sheer grit and determination. We finally got our first Best Buy and our first Super Wal-Mart in the past six months, long after Lafayette, Louisiana (Rich's hometown) had both of them. One of these days we might even get Target, or Trader Joe's. Or cable modem service that really works, for a change! :)

Oh well... I remember being a teen in Honolulu in the early 60's, and having the same orange dress with yellow trim that half my friends at school had. It wasn't a fad; it's just that there weren't that many styles available there, then. That's a place that's really changed in the past 50 years.

Carole C

Re: Paula, orthotist/cped confustion

paula on 2/03/02 at 18:05 (072474)

donna you are real helpful i went to all those sites and saved them. thank you.

Re: Paula, orthotist/cped confustion - links all on one page

Donna SL on 2/03/02 at 20:01 (072481)

Paula,

I just noticed myself in case you didn't already on the left hand side towards the bottom in red under 'quick links' on the American Academy of Orthotist, and Prosthetist site

http://www.oandp.org/

it list all the major O&P societies. I had met some of the top orthotist last year at UCSF, and most of them were all found on the ABC, besides the other boards. After you are in the ABC site click 'site map' on the bottom of the page. You will then see search on 'individual and facilities' and can easily find if someone is accredited by the ABC by plugging in their name. You can also plug in just your address, and it will give you up to 50 listings. Leave out the zip if you don't get many results, and plug in just city and state. I think the ABC has the most stingent standards. They also have some good links under 'resources'.

I remember using these sites last spring when I was checking an orthotist out. He called himself an orthotist, but through these sites, I had found out he was only a orhotist technician. I even had called some of the boards personally.

Donna

Re: Paula, orthotist/cped confustion - links all on one page

paula on 2/03/02 at 20:18 (072484)

hey thanks donna. i think it's a lousy system where you pay them all the money up front and then maybe they will adjust it once or twice and never,so far , with any grace or decency of attitude. the guy who did my expensive plastic thing has found a way to never have me bug him. every time he adjusts it it get much worse.

Re: Paula, It's a shame it has to be that way

Donna SL on 2/03/02 at 21:21 (072494)

Paula,

I know what you mean. I've had similar experiences with orthotics, and can understand your frustration. I've had so many bad experiences over
the years it's almost unbelievable, and in retrospect some of the
treatment I received was disgraceful. I'm wiser now, and wouldn't
tolerate what I did in the past, because my condition has improved, but
it's hard not to give people your trust when you're hurting, and
desperate for relief.

Also, most practitioners I've met so far for orthotics in my area have similar pricing, and offer no guarantees which means no refunds, even if their device cause injury, or worsen your condition. That attitude sent me looking for alternative methods to improve, and I'm better off for doing so. I could really survive without orthotics now, but feel I could still benefit from them. I don't think that's possible in your case at this point, but hopefully in the future it will be.

Was this orthotist listed as certified on any of these sites? I wonder if you would have any recourse if he/she was.

Its a shame that you have to interrogate future orthotic/afo makers, but it seems you have to drill them on every bit of info you can think of. I would think if you went to a large O&P organization at a hospital with a lot of orthotist, if one wasn't connecting another one might be able to step in. I know that's how they operated at UCSF. Also, I heard Hanger Orthopedics is one of the largest O&P chains in the U.S. I know nothing about them, but it would worth looking into. I had spoken to some orthotist in various locations, and noticed their standards vary from office to office, so you need to interrogate them too.

http://www.hanger.com/

I'm sure you'll find someone compassionate, and who will help you eventually. It's just a shame it has to be a difficult, and expensive task.
I'm hoping you might have a better chance if they were part of the ABC.

Good luck with your search.

Donna

Re: Paula, It's a shame it has to be that way

paula on 2/03/02 at 21:24 (072495)

thank you donna. hangar didn't work for me by the way.

Re: Paula, orthotist/cped confustion - links all on one page

BG CPed on 2/03/02 at 22:06 (072500)

There are a few things to watch out for. There are many cases of practitioners claiming they are 'Orthotists' or 'Pedorthists' that are not certified. It is legal but in my opinion it is a bit shady. If the use the term 'Certified' and they arent the board should be notified and the person will be contacted by boards attorney.

It is similar to say an ear nose throat Doc doing plastic surg, they can do it but if they claim board cert and they are not they get in trouble. Orthotists do bracing for entire body. Some will specialize in certain areas like spinal, hands etc. I would seek somebody that does feet most or all of the time. I know of an Orthotist that was brilliant with hand orthosis, and they are a pain in the but, but he was terrible with feet. He didnt like to do feet so he was bad at it and didnt want to learn.

I also dont see what the deal is with people charging for adjustments. I can see after several if that is the case but I wouldnt think of doing that. This industry is rampant with people that should not be involved in it. I am not saying that they are crooks but the over charging and bad results are far too common. I would see Dr Ed, he will make correct cast and modifications in orifinal device. If you follow the shoe advice and break in you probably will be ok if he just mails them to you, most likely you wont need them adjusted at all

Sounds to me like you have been just unlucky.

Re: question for cped and dr ed

paula on 2/04/02 at 09:14 (072519)

that is the question i have for you and dr ed. i must start therapy in a pool. dr ed makes orthotics that go on land, not in pools. orthotists make plastic afos that go in water. don't know if peds make plastic orthotics. please clear up this confusion if i have it wrong. my point is i'm not ready for dr ed yet, i think. dr ed can help me when i am ready to walk on land. then i would fly there to get an arothotic that fits into a shoe he recommentds. if i have this wrong please explain.

Re: Orthotists and C.Ped's

Richard, C.Ped on 2/04/02 at 11:57 (072528)

Just a quick FYI on C.Ped -vs- orthotist. C.Peds are limited to below the ankle as to what they can do. An orthotist can make foot orthotics as well as custom AFOs and can also fit leg braces.
Richard

Re: othotic

Richard, C.Ped on 2/04/02 at 12:02 (072530)

Paula,
I can see why this is so frustrating to you. My blood pressure went up just reading your post. I am only 3 1/2 hours from Atlanta. If you would like to take a short trip this way, Mike and I would be happy to look you over with a thorough pedorthic exam.
Richard

Re: othotic

paula on 2/04/02 at 13:51 (072542)

do you make plastic afos that you addjust with a heat gun?

Re: To elliott

D.J. on 2/04/02 at 16:17 (072557)

Elliott,

I live about an hour from Baltimore. Would you be able to give me the name of the Baltimore doctor you have recommended for Paula. I have seen one well-respected orthopedic foot and ankle specialist in Baltimore but am always looking for new opinions. Here is my email if you prefer (email removed)

Thanks!

Re: thanks, Richard (nm)

Carole C in NOLA on 2/04/02 at 16:28 (072560)

.

Re: question for cped and dr ed

BG CPed on 2/04/02 at 17:29 (072566)

Plastic afo are sometimes used,and sometimes not . It can be overkill in some cases. If you dont have drop foot and just a bad case of ptti in most cases the right shoe and orthotic should work, provided they are both correct. If you are in a pool your wt is lessened to a great degree so an afo for aqua therapy may be more than you need.

One reason I am not big on afo for ptti is that there is never enough hindfoot or rearfoot correction and they rely on too much arch. If you have tight heel cords like most you will get skin irritation or even breakdown on inside of arch or ankle. Have your tried exercise bike? even one that you sit on like a chair and pedal. there is no impact or wt bearing so you can strengthen legs and build up to walking.

If Richard is 3 hours away you may want to visit him. There are different ways to support the foot, dont get too wraped up in what exact type of brace or orthotic it is. Let me know if I am missing your question here

Re: question for cped and dr ed

paula on 2/04/02 at 17:51 (072568)

i didn't realize there are two peds on the board. thank you for your response. trust me, i need a support for the post tib ankle area when i walk in the pool and i need an arch as well. it has to be waterproof so i figure a plastic afo is what i've go to have? i already use an exercise bike. now my physical therapist would like to stand me up vertically in a pool so my legs and hips can unbend from a year in a half in a wheelchair. but i need to support my post tib when i do this.

Re: To elliott

elliott on 2/04/02 at 18:59 (072574)

Mark Myerson is the big name, certainly for PTTD. Go to hotbot.com, and type in

myerson posterior tibial

and take a look at the sites that pop up.

Re: To elliott

BG CPed on 2/04/02 at 20:19 (072579)

Myerson is the guy that did/re-did NBA Grant Hill. He is supposed to be playing again in late June

Re: question for cped and dr ed

BG CPed on 2/04/02 at 20:28 (072580)

There are 2 peds on here. Wt bearing pt is beneficial for some reasons over aqua pt. I still dont see why you need an afo for aqua ther. Does your pt suggest this? There is much less load/wt bearing in pool and if it is that bad they also have a harness that can further unload you.

What about a water shoe or snug athletic shoe with an orthotic made of eva? I made an orthotic for a worls champion water skier and she uses it both salt and fresh water. It is pure eva and has lasted over 2 years now. If the water level in the pool is near your chest you should not need a full afo. I am not second guessing your pt but you may want to discuss it further. If you are afraid becuase you have been in a chair you can also use an inflatable ring to unload you till you are comfortable.

If you start slow then get a good shoe and orthotic and start wt bearing you will get more confidence. Get pissed at that chair like it is a bad, loud, rude neighbor that you are sick of

Re: question for cped and dr ed

paula on 2/04/02 at 21:41 (072595)

i have to start in a pool because i have not walked in a year and a half. i have to have support for my post tib tendon cause it is severely dysfunctional.i have to have arch support cause i have almost no arch. that is why i need a waterproof afo.

Re: question for cped and dr ed

paula on 2/04/02 at 21:43 (072597)

which is why i was asking if anyone knew of a good plastic afo maker.

Re: question for cped and dr ed

BG CPed on 2/05/02 at 07:04 (072612)

I realize that Paula, that is why I was saying that in chest deep or more water there ismuch less strain on your ptt,etc. If your pt said you needed an afo to for water therapy? If you get a good ortotic of eva and a nylon/eva running type shoe with no leather it would work and dry out over night for the next day. It will be hard to wear an afo without a shoe unless they put 4 velcro straps on it, then you have to worry about the bottom of it getting scraped and damaged.

Again being in chest deep water will put much less stress on your soft tissue, I dont remember the rtio of wt unloading, Elliott prob knows the formula to figure it.

Re: To elliott

D.J. on 2/05/02 at 09:42 (072623)

Thanks! I've heard the name. In fact, one of the doctors I've seen is also at Union Memorial Hospital. He also has a great reputation for working with athletic foot and ankle injuries. Unfortunately he was stumped after a couple visits. I'm surprised he didn't refer me to his colleague. I'll definitely look into Myerson.

Re: question for cped and dr ed

paula on 2/05/02 at 13:17 (072645)

i am already in the pool. problem is, with water up to my nose, i still pronate badly cause i lost all my muscles and have to grow em back by walking in a pool. at this point an afo is needed for ankle support because the post tib needs to not be stretched since there is not much in the way of muscles to hold it up right now. i didn't realize that eva orthotics were waterproof. don't they have glue ? they can hold up in warm water for a few hours a day? when i don't need strong ankle support and post tib support higher up i could try to graduate to that. but now i need a plastic af. that is specific for post tib dysfuncion that goes in water. after not walking in a year and a half i need to find something that works soon or leg musclse will die as i understand. this is frustrating and tragic beyond belief. i need a n orthotist who has some clue abou+ severe post tib and makes plastic afos. and i can't seem to find one nor does anyone on this board seem to know of one.

Re: Paula, did you try this?

elliott on 2/05/02 at 14:21 (072649)

http://www.oandp.com/products/atlanta/custom.htm

Located right next door to you, so maybe you can go in for a fitting. They have several materials (isn't polypropylene waterproof?) and claim they fulfill custom requests. Phone number is on their home page.

Hope this post goes through; it's still taking me minutes to load after just about every click.

---

Re: question for cped and dr ed

BG CPed on 2/05/02 at 19:28 (072706)

Yes eva is water proof, the glue is also as long as it is a rubber cement typ and not water based which most are. I would still think you may want to get a good orthotic and a solisd shoe that is not laeather but nylon and synthetic. The other problem with an afo that is not in a shoe is that when you dorsiflex or toe off your foot will want to migrate or move out of it unless it is in a shoe or it is articulated at the ankle. If an afo is the only solution they can use a becker joint that is mostly nylon and all the screws are stainless so it can go in water

Re: othotic

Ed Davis, DPM on 2/01/02 at 18:47 (072245)

$1500????? What type of orthotic did you get for that price? It would need to be diamond studded or have a 18k gold inlay for that price.
Ed

Re: othotic

paula on 2/01/02 at 19:26 (072253)

it's a plastic afo with a hinge and it goes up my calf. and it's got velcro that is falling off after one month and it feels like a torture device, but dr ed, 1500 dollars is nothing, i've denuded a large part of my retirement, everything i've worked for and i'm 55. i have a closet full of orthotic devices, and the foot and ankle surgeons and pods and therapists of atlanta are all partying in the tropics on my dollar i suppose. the plastic thing was for post tib. dysfuncion. not one of my device makers knew what a post or wedge was, let alone anything else that is supposed to go in an orthotic device. i'm so beyond depressed there aren't words for it. do you know a good orthotic college or two? i think i'll call and see if the instructors there know anyone here. i really have no idea what my next move should be .

Re: othotic

Ed Davis, DPM on 2/02/02 at 16:55 (072309)

I am not really familiar with the programs at schools for orthotists and prosthetists. I still cannot imagine what you recieved for $1500.

I cannot put a guarantee on a device which I dispense but I will everything possible to make sure that it works--repairing, modifying and remolding it till it does. One remedy for depression is to take action. I would demand that they make good on the device or at least provide a partial refund if they cannot.

If PTTD is present, is it on both feet? Have any of the doctors stated if it is stage 2 or 3?

I realize that I am far away but a plane ticket to Seattle is far less expensive than what you have paid. I would be happy to examine you, let you know what device I would recommend (provided that there is a device that would work--there usually is), then proceed to fabricate or have the device fabricated for you. You would pay me ONLY if the device is successful. (I would not make such an offer if I was not fairly confident about being successful). I may ask you to change shoegear to a stable running shoe such as the New Balance 1121 in order to enhance the action of the orthotic, would give you the names of local shoe dealers or pedorthists which you would need to obtain on your own. Occasionally we may want to combine some shoe modifications, performed by the pedorthist with the orthotic. I would also ask that you bring as many of the prior devices along as possible (two reasons--to see why they did not work and to see if they are modifiable).
Regards,
Ed

Re: othotic

BG CPed on 2/02/02 at 18:20 (072331)

That is a great offer Dr Ed. I also have a feeling you may fix her. It irks me to no end to hear this same story 2 times a week. The program at Northwestern Chicago may be a source, they have what I feel is the best program for Orthotists and Pedorthists. I am not sure if Mrs. Cotterman is still there, she may be able to get you some names. They are located in the Med School downtown not at the Evanston campus. I would think that they have some links on a website. Dr Ed offer sounds like a plan

Re: othotic Then I must have really been robbed

Donna SL on 2/02/02 at 19:28 (072336)

If you think $1500.00 is a lot, between the last two pods I saw they charged close to $11,000 for several pairs of failed orthotics, and adjustments, and got paid for most of it from my insurance company. I'm also responsible for 20% in copays. They don't contain any diamonds, or gold in them either.

Donna

Re: othotic

paula on 2/02/02 at 20:55 (072352)

dr ed i have seriously considered consulting with you for a while now. pttd is in both feet. terrible in one, worse in the other. i am the person who lost all her muscles in a muscle wasting syndrome, which has been corrected. , what i'm left with is severe pttd and a rehabilitation that can't get started till i get support for the post tib. i bought a therapy pool and need a plastic orthotic for now, to start walking with water up to my shoulders, since i have to start bearing weight slow. as i understand it, you, as a podiatrist, would be making an orthotic that is not plastic. so i reckon i must wait till i'm walking on land before i come to you. as i understand it i need an orthotist, with plastic things and heat guns? for now so i can get a plastic orthotic for the pool. the stage of pttd i'm in is anyone's guess. more than one doc said it's impossible to tell cause i can't stand up for the many toe test and the raise on toe test. time is wasting and my muscles will die of disuse and i need a plastic orthotic that works. this is beyond tragic.

Re: p.s.

paula on 2/02/02 at 21:08 (072356)

dr ed, i know you would be the best. the folks who live in your area are lucky. r ped thank you for the name of that school . i will call them monday. it will be refreshing to find an orthotist who has ever heard of a post or wedge. let alone anyghting more complex.donna, your experience sounds all too familiar. i have been throwing money at clowns for a year and a half. it would have been less time consuming, easier and cheaper to enroll in orthotic school myself and then take a piece of plastic and bite it into the correct orthotic.

Re: Paula

elliott on 2/02/02 at 23:46 (072377)

Look, I've had disagreements with you on this board over questioning those who come on here pushing their wares. But feeding off the injured, sick and elderly is big business; they know that crowd is desperate and susceptible. They rooked you. Such a device should cost maybe a few hundred, not well over a thousand. (Try and insist on at least a partial refund. If you make enough of a stink, you might get somewhere.) Sounds like this is not the first time sometihng like this has happened to you either. If you'd question them more beforehand and do a little shopping around too, you'd spend a lot less. I'm really sorry for your situation, but I do believe that too.

I'm not sure I understand why you can't find a competent doc to figure out what you have, and if it's PTTD, what stage you're in. If it surely is PTTD and it surely is an advanced stage, even ankle fusion allowing you to walk would be far more preferable than a life in a wheelchair. (BTW, did you have an MRI? What kind of health insurance do you have?) Are you in Atlanta? There must be competent docs there. Can't you ask around a lot about doctors? If you really can't find anyone, that trip out to Seattle to see Dr. Ed, in a wheelchair if necessary, is sounding all the more wiser and cheaper. Southwest has some pretty cheap flights these days. I can recommend a good doc in Baltimore too if that's more convenient.

--

Re: p.s. Paula

Donns SL on 2/03/02 at 01:57 (072382)

Paula,

I was thinking the same thing. Ater throwing so much money away over the years I'm seriously thinking about taking orthotic fabrication, and cped courses even if I only make them for myself initialy. I would have done it already if I didn't have to go out of state. For the price of a pair of orthotics, with several adjustments you could buy most of the equipment needed to produce them, and have the luxury of experimenting with what feels right to you.

Donna

Re: orthotic

Julie on 2/03/02 at 02:43 (072383)

Paula

I hope you'll give Dr Ed's kind offer some clear, serious thought - and make the trip to Seattle to consult with him. It would be more than worth the journey on the chance that he will see a way to cut through the complexity of your problems and point you towards a way out of them. At the very least you'll get a fresh look, by a doctor who has proved again and again that he knows his stuff.

In your shoes, I'd have no hesitation: I'd go.

Re: p.s. Paula

Carole C in NOLA on 2/03/02 at 07:50 (072391)

From what my pedorthist told me, her years of experience taught her more than she learned in school. Still, I think the C.Ped. after someone's name is a must.

Carole C

Re: p.s. Paula

paula on 2/03/02 at 09:35 (072399)

thank you all for your input. it is obvious from this board that dr ed is a great pod and a great human. i have and will consider makeing the trek to the guru. however i will first try calling the orthotic college in northwestern and getting an orthotist here in atlanta cause i must start with a plastic afo to begin in the pool. once i start walking on land i would want no one but dr ed to make my orthotic. as i understand it he makes a different orthotic, not a plastic thingy. pods make orthotics that go in shoes but not in water, orthotists make plastic thingies that support the ankle and post tib in a more hugging way, and i'm not sure what c peds do. tell me if i'm wrong about this. also in order to afford a plane ticket, a hotel room and staying long enuf to get it ?dgusted over a period of time, i would have to wait for another c.d. to mature and that's a few months away. i am broke. elliot, thank you for your caring post. these plastic afo's with hinges all seem to run about 750 apiece as far as i can tell. what is the difference between a c ped and an orthotist with those plastic afos?
it is good to know dr ed is out there for me and for the rest of us and i'm sure i'll be showing up at his place at some point of this rehabilitation, but right now i need a plastic afo that works. dr ed, if you think i've got this sequence wrong please let me know either here or at my email address.

Re: donna, i hear you

paula on 2/03/02 at 09:41 (072400)

donna, i have actually rigged something that works better than my zillions of orthotics. so i can only imagine how ggod a professional afo would be for me if i found the right person to make it. i have to have inner ankle support right now cause of the post tib, so when i walk in the pool i have a rube goldberg set up with canvas ankle brace, ace bandages, heel lifts, birkenstocks that should not be in water. and my zillion expensive orthotic devices enjoy sitting by the side of the pool as they smirk at me. so i understand your desire to learn how to do this yourself. give me some tupperware and a heat gun and i'll probably rig a plastic afo that works better than the useless one i have

Re: dr ed and c ped

paula on 2/03/02 at 10:01 (072408)

well the riff above my response to donna was a confusing right brain paragraph. let me try to be more coherent. what is the different brands of orthotics that are made my pods, by orthotists by c peds? who or what makes the plastic ones that go in water? i must start walking in water. also, i cannot put my legs in a vertical straigh+ walking position at this time even with wa+er up to my nose, without heel lifts, ankle supports arch support. or it tears at my post tib.

Re: donna, i hear you

paula on 2/03/02 at 10:02 (072410)

donna, i have actually rigged something that works better than my zillions of orthotics. so i can only imagine how ggod a professional afo would be for me if i found the right person to make it. i have to have inner ankle support right now cause of the post tib, so when i walk in the pool i have a rube goldberg set up with canvas ankle brace, ace bandages, heel lifts, birkenstocks that should not be in water. and my zillion expensive orthotic devices enjoy sitting by the side of the pool as they smirk at me. so i understand your desire to learn how to do this yourself. give me some tupperware and a heat gun and i'll probably rig a plastic afo that works better than the useless one i have

Re: p.s. Paula

paula on 2/03/02 at 10:02 (072411)

thank you all for your input. it is obvious from this board that dr ed is a great pod and a great human. i have and will consider makeing the trek to the guru. however i will first try calling the orthotic college in northwestern and getting an orthotist here in atlanta cause i must start with a plastic afo to begin in the pool. once i start walking on land i would want no one but dr ed to make my orthotic. as i understand it he makes a different orthotic, not a plastic thingy. pods make orthotics that go in shoes but not in water, orthotists make plastic thingies that support the ankle and post tib in a more hugging way, and i'm not sure what c peds do. tell me if i'm wrong about this. also in order to afford a plane ticket, a hotel room and staying long enuf to get it ?dgusted over a period of time, i would have to wait for another c.d. to mature and that's a few months away. i am broke. elliot, thank you for your caring post. these plastic afo's with hinges all seem to run about 750 apiece as far as i can tell. what is the difference between a c ped and an orthotist with those plastic afos?
it is good to know dr ed is out there for me and for the rest of us and i'm sure i'll be showing up at his place at some point of this rehabilitation, but right now i need a plastic afo that works. dr ed, if you think i've got this sequence wrong please let me know either here or at my email address.

Re: Orthotists and C.Ped's

Carole C in NOLA on 2/03/02 at 10:43 (072415)

Paula, a C.Ped is a Certified Pedorthist. That means an orthotist that deals with problems that involve the feet.

One of the C.Ped's on this board says that a C.Ped. is like a pharmacist for the feet. After you get the diagnosis from the doctors and/or podiatrists, a C.Ped. can make the orthotic that will help you.

I haven't ever seen a podiatrist, because I took a prescription from my regular rheumatologist straight to the C.Ped. he recommended, who did a wonderful job for me. From what I gather from reading this board, some podiatrists make their own orthotics rather than sending the patient to a C.Ped with a prescription. I don't really know if or why the materials might differ between a podiatrist vs a C.Ped.

Carole C

Re: p.s. Paula

elliott on 2/03/02 at 10:47 (072416)

Dr. Ed is great; I wish he were closer to home too. One reservation is that orthotics often need a few adjustments later on, and you can't keep flying out just for that. Also, he can't monitor your progress in person either.

Do you have insurance (HMO? FFS?) If so, what does it cover? If not, what can you get?

One note: I too have at least some sort of problem at least involving my PT tendon. I've noticed that a bicycling shoe, which has a superstiff and thick ball and seems to rise from heel to ball, allows me to walk more or less painfree (although you can't walk too fast in them). I'm not telling you to buy a cycling shoe, but you may want to try one on in a bike shop and try and take a few steps. Just a wacko idea of my own (and no, I don't own stock in bike shoe companies :-)).

To get freebie information, you may want to go to a web searcher like hotbot.com and type in buzz words like

afo posterior tibial.

Doing so and I found not only info on AFOs, but also the three stages of PTTD spelled out:

http://www.myfootshop.com/detail.asp?Condition=Posterior%20Tibial%20Tendon%20Dysfunction

---

Re: one more thing

elliott on 2/03/02 at 12:21 (072424)

Dr. Ed claims that the orthotics made by Northwest Podiatric (nwpodiatric.com) are just about the best in the world. I am considering ordering a pair myself. If you go to that site, click on orthotics, and then click on the doctor search, it brings up those in your area who prescribe them. Hopefully there's a correlation between competency and being on that list. Curious if you've seen any of those DPMs. Here are the ones listed for Atlanta:

ATLANTA FOOT CARE CENTER
3312 PIEDMONT RD. #160
ATLANTA, GA, 30305
(404) 233-7151

NOONAN PODIATRY GROUP, P.C.
3312 PIEDMONT RD # 510
ATLANTA, GA, 30305
(404) 233-2424

---

Re: one more thing

Dr. Zuckerman on 2/03/02 at 12:42 (072426)

Hi

I am not familiar with these DPM. The sucess of the orthosis has to do with
the biomechanical examination and the casting of the orthosis. The lab is what comes last. Without a good cast the orthosis was going to turn out fair to poor. what you can do is have your feet casted near you and then tell the DPM to order them from Northwest Podiatric. I have also heard the are pretty good.

Re: Paula, orthotist/cped confustion

Donna sL on 2/03/02 at 14:01 (072431)

Hi Paula,

You may need to take some orthotist courses also to help bend that tupperware into the proper position. Until then you should keep trying to find at least a certified orthotist to develop the right AFO. They are trained in bracing all parts of the body. An orthotist is not a cped, but can have a cped cert in addition to being an orthotist. Orthotist require extensive training, and certification, and require at least a 4 year college degree in that subject. A cped is only trained in foot orthosis, and shoe modifications, and the initial training required for certification is usually only a couple of weeks if that.

These links may help you find a certified orthotist, or at least check to see if whom you are dealing with is certified.

http://catalog.aopanet.org/membersdir/Default.cfm

http://www.oandp.com/facilities/

This link gives a little info about certified orthotist

http://www.aopanet.org/aboutaopa/index.html

If you plug in 'afo' some info comes up that may be of interest to you.

http://www.oandp.org/

http://www.oandp.com/

Do you have any large teaching hospitals in your area that have an Orthotics, and prothetics department, and are experienced with your condition?

If I see anything else that is helpful, I'll add it later.

Donna

Re: one more thing

Carole C in NOLA on 2/03/02 at 14:38 (072438)

Elliott, if you are right then it's a good thing she doesn't live in New Orleans. They don't list ANY doctors in Louisiana, at all!!!

I suspect that their list of good, competent doctors is less than exhaustive. Louisiana is not a third world country! It only tries to be. lol

Carole C

Re: try again

elliott on 2/03/02 at 14:56 (072444)

You made the same mistake I first made. You must still click on State at left even though you clicked on Louisiana at right (I hope their orthotics are designed better than their user-unfriendly web site). :-) So they do indeed have Louisiana!

Here are the doctors nearest you...

--------------------------------------------------------------------------------
Name:
Address:

Phone: DRS. L. BARONNE & N. MCGEE
2848 S. UNION ST.
OPELOUSAS, LA, 70570
(337) 942-7567

--------------------------------------------------------------------------------
Name:
Address:

Phone: JARED REEVES, D.P.M.
2106 N. 7TH ST #111
WEST MONROE, LA, 71291
(318) 325-0183

--------------------------------------------------------------------------------
Name:
Address:

Phone: KENNETH QUICK, DPM
804 HEAVENS DR. # 204
MANDEVILLE, LA, 70471
(985) 845-0505

--------------------------------------------------------------------------------
Name:
Address:

Phone: QUI LE, D.P.M.
5215 ESSEN LANE STE #1
BATON ROUGE, LA, 70809
(225) 757-8808

--------------------------------------------------------------------------------
Name:
Address:

Phone: ROBERT KIRTON, D.P.M.
105 E. REYNOLDS DR D
RUSTON, LA, 71270
(318) 255-3234

Now about Loiusiana being a third world country...

Re: try again

Carole C in NOLA on 2/03/02 at 15:22 (072450)

Thanks, Elliott! NW Podiatrics doesn't think we're a third world country after all, or they wouldn't list our doctors.

And here in New Orleans, we are making great strides at pulling ourselves up out of third world country status through sheer grit and determination. We finally got our first Best Buy and our first Super Wal-Mart in the past six months, long after Lafayette, Louisiana (Rich's hometown) had both of them. One of these days we might even get Target, or Trader Joe's. Or cable modem service that really works, for a change! :)

Oh well... I remember being a teen in Honolulu in the early 60's, and having the same orange dress with yellow trim that half my friends at school had. It wasn't a fad; it's just that there weren't that many styles available there, then. That's a place that's really changed in the past 50 years.

Carole C

Re: Paula, orthotist/cped confustion

paula on 2/03/02 at 18:05 (072474)

donna you are real helpful i went to all those sites and saved them. thank you.

Re: Paula, orthotist/cped confustion - links all on one page

Donna SL on 2/03/02 at 20:01 (072481)

Paula,

I just noticed myself in case you didn't already on the left hand side towards the bottom in red under 'quick links' on the American Academy of Orthotist, and Prosthetist site

http://www.oandp.org/

it list all the major O&P societies. I had met some of the top orthotist last year at UCSF, and most of them were all found on the ABC, besides the other boards. After you are in the ABC site click 'site map' on the bottom of the page. You will then see search on 'individual and facilities' and can easily find if someone is accredited by the ABC by plugging in their name. You can also plug in just your address, and it will give you up to 50 listings. Leave out the zip if you don't get many results, and plug in just city and state. I think the ABC has the most stingent standards. They also have some good links under 'resources'.

I remember using these sites last spring when I was checking an orthotist out. He called himself an orthotist, but through these sites, I had found out he was only a orhotist technician. I even had called some of the boards personally.

Donna

Re: Paula, orthotist/cped confustion - links all on one page

paula on 2/03/02 at 20:18 (072484)

hey thanks donna. i think it's a lousy system where you pay them all the money up front and then maybe they will adjust it once or twice and never,so far , with any grace or decency of attitude. the guy who did my expensive plastic thing has found a way to never have me bug him. every time he adjusts it it get much worse.

Re: Paula, It's a shame it has to be that way

Donna SL on 2/03/02 at 21:21 (072494)

Paula,

I know what you mean. I've had similar experiences with orthotics, and can understand your frustration. I've had so many bad experiences over
the years it's almost unbelievable, and in retrospect some of the
treatment I received was disgraceful. I'm wiser now, and wouldn't
tolerate what I did in the past, because my condition has improved, but
it's hard not to give people your trust when you're hurting, and
desperate for relief.

Also, most practitioners I've met so far for orthotics in my area have similar pricing, and offer no guarantees which means no refunds, even if their device cause injury, or worsen your condition. That attitude sent me looking for alternative methods to improve, and I'm better off for doing so. I could really survive without orthotics now, but feel I could still benefit from them. I don't think that's possible in your case at this point, but hopefully in the future it will be.

Was this orthotist listed as certified on any of these sites? I wonder if you would have any recourse if he/she was.

Its a shame that you have to interrogate future orthotic/afo makers, but it seems you have to drill them on every bit of info you can think of. I would think if you went to a large O&P organization at a hospital with a lot of orthotist, if one wasn't connecting another one might be able to step in. I know that's how they operated at UCSF. Also, I heard Hanger Orthopedics is one of the largest O&P chains in the U.S. I know nothing about them, but it would worth looking into. I had spoken to some orthotist in various locations, and noticed their standards vary from office to office, so you need to interrogate them too.

http://www.hanger.com/

I'm sure you'll find someone compassionate, and who will help you eventually. It's just a shame it has to be a difficult, and expensive task.
I'm hoping you might have a better chance if they were part of the ABC.

Good luck with your search.

Donna

Re: Paula, It's a shame it has to be that way

paula on 2/03/02 at 21:24 (072495)

thank you donna. hangar didn't work for me by the way.

Re: Paula, orthotist/cped confustion - links all on one page

BG CPed on 2/03/02 at 22:06 (072500)

There are a few things to watch out for. There are many cases of practitioners claiming they are 'Orthotists' or 'Pedorthists' that are not certified. It is legal but in my opinion it is a bit shady. If the use the term 'Certified' and they arent the board should be notified and the person will be contacted by boards attorney.

It is similar to say an ear nose throat Doc doing plastic surg, they can do it but if they claim board cert and they are not they get in trouble. Orthotists do bracing for entire body. Some will specialize in certain areas like spinal, hands etc. I would seek somebody that does feet most or all of the time. I know of an Orthotist that was brilliant with hand orthosis, and they are a pain in the but, but he was terrible with feet. He didnt like to do feet so he was bad at it and didnt want to learn.

I also dont see what the deal is with people charging for adjustments. I can see after several if that is the case but I wouldnt think of doing that. This industry is rampant with people that should not be involved in it. I am not saying that they are crooks but the over charging and bad results are far too common. I would see Dr Ed, he will make correct cast and modifications in orifinal device. If you follow the shoe advice and break in you probably will be ok if he just mails them to you, most likely you wont need them adjusted at all

Sounds to me like you have been just unlucky.

Re: question for cped and dr ed

paula on 2/04/02 at 09:14 (072519)

that is the question i have for you and dr ed. i must start therapy in a pool. dr ed makes orthotics that go on land, not in pools. orthotists make plastic afos that go in water. don't know if peds make plastic orthotics. please clear up this confusion if i have it wrong. my point is i'm not ready for dr ed yet, i think. dr ed can help me when i am ready to walk on land. then i would fly there to get an arothotic that fits into a shoe he recommentds. if i have this wrong please explain.

Re: Orthotists and C.Ped's

Richard, C.Ped on 2/04/02 at 11:57 (072528)

Just a quick FYI on C.Ped -vs- orthotist. C.Peds are limited to below the ankle as to what they can do. An orthotist can make foot orthotics as well as custom AFOs and can also fit leg braces.
Richard

Re: othotic

Richard, C.Ped on 2/04/02 at 12:02 (072530)

Paula,
I can see why this is so frustrating to you. My blood pressure went up just reading your post. I am only 3 1/2 hours from Atlanta. If you would like to take a short trip this way, Mike and I would be happy to look you over with a thorough pedorthic exam.
Richard

Re: othotic

paula on 2/04/02 at 13:51 (072542)

do you make plastic afos that you addjust with a heat gun?

Re: To elliott

D.J. on 2/04/02 at 16:17 (072557)

Elliott,

I live about an hour from Baltimore. Would you be able to give me the name of the Baltimore doctor you have recommended for Paula. I have seen one well-respected orthopedic foot and ankle specialist in Baltimore but am always looking for new opinions. Here is my email if you prefer (email removed)

Thanks!

Re: thanks, Richard (nm)

Carole C in NOLA on 2/04/02 at 16:28 (072560)

.

Re: question for cped and dr ed

BG CPed on 2/04/02 at 17:29 (072566)

Plastic afo are sometimes used,and sometimes not . It can be overkill in some cases. If you dont have drop foot and just a bad case of ptti in most cases the right shoe and orthotic should work, provided they are both correct. If you are in a pool your wt is lessened to a great degree so an afo for aqua therapy may be more than you need.

One reason I am not big on afo for ptti is that there is never enough hindfoot or rearfoot correction and they rely on too much arch. If you have tight heel cords like most you will get skin irritation or even breakdown on inside of arch or ankle. Have your tried exercise bike? even one that you sit on like a chair and pedal. there is no impact or wt bearing so you can strengthen legs and build up to walking.

If Richard is 3 hours away you may want to visit him. There are different ways to support the foot, dont get too wraped up in what exact type of brace or orthotic it is. Let me know if I am missing your question here

Re: question for cped and dr ed

paula on 2/04/02 at 17:51 (072568)

i didn't realize there are two peds on the board. thank you for your response. trust me, i need a support for the post tib ankle area when i walk in the pool and i need an arch as well. it has to be waterproof so i figure a plastic afo is what i've go to have? i already use an exercise bike. now my physical therapist would like to stand me up vertically in a pool so my legs and hips can unbend from a year in a half in a wheelchair. but i need to support my post tib when i do this.

Re: To elliott

elliott on 2/04/02 at 18:59 (072574)

Mark Myerson is the big name, certainly for PTTD. Go to hotbot.com, and type in

myerson posterior tibial

and take a look at the sites that pop up.

Re: To elliott

BG CPed on 2/04/02 at 20:19 (072579)

Myerson is the guy that did/re-did NBA Grant Hill. He is supposed to be playing again in late June

Re: question for cped and dr ed

BG CPed on 2/04/02 at 20:28 (072580)

There are 2 peds on here. Wt bearing pt is beneficial for some reasons over aqua pt. I still dont see why you need an afo for aqua ther. Does your pt suggest this? There is much less load/wt bearing in pool and if it is that bad they also have a harness that can further unload you.

What about a water shoe or snug athletic shoe with an orthotic made of eva? I made an orthotic for a worls champion water skier and she uses it both salt and fresh water. It is pure eva and has lasted over 2 years now. If the water level in the pool is near your chest you should not need a full afo. I am not second guessing your pt but you may want to discuss it further. If you are afraid becuase you have been in a chair you can also use an inflatable ring to unload you till you are comfortable.

If you start slow then get a good shoe and orthotic and start wt bearing you will get more confidence. Get pissed at that chair like it is a bad, loud, rude neighbor that you are sick of

Re: question for cped and dr ed

paula on 2/04/02 at 21:41 (072595)

i have to start in a pool because i have not walked in a year and a half. i have to have support for my post tib tendon cause it is severely dysfunctional.i have to have arch support cause i have almost no arch. that is why i need a waterproof afo.

Re: question for cped and dr ed

paula on 2/04/02 at 21:43 (072597)

which is why i was asking if anyone knew of a good plastic afo maker.

Re: question for cped and dr ed

BG CPed on 2/05/02 at 07:04 (072612)

I realize that Paula, that is why I was saying that in chest deep or more water there ismuch less strain on your ptt,etc. If your pt said you needed an afo to for water therapy? If you get a good ortotic of eva and a nylon/eva running type shoe with no leather it would work and dry out over night for the next day. It will be hard to wear an afo without a shoe unless they put 4 velcro straps on it, then you have to worry about the bottom of it getting scraped and damaged.

Again being in chest deep water will put much less stress on your soft tissue, I dont remember the rtio of wt unloading, Elliott prob knows the formula to figure it.

Re: To elliott

D.J. on 2/05/02 at 09:42 (072623)

Thanks! I've heard the name. In fact, one of the doctors I've seen is also at Union Memorial Hospital. He also has a great reputation for working with athletic foot and ankle injuries. Unfortunately he was stumped after a couple visits. I'm surprised he didn't refer me to his colleague. I'll definitely look into Myerson.

Re: question for cped and dr ed

paula on 2/05/02 at 13:17 (072645)

i am already in the pool. problem is, with water up to my nose, i still pronate badly cause i lost all my muscles and have to grow em back by walking in a pool. at this point an afo is needed for ankle support because the post tib needs to not be stretched since there is not much in the way of muscles to hold it up right now. i didn't realize that eva orthotics were waterproof. don't they have glue ? they can hold up in warm water for a few hours a day? when i don't need strong ankle support and post tib support higher up i could try to graduate to that. but now i need a plastic af. that is specific for post tib dysfuncion that goes in water. after not walking in a year and a half i need to find something that works soon or leg musclse will die as i understand. this is frustrating and tragic beyond belief. i need a n orthotist who has some clue abou+ severe post tib and makes plastic afos. and i can't seem to find one nor does anyone on this board seem to know of one.

Re: Paula, did you try this?

elliott on 2/05/02 at 14:21 (072649)

http://www.oandp.com/products/atlanta/custom.htm

Located right next door to you, so maybe you can go in for a fitting. They have several materials (isn't polypropylene waterproof?) and claim they fulfill custom requests. Phone number is on their home page.

Hope this post goes through; it's still taking me minutes to load after just about every click.

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Re: question for cped and dr ed

BG CPed on 2/05/02 at 19:28 (072706)

Yes eva is water proof, the glue is also as long as it is a rubber cement typ and not water based which most are. I would still think you may want to get a good orthotic and a solisd shoe that is not laeather but nylon and synthetic. The other problem with an afo that is not in a shoe is that when you dorsiflex or toe off your foot will want to migrate or move out of it unless it is in a shoe or it is articulated at the ankle. If an afo is the only solution they can use a becker joint that is mostly nylon and all the screws are stainless so it can go in water