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Orthotics

Posted by Pauline on 8/07/02 at 21:06 (091897)

Why do so many of us have a collection of orthotics that we cannot wear?

Some of us had our impressions made by cast, others used the mat, some the foam box, and many used a combination of things to get a so called accurate impression yet we all end up the same way. Our ice scrapers are collecting dust in a bag.

What's the trick for getting a working pair of orthotics from impressions taken of the patients foot, to the lab and back to the patients foot in a wearable condition?

Re: Orthotics

JJC on 8/08/02 at 09:45 (091943)

Assumeing a patient has 4 pairs of shoes he uses in a week.
If the orthotics only feel good in 1 or 2 pairs, does the
podiatrist think they are good enough? The patient is still
left with uncomfortable orthotics (during the week). In my
book, that means they aren't good enough.

Re: Orthotics

elliott on 8/08/02 at 10:12 (091946)

I can't agree. Since walking and healing are important, you switch to shoes that work, typically appropriate walking or running shoes with a removable insert. There are some black walking shoes which may help, some a bit more dressy than others. You may need a separate unposted orthotic for brief excursions into dress shoes when absolutely necessary.

Actually, most shoes out there do not have the appropriate features (e.g. adequate medial stability) for problem feet, so you have to find the right shoes to start with. This is more a function of the typical shoe sold than a a defect in orthotic design. If orthotics don't work in an unstable high-heeled toe-crushing women's dress shoe, that's not the fault of the orthotic.

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Re: Orthotics

elliott on 8/08/02 at 10:18 (091947)

You're almost inviting a response from Dr. Kiper.

Did you try NW Podiatric orthotics? I wonder how much is due to the pod. My pod has fitted several runners I know having differing foottypes (I've seen their feet with my own eyes), most for PF, all with the above orthotic, all comfortably.

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Re: Orthotics

pala on 8/08/02 at 10:29 (091949)

who is your pod? maybe folks nearby want to see him. thanks for the suggestion about nw podiatric. it is good to have lots of options here.

Re: Orthotics

pala on 8/08/02 at 10:52 (091955)

i like to see lots of options here. here is another one. there are these folks called orthotists. they make afos, ucbl, and other orthotics that pods usually don't make, i believe. they are a sort of plastic, molded. i have one pair. didn't work for me, but at least it is another option and aparrantly works for some people. has anyone else here ever gotten a device from an orthoitst other than me? did it help?

Re: Orthotics

JJC on 8/08/02 at 12:35 (091974)

My current pair, the best of the bunch, is 'DesignLine' By Langer.
They work in my daily dress shoes (Liz Claibourne rubber heels/nearly
flats).

Re: Orthotics

elliott on 8/08/02 at 13:53 (091984)

Bet it's the shoes, not the orthotics.

--

Re: Orthotics

Ed Davis, DPM on 8/11/02 at 12:19 (092200)

Pauline:

There really is no trick to getting good orthotics -- it is something that is being done thousands of times per day across the country.

Keep in mind that even the best orthotics in the world will not be an effective treatment all the time. All treamtments, including those done perfectly will fail a certain percentage of the time. Unfortunately, it is not always possible to know ahead of time before the treatment is rendered.

If one obtains an orthotic which is made poorly, then the question as to whether orthotic therapy will work for that patient remains unanswered. The best thing is to have one orthotic, expertly made without compromise.
If it does not work one can conclude that orthotic therapy will not work for a patient and attempts a making further devices will not be fruitful.
Ed

Re: Orthotics

JJC on 8/08/02 at 09:45 (091943)

Assumeing a patient has 4 pairs of shoes he uses in a week.
If the orthotics only feel good in 1 or 2 pairs, does the
podiatrist think they are good enough? The patient is still
left with uncomfortable orthotics (during the week). In my
book, that means they aren't good enough.

Re: Orthotics

elliott on 8/08/02 at 10:12 (091946)

I can't agree. Since walking and healing are important, you switch to shoes that work, typically appropriate walking or running shoes with a removable insert. There are some black walking shoes which may help, some a bit more dressy than others. You may need a separate unposted orthotic for brief excursions into dress shoes when absolutely necessary.

Actually, most shoes out there do not have the appropriate features (e.g. adequate medial stability) for problem feet, so you have to find the right shoes to start with. This is more a function of the typical shoe sold than a a defect in orthotic design. If orthotics don't work in an unstable high-heeled toe-crushing women's dress shoe, that's not the fault of the orthotic.

---

----

Re: Orthotics

elliott on 8/08/02 at 10:18 (091947)

You're almost inviting a response from Dr. Kiper.

Did you try NW Podiatric orthotics? I wonder how much is due to the pod. My pod has fitted several runners I know having differing foottypes (I've seen their feet with my own eyes), most for PF, all with the above orthotic, all comfortably.

---

Re: Orthotics

pala on 8/08/02 at 10:29 (091949)

who is your pod? maybe folks nearby want to see him. thanks for the suggestion about nw podiatric. it is good to have lots of options here.

Re: Orthotics

pala on 8/08/02 at 10:52 (091955)

i like to see lots of options here. here is another one. there are these folks called orthotists. they make afos, ucbl, and other orthotics that pods usually don't make, i believe. they are a sort of plastic, molded. i have one pair. didn't work for me, but at least it is another option and aparrantly works for some people. has anyone else here ever gotten a device from an orthoitst other than me? did it help?

Re: Orthotics

JJC on 8/08/02 at 12:35 (091974)

My current pair, the best of the bunch, is 'DesignLine' By Langer.
They work in my daily dress shoes (Liz Claibourne rubber heels/nearly
flats).

Re: Orthotics

elliott on 8/08/02 at 13:53 (091984)

Bet it's the shoes, not the orthotics.

--

Re: Orthotics

Ed Davis, DPM on 8/11/02 at 12:19 (092200)

Pauline:

There really is no trick to getting good orthotics -- it is something that is being done thousands of times per day across the country.

Keep in mind that even the best orthotics in the world will not be an effective treatment all the time. All treamtments, including those done perfectly will fail a certain percentage of the time. Unfortunately, it is not always possible to know ahead of time before the treatment is rendered.

If one obtains an orthotic which is made poorly, then the question as to whether orthotic therapy will work for that patient remains unanswered. The best thing is to have one orthotic, expertly made without compromise.
If it does not work one can conclude that orthotic therapy will not work for a patient and attempts a making further devices will not be fruitful.
Ed