Comparing Custom Orthotics and Off-The-Shelf Insoles
Canadian Certified Pedorthists (C. Ped (C)s) are trained in the analysis and assessment of foot and lower limb biomechanics. If you’ve booked a Pedorthic assessment appointment, you were likely given an idea of what to bring to the appointment, but what should you expect at your first visit with your Pedorthist, and subsequent visits?
Review of Your Medical History
Well, first off it’s not scary! At your initial visit, a thorough assessment will be done, beginning with your medical history. We will ask questions about your injury or pain, past history of injuries and/or surgeries, relevant medical conditions, your footwear and what kind of activities you do. The Pedorthist will also take a look at the footwear you bring in and note any wear patterns.
A Weight-Bearing, Non-Weight Bearing Assessment, and Muscle Testing
A non-weight bearing assessment will be conducted, where your Pedorthist will test your range of motion to note any abnormalities. A weight-bearing assessment and muscle testing will also be completed to note any differences. Your Pedorthist will determine specific muscle testing for you based on your assessment.
A Review of Your Gait Profile and Assessment
Then, the Pedorthist will have you walk a few times and observe your gait (how you walk) from different angles.
A Discussion of Available Treatment Options
After the assessment, your Pedorthist will discuss observations and education about your gait, injury or likely reasons for your pain/discomfort. At this time the Pedorthist will discuss treatment options with you, which may include stretching, off-the-shelf orthotics, custom orthotics, or a referral for physiotherapy. Footwear recommendations will also be made based on your footwear needs, foot type and gait.
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Casting Your Custom Orthotics
If custom orthotics are determined to be part of your treatment plan, you will be casted using a method that provides a 3D mould of your foot (most often using a foam box, plaster or computer software).
There are a number of ways that your Pedorthist may cast your custom orthotics, including:
A Foam Box
If your Pedorthist casts using a foam box, they will complete the cast either with you sitting or standing and by placing one foot at a time gently into the foam box. The Pedorthist will control your foot position while placing it into the box to create an impression of your foot.
A Plaster Casting
Plaster casting is primarily completed while the patient is laying down, and involves the Pedorthist placing plaster on the sides and bottom of your foot while holding the foot in a ‘neutral’ position. Once the plaster has dried, the Pedorthist will remove the cast from your foot and complete the same process for your other foot.
Computer Software Casting
There’s also a computer software (contact digitizing) that’s used for casting purposes; it’s able to create a 3D image on the computer by capturing the contours of your foot. The process uses small cylinders that are able to move and contact the foot to form a 3D image. This contact digitizing differs from pressure mats, as standing on a pressure mat only provides you with a 2D image. The pressure mat is not able to correctly capture the areas where the mat does not come into contact with your foot (foot contours, through the arch, etc.).
Modification of Your Current Footwear
A Canadian Certified Pedorthist may also modify your current footwear or new shoes for accommodative or corrective purposes. For example, this tactic could be used for adding a lift for a leg length discrepancy.
Follow Up and Orthotic Pick Up Appointment
At your orthotic pick up appointment, your Pedorthist will ensure that your new custom orthotics fit well to the shoes that you have provided and that they are comfortable for you to wear. A follow up appointment need to be scheduled to ensure your orthotics are comfortable and working well for your needs.
Your Pedorthist should maintain an open-door policy with you to ensure that they are available for any adjustments or follow up appointments that may arise.
Read our feature to find out the differences between a Pedorthist and a Podiatrist and other footcare professionals.
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