Over the Counter and Custom Orthotics

Over the Counter and Custom Orthotics

Over the Counter and Custom Orthotics

Foot orthosis defined:

A foot orthosis is a device that is used to brace, support, or protect the foot or a part of the foot.

What are foot orthoses?

Good question! Foot orthotics are referred to by many names. Some common names used to describe foot orthoses and related products are arch supports, shoe inserts, orthotics, orthoses, custom orthotics or orthoses, prefabricated orthotics or orthoses, just to name a few! Needless to say, this can all be very confusing to patients or consumers who are interested in understanding prescription and non-prescription foot care products and devices.

Do you need an orthosis and if so, what type of orthosis is best for you?

There is no simple answer to this question. In some cases, a simple over-the-counter orthotic may be all that is required to relieve minor pain or foot fatigue. On the other had, minor symptoms may be an indication of a more serious medical problem that may require a podiatrist’s attention. To compound matters, some diseases or conditions have an asymptomatic stage in which pain can be absent or may be intermittent even when the condition is progressive. In such cases, early intervention can be very important. The best way to determine if you need an orthosis is to consult your podiatrist.

One method of categorizing foot orthoses is to divide them into groups according to prescription and non-prescription foot orthoses. Non-prescription foot orthoses are often referred to as “over-the-counter” devices and may be obtained with or without the assistance of a licensed podiatrist. Non-prescription orthoses are sometimes custom made but are typically pre-manufactured. Prescription foot orthoses are prescribed by a licensed podiatrist and are not available without a prescription. Prescription foot orthoses are typically custom made but there are some varieties that are pre-manufactured and not custom made.

Over-the-counter orthotics are manufactured using predetermined shapes or pre-made models, or are made by injection molding or computer milling. Over-the-counter orthotics are not made from the patients own foot anatomy and are more generic or general in shape.

Categories of foot orthoses:

There are many types of foot orthoses and there are different ways that we can attempt to categorize them. It is somewhat difficult to categorize foot orthoses due to variations in orthotic device design and manufacturing.

One method of categorizing foot orthoses is to divide them into groups according to prescription and non-prescription foot orthoses. Non-prescription foot orthoses are often referred to as “over-the-counter” devices and may be obtained with or without the assistance of a licensed podiatrist. Non-prescription orthoses are sometimes custom made but are typically pre-manufactured. Prescription foot orthoses are prescribed by a licensed podiatrist and are not available without a prescription. Prescription foot orthoses are typically custom made but there are some varieties that are pre-manufactured and not custom made.

Custom Orthotics

Another way to categorize foot orthoses is by their method of manufacture. Custom foot orthoses are individually made, and are typically manufactured using the patient’s own foot anatomy by creating a model of the foot (a cast, impression, impression foam, scanner, etc.). The anatomical model serves as the foundation of the form used to produce the orthosis.

A custom foot orthosis is a device that is designed to brace, support, or protect the foot or a part of the foot. The biomechanical benefit derived from a custom foot orthosis is largely related to the shape and physical properties of the device. The shape of an orthosis is determined by the original cast of the foot and by any shape modifications made to the cast during the manufacturing process. While modification of the cast influences the shape and is critical in the production of an orthosis, the fundamental shape of an orthosis is first governed by the patient’s individual foot anatomy and the physiological position in which the foot is casted. The importance of a good quality cast of the foot can not be overstated!

Types of prescription foot orthoses:

There are basically three types of prescription foot orthoses. The two most common types of prescription foot orthoses are accommodative orthoses and functional orthoses.

Accommodative orthosis:

An accommodative orthosis is a device that is designed to pad and protect the foot or a part of thefoot. An accommodative orthosis supplements the foots natural padding and may be designed to reduce pressure by accommodation, in certain areas.

 

Functional orthosis:

A functional orthosis is a device that is designed to influence the position and/or motion of the foot through the application of biomechanical principles. A functional orthosis is the most biomechanically advanced type of foot orthosis and is only available by prescription. It influences the position or motion of the foot altering the forces acting on the foot. A functional orthosis requires a significant degree of expertise to prescribe and manufacture.

Functional Hybrid Orthosis:

In some cases, the characteristics of an accommodative orthosis are combined with those of a function orthosis to create a hybrid orthosis.

Prescribing accommodative, functional, or hybrid orthoses should be done by a podiatrist who has been educated and properly trained in their to use.

An orthosis is an orthosis, or is it?

Foot orthoses and related devices are available from a variety of different sources these days. Custom and non-custom foot orthoses, arch supports, and shoe inserts may be obtained at retail establishments, via the internet, or from professional healthcare providers. There can be major differences between foot orthoses from different sources, so finding a specialist who is qualified in biomechanics and foot orthotic therapy is very important. A prescription foot orthosis is a medical device that should only be provided after an appropriate biomechanical examination. A biomechanical examination enables a podiatrist to understand the patient’s individual needs so that a proper foot orthosis can be prescribed.

The process of prescribing a prescription foot orthosis requires a qualified podiatrist. There are many variables which influence the prescription process. Careful consideration of the patient’s individual biomechanics, medical condition, health history, and other needs must be done in order to develop a treatment plan and the proper orthotic prescription. The value of the services of a qualified podiatrist should be recognized by patients when considering the need for foot orthotic therapy. A qualified medical podiatrist is important component in achieve favorable outcomes with foot orthoses.

                                      

Pressure Wave Therapy (PWT)

Pressure Wave Therapy (PWT)

Pressure Wave Therapy (PWT)

What is PWT?

Pressure Wave Therapy (PWT) is a noninvasive surgical procedure that uses sound waves to stimulate healing in some physical disorders, including plantar fasciitis.  Because there is no incision, PWT offers two main advantages over traditional surgical methods: fewer potential complications and a faster return to normal activity. PWT has been used extensively for several years to treat plantar fasciitis and other disorders.

What is Plantar Fasciitis?

Plantar fasciitis is the most common form of heel pain. This painful condition results from inflammation of the plantar fascia-the connective tissue that stretches from the heel bone, across the arch, and to the base of the toes. Plantar fasciitis is sometimes also called heel spur syndrome when a spur (bony protrusion) is present.


Who is a Candidate for PWT?

PWT may be considered as a therapeutic option for the patient whose heel pain has not resolved with conservative treatment. Conservative measures include use of anti-inflammatory medications, steroid injections, ice packs, stretching exercises, orthotic devices (shoe inserts), and physical therapy.

Some patients should not be treated with PWT. The procedure is not appropriate for patients who have a bleeding disorder or take medications that may prolong bleeding or interfere with clotting. Your foot and ankle surgeon will determine if the procedure is appropriate for you based on your medical history.

What to Expect With PWT

In preparation for PWT, the foot and ankle surgeon will instruct the patient to stop taking any anti-inflammatory medications (for example, aspirin or ibuprofen) for about five days before the procedure. It is important to avoid these medications because they are known to prolong bleeding under the surface of the skin.

PWT is performed on an outpatient basis, so it does not require an overnight stay in the hospital. Before the procedure begins, the patient is comfortably positioned and may receive local and/or sedation anesthesia. The treatment may take up to 5 minutes per foot. During the procedure sound waves penetrate the heel area and stimulate the healing response. Sometimes more than one session is needed to adequately treat the inflammation and reduce the patient’s symptoms.

   

After the Procedure

The foot and ankle surgeon may advise you to have someone drive you home after the procedure. Other instructions may include:

  • Rest and elevate the foot for the remainder of the day and night.
  • Resume gentle stretching exercises the day following the procedure.
  • Avoid taking any anti-inflammatory medication, such as ibuprofen or aspirin, for up to four weeks after PWT.
  • Avoid heavy lifting until the surgeon approves resuming this activity.
  • You may walk on the foot.
  • Avoid running or excessive activity.
  • Avoid going barefoot during the healing process.
  • Wear supportive shoes.
  • In some cases, orthotic devices (shoe inserts) will be prescribed.

Although patients sometimes feel they can return to normal activities right away, the surgeon will determine when that is appropriate for your situation. It is important to use caution and follow the doctor’s instructions to avoid injuring the treated foot. Because PWT temporarily reduces or eliminates the sensation of pain, patients sometimes become too active too soon.

PWT is very safe and effective, but every surgical procedure carries the possibility of complications. In addition to mild pain and tingling or numbness, bruising and swelling sometimes develop after PWT. There have also been reports of rupture of the plantar fascia and damage to the blood vessels or nerves.

PWT in the Future

Like many other innovative noninvasive therapies, PWT is an evolving technology. As the body of information on this technique continues to expand, the result will be additional uses for PWT that will benefit more patients in the future.

                                      

Sports Medicine

Sports Medicine

Sports Medicine

Whether you are a walker or running for fun, training for a marathon or hoping for a career in basketball, sports can be demanding on the feet and ankles. Overuse or improper form can cause pain that may lead to more serious complications.  We are Albuquerque’s sports podiatrist’s, and we will work with you to eliminate the pain and prevent future injury. Whether you are a gymnast, a runner, or a dancer, we know and understand how important your sport is; we won’t ask you to stop training unless it is necessary for your recovery.

                                      

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