People are becoming more aware of orthotic therapy today. Orthotics are inserts for your footwear that help correct structural problems in the foot such as high arches or flat feet. These problems often result in pain in the sole, heel, forefoot, ankles, knees, and, sometimes, the hips and back. Orthotics can also be helpful in addressing structural conditions that lead to the buildup of callus, formation of corns, diabetic foot wounds, and complications from claw toes, curly toes, hammer toes and bunions. When used appropriately, they can be extremely effective.
However, as orthotics become a more recognizable form of therapy, it seems everyone from shoe stores to shopping mall kiosks and other aggressive entrepreneurs is selling them. Even some health practitioners who are not foot specialists are providing orthotics as a sideline business. Methods like foam boxes, ink pad prints, and seemingly “advanced” technology like electronic pressure mats may seem impressive to the average consumer. However, what the unsuspecting public may be purchasing is an overpriced arch support or, worse, a custom insert that is shaped to a faulty foot.
Suspended Sub-talar Joint Neutral Casting
Ideally, prescription custom orthotics are precisely “cast” using a very specialized technique. The practitioner adjusts your foot into a special position called "sub-talar joint neutral" while it is suspended in the air, and then creates a plaster mold. Recent 3D computer advancements allow the chiropodist or podiatrist to create an electronic image using highly advanced software from which the mold for the orthotic is generated — more accurately and without the mess. He or she prescribes adjustments to the cast using precise calculations to help correct any deficiencies in your foot structure. It's very important to note that this 3D technology leverages the immense skill and training of chiropodists, giving them a tool to be even more precise. It is not to be confused with vastly inferior two-dimensional computer step-on pads and scanners common with unregulated providers or non-foot specialists.
Suspended sub-talar joint neutral casting is considered to be the gold standard. In fact, many insurance companies insist on orthotic prescriptions from registered members of the College of Chiropodists of Ontario, who use this technique.
Orthotics in Canada
Unfortunately, orthotics are not regulated in any Canadian province. Essentially, anyone can set up shop to provide a device they call an “orthotic”. This makes it challenging for the average foot pain sufferer to choose a device and provider.
However, as provincially regulated foot specialists, members of the College of Chiropodists of Ontario (chiropodists and podiatrists) are bound by specific rules regarding orthotic therapy as part of their licensing. They are also highly trained. Chiropodists and podiatrists receive nearly four years of intensive lower limb bio-mechanics, gait analysis, and orthotic therapy training as part of an overall foot medicine program. Some people providing orthotics receive as little as one day of training, or, worse, some are providing orthotics with no training at all. It is an unfortunate situation, and both the Ontario Society of Chiropodists and the Ontario Podiatric Medical Association are lobbying the government for regulation and provincial standards of practice for providing orthotics.
More Reasons to See your Chiropodist for Orthotics
Not everyone who suffers from foot pain or problems necessarily needs a pair of orthotics. When you see your registered chiropodist, you are seeing a highly trained foot medical specialist who can provide a wide range of treatments. He or she can identify your problem and match it to the most appropriate treatment approach or combination of approaches.
In some cases, as well, foot pain or problems may simply be symptoms of other more serious foot health issues. Orthotic therapy may or may not be the best approach to help address these symptoms. Your chiropodist is able to determine the best treatment based on your overall foot health. As a foot medical specialist, he or she helps ensure that any potentially more serious underlying problems do not go undiagnosed and unresolved.
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