What is Pedorthics?
Pedorthics is the design, manufacture, modification and fit of footwear, including foot orthoses, to alleviate foot problems caused by disease, overuse, congenital defect or injury. It is footwear carefully fitted, to relieve or accommodate temporary or permanent foot problems. A certified pedorthist (C.Ped.) studies shoe construction and modification, foot orthotic materials and fabrication, and lower extremity anatomy, physiology and biomechanics. A C. Ped learns to understand from the doctor’s diagnosis and prescription just what the patient needs in the way of footwear, and/or modifications to footwear.
Jim McFarland is state licenesed and is board certified. It gives him great satisfaction to be able to fill a doctor’s prescription, and meet the footcare and footwear needs of his customers. With the proper credentials, he is able to dispense therapeutic shoes under the Therapeutic Shoe Bill and bill Medicare. JIm has a complete casting lab for orthoses (orthotics) fabrications. He specializes in shoe modifications such as; elevations (shoe lifts) for leg length differences (often a result of hip replacements), stretching for bunions, rocker-soles, medial and lateral wedges, and flares, and alterations to accomodate foot deformities.
Pedorthic Solutions
Over the course of a lifetime, most people experience some type of foot problem. It may be as simple as a blister or callus, or something complicated enough to require hospitalization. But the majority of foot problems, although they can be serious in degree, are relatively routine in nature.
Pedorthics uses footwear to help ease foot problems. A certified pedorthist works as part of the allied health care team, dispensing footwear to keep people as mobile as possible.
Even people who don't require medical evaluation and treatment sometimes need orthotics in their shoes, simply to make the shoes function better. Most certified pedorthists work primarily on prescription footwear and custom orthoses, but they can provide over-the-counter inserts when custom work isn't necessary. Also, because they can recognize routine foot conditions that may need medical attention, C. Peds often refer clients to health care providers before a potential foot problem becomes a major one.
A Growing Field
Although there were fewer than 2,000 C.Peds in the U.S. and Canada at the end of 1998, the number increases yearly--and is expected to continue growing as more and more people begin to understand the relationship between footwear and health.
A C. Ped. studies shoe construction and modification, foot orthotic materials, and fabrication, and lower extremity anatomy, physiology and biomechanics. He or she also learns to understand from the doctors' diagnosis and prescription just what the patient needs in the way of footwear.
Testing for certification is done by the American Board of Certification (ABC), which also requires that C.Peds attend Continuing Education courses to maintain their certification.
Meeting Individual Needs
Because no single type of footwear is appropriate to every activity, most people find that their footwear needs--including shoes, orthotics and hose for socks--will vary according to their activities and performance levels. Shoes designed for office wear, for example, are probably not sufficient to support feet through a long afternoon at a shopping mall. Similarly, orthoses designed for a basketball player provide a different kind of support than orthoses for a golfer.
Whatever their activities, people should have a minimum of two pair of shoes for daily use, and should alternate wearing them. Wearing the same pair, day after day without change, can hasten the onset of foot problems, because over time a shoe's features become distorted by use.
Several manufactures make shoes suitable for use in pedorthics. Some are specialized, such as "depth" shoes. Many can be customized or modified to fit an individual's needs. Shoes can also be custom-made from a model of the patient's own foot.
Modification, Fabrication and Fitting
Shoe modifications may be external, internal, or both. External modifications frequently used to stabilize the foot include flares and wedges. In addition, ambulation can be improved with various typesa of rocker soles and elevations. Internal modifications are intended to adapt the interior surface of the shoe for the contours of the patient's foot, relieving or accommodating conditions.
Foot orthotics are often used to address foot problems. Orthoses can be fabricated from a variety of materials and used in many types of shoe--athletic, therapeutic, work or even some dress shoes. Patients should discuss their activities with their pedorthist so the C. Ped. can provide the most effective materials for treatment based on the doctor's prescription.
Because fit is a critical part of pedorthics, most pedorthic patients will need more than one appointment to ensure that their footwear fits and functions properly, particularly if the prescription includes both an orthosis and a shoe.
Cost of Pedorthics
Pedorthic care, undertaken at the onset of a foot condition, can reduce pain and a later need for hospitalization or surgery. Charges for pedorthic care are based on the shoes, modifications and/orthoses needed. The cost of pedorthic services and products varies, depending on factors like materials used and complexity of the problem(s).
Most certified pedorthists work by appointment. During the initial evaluation appointment, the patient can expect a cost estimate for footwear and related work.
Quality Care
Pedorthics, because it is conservative, can be truly cost-effective. Relying on the doctor's diagnosis, the certified pedorthist's ability to provide, fit and maintain the appropriate footwear, and the patient's willingness to use footwear properly, pedothics can make a profound difference in the quality of an individual's daily life.
A footwear prescription, like a prescription for medicine or eyeglasses, is a matter of health. When you give a prescription to a certified pedorthist, you can rest assured you're working with a qualified professional committed to a high level of care as a member of the allied health team.
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