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What
are Orthotics?
Orthotics are shoe inserts designed to correct an abnormal,
or irregular, walking pattern. Orthotics are not solely for
the purpose of providing"arch supports," They perform functions
that make standing, walking, and running more comfortable
and efficient, by altering slightly the angles at which the
foot strikes a walking or running surface.
Orthotic
Standards
The college of Chiropodist of Ontario has developed its orthotic
standard with the sole purpose of ensuring that the public
has safe and effective foot care. Currently, many professions
with varying levels of competency provide orthtotics. However,
Chiropodists and Podiatrists are the only health care providers
whose scope of practice includes the provision of orthotics.
( go to: http://www.cocoo.on.ca/pdfs/sop-orthotics-june-2004.pdf
for orthtotics standards)
Types of Orthtotics
A pre-fabricated orthotic is one that is already made for
various sizes and can be purchased at drug or shoe stores.
One can benefit from these devices, but I suggest you consult
your chiropodist before you purchase them to ensure that the
device will alleviate your problem. A custom made orthotic
is made on the basis: of precise measurements of your feet;
biomechanical assessment of your feet and gait cycle. There
are three types of orthotics and they are categorized by the
function they perform.
Rigid
Orthotics
The rigid orthotics are designed to control function, designed
to control function, and is usually made of a firm material,
and is used primarily for walking or dress shoes.. Rigid orthotics
are chiefly designed to control motion in two major foot joints,
which lie directly below the ankle joint. These devices are
long lasting, do not change shape, and are usually difficult
to break. The devices are designed to correct abnormal problems
which cause strains, aches, and pains in the legs, thighs,
and lower back that may seem only remotely connected to foot
function.
Soft Orthotics
The soft, orthotic device helps to absorb shock, improve balance,
and deflect pressure from sore and comfortable areas of the
foot. It is usually constructed of soft, compressible materials.
It extends from the heel to the toes. The advantage is that
it is flexible and can adapt to varying weight-bearing forces.
The disadvantage is that it must be periodically replaced
or refurbished. It is used primarily to provide comfort and
therefore very effective for arthritic and grossly deformed
feet and diabetic feet.
Semirigid Orthotics
The semirigid orthotic provides for dynamic balance of the
foot while walking or participating in sports. It helps guide
the foot through proper functions, allowing the muscles and
tendons to perform more efficiently. The orthotic is constructed
from a combination of soft and more rigid materials.
Orthotics for Children
Orthotic devices are effective in the treatment of children
with foot deformities. I recommend that children with foot
deformities be placed in orthotics soon after they start walking,
to stabilize the foot. The length of time a child needs orthotics
depends on the extent of the deformity and how fast it is
corrected.
Gait Analysis/ Biomechanical Assessment
A biomechanical assessment involves assessing & measuring
different motions of the foot, ankle, leg & lower back to
determine whether it functions & moves correctly. Gait analysis
involves assessing these movements while walking. There are
several techniques available on the market for the evaluation
of the gait cycle. The computerized gait cycle analysis is
one of them. The measurements taken with this technique vary
with: the posture of the patient while standing; and the number
of times the patient walks over the mat. Most chiropodists
and podiatrist do not use this technique. The reliability
of this technique depends on the qualification of the evaluator.
If you decide to pursue with this technique, I suggest that
you consult with a chiropodist or a podiatrist to determine
if the weight bearing measurement technique will suit your
purpose
Casting Technique
In our clinic, we use the Plaster of Paris casting technique.
This technique is used by majority of the Podiatrists or Chiropodists.
This technique captures the precise measurement of your foot
and allows for the corrections to be made on the mold of your
foot before the orthotic is made.
How is the orthotic made in our lab?
Once the cast is removed from the foot, a mold is made by
using Plaster of Paris. Corrections are applied to the mold
based on the biomechanical assessment. This is done by removing
or adding plaster depending on the condition to be corrected.
So, for example, if pressure has to be deflected away from
the area where the corn occurs, corrections have to be made
on the mold accordingly. After the corrections are done, the
molds are placed in a vacuum former. The heated orthotic material
is placed on the mold and a vacuum is generated to make the
plastic conform to the shape of the mold. The "shell" resulting
from this process is then grinded on a machine to shape it
to fit into the shoe. A top cover is then applied to the shell.
The final product is buffed before being fitted into the shoe.
Our lab is on site. Therefore our turn around times for new
appliance are very short and repairs can be done readily..
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