Orthotics or not??
How does a clinician decide if orthotics are indicated for a specific patient?
Some health care professionals prescribe custom-made orthotics to every single patient that walks through their door whether they need it or not. I am afraid I cannot agree with that philosophy.
Orthotics may be indicated if?
- A patient has not satisfactorily responded to appropriate joint mobilizations, muscular retraining exercises and pain relieving modalities (e.g. ultrasound, laser, etc.)
- A patient has not satisfactorily responded to activity modification recommendations
- A patient has not satisfactorily responded to footwear modifications
- A patient admits to finding orthotics beneficial in the past
- A patient reports of immediate improvements in symptoms after the low dye taping technique (which limits pronation), or after using the orthotics to walk around the clinic before even heat molding themOrthotics may be indicated if?
- In standing, it is noted that the patient has a reduced medial longitudinal arch
- In standing, it is noted that the patient has a valgum / everted Calcaneus
- It is noted that the patient has a callus on the plantar aspect of the 2nd metatarsal head (indicating an unstable 1st ray)
Clinical Relevance: Just as it is unethical to prescribe custom-orthotics to every single patient, it is also unethical not to recommend orthotics to those who could have potentially benefited from them!
Personal Comment:Highly effective Foot & Ankle management techniques (outside of Orthotics) are reviewed in the APTEI Video/Book program “Foot & Ankle Complex (Part I)”
Posted on: December 26, 2002
Categories: Foot & Ankle