Pedorthics: Foot Care Through Proper Footwear
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Pedorthics: Foot Care Through Proper Footwear

Pedorthics (peh-DOR-thiks) is the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices. It's footwear, carefully fitted, to relieve or accommodate temporary or permanent foot problems. It can look so "mainstream” that others don't realize a foot problem exists. It costs less than a lot of people expect. And it can help people stay healthy.

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 credentialed pedorthist works as part of the allied health care team, dispensing footwear to help 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 credentialed 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, credentialed pedorthists often refer clients to health care providers before a potential foot problem becomes a major one.

A Growing Field

Although there were fewer than 3,300 credentialed pedorthists in the in the U.S. and Canada at the end of 2012, 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 credentialed pedorthist 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 doctor's diagnosis and prescription just what the patient needs in the way of footwear.

Testing for credentialing is done by numerous independent credentialing organizations and states, which also requires that credentialed pedorthists attend continuing education courses in order to maintain their certification and/or license.

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 or 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 the 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 manufacturers 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 types 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 shoes – athletic, therapeutic, work or even some dress shoes. Patients should discuss their activities with their pedorthist so he or she 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 their footwear fits and functions properly, particularly if the prescription includes both an orthosis and a shoe.

Costs 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/or orthoses needed. The cost of pedorthic services and products varies, depending on factors like materials used and complexity of the problem(s). Most credentialed 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 credentialed pedorthist's ability to provide, fit and maintain the appropriate footwear, and the patient's willingness to use footwear properly, pedorthics 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 credentialed pedorthist, you can rest assured that you're working with a qualified professional.

Patients may be eligible through health insurance for partial or full reimbursement for footwear prescribed to accommodate or alleviate medical conditions.

This page contains generalized information. Use of specific words within this generalized framework is not intended either to reflect or to contradict technical pedorthic definitions. Nothing in this brochure should be interpreted as a substitute for professional consultation.

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