Pedorthic assessments are one of the most important aspects of my work and a considerable portion of my weekly clinic time is devoted to them. Many patients come to my clinic with persistent and unexplained foot, ankle, knee, hip or back pain. A complete and thorough pedorthic assessment enables me to determine if the pain they are experiencing is related to poor foot structure or biomechanics. At the end of the assessment, I am able to clearly explain their medical condition to them and to recommend an individualized treatment plan that addresses the causes of, and contributing factors to, their condition rather than just the symptoms.
All Canadian Certified Pedorthists conduct similar assessments; we evaluate your lower limb anatomy, muscle and joint function, as well as the interaction of your feet and lower limbs with the rest of your body. If you have an upcoming pedorthic assessment or are trying to determine if you should schedule one, here is what you can expect:
What to bring:
On the day of your assessment, dress in loose clothing or shorts so your Pedorthist can easily examine your feet and lower limbs and wear, or bring, your everyday footwear with you. Walking or running shoes are ideal. Make sure the footwear you bring is well worn as your Pedorthist will look closely at the wear pattern at the top, bottom and insole inside of your shoes as part of the assessment. If your assessment was booked following a referral from your physician, also bring the prescription your physician provided.
What to expect:
A pedorthic assessment typically takes between 30 and 60 minutes. Your Pedorthist will begin by taking a thorough history to identify patterns and expose causes of your pain. Questions will probe:
- Previous injuries
- Family history
- Systemic diseases
- Lifestyle and activities
Following the history, your Pedorthist will perform a series of weight bearing and non-weight bearing tests including:
- Testing the joint range of motion in your feet and ankles to make sure that each joint moves in its full range
- Testing the strength of certain muscles
- Checking to see the type of foot you have: normal, flat or high arched
- Identifying any boney prominences, swelling, discolouration
- Examining the alignment of your knees and lower back
- Analyzing how you walk and run particularly the position of your foot at each phase of the step
Your Pedorthist will analyze the findings of each aspect of the assessment and will recommend a treatment plan to address your condition. Depending on what your assessment reveals, your treatment may include:
- Custom-made or over-the-counter foot orthotics
- Stretching and strengthening exercises
- Different style or brand of footwear or possibly modifications to new or existing footwear
- Ice therapy
- A recommendation to consult with another healthcare professional such as a physiotherapist, chiropractor or a massage therapist
Like all pedorthic treatment plans, your individualized plan will be designed to help alleviate pain, improve your mobility and enhance your quality of life.
If you are experiencing pain in your feet or lower limbs don’t ignore it or assume it is something you have to live with. A pedorthic assessment will provide you with valuable insight into its cause as well as a plan to address it. To schedule a pedorthic assessment you can either contact a Canadian Certified Pedorthist in your community directly or ask your healthcare practitioner for a referral.
Written By: Steve Stredulinsky B.Sc.Kin., C. Ped.(c)
Karl Hager Limb & Brace
We often hear, “what is the best shoe or brand of shoe on the market”? The easy answer is…it doesn't exist! This is because your feet, and how they move, is completely unique to you. However, there are a couple of important factors to keep in mind:
1. Look for a strong, semi-rigid heel counter in the shoe. This support will stabilize the heel and help to provide stability during motion. An easy way to check for this is to squeeze the heel of the shoe at about the middle of the heel; you should feel stiffness in this area. If the shoe is easy to compress inwards, there is likely a soft heel counter or it is completely absent.
2. The midsole of the shoe should also torsional stiffness. If you grab the heel and forefoot of the shoe and twist in opposite directions you should meet resistance. If you can wring the shoe out, the midsole is very flexible and could present problems if you are prone to foot trouble.
There are countless options in regards to knee sleeves and knee wraps. Often these are used when compression of the knee provides some support and pain relief. While the support may vary so to can the condition of the knee that needs this treatment option. Most designs do not provide a high level of support but work well in mild cases. When considering a knee sleeve or support, consider the following:
1. What is the brace made of? Neoprene is rubber based and while the brace may last longer the brace will be very hot to wear.
2. Are there any non elastic straps or metal joints? If the entire brace stretches there is very little support provide to the knee other than compression and warmth.
3. Does your patella (knee cap) require control? Many sleeves have a “doughnut” hole in the middle and indicate that this helps support the patella. In fact this is false as most sleeves cannot achieve patella support as your patella will travel inside the sleeve. There are special designs for cases where patella control is required.
-Mr. Al Heaver C.O. (c)