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June 6, 2003
Some caught flat-footed
Doctors warn against non-prescription orthotics.
KYLE BERGER REPORTER
Some retailers may be selling people short on orthotics, warned
one of B.C.'s leading podiatrists. According to Dr. Alan Boroditsky,
from health fairs to malls, and even on some local street corners,
foot merchants around the province have been selling prefabricated
foot supports as orthotics to consumers who aren't aware of the
difference.
"Orthotics are medical devices that shouldn't be purchased
without a diagnosis by a qualified medical professional who provides
a prescription," Boroditsky told the Bulletin.
When properly prescribed by a podiatrist, he explained, orthotics
can compensate for an irregular walking or running pattern. Before
prescribing an orthotic, a podiatrist will perform a full biomechanical
examination, bone position measurements, stance and gait analysis
and take into account all relevant medical findings, including signs
and symptoms of pathology.
To correct the bone imbalance, orthotics are made from plaster casts
while the patient is seated. The podiatrist places the patient's
foot into its correct position and captures it in a plaster mold.
The three-dimensional plaster cast is then sent to an accredited
laboratory to fabricate the custom orthotic.
While many of the prefabricated orthotics that are being sold can
help create an arch support while a person is standing, they can
not control foot motion or correct foot imbalances.
Boroditsky explained that the prefabricated devices are often "customized"
with topcovers or other additions to give the appearance of being
custom-made.
"People shouldn't be fooled by ink-pad prints, foam impressions
or computerized foot scans," he warned. "At best, those
gimmicks will result in an arch support that is based on guesswork.
I've seen a lot of patients who have spent more than $300 for a
'customized' arch support that doesn't solve their problem. Then
they're faced paying a second time for something they should have
bought the first time." Many retailers are charging consumers
a similar price for prefabricated, customized orthotics as a podiatrist
would charge for prescribed custom-made orthotics.
A survey sponsored by the British Columbia Association of Podiatrists
earlier this year indicated that about 20 per cent of British Columbians
have used orthotics, but nearly two-thirds purchased them without
consulting a podiatrist first.
"It's a situation that's frustrating both for podiatrists and
patients and insurance companies are beginning to listen,"
Boroditsky said, noting that a growing number of extended-benefit
health plans no longer cover non-prescription orthotics.
Common symptoms that may indicate a need for orthotics include uneven
wear on one side of a shoe's sole, frequent ankle sprains, chronic
heel, knee or lower back pain, painful shins, curved toes, feet
pointing inward or excessively outward when walking or general discomfort.
Podiatrists are doctors who specialize in preventing, diagnosing
and treating foot pain and foot disorders both medically and surgically.
Patients do not need a referral from their family doctor to see
a podiatrist.
For more information about orthotics, go online at www.alliedfootspecialists.com.
Kyle Berger is an award-winning freelance journalist and a graphic
designer living in Richmond.
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