WHAT ARE PEDORTHICS AND WHAT IS A C. PED.?
Pedorthics, the art and science of managing the environment of the foot, uses shoes and foot orthoses to accommodate change, improve function and/or relieve pain. A certified pedorthist (C.Ped.) is qualified by education and experience to make, modify and fit shoes and to fabricate and fit orthoses according to a doctor’s prescription. Pedorthic results can sometimes be immediately apparent. Other times, positive results come with wearing the appropriate shoe or orthosis properly, over time.
A C.Ped. has studied shoe construction and modification, foot orthotics materials and fabrication, and lower extremity anatomy, physiology and biomechanics. He or she has also learned to understand a doctor’s diagnosis and prescriptions.
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 a 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 feet.
Shoe modifications may be external, internal, or both. External modification 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 painful conditions.
Orthotics are often used to address foot problems. They 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 the C.Ped. can provide the most effective materials for treatment based on the doctor’s prescription.
Pedorthic care, undertaken at the onset of a foot condition, frequently reduces 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).
Pedorthics, because it is conservative, can be truly cost effective. Relying on the doctor’s diagnosis, the certified 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 Board Certified Pedorthist, you can rest assured you’re working with a qualified professional committed to a high level of care as a member of the allied health team.
The American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC) is an independent certification agency, recognized by the National Commission for Certifying Agencies. The ABC establishes the standards for initial and continued certification in pedorthics and creates and supervises certification tests. In addition, the ABC also accredits facilities that meet its standards for personnel, equipment, inventory and record keeping.
A C.Ped. can also modify a shoe’s interior or exterior to improve the fit. If the physician prescribes a foot orthosis, a C.Ped. – who is familiar with shoe construction, lower extremity orthotics fabrication, and the materials, fabrics and components appropriate in addressing a foot condition according to a prescription- can fabricate the orthosis and fit it properly to both foot and shoe.
Working from a doctor’s prescription, a C. Ped. alleviates foot problems by fabricating or modifying shoes and foot orthoses. The footwear adjustments may be internal, external or both. Once the shoes and/or orthoses meet the prescription’s requirements, the C. Ped. carefully fits them. Follow-up care is essential to assure the shoe/orthosis continues to perform as prescribed. Filling a prescription includes measuring the foot, and may include taking a computer scan of the foot. The two basic elements of fit are shape and size. A shoe’s shape - rounded versus squared toe, for example - must match the foot’s shape. Once the correct shape is identified, size is determined by measuring length, arch and width. Because a foot orthosis can only be worn with a shoe, it is imperative that the foot, orthosis and shoe be treated as a unit. Only then can the doctor and the patient rest assured the orthosis will be effective.
When a standard shoe won’t accommodate an individual’s needs, a C. Ped. can recommend a different type or style, modify the shoe, or even construct one from a cast of the patient’s foot. In cases of severe injury and partial amputation, such tailoring is often prescribed.
A foot orthosis can be fabricated from a variety of materials. C. Peds are qualified to determine the materials appropriate for a condition and its prescription. They know what will perform most effectively, and how long the materials can be expected to function as prescribed. The certified pedorthist is a footwear specialist who works with the patient to make sure shoes and foot orthoses, instead of being part of the problem, are part of the healthy solution.