Canadian Certified Pedorthists – C. Ped (C)
Canadian Certified Pedorthists are one of very few healthcare professionals who are trained in the assessment of lower limb anatomy and biomechanics. They are experts in designing, fitting and modifying custom made orthotics and orthopaedic footwear. Canadian Certified Pedorthists are unique from other orthotic experts because they do not both prescribe and dispense the treatment for their clients.
With specialized education and training in foot orthotics and footwear, Canadian Certified Pedorthists help to alleviate pain, abnormalities and debilitating conditions of the lower limbs and feet.
As proud members of patients’ healthcare teams, Canadian Certified Pedorthists consult with patients based on a referral from your family physicians, physiotherapist or other healthcare providers. The goal of every Canadian Certified Pedorthist is to help patients achieve and maintain proper foot care and lower limb health, and live healthy, active lives.
What are Orthotics? A custom orthotic insole is a corrective device designed to align your foot and ankle into the most functionally effective position. They reduce stress and strain on your body by bringing your feet back into proper alignment and improve weight distribution.
What to Expect: Our orthotic dispensers will come to your home or office and perform a gait scan, cast your feet, fit your othortics and educate you on how to wear and care for them.
WHAT CAN ORTHOTICS HELP?
- Planter Fasciitis
- Achilles Tendonitis
- Shin splints
- Heel pain
- Knee pain
- Low back pain
- Hip pain
- Neck pain
HOW ORTHOTICS WORK:
Custom orthotics insoles are shoe inserts that help to minimize and correct abnormal foot motion and weight distribution. Especially excessive pronation (a “knock-kneed” person has overly pronated feet) and supination (a “Bow-legged” person suffers from supinated feet) of the lower ankle or subtalar joint (where the Talus meets the Calcaneus). They provide stability for the foot and correct injury-causing imbalances; this improves the integrity of your body’s muscles and supports proper skeletal alignment.
The 5-Step Pedorthic Assessment for Custom Orthotics
1. Detailed History Taking (10 minutes)
In this section, a thorough history taking is conducted. This is basically the investigative section. The C. Ped (C) would cover the patient’s primary complaint, symptom behaviour, the cause of the pain (important and would dise, any previous injuries/surgeries, any major health issues, occupation, number of hours weightbearing per day, flooring at home, physical activity levels, and footwear choices. By the end of this section, the C. Ped (C) should have enough information to determine the nature of the problem
2. Non-Weightbearing Assessment (10 minutes)
This section is about evaluating both the feet, one at a time, while the patient is sitting or lying supine. The C. Ped (C) will conduct a thorough observation of the patient’s feet for any warts, corns, callouses, boney abnormalities, and overall skin condition. Then the C. Ped (C) would compare ranges of motion of all the gait important joints (Subtalar, Ankle, 1st MTPJ, Midtarsal, and 1st Ray) in the foot with the ‘standard norm’. If there were any restricted ranges of motion or pain noticed, it would be documented and would be valuable information for the design of custom orthotics. Then, the general foot will be palpated for any pain.
3. Weightbearing Assessment (10 minutes)
This section is evaluating the feet while the patient is standing. The C. Ped (C) will again conduct a full observation of the patient’s stance and note if there are any collapses in the arch, abducted or adducted stance, genu valgum or varum in the knees, rearfoot valgum or varum, general posture from head to toe and compare it with the ‘standard norm’ again. The C. Ped (C) would also ask patients to do a few muscle active tests to test for imbalances or weaknesses. A few common ones would be the tibialis posterior test, where the patient would go onto their tiptoes and we should see an inversion at the rearfoot to see the tibialis posterior is intact. Not all active tests need to be completed; it will be under the C. Ped (C)’s discretion.
4. Visual Gait Analysis (10 minutes)
This is probably the most important step in this assessment and requires the most skill. When a patient walks there are multiple joints in the feet that are activating at the same time at an extremely high rate that is very difficult to see even if the patient is just walking at a normal speed. A gait analysis would require the C. Ped (C) to visually disect the entire gait into 5 sections (heel strike, full forefoot load, heel lift, toe-off, and swing). All these sections will occur in less than half a second and it would require a lot of experience to visually capture all the phases and determine what is an ‘irregular or regular’ joint motion.
5. Treatment education (5 minutes)
At the end of the assessment, the C. Ped (C) would go over what is exactly causing the pain and how it can be managed through treatment options. If the patient were a candidate for custom orthotics, then the C. Ped (C)
would explain in detail how the custom orthotic will be manufactured in order to be accustomed to their situation. The C. Ped (C) can discuss possible alternate footwear options to benefit the patient’s scenario or if any modifications to existing footwear is necessary.