Orthotics

What is an orthotic?
An "orthotic" is a device used to re-align the foot and lower ankle into a more neutral position to restore your natural foot function during walking, running or within a sport activity.

Why do I need an orthotic?
A large percentage of the population may benefit from some type of orthotic device. The feet can affect the body much like a foundation of a big building. The job of the feet is to support and balance a large and sometimes heavy structure on two relatively small surfaces. Imbalances of the bones and soft tissue structures in our feet can result in abnormal foot motion. This can lead to problems elsewhere: the ankles, knees, hips and or lower back. Small structural changes in the feet can lead to significant issues elsewhere and the job of the orthotic is to help correct the changes to improve function of the total body.

What are some common patient related diagnoses that maybe helped by an orthotic?

1. Arch or heel pain.
2. Plantar fascitis.
3. Achilles tendonitis.
4. Post op Bunionectomy.
5. Ankle sprains or flat feet.
6. Metatarsalgia (pain in the toes).
7. Neuromas (nerve irritation usually between the 2nd and 3rd or 3rd and 4th toe).
8. Shin splints.
9. Cramping and or aching legs.
10. Knee problems, chrondromalacia patellae.
11. Various hip and lower back trouble.

Why wont a store bought "arch support" or an over the counter device work as well?
An "arch support" is merely a device according to shoe size that pushes against your arch to provide some support while standing. Although an inexpensive arch support may be helpful to some, they are very limited. Just like getting a pair of glasses for your eyes, orthotics need to be designed to fit your specific needs and problems of your feet while you walk. The specific measurements during your evaluation and/or casting of your feet will allow us to make an orthotic device to suit your needs for every day or sport activity.

How do orthotics help the needs of people who engage in sports?
port activities result in unusually high amounts of stress and pressure on the foot and the surrounding joints. Slight imbalances or abnormalities in the foot structure can result in unnecessary strain on the muscles, tendons and joints that could result in injuries. Orthotics can eliminate the need for your muscles to compensate for these quite often "hidden" abnormalities, reduce fatigue and promote a more efficient "muscle memory" that is crucial to an effective sports performance.

Runners, walkers, skaters, tennis players, volleyball, cyclists, skiers, baseball, softball, soccer or any one who may engage in sports activities can benefit.

How long will my orthotics last?
Our orthotics will last for the following time periods:

1. A BFO orthotic will last 6-8 months.
2. An XPE orthotic will last 12-18 months.
3. A custom lab orthotic will last 6-8 years.

Does it take time to get used to an orthotic in my shoe?
There is normal break in time for any orthotic device. You may find that your orthotics are very comfortable right away, but we would expect that it will take you approximately 6-10 days to get used to wearing them all day long.

Do I need special shoes for my new orthotics?
Most orthotics fit in sneakers, boots and dress shoes. In some instances, some dress shoes with a narrow toe box need to have a dress orthotic made to fit into the shoe better.

Please keep in mind that a new orthotic usually performs more efficiently when it is in a new, properly fitted shoe.

What if my new orthotics do not fit right?
There are many modifications that can be made to ensure proper fit of your in house or custom orthotic. Speak with your orthotic specialist to go over any specific issues.

Orthotics Fabrication and Fitting Program
Ramsey Rehab offers three different styles of Orthotics with different costs. A description of each product is below:

1. BFO
   
   The BFO is a semi flexible foam orthotic shell that provides support, control and durability. This flexible orthotic can be used for a basic arch support or modified with a wedge for pronation/ supination control. This orthotic is designed for the general population and is readily tolerated, even during the most active sports.
   
   This orthotic is reasonable priced at $65.00
   
   (A spenco shock absorbent top cover can be added for $5.00)
   
2. XPE
   
   The XPE is semi rigid orthotic that won’t compressor change its shape during normal use. This insole can be easily modified with wedge material to provide functional, long lasting pronation/supination control.
   
   This orthotic is reasonable priced at $65.00
   
   (A spenco shock absorbent top cover can be added for $5.00)
   
3. Composite Orthotics
   
   The composite Orthotic is a pre molded graphite shell orthotic that is designed to provide more support then the BFO or XPE. The graphite shell is a 3/4 length with a top cover, and is customized for your needs.
   
   This orthotic is reasonable priced at $115.00
   
4. Quadrastep Orthotic System
   
   This new orthotic system offers 6 types of functional orthotics, each biomechanically tailored to a true custom prescription. These orthotics are offerd at a fraction of the cost of a typical custom device.
   
   This orthotic is competitively priced at $150.00
   
5. Lab Orthotic
   
   Prescription lab orthotics are fabricated using a new foot scanner called "Extremity One". With this new scanner we simply scan your foot and the information is sent electronically to PAL where your orthotics are created. The orthotics are normally back in our office in 1-2 weeks! This scanner is a great improvement to casting due to enhanced accuracy and much faster production. They come in a variety of sport, leisure, dress, and other accommodations can be determined by your therapist.
   
   This orthotic is competitively priced at $325.00

Some Other Payment Issues:

1. If being referred by a physician, we will need a signed prescription for evaluation and any orthotic device recommendations that they may have. A Physical Therapy Evaluation will be performed by a Licensed Physical Therapist and in many cases can be billed to your medical insurance. Workers' Compensation and or Motor Vehicle Accident Insurance need prior authorization prior to evaluation, orthotic fabrication and or fitting.
2. Even though your medical insurance will pay for your evaluation and or fitting, they in most cases will not pay for the orthotic fabrication and or the device itself. Feel free to check your individual medical insurance plan to see if they cover orthotics.
3. If you plan to use your medical insurance, please follow all applicable insurance programs for Physical Therapy. If you have questions about your insurance's Physical Therapy benefit, call our office and we can help you sort your insurance info out.
4. If you wish to pay out of pocket, you will be responsible for the cost of the evaluation ($75.00) and for at least 1 follow up visit ($50.00).

You can schedule an Orthotic Evaluation to see if an orthotic device is appropriate for you.

Appointments can be made through our Leominster location.

A full PT evaluation will be performed including flexibility, structural assessment, muscle function and balance, as well as a lower leg biomechanical gait assessment either just walking or on one of our treadmills.

Upon completion of the exam, discussion on whether or not an orthotic device would be helpful for you, and if so, what types and selection of orthotics are available will be done at that time.

If being referred by your physician, we will need a signed prescription for evaluation and any orthotic devise recommendations that they may have.