When a good friend asked me today to explain orthotics to her, I realized I had not done a good job of preparing the subject background. Then when I went back to look at the actual post I found the first paragraph to be meaningless without more background. If you understood it all you can skip to the end of this post.
Kaiser is the name of a health care organization that operates a lot like an HMO but they don't like to use that description for themselves. In California and several other states it is a major player in hospital and medical care while there are other areas of the country where saying the word Kaiser brings up only the mental image of an early 20th century German ruler. Kaiser is literally the German word for Caesar.
Being a major player, Kaiser can set the lead in how medicine is practiced in an area or they can drag their feet. We have seen examples of both. For example, their integrated online medical record system is marvelous. Their podiatry service is not.
Podiatry, a specialty limited to care of feet, is sort of like chiropractic, if your family uses them, you find them a vital part of medical care. If not, you don't. There is a long-standing tension between othopedists and podiatrists where the dividing line is drawn somewhere around the ankle. Podiatrists rarely venture above while orthopedists are always "helping out" below.
Orthotics is the name given to a combination of plastic, leather, and cloth which has been individually designed and manufactured for a patient. Each pair is unique. The purpose of the orthotic is to support, align, prevent, or correct deformities of the feet. By definition they may be used to assist a child's feet to grow properly and they may be used to maintain proper alignment after growth.
If you think that a support insert for your running shoes costing $20 is outrageous, be prepared to be really outraged at orthotics which can run from $300 to $500 per pair. Most of that cost is for the skill and labor of measuring and fitting the device to a patient's feet and indeed knowing what problems need to be addressed by the orthotic in the first place. Thus, additional pairs of orthotics are considerably less expensive.
To complete the background info here are a couple photos of my orthotics. Using orthotics is as simple as pulling out the shoe lining and replacing it with the orthotic.
Questions?
I use ankle-foot orthotics (AFO's) to prevent foot drop, where the ball/toes don't stay up when you step forward. They were prescribed by an orthopedic surgeon, and help a lot! One big problem, you can't push down the gas pedal with them--I compensate by sliding the whole foot up and down. (Newer ones are hinged at the heel so you can push down, but the hinge only goes so far so the foot doesn't drop--works much better). AFO's were covered by my insurance, but regular orthotics would not have been. They, too, are custom made and are expensive--my deductible on them was about the price of your orthotics.
ReplyDeleteMarilyn from Florida (since we have 2 Marilyns)
Thanks Arnold!
ReplyDeleteArnold, let me give a bit more clarification on this topic. Actually Orthotics is a noun describing a profession. The professional is an Orthotist and what the Orthotist designs, fits and fabricats is an orthosis (singular) and orthoses (plural, pronounced orthos-eze). What you have show is a pair of foot orthoses, not foot orthotics. The term "orthotics" have incorrectly been used to describe the orthoses which go into someone's shoes.
ReplyDeleteIn case you wondered, yes I am one of those Orthotists!
Why do so many of the best comments come from Anonymous? Thank you for your clarification. I doubt that it will change the common, incorrect usage, however.
ReplyDeleteNow can you explain why orthoses are so seldom covered by insurance plans? Have controlled studies been done on their effectiveness and what are the results?