Orthotics by Diagnosis

“Two Approaches to Orthotics”

From years of working with literally hundreds of practitioners, I learned that there are two ways of dealing with orthotics. One leads to large numbers of orthotics and one does not.

You will note that one of these assesses the patient’s mechanics and the other does not. 

Most practitioners handle orthotics like this:

1. Patient Presents with Chief Complaint which you document. 
2. You work up the patient appropriately, utilizing the various tools at your disposal.
3. You then assign a diagnosis to the Chief Complaint.
4. Now, if the diagnosis is one that you find is appropriate for orthotics, or which you feel comfortable treating with orthotics, you may offer orthotics (or may not). Any other diagnosis, orthotics aren’t on the table as an option.

Most practitioners use or offer orthotics based almost entirely on a diagnosis.

Now compare this method of handling orthotics:

1. Patient Presents with Chief Complaint which we document.
2. We immediately assess the patients mechanics using static and dynamic exams.
3. We look for and note any areas of faulty mechanics.
4. We then discuss the clinical findings and give them a diagnosis.
5. So long as we can trace the chief complaint back to the faulty mechanics, we offer orthotics regardless of diagnosis

The most profound difference between these two is the first approach or “algorithm” limits orthotic patients to a few “choice or cherry picked” diagnoses.

You might be surprised to learn that upon survey we found that the average practitioner commonly uses less than three diagnoses in their decision to offer orthotics or not. 

Our alternative algorithm is not limited by diagnosis.

Therefore our list of indications for offering orthotics spans literally dozens of diagnoses along the entire kinetic chain.

Assessing Patients’ Mechanics

To do large numbers of orthotics each and every month of the year, you have to be able to achieve consistent results. The key to that is being able to assess your patient’s mechanics. You must be able to spot areas of imbalance and interpret what they mean. Then you can relate them to your patient’s chief complaint.

Something to think about – Have you ever wondered why you many times get three different results when you cast three different patients for orthotics despite the fact that they all have the same diagnosis?  The answer for this is profoundly simple - It is because all three patients had different mechanics and you made the orthotics to address a diagnosis, not the patient’s mechanics.

Sometimes it is just as important to know who not to offer orthotics! 

Biomechanics is nothing but a tool and it is a relatively simple tool once you break it down into the basic segments of a static exam and dynamic exam.  Additionally, we have simplified and streamlined these exams so that they are quick, easy and definitive. There are no subjective values or minor differences involved. 

Unfortunately, there is a relatively big problem that presents when we say the word biomechanics as it has the bad fortune. In our experience, Say “Biomechanics” to a Podiatrist and you may as well be saying “Confusing”.

Purpose of BioMechanics►