When you have a foot or lower limb problem a thorough assessment with an experienced podiatrist is important to obtain the correct diagnosis and appropriate management plan to resolve the problem. This may be simple or more complex advice and treatment from your Podiatrist or by a multidisciplinary approach.
Sophie and Amanda’s specialist areas include Running and running shoe analysis, foot assessment for Cycling and cycling orthotics prescription, Ski boot assessment and ski orthotic prescription, Sports and general footwear advice and prescription/modification, Paediatrics and normal development assessments and custom ankle brace prescription of the Richie Brace (www.richiebrace.com )
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New Patient Assessment
The New Patient Assessment is the initial appointment where a detailed history is taken, a biomechanical assessment and video gait analysis conducted then a diagnosis of the presenting problem is made.
The detailed history involves asking questions to identify the problem and possible causes for the injury. A biomechanical assessment involves looking at the structure and function of the feet and legs by assessing the range of motion and alignment of joints in the lower limbs as well as assessing muscle strength and flexibility.
The information gained from the biomechanical assessment often reveals the causes of biomechanical deformities. A video is then taken during barefoot walking and played back frame by frame to assess the dynamic function of the feet and legs. A video may then be taken during running in Trainers either on a treadmill or a walkway to further help identify the problem.
The diagnosis and treatment plan are then discussed in the consultation and then the treatment plan implemented. The treatment plan may involve Orthotics (Insoles), temporary padding, footwear advice, exercises, diagnostic imaging, training advice, or appropriate onward referral.
Insoles / Orthotics
Insoles and Orthotics are foot supports that are put in the shoes to help improve foot function and therefore try to relieve symptoms. There are wide ranges of Insoles and Orthotics that are available ranging from over the counter Insoles to custom-made Orthotics. Temporary Orthotics are sometimes prescribed which can be made up within a day. The type of insole that you may need depends on the nature of the problem and what is required to resolve the problem.
Custom Made Orthotics can be made for all different types of footwear from Orthotics that are specifically for Running Shoes to ones that fit in ladies high heel shoes. Orthotics can be made from different materials ranging from rigid carbon fibre to flexible cushioning materials. Sometimes the same Orthotic can be used both for sports shoes and everyday footwear. The design of the Custom Made Orthotic suggested will be discussed in your consultation.
In order for custom made Orthotics to be manufactured; a plaster of Paris impression (a Cast) of the feet needs to be taken. The Casts are then sent off to an Orthotics Laboratory in Canada where they are scanned and stored electronically. According to the prescription designed by the Podiatrist, the orthotic devices are made from the scanned image being modified, 3D milled and the manufacture completed manually. Casting can be done in the initial consultation if required.
Sometimes one or more adjustments need to be made to the Orthotics to improve their efficacy, improve their comfort or improve fit and this is covered under a 6 month warrantee including free of charge consultations.
It may be that orthotics aren't the only treatment option. Many aches and pains can settle quickly without the need for long term management strategies.
Instructions on how to break in orthotics can be found on the patient resources page