When you get a prescription from your doctor foot orthoses, orthotics or insoles (usually all the words mean the same thing) often people wonder what the next step would be. Here is a check list of the steps of the process of obtaining the orthoses.
1. Set up an appointment. Sometimes your doctor will advise you on where to go or if not, talk to your friends and family. Find a clinic that is convenient for you. It is also important to make sure that the person that will be treating you is qualified. In Ontario, there is no regulation on who can provide orthotics, so ask questions such as:
- Is the person who will be treating me a Certified Orthotist C.O.(c) or Podiatrist or Chiropodist?
- Are the orthoses made on site or sent away?
- Can adjustments be made while I wait?
- Does the cost of the orthoses include any follow-up and adjustments?
2. The first appointment provides an opportunity for the Certified Orthotist to assess your needs. This session of gathering information will include a personal history (complaint/problem, age, activities, past medical history), a gait assessment (how you walk) and a physical examination (range of motion of joints, muscle strength, identification of deformities, abnormalities). The Certified Orthotist will also discuss with you your goals and expectations. You will then set up a plan together which may include foot orthoses and education regarding other factors such as footwear that you may need to take into consideration. If orthoses are indicated and you choose to proceed, a cast impression of your feet is taken. The cast material is put on your feet (it feels nice and warm) and your feet are held into the appropriate position until the cast material sets (about 10 minutes). A return appointment is then set up.
3. For second appointment it is important to bring in the shoes that you usually wear - even two or three pairs if you need to. The Certified Orthotist fits the orthoses into the shoes and checks for proper alignment. You will then try on the shoes with the orthoses. The Certified Orthotist will check your standing position and have you walk to recheck your alignment and gait once more. The orthoses will feel strange at first but should never be uncomfortable. Sometimes based on your gait or how you feel, the orthoses will be adjusted. You will be given instructions on wear times and care of the orthoses and sent on your way to try them.
4. The third appointment is arranged for a follow-up to check and see if everything is going well and that the goals that were set at the initial appointment are being met. Often the symptoms are not completely gone by the second or third week of wearing the orthoses but there should be noticeable improvement.
5. At any time if there is any discomfort or if the orthoses are not helping, you should be encouraged to book an appointment for a recheck. There should be no charge for the follow-up appointment. If the orthoses are comfortable but not reducing the symptoms sufficiently, sometimes other interventions such as physiotherapy are required and your Certified Orthotist will suggest them to you and your doctor.
For more detailed information please check Foot Orthoses - What Should you Expect?
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