Biomechanics and orthotic production are learned skills, and just as in any other learned skill, practice makes perfect (almost). Like a batting average in baseball, 100 percent success in orthotic therapy is a goal to be pursued, but in reality never attained. So when you swing and miss, even in a seemingly simple and straightforward case, you need to diagnose what went wrong and figure out how to adjust, modify, or replace the prescribed orthotic devices in order to ultimately have a positive outcome.
Mistakes happen! Here are some possible sources of error to look at in evaluating how to improve your outcome in a particular case.
- Was something overlooked in the history of the patient? A particular activity, or shoe wear issue that is hampering your ability to control your patient's condition? Low back pain. A joint replacement in the knee or hip?
- Was something missed during the examination of the patient? A restricted joint range of motion, a muscle weakness, a leg length inequality Was there an error in your evaluation of angular relationships of forefoot to rearfoot, rearfoot to leg, Tibial torsion, genu valgum or varum?
- Was your impression/scan accurate? Was the subtalar joint neutral with the midtarsal joint fully pronated for a Root type device?
- Did you order the correct type of orthotic to match your patient’s needs? Rigidity versus flexibility correct as per patients activities, shoe type and body weight? Are the posts, pads and extensions proper?
- Was the lab order form filled in correctly? Did the lab fill the prescription as you ordered? Was there good communication between your office and the lab?
- Is the patient using the orthotics correctly? Are they following your instructions on break in periods and appropriate shoes and/or activities the orthotics are intended for?
- Does the patient need additional orthotic devices for particular situations?
These are just a few examples of how the process of orthotic therapy can be sidetracked. It is up to the clinician to adequately and expertly evaluate and address less than excellent results.
The KevinRoot Medical team is here to help you hit more home runs in your biomechanics practice!
