After the correct orthoses have been selected and fitted to your footwear, the next stage is to start wearing the orthoses. Orthoses alter the way that forces act on the tissues in the feet and lower limbs, and can ultimately affect the way you walk. It is, therefore best to wear the orthoses in gradually to allow the tissues in you lower limbs and back to adapt. This could take a week or two. We usually recommend wearing them for no more than an hour the first day, increasing by an hour each day until you can wear them all day. In this period some aches and pains may be normal, however if these persist, remove the orthoses and try again the next day. Should these aches or pains continue, let your podiatrist know as soon as you can.
It is very important that you continue with any exercises that the podiatrist has advised during this period, even if you feel that the orthoses have alleviated your symptoms. Although relief can be instant, it can take up to 6 weeks to get a good response from your orthoses.
After 6 to 8 weeks, we like to book a review with you to see how you are getting on. At this short appointment we will check that the orthoses are well tolerated and that they continue to fit correctly to your feet and shoes. We will also review any exercises issued to ensure that you are performing them correctly. At this point we can make minor adjustments to your orthoses or exercise regime.
After around a year we like to review progress with our patients and their orthoses. These are usually standard appointments and it allows us to ensure that the orthoses are still working and that the prescription is still correct. We can also perform an additional assessment and modify our management plan to ensure that your needs and expectations are met. If you are no longer symptomatic, we will discuss whether you need to continue with your orthoses in the longer term, or whether they can be withdrawn altogether.
How do I look after them?
You do not have to do much to look after your orthoses, but it helps to keep them clean and dry. It is best to avoid submerging them completely, but if they do get wet, remove them from your shoes and leave to dry in a warm dry place, away from direct heat (not on a radiator!) or sunlight. Exposing them to direct heat may cause the plastics to deform rendering them useless. To clean your orthoses, remove them from your shoes and wipe them down with a damp cloth or baby wipe and leave to dry.
Sometimes, certain shoes can cause the orthoses to squeak when you walk. This is caused by the materials rubbing. If this happens, remove the orthoses pour some talc into your shoe and spread around and then replace the orthoses. If that does not work you can rub candle wax around the back edge of the orthoses at the heel.
If the top covers on your custom orthoses are looking tired or excessively worn, but the orthoses are still working, we can offer replacement of the covers for a fee.
Finally, make sure you keep the orthoses out of reach of your dog, as often they can mistake your expensive orthoses for a chew toy!
Orthotic myths and frequently asked questions
Do I really need orthotics?
Don’t orthotics make muscles weak?
Will they cure my flat feet or bunions?
How long do they last?
It depends on the type of device, how often it is used, how heavy the patient is and what kind of activity it is used for. Generally softer, accommodative orthoses do not last as long as more rigid devices, and custom devices tend to last longer than prefabricated devices. You will be able to tell if the orthoses have worn out as they may appear worn or tatty and may not be relieving your symptoms any longer. As a general rule we tend to expect:
However, it must be noted that we can make no guarantee for the longevity of the devices (except Firefly carbon/polypropylene) as some patients subject their orthoses to heavier use than others, different conditions such as heat an moisture levels will also cause the glues and plastics to degrade over time at different rates.
They look bulky, will they fit into my shoes?
Orthoses will not fit into all shoes. Ballet pumps and high heels are particularly problematic, and we would often advise against wearing these types of shoes whether or not you have foot pain. Many foot complaints are caused or exacerbated by inappropriate footwear. We would recommend that you wear sensible shoes with adequate room, suitable fastening and supportive soles- running shoes are often ideal. We do however, understand that there are times where you can’t wear trainers or lace-ups, in which case we can offer slim or fashion orthoses to fit into your shoes. Custom orthoses can also be made to fit specific shoes such as running, golf, or cycling shoes as well as walking or ski boots. Your podiatrist can advise on the most appropriate orthoses for your needs.
Is there any discount for second/third pairs?
If at the time of casting you request additional pairs of orthoses we can offer a discount of £50 off Sidas or Firefly orthoses, however if these are requested at a later date, a subsequent casting appointment will be required and the orthoses will be charged at full price. We are unable to offer discount on additional pairs of simple, prefabricated or bespoke modular orthoses.
What happens if I lose/break my orthoses or the dog eats them?
Unfortunately, these things do happen. Firefly offer an insurance policy called SHIELD where orthoses are covered for loss/theft or damage. Refurbishment and re-covering is also covered, and the policy costs £55 for 2 years. Some fees may apply and the scheme is run by Firefly Orthoses and Betafeet Podiatry accepts no responsibility for any issues with this scheme.
Unfortunately, there is no insurance policy available for simple, prefabricated, bespoke modular or Sidas orthoses.
Will they work in my work/running/cycling/walking shoes?
Yes, we have models of orthoses suitable for most types of work or sports shoes. Ask your podiatrist who will be able to advise further.
References/ useful links:
We are delighted to announce that prose written by our Practice Business Manager, Reggie Simpson, will be featured in the Rennie Grove Hospice Care’s Rhyme & Reason 2018 diary, now in its 26th year. The theme for this forthcoming year’s diary is ‘Freedom’. All proceeds from sales of the diary go to support this worthwhile charity.
Reggie says: ‘Although my entry wasn't among the top poetry and prize winners, I was chuffed to be selected for the 2018 diary. The theme was quite broad, but my degrees in politics and love of writing invariably drew me to entering the competition. In the end I settled on a focus of freedom in healthcare, no doubt inspired by my current employment at Betafeet Podiatry and the noble work of Rennie Grove Hospice Care ( www.renniegrove.org ).
Rennie Grove Hospice Care, formally known as Iain Rennie Hospice at Home, merged with Grove House, St Albans in 2010 to integrate services in south western Hertfordshire. The ethos and values of the two charities were closely aligned with the principle of allowing patients to lead a good quality of life at home for as long as possible, helping patients and their families avoid the distress of unnecessary hospital visits whenever possible.
The diaries can be ordered from the Rennie Grove website, payment by debit/credit card. It's part of their annual Christmas/holiday promotion. There will also be copies in local Rennie Grove shops. They are £5 each with additional postage if bought online. Shop locations can be found here: http://www.renniegrove.org/support/our-shops/online-shop/page/2/ .
Here is Reggie’s entry (to appear in the month of September 2018):
‘Do not count the days; make the days count.’
Muhammad Ali. Professional Boxer. Audacious. Charismatic. A winner in the ring.
But even when you have won it all, life throws you a few more punches.
Yes, his name opened doors and wealth, but the bombastic man of his younger years was humbled in later life, and following retirement, he dedicated himself increasingly to charitable work. Parkinson’s was already taking hold.
He received the Presidential Medal of Freedom in 2005, the highest honour the USA can bestow. He died in June 2016, aged 74.
Now the news is about boxing helping dementia sufferers.
So what does this mean for freedom? Does getting battered around the head spell freedom and choice? One would say yes; a boxer is free to take such risks. When the consequences deal you a fatal blow as a result, when do you lose your freedom? Is it when you have been reduced to a shadow of your former self, a normal human being, and have to rely on others? Muhammad Ali likely had plenty of resources to ensure his final days would help him on his final journey.
We tend to think of freedom in political terms. It is hard to remove freedom in healthcare from politics. Think NHS reform, among others. Freedom in a healthcare environment means more to the individuals and families when they have life-limiting illnesses and need the care of volunteer-run hospices such as Iain Rennie Grove.
The NHS gives patients the rights to make choices about different aspects of the care they receive, from the different treatment options available. How these are chosen is individual, although for those with life threatening or limiting illnesses this choice will fall on family members.
I quote the following:
‘In health there is freedom. Health is the first of all liberties’.
Henri-Frédéric Amiel, Philosopher
September is World Alzheimer’s Month.