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What is a pedorthic assessment?

Pedorthic assessments are one of the most important aspects of my work and a considerable portion of my weekly clinic time is devoted to them. Many patients come to my clinic with persistent and unexplained foot, ankle, knee, hip or back pain. A complete and thorough pedorthic assessment enables me to determine if the pain they are experiencing is related to poor foot structure or biomechanics. At the end of the assessment, I am able to clearly explain their medical condition to them and to recommend an individualized treatment plan that addresses the causes of, and contributing factors to, their condition rather than just the symptoms.

All Canadian Certified Pedorthists conduct similar assessments; we evaluate your lower limb anatomy, muscle and joint function, as well as the interaction of your feet and lower limbs with the rest of your body. If you have an upcoming pedorthic assessment or are trying to determine if you should schedule one, here is what you can expect:

What to bring:

On the day of your assessment, dress in loose clothing or shorts so your Pedorthist can easily examine your feet and lower limbs and wear, or bring, your everyday footwear with you. Walking or running shoes are ideal. Make sure the footwear you bring is well worn as your Pedorthist will look closely at the wear pattern at the top, bottom and insole inside of your shoes as part of the assessment. If your assessment was booked following a referral from your physician, also bring the prescription your physician provided.

What to expect:

A pedorthic assessment typically takes between 30 and 60 minutes. Your Pedorthist will begin by taking a thorough history to identify patterns and expose causes of your pain. Questions will probe:

  • Symptoms
  • Previous injuries
  • Family history
  • Systemic diseases
  • Lifestyle and activities
  • Occupation
  • Footwear

Following the history, your Pedorthist will perform a series of weight bearing and non-weight bearing tests including:

  • Testing the joint range of motion in your feet and ankles to make sure that each joint moves in its full range
  • Testing the strength of certain muscles
  • Checking to see the type of foot you have: normal, flat or high arched
  • Identifying any boney prominences, swelling, discolouration
  • Examining the alignment of your knees and lower back
  • Analyzing how you walk and run particularly the position of your foot at each phase of the step

Treatment:

Your Pedorthist will analyze the findings of each aspect of the assessment and will recommend a treatment plan to address your condition. Depending on what your assessment reveals, your treatment may include:

  • Custom-made or over-the-counter foot orthotics
  • Stretching and strengthening exercises
  • Different style or brand of footwear or possibly modifications to new or existing footwear
  • Ice therapy
  • A recommendation to consult with another healthcare professional such as a physiotherapist, chiropractor or a massage therapist

Like all pedorthic treatment plans, your individualized plan will be designed to help alleviate pain, improve your mobility and enhance your quality of life.

If you are experiencing pain in your feet or lower limbs don’t ignore it or assume it is something you have to live with. A pedorthic assessment will provide you with valuable insight into its cause as well as a plan to address it. To schedule a pedorthic assessment you can either contact a Canadian Certified Pedorthist in your community directly or ask your healthcare practitioner for a referral.

By Steve Stredulinsky, C. Ped (C), Edmonton, AB


Numb, tingling or painful feet should not be ignored

If you’re experiencing numbness, loss of feeling or stabbing/burning pain in your feet and hands you may have peripheral neuropathy. Peripheral neuropathy – damage to your peripheral nerves – is a condition Canadian Certified Pedorthists see frequently as it can have a significant impact on the health of your feet and your mobility.

Individuals who have peripheral neuropathy are at increased risk of falling as the lack of sensation, loss of coordination and muscle weakness make it more difficult to move around safely. They’re also at increased risk of serious foot wounds and ulcers as the reduced sensation makes it difficult to feel a small injury developing. Left unnoticed a small rub, blister or nick can quickly become a difficult to treat wound.

Although peripheral neuropathy is commonly caused by diabetes there are a wide variety of other causes including: traumatic injuries, alcoholism, vitamin deficiencies, exposure to toxic substances, infections, diseases, genetics and more. If you have any of these risk factors and are experiencing any of the symptoms above, consult your family doctor and add a Canadian Certified Pedorthist to your healthcare team.

If you have peripheral neuropathy, these safety tips will reduce your risk of developing a serious foot wound or having an accidental fall:

• Inspect your feet daily for abnormal redness, rubs or blisters. If you have trouble bending, use a small mirror to inspect the bottom of your feet.

• Always wear properly-fitted, supportive footwear. Footwear that is too tight will pinch and cause blisters and irritations. Footwear that is too loose is a tripping hazard.

• Book a consultation with a Canadian Certified Pedorthist. Your Pedorthist will do a full assessment and determine if you require foot orthotics or different footwear to ease the pressure on sensitive areas of your feet.

• Avoid putting hot water bottles on your feet and always check the temperature of your bath with your elbow before getting in.

• To protect your feet, wear shoes indoors and outdoors;avoid slippers inside your home. Purchase a pair of supportive, well-fitting shoes for use at home.

• Keep moving. Exercise regularly and avoid sitting down for long periods of time.

As with many healthcare issues, peripheral neuropathy requires the support of your full healthcare team; working closely with your family doctor and Pedorthist will ensure you stay healthy and can continue to participate in all the activities you enjoy.

By Alyssa Milton, C. Ped (C), Cambridge, ON


High heels should be an employee’s choice

In October, Ontario MPP Cristina Martins introduced a private member’s bill to prevent employers in Ontario from requiring workers to wear unsafe footwear (specifically high heels) to work. Ms. Martins says high heels should not be a requirement of an employee’s uniform or dress code; it should be employees’ not employers’ choice whether they wear them. Earlier this year, British Columbia adopted similar legislation banning mandatory high heels at work.

I applaud Ms. Martins and British Columbia for taking these important steps. High heels can cause foot, back and knee injuries and no employee should be required to wear them. High heels force your weight onto the ball of your foot, a part of your body that is not naturally designed to bear weight. Shoes that lift your heels, also shorten your calf muscles. To prevent you from toppling forward, the muscles in your knees, hips, pelvis and lower back are forced to work harder than normal. The higher the heels and the more frequently you wear them the greater the pain and the risk of long term damage to your body.

Employers in industrial workplaces or construction have strict guidelines in place to protect their employees’ feet from workplace accidents and steel toed safety shoes and boots are the norm. Healthcare facilities have similar requirements; it would be absurd to see healthcare employees in anything other than soft soled, supportive shoes to help them through the long days they spend on their feet. Why then should our standards be different for women working in the hospitality industry who spend equally long periods on their feet?

If you choose to wear high heels, for work or pleasure, I recommend the following:

  • Select heals that are 2.5 cm or less and have a solid, wide base. This will maximize your support and reduce the pressure on the ball of your foot.
  • Limit heels higher than 2.5 cm for special occasions such as weddings or parties. When purchasing higher heels select ones that have a platformed forefoot and incorporated toe spring as they will provide some cushioning to the ball of your foot.
  • Avoid heels that have very narrow toes; look for styles that accommodate your foot’s length and shape. If your high heels don’t fit well you are at risk of developing corns, bunions, blisters and even nerve damage.

When it comes to high heels, Canadian Certified Pedorthists recommend balancing style and comfort. If high heels are part of your personal style, follow the tips above to reduce your risk of injury. However, nobody should be told they must wear high heels to work. It’s time for Ontario to adopt legislation that protects workers’ feet in all industries.

By Amy Chapman, C. Ped (C), Kingston, Ont.


Looking for a rewarding career in healthcare?

If you’re studying kinesiology or health sciences and are interested in pursuing a rewarding career in healthcare with excellent employment prospects, I highly recommend you consider becoming a Canadian Certified Pedorthist. My days are interesting and varied and I have a great work/life balance. This short video will give you a taste of a career as a Canadian Certified Pedorthist.

Canadian Certified Pedorthists are orthotic and orthopedic footwear experts. Trained in the assessment of lower limb anatomy and muscle and joint function, we work alongside physicians and other healthcare providers to improve or maintain the activity level and mobility of patients with pain, abnormalities and debilitating foot and lower limb conditions. 

Once you have completed a university degree with the required pre-requisite courses, you can choose one of two paths to complete your post-graduate pedorthic training: a 12-month distant learning program through Western University, or an apprenticeship program which requires a minimum of 3,500 hours or approximately 2-3 years of training. Both paths provide excellent preparation for the final certification exams; you should select the path that best meets your time goals and preferred method of learning.

Unlike many careers, new Pedorthist graduates have little difficulty finding work in their field. Our growing aging population combined with an increased awareness of the benefits of custom foot orthotics and appropriate footwear and the importance of living a healthy, active life, means the number of patients looking for pedorthic care continues to increase each year.

One of the things that drew me to pedorthics was the flexibility to shape my career. I wanted to work in a field that combined health and athletics and today I see patients from professional athletes to individuals living with diabetes. However, there are a wide variety of other options within the pedorthic field, depending on your area of interests and career goals. If you’re entrepreneurial, you can open an independent practice or buy a pedorthic franchise. If you prefer collaborating with team members, you can work in a large multidisciplinary clinic or healthcare centre. If you prefer part-time work, you can join an established pedorthic clinic.  

I cannot imagine a better career. I think you’ll feel the same way.

By Peter Morcom, C. Ped (C), President, Pedorthic Association of Canada


Don’t let a fall change your life

As a healthcare professional who regularly works with elderly patients I am keenly aware of the negative effect of falls; on numerous occasions, I have seen a fall change the quality of an individual’s life.


Pedorthic Terminology

When I consult with patients I always encourage them to stop me at any point if I say something they don’t understand. This is important, as pedorthic treatment is most successful when patients have a clear understanding of my assessment and recommended treatment. Despite my encouragement, some patients are still reluctant to tell me when they need further explanation.


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