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Getting A Rheumatoid Arthritis Sufferer Back On Her Feet

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When I was completing my Bachelor of Science at the University of Waterloo I had the opportunity to work with a number of professors and graduate students who were doing biomechanical research. This experience sparked my interest in foot biomechanics, particularly how people adapt to walking on varying terrain and how they modify their techniques when they are injured or in pain.

Today, one of the aspects I enjoy most working as a Canadian Certified Pedorthist is assessing abnormalities in patients’ walking cycle and following the evaluation, determining the pedorthic treatment that will help them achieve their personal activity goals. I get a deep personal satisfaction each time I am able to help a patient who has been struggling to perform their daily activities.

One of the most satisfying cases I have treated is a female patient who was in constant pain and whose mobility was seriously restricted because of a severe case of rheumatoid arthritis. This patient had had numerous medical interventions over the past 20 years, including bilateral ankle fusions and bilateral total knee and total hip replacements. When she first visited my clinic several years ago she was in pain all day, especially on the bottom of her heels where she had numerous rheumatoid nodules that had caused her skin to become quite thin. She also had painful callouses under her forefoot, caused by additional nodules. She had adjusted her walk to minimize the time she spent on the balls of her feet and accommodate her fused ankles and her ability to walk was limited.

As the pain was worse under her forefoot, I focused on taking the pressure off the rheumatoid nodules that were present there. Usually custom foot orthotics are the best treatment for reducing pressure in sensitive areas, however, I knew they wouldn’t be enough for the severity of this patient’s case so I recommended modified shoes. Together she and I selected a pair of stylish, deep, orthopaedic sandals that would reduce the pressure on her forefeet. I then carved away material at the forefoot of the sandals to minimize friction between the sandal and the bottom of her foot where the nodules were.

This treatment plan worked perfectly and the patient was able to return to her daily living activities pain free. Over the past few years I have continued this treatment program; I have excavated numerous shoes and I have also designed and manufactured custom foot orthotics for her. The patient couldn’t be happier as before her treatment she was having difficulty walking and now she is able to walk comfortably and enjoy her daily activities.

Working as a Canadian Certified Pedorthist I have numerous rewarding stories like this of patients re-claiming their mobility. It is these moments that brings me to the clinic every morning.

By Brandon Wittig, C. Ped (C), Kitchener, ON

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