So, it’s that time already, and a month has passed since my first ‘offerings’ about all things Orthotic. What I want to do in this post, is to try to make sense of some of the myth and hype that exists around orthotics, and particularly starting with the humble insole. You probably all know what an insole is, but just in case, it is an insert placed into footwear, sometimes simply for comfort, but often to rectify an issue and to provide some kind of support or stability. The word ‘Orthosis’ actually derives from Greek, and means ‘straightening out’, and whilst not all orthotics are about straightening, they are about bracing or providing stability. Anyway, so back to the insole……

I’ve already suggested that there is something of a hype or myth around insoles, and particularly at the moment. It’s not as if insoles are a new phenomenon, but like most other things, they are ‘big’ in the USA right now, and we tend to catch up eventually. Insoles vary in size, shape, materials, design, and possibly most importantly for many, cost. They are available off the shelf in large pharmacy chains in the UK very cheaply, but would you know what they were actually doing for you, and how would you know that they weren’t actually doing you more harm than good? The answer, unless you are clinically trained is of course, that you wouldn’t, until perhaps it was too late and more damage has been done. This is clearly the worst-case scenario, and the likelihood is that they won’t cause lasting damage, they just won’t necessarily do you any good either. Sadly, it’s not only cheap insoles that might not be doing you any good, as sometimes, the expensive ones are just as pointless, particularly if not prescribed correctly – more on this shortly so stay tuned! Some shoe shop chains, and increasingly sports footwear specialists, now offer to check your ‘gait’, in order to provide insoles for your shoes, be they work, leisure or sports-specific. These again can be made of a variety of materials, and can be costly.

The key to all of this, is the biomechanical assessment, and some of this refers back to my post last month, where I very briefly discussed what an ‘Orthotist’ is, how they’re trained and qualified, and what they can do for you. It’s no accident that there is a university degree course in Orthotics and Prosthetics (false limbs, and this will undoubtedly be the topic of this blog at some point into the future), and that this course permits those who have passed it, to register with the Health and Care Professions Council, or HCPC for short, and then allows them to go on to practice in the NHS or beyond. The HCPC registration is vital here, as this provides ‘protected status’ for qualified Orthotists, and means that someone who isn’t qualified, can NOT call themselves one. The Orthotist spends much of their time at university studying biomechanics, which I have mentioned briefly before, but which is the ‘scientific discipline which studies biological systems, such as the human body, by the methods of mechanical engineering’ (Whittle, 1991:34). This training allows the Orthotist to establish precisely what is causing someone’s issue, however serious, and to prescribe an appropriate intervention accordingly. Hopefully you have already identified, that if you purchase insoles from a pharmacist, a shoe shop, a sports shop, or actually from anyone who isn’t sufficiently qualified to prescribe them, then you are wasting your time and money, however much that might be.

It doesn’t necessarily follow that an assessment with a qualified and experienced Orthotist will result in a more expensive insole, just that it will result in you being prescribed the ‘right’ insole to meet your requirements. An Orthotist will also take lifestyle and social factors into account when prescribing, so if you make it clear that you are a runner, a gardener, play bowls, golf, have a dog, enjoy dancing and nights out, or even just enjoy sitting down and doing very little, then this will all be factored in to what is deemed to be most appropriate for you. I do need to make one thing very clear at this point, and that is whilst an Orthotist working in the NHS will also find this detail helpful in prescribing, the range of products made available by our fantastic health service is limited, and thus a visit to a private Orthotist will often mean that more options are available to those who can pay. This is a sad reality I guess, but isn’t new, as we now find this with eyecare, dentistry, audiology, physiotherapy, surgery……. the list goes on.

The reality for many, is that pain is something we often manage and live with, because we either don’t have time, or the money, or the knowledge as to where to seek help, and thus we endure it daily, with it often getting worse over time. We don’t do this with our cars however, and if we hear a noise, or our tyres get bald, then we are straight into the garage to get them fixed. You probably spend more time on your feet than you do in your car, so why not make arrangements to have a biomechanical MOT sometime soon – you know it makes sense.

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