Orthotics

Orthotics describes the science and practice of assessing a patient and designing, fabricating, assembling, fitting, altering or servicing an orthosis. Some orthotics can be found in over-the-counter venues such as cushioned heel cups or insoles for shoes. Other orthotic devices require custom fit.
An orthosis means an apparatus designed to furnish support to sickly, fragile or nonfunctioning joints and/or muscles. An orthosis refers to an orthopedic appliance or device used to support, align, prevent or correct deformities, and to improve function of the spine or limbs. Some examples of orthoses include such items as knee braces, elbow supports, ankle/foot or leg braces, spinal and neck braces.
Health professionals, called Orthotists, assess, quantify, propose, fabricate, assemble, tailor, alter and service orthotic braces. Their role encompasses patient assessment, formation of a treatment plan, follow-up and practice management. Orthotists operate in conjunction with licensed physicians, chiropractors or podiatrists to remedy or mitigate neuromuscular or musculoskeletal dysfunction, disease, injury or deformity. Certified Orthotists benefit patients by:

• Adapting their devices to fit on debilitated body parts
• Re-organizing anatomical structures
• Assisting individuals to walk safely and effectively
• Helping individuals learn how to enhance the functionality of their orthotics
• Recognizing environmental obstacles in social, home and work settings
• Perfecting overall balance; and
• Improving the function of limbs that have been altered by accident, congenital deformity, neural condition or disease.

Pedorthists design, manufacture, modify and fit foot orthotics, custom footwear and some ankle and foot braces.

Yes. A physician must write a prescription before an orthosis can be custom made. However, an initial evaluation by the Orthotist does not require a prescription.

Donning an orthosis and wearing it should not be uncomfortable or painful. If an orthosis creates any discomfort or pain, the individual should contact their orthotist as soon as possible for an evaluation of the fit of the orthosis.

While dressed in any style of orthosis, individuals need to take safe care of their skin to guard against skin irritation. Alteration in the skin integrity can appear as redness, blisters, open sore or rawness. Individuals with an orthosis can avoid skin breakdown by always: 1) cleaning the orthosis with gentle soap and water or a non-toxic cleaning product, and 2) do not use topical creams or lotions in close proximity to the orthosis. When any skin breakdown occurs, the individual needs to contact their orthotist as soon as possible.

Many factors affect the useable life of an orthosis. The level of activity, how much an individual weighs, and the particular design of the apparatus influence the actual wear time of the orthosis. Durable materials are generally used to create most orthosis so degradation of the material usually fails to be a reason for a new apparatus. Straps and other parts undergo replacement and maintenance multiple times before a orthosis needs to be entirely exchanged for a new one.

Most often, the replacement of an orthosis occurs because of changes in a person’s body habitus that alters the fit of the device. Most orthoses can usually last for one or more years, and many can be worn for multiple years. Individuals with orthoses should request a re-evaluation of the orthosis every six months to a year to confirm integrity of the device.

Individuals with orthosis devices should follow-up with an orthotist every 3 to 6 months for assessment or sooner if changes in their weight occur or their activity level increases or decreases. These follow-up appointments help to recognize changes in the anatomy or overall circumstances of the patient prior to a difficulty arising.