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1114 Raritan Road
Clark, NJ 07066

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By cl7219
January 20, 2011
Category: Uncategorized
Tags: Untagged

The January 18 edition of the NY Times published an article about foot orthotics. The article used comments from a few doctors, particularly a Dr. Nigg from the University of Calgary to raise doubts about their use and effectiveness.

 

Much like a short feature on your local television news, the article was a superficial presentation of a complicated topic. It had a particular premise--a "warning" about the downside of a common treatment modality for a wide range of foot problems. Scientific resources were used to back up the viewpoint the writer was espousing. The problem is that the article is too brief and narrow in its point of view to be of significant value.

 

Biomechanics, as with so many issues dealing with the human body, is an inexact science with several overlapping, competing and sometimes contradictory theories of explanation. Therein lies a common problem in medicine--we want definitive answers to our problems, backed up by pr oven science, that are virtually assured of solving those problems. There are plenty of common issues to be found, but there are physical, social and psychological factors which can render any situation unique. On top of that, the government and the insurance industry want to manage health care by statistics--only doctors and their patients want customized care.

 

The academic world is one thing. I live and practice in a clinical world. My focus is on accurate diagnosis and treatment of a patient's given problem. When it comes to biomechanics and orthotics, my goal is to relieve pain as quickly and efficiently as possible while doing what can be done to limit recurrences. Sometimes that can be done with a prefabricated orthotic, sometimes with something custom made.

 

Orthotics are similar to eyeglasses in that eyeglasses help you see better--they don't change your eyes. I don't utilize orthotics to correct deformities--I use them to reduce mechanical stresses, to make foot function more balanced and efficient, allowing you to walk "better". By doing that, it is part of a process to relieve a particular pain and possibly prevent a recurrence or other new pains from popping up.

 

In the case of plantar fasciitis, the use of orthotics is the foundation of a treatment plan. Oral anti inflammatory medications, cortisone injections, laser therapy, along with other treatments such as shockwave therapy are frequently added as part of the process. The orthotics deal with the biomechanical stresses that are at the root of the problem.

 

Why are some orthotics comfortable and helpful while others don't help or seem to cause even more pain? Store bought and orthotics found on infomercials are too flimsy or have so many hard lumps and bumps that they don't work or are too uncomfortable to wear. Just because you have a custom made orthotic doesn't mean it was made well. The foot impression could have been made poorly or the materials used may have been too rigid or too flexible. A great orthotic worn in an old, beat-up pair of shoes won't help as much as it could until the shoes are replaced.

 

If an orthotic isn't comfortable, then something is wrong, period. That's when you should bring it back to the doctor to loo into the reason for the problem. Often, it is a simple adjustment that has to be made.

 

Its all about being comfortable, not about whether the scientists and/or doctors can agree on all the details about why they work. Ask questions, find out the whole story for yourself--not just the small portion that one reporter put out there.

 

 

 

 

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Podiatrist - Clark, Dr. Brandon Macy, 1114 Raritan Road, Clark NJ, 07066 732-382-3470