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Discussion in 'Podiatry Students' started by krabmas, Nov 28, 2005.
Has anyone heard of sole supports? it is an orthotic company.
They are just one of many custom made orthotic labs out there - they claim to be somewhat different to the rest and have a lot of hot air in the marketing and voodoo in what they claim they can do, but do make a pretty good orthotic. ...
How do you know they make a pretty good orthotic? Do you have them? Rx them....?
We had the founder come to our school and give a presentation and I just wanted to get some other oppinions.
I have used the lab and other labs as well. If you have been to his workshop, then you have heard the hot air masquerading as science. Unfortnately the product is not bad, but wrapped up in the hype, it puts you off it.
I know its been a few years since the last comment but after reading the last review I had to chime in.
I've been practicing for over ten years. I've worked with four different orthotic labs. They all failed because they all practice cast correction.
When you cast correct a mold (that is adding plaster to the positive mold of an arch) you change the shape of the orthotic dramatically and permanently. It will never fit the arch perfect. It can't because you just changed the mold.
When you make a "regular" orthotic there are three reasons why the pedorthist does cast correction:
1. Because the cast is usually done in the air the ground is not incorporated into the cast. You can't cast that way. The ground is the floor of the arch support and without it the pedorthist has absolutely no idea how high to build the arch. If by chance it is made too high the patient will return it. Not good for sales. So the pedorthist adds plaster to the mold thus lowering the arch. Thats why the orthotic NEVER fits right.
2. If you cast the foot on the ground weight bearing you will mold the foot in its pathologic position. Might as well buy an over the counter arch support.
3. Finally, when the doctor writes out the prescription he never CALIBRATES the flexibility of the orthotic. In fact most of the doctors I know either guess on the thickness or choose Lab Standard. Wait a minute.... your eye doctor doesn't guess or choose lab standard when calculating your eyeglass prescription.
And in my opinion, rearfoot posts (tilts added to the bottom rear of the plate) make you walk off your fifth toe. Try this: Cover a rearfoot posted orthotic with spenco. Check it in six months. The wear pattern goes right off the fifth toe. In addition, and here we go again, the doctor usually checks LAB STANDARD for the rearfoot post. WHAT??? So everybody gets 3 or 4 degrees?
So lets put this equation together: Cast corrected foot mold + lab standard plate thickness + lab standard rearfoot post = Custom Molded Orthotic.
Where are the smoking chicken bones and mirrors with this one?
This is why biomechanics class and orthotics class never made any sense in school (or in practice for that matter). Thats why there aren't any scientific books or journals written on how to adjust them. I hope the fog is starting to clear, especially for you current podiatry students.
I started using Sole Supports in 2005. They, along with E-Soles, are as far as I know the only two companies which make a form fitting orthotic that is molded on the ground with the arch all the way up. That is the key. And thats been the 40 year old problem with regular orthotics.
Sole Supports then calibrates the inserts by matching the plate flex to the corresponding weight AND foot flex. With Sole Supports there is no such thing as "lab standard".
So now you have an arch support that fits perfect. It flexes just enough to allow you to absorb shock and then raises the arch back up through midstance and propulsion. This lowers the first met head and allow you to walk off the great toe.
They work because they follow the rules of engineering. If you decide to make Sole Supports study the CD they offer so you can appreciate how they function. You will be surprised at how quickly you'll become an expert in biomechanics. You'll really make a difference in people's lives and do a whole lot less unnecessary surgery.
I agreed with the whole method until I tried them myself. Everytime I tried to take a step my left knee would lock (hyperextend).
If the person is equinus it seems that these will not work. Are there really that many people with flat feet that are not equinus?
Since we are discussing orthotic labs, what do you guys (podiatrists) think of ProLab Orthotics?
ProLab and Northwest are probably among the biggest, most respected, and commonly used labs. You will find a lot of pods who use them.
Everyone has their own unique preferences on orthotic labs and shoe stores, though. You will see many different opinions and reasonings when you shadow in private practices. Some docs use one lab for sports insoles, and other labs for other types (dress, everyday, diabetic, etc).
I use Prolab quite frequently and I like the ability to have custom made orthotics that are specific for a lot of common pathologies. I also like the fact that they have an easy way to talk to one of the consultants (a DPM who is well versed in biomechanics) to talk about difficult pathologies. Another nice feature is that the positive mold is stored onto a computer. This allows the me the ability to get another type of orthotic for that patient without having to re-cast them.
My only gripe with them is that they do have a slow turn around time, usually on average of 3 weeks. Most of my patients don't mind though, and if needed they do have a rush option, which you can pass on to the patient.
I'm glad to see that my posting created some more interest on the subject. These are my opinions from my experience that I share for you to enhance your ability to practice medicine.
I'll make it real simple for all you podiatry students (and attendings).
If you cast a foot in the air or standing on the ground then the lab must cast correct your mold. If a lab performs cast correction then the product is baloney. Period. Read my other listing for the reason why. Don't let the lab fool you with the size of their business, client list or years of experience. Remember, these things have been made without using engineering principles now for 40+ years.
As far as I know there are only two labs that make an insert that does not require cast correction because it is fit directly to the foot: E-Soles and Sole Support. The AMFIT system is lacking. The inserts don't raise the arch all the way and the flex is often way too soft.
I made the standard rootian orthotics we learned in school for ten years and I found that they are no better than premolded or over the counter for many foot ailments. I'm not the only one who agrees: Check out Foot&Ankle Int/Vol 20, April 1999 or BioMechanics Oct 2000 or JAPMA Feb 2001.
Sole Supports have resolved every Morton's Neuroma and Plantar Fasciitis problem I have had in the office in the past 18 months.
As for the individual (KRABMAS) who experienced the hyperextension of the knee you should have contacted Sole Support regarding that.
KRABMAS is correct about the equinus issue. Since Sole Support is the real deal it will not allow any excess pronation beyond the calibration measurements that are prescribed. Thus an individual with an equinus (like a woman who wears high heels all the time) will find the foot slipping out of the shoe.
I welcome any further questions or challenges on the issue and will check back from time to time.
Are you planning on doing a study regarding your inserts?
How come when I read your posts, I can hear Ed Glaser's voice in my head? $5 says you're Ed.
Sole Supports is my main lab. I use them for sport and other functional devices. I get a few disgruntled patients from time-to-time...hell, they're all disgruntled. I ain't running no damn daisy farm. My motto is "Do it my way or watch your butt!" [5 more bucks to whomever can name that movie quote.]
I'm pretty happy with the end results.
Ace is my main lab for diabetic and other soft devices. Excellent turnaround time and great customer service.
ProLab takes ridiculously long. The patient might get better by the time you get the orthotic back!
Sorry, I'm not Ed. Honest. And no, I am too busy in the office to even think about doing a research project. Its their job.
No, I have an office practice. I have a background in endurance racing activities and my practice is heavy in sports med. Probably why I have such an interest in biomechanics. The Sole Support is just so tangible. Unlike other facets of medicine I can actually visualize how they work and I can teach it to my patients so that they understand it too.
The rate at which it solves problems is outstanding. I think the biggest challenge for inserts like Sole Supports is that it requires doctors to "unlearn" many misconceptions that we were taught in orthotics class.
So forgive me for sounding so enthusiastic. And I appreciate your comments.
And the quote is from the movie "Raising Arizona".
So now you owe me $10.
The MASS theory is pretty interesting stuff for anyone who has completed biomech class...