Technology & Recommendations

[RedWingsHockey]

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Hi!

I am currently considering seeing a podiatrist and I was wondering if someone could answer a couple questions I have. At first I thought the Dr. Scholl’s Footmapping machine might be a good idea but after a bit of research I’m starting to doubt that because the “The Footmapping scanner takes a static look at the footprint. Dr. Schneider commented, "The mechanics of the foot is not taken into account."” Despite this though Dr. Schneider says that “A similar device is the Aetrex iStep, which is found in many podiatrist’s offices and at [pedorthist stores].” If this is the case, why go and see a podiatrist if my foot will be scanned by basically the same thing?

Looking online I’ve found other better devices (in my opinion) that exist such as the AMFIT System, TOG GaitScan, STS Casting Technology, and the Otabo 3D scanning machine, so I was wondering what device most podiatrists use. Is Aetrex iStep the most popular or do podiatrists vary in which device they use based on location? Are there other scanners out there that are better than those I’ve mentioned above?

Also, if I were to have custom shoes made, which technology would be best?


Info above from http://walking.about.com/od/insoles/a/drschollsfootmappingreview.htm

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Thanks!

 

[Feli]

TOG is pretty popular among the practices I've shadowed, and most purists still do custom plaster casting. It's dealers' choice, though. In the end, even custom plaster casted devices may need some mods based on the patient's shoe type, activity demands, etc. It's a fairly subjective art, but DPMs who "get it" can really help a lot of patients who are not - or don't want to be - surgical candidates.

The DrScholl scanner might be almost on the level of the ones you see in DPM offices or pedorthist offices, but the product is definitely inferior materials and more of a cookie-cutter insole. As if that's not enough, the "customer support" of fitting, modifications, Q&A, etc is obviously basically nonexistant with a dispensing machine. Like most things in life, you usually get what you pay for. 😉

 

[jonwill]

Hi!

I am currently considering seeing a podiatrist and I was wondering if someone could answer a couple questions I have. At first I thought the Dr. Scholl's Footmapping machine might be a good idea but after a bit of research I'm starting to doubt that because the "The Footmapping scanner takes a static look at the footprint. Dr. Schneider commented, "The mechanics of the foot is not taken into account."" Despite this though Dr. Schneider says that "A similar device is the Aetrex iStep, which is found in many podiatrist's offices and at [pedorthist stores]." If this is the case, why go and see a podiatrist if my foot will be scanned by basically the same thing?

Looking online I've found other better devices (in my opinion) that exist such as the AMFIT System, TOG GaitScan, STS Casting Technology, and the Otabo 3D scanning machine, so I was wondering what device most podiatrists use. Is Aetrex iStep the most popular or do podiatrists vary in which device they use based on location? Are there other scanners out there that are better than those I've mentioned above?

Also, if I were to have custom shoes made, which technology would be best?


Info above from http://walking.about.com/od/insoles/a/drschollsfootmappingreview.htm

​

Thanks!

So first off, it would appear that you are assuming that you infact need orthotics.

I don't do a lot of orthotics in my practice. We do have a pedalign machine in one of my offices. I've still been doing my own casts though when custom is needed. The issue with the Dr. Scholl scanner thing is that while it does scan your feet, it still recommends a prefab orthotic that doesn't fit your foot exactly. The scanners used in most podiatrists offices (most systems) are used to make custom inserts that fit the person's feet exactly (an exact mold of the patients foot is created from the scan and then a custom insert is created). So there is still a big difference. On the other hand, my personal opinion is that prefab orthotics work fine on quite a few patients who have a fairly neutral foot type. Unless they have a severe deformity, I will usually start with a prefab (Prolab) orthotic if I determine that orthotics are indeed needed. A BIG reason I do this is that very few insurance companies cover orthotics and $300-400 is a lot for most patients. On the other hand, if they have a severe deformity, I'm honest with them that they need the custom.

For podiatrists that do a lot of orthotics, this is a "hot button" issue and there are diverse opinions on all the various scanners out there.

P.S. I trained in Detroit, go wings!

 

[Footsurg]

So first off, it would appear that you are assuming that you infact need orthotics.

I don't do a lot of orthotics in my practice. We do have a pedalign machine in one of my offices. I've still been doing my own casts though when custom is needed. The issue with the Dr. Scholl scanner thing is that while it does scan your feet, it still recommends a prefab orthotic that doesn't fit your foot exactly. The scanners used in most podiatrists offices (most systems) are used to make custom inserts that fit the person's feet exactly (an exact mold of the patients foot is created from the scan and then a custom insert is created). So there is still a big difference. On the other hand, my personal opinion is that prefab orthotics work fine on quite a few patients who have a fairly neutral foot type. Unless they have a severe deformity, I will usually start with a prefab (Prolab) orthotic if I determine that orthotics are indeed needed. A BIG reason I do this is that very few insurance companies cover orthotics and $300-400 is a lot for most patients. On the other hand, if they have a severe deformity, I'm honest with them that they need the custom.

For podiatrists that do a lot of orthotics, this is a "hot button" issue and there are diverse opinions on all the various scanners out there.

P.S. I trained in Detroit, go wings!

I tend to do quite a few orthotics. We use the foam box and position the foot in a tripod thing position. It gives a very high arch. We have had pretty good results with them and get a lot of people who pay cash for them. My mom and mother in law both love em!. I have had a lot of patients bring in their Good Feet orthotics or other various OTCs. They claim they have made their feet worse or have not done much at all. I am a big believer in the right orthotic. Not everyone needs a custom orthotic, but for those who do I have seen them make a big difference.

Long live D-town

 

[NatCh]

You've already decided on your treatment? If you do end up going to a podiatrist's office, I'd recommend you go in being open to treatments other than orthotics rather than go in specifically requesting orthotics. Orthotics are only one of many possible treatments and they might not be the best treatment for your specific condition.

An analogy would be if your car was making a clunking noise and you were to take it to an auto garage asking for them to replace the transmission. They listen to you, replace the tranny, and the car still makes a clunking noise because all along it was the driveshaft that was faulty and not the tranny. If you had simply told the mechanic that your car was making a clunking noise and let the mechanic do his job diagnosing the problem it would have worked out better.

Same goes for seeing the doctor. Let him or her do his or her job diagnosing the problem before you decide on your treatment. You may have been right all along but maybe not.

 

[PADPM]

You've already decided on your treatment? If you do end up going to a podiatrist's office, I'd recommend you go in being open to treatments other than orthotics rather than go in specifically requesting orthotics. Orthotics are only one of many possible treatments and they might not be the best treatment for your specific condition.

An analogy would be if your car was making a clunking noise and you were to take it to an auto garage asking for them to replace the transmission. They listen to you, replace the tranny, and the car still makes a clunking noise because all along it was the driveshaft that was faulty and not the tranny. If you had simply told the mechanic that your car was making a clunking noise and let the mechanic do his job diagnosing the problem it would have worked out better.

Same goes for seeing the doctor. Let him or her do his or her job diagnosing the problem before you decide on your treatment. You may have been right all along but maybe not.

👍

 

[RedWingsHockey]

Thanks for the input everybody. Can anybody tell me anymore about the devises they use, or any personal opinions?

 

[PADPM]

Thanks for the input everybody. Can anybody tell me anymore about the devises they use, or any personal opinions?

1) I personally believe that presecription orthoses are over-prescribed

2) Although the biomechanical purists will surely blast for me this one, I have found that despite which method I have utilized, or despite the complexity or simplicity of my biomechanical exam, it was the accuracy of my diagnosis that mattered the MOST.

3) As per #2 above, I have utilized several different scanners, casting via different methods and foam boxes, and when each method is performed properly and when the orthoses are utilized for the RIGHT diagnosis, I have personally found equal results with each method. However, when push comes to shove, I've actually probably had the least accurate "fit" with scanners.

 

[347932]

1) I personally believe that presecription orthoses are over-prescribed

2) Although the biomechanical purists will surely blast for me this one, I have found that despite which method I have utilized, or despite the complexity or simplicity of my biomechanical exam, it was the accuracy of my diagnosis that mattered the MOST.

3) As per #2 above, I have utilized several different scanners, casting via different methods and foam boxes, and when each method is performed properly and when the orthoses are utilized for the RIGHT diagnosis, I have personally found equal results with each method. However, when push comes to shove, I've actually probably had the least accurate "fit" with scanners.

👍

 

[NatCh]

1) I personally believe that presecription orthoses are over-prescribed

2) Although the biomechanical purists will surely blast for me this one, I have found that despite which method I have utilized, or despite the complexity or simplicity of my biomechanical exam, it was the accuracy of my diagnosis that mattered the MOST.

3) As per #2 above, I have utilized several different scanners, casting via different methods and foam boxes, and when each method is performed properly and when the orthoses are utilized for the RIGHT diagnosis, I have personally found equal results with each method. However, when push comes to shove, I've actually probably had the least accurate "fit" with scanners.

Agreed on all points.

 

[RedWingsHockey]

Okay thanks