orthotic insoles

moneylover

Why are orthotists better? Feet are only one of the things orthotists are doing as orthotist are making devices to support weak muscles and joints all over the body whilst a podiatristspecialises in the feet. These days podiatristsare highly trained and are involved in minor foot surgery and when providing orthotics advise on appropriate exercises, posture adjustment etc. And podiatrists are also regulated by exactly the same body as orthotists ie the Health Professions Council. For both professions their title is protected by law.

I do not believe it is always possible to reduce secondary pain/problems with orthotics (insoles) however accurately they are made and however good the assessment of the foot problem. Once you have secondary problems they often have to be dealt with separately

But, hey, what do I know? I am only a patient who has had foot orthotics for twenty years or so. Orthotics have kept my pronating (flat) feet comfortable, there is no doubt that I could hardly walk without them. However I would cry out if someone cupped my ankle as the bone on the inside of my leg above the ankle is very painful, I have all sorts of vague pains about my knees and hips and the bones in my bum hurt when I sit down.

I have orthotics from assuredly one of the best hospitals in the UK - the Royal National Orthopaedic Hospital. I have them privately from the chief orthotist there and he can see anyone privately - you can self refer or, preferably, get your GP to write a letter. When I first went there I was worried about seeing an orthotist rather than a podiatrist but this is one very experienced orthotist who has been practising for 30 years. If I was going anywhere but RNOH I would be looking for a podiatrist rather than an orthotist. For years I went to the London Foot Hospital and saw podiatrists but that has closed down. The treatment I get now from a top class orthotist is as good but no better or different from what I got from a top class podiatrist.

PubMed which is a database of the world's medical literature has plenty of articles about the effect of wearing orthotics. There is no doubt they help the feet but there appears little but anecdotal evidence that they affect knees etc as in recent years it has been possible to make very accurate measurements of gait in laboratories - a huge amount of work is coming out of Salford Gait Analysis Lab for example if you want to read up on it.

Anyway, the one thing we are all agreed on - is don't risk your feet! If you are in or near London there are some excellent people you can see privately but it can perhaps be a bit harder to find the right person otherwise.

Are there any podiatrists on this board? If so, please do post!

littlereddevil

I am going to my podiatrist today (private) about other matters so I'll see if he knows where to go. The nhs waiting list in this area is 25 weeks for an initial appointment(if you are lucky)

lolly5648

Does anyone know where I can get gait analysis in London? I have bunions (inherited from my mother), quite bad pronation and also thigh bursitis which doctors is from walking badly. My bursitis doctor suggested that I saw a physio to teach me how to walk! I would rather see someone who specialises in gait analysis and I don't think our local physio knows much about it.

moneylover

The first thing a podiatrist does is watch the way you walk. Some have instrumented walkways. Maybe you need to start with insoles and see how that goes. My own experience has been that insoles have made my feet comfortable but have not helped other pains (and thigh bursitis is one of the things I have). However you might be luckier. You can be taught to walk differently but I was told by a musculoskeletal specialist that its a very difficult thing to change the way you walk. But you would get postural advice from a good podiatrist or be referred on
But its all expensive and not usually covered by private health insurance if you have this.
I think my appointments at RNOH worked out between £200 and £300 when I first went - that was an intial appt, fitting of the insoles and then a follow up. Lots of places are much more. And I havent had any physio from them so not in the price.
I have got various bits and pieces I have kept about gait analysis and podiatry in London and I could look some out and photocopy some or send links to the stuff on the web and you could ring around. I am happy to do this if you pm me but it wouldnt be for a week or two as have a lot on my plate just now.
Have you tried the local NHS service - is it an NHS specialist you have seen?

cptnsausage

lol like i said, being an orthotist for years myself i am definitely biased toward the service we provide, I know i am not speaking of all podiatrists but in the NHS I've seen hundreds of cases referred to us with simply flat everyday insoles with bits of rubber stuck underneath that are uncomfy and 99 times out of 100 don't do a thing, but like i said i cannot speak for private podiatrists, but as you say any podiatrist should know the theory behind the treatment, i think its just a case of finding someone with the resources to manufacture what we sould deem acceptable and i know the NHS doesn't really give podiatrists that kind of labour support so it would defo be private. again pod's and ortho's both do gait analysis and are taught identically on terms of biomechanics of the foot ankle complex in relation to the interaction with ground reaction forces so they would be pretty similar there too.

like moneylover said i think its a case of going for whatever you feel most comfortable with! also if you do get a private podiatrist that does custom made stuff could u give me the company name, id be interested to see the potential there :-D