Focus on Plantar Fasciitis
Pedorthics can alleviate the
pain of plantar fasciitis
For the past six years, Brian Emmerson
suffered chronic pain in his right foot
caused by plantar fasciitis impacting
this avid traveler’s mobility and overall
quality of life. The retired Information
Technology professional found the pain
to be most severe when first getting
out of bed in the morning and while
walking long distances. He tried various treatments including physiotherapy,
reflexology, a cortisone injection, antiinflammatory creams, a night splint and
orthotics from various vendors. However,
none of these treatments proved to be a
long term solution for alleviating the pain
leaving Mr. Emmerson feeling like he was
just going to have to “live with the pain”.
Mr. Emmerson was referred to Jody
Simpson, a Canadian Certified
Pedorthist - C. Ped (C), through his family physician after experiencing his most
painful bout of plantar fasciitis pain ever.
A s o r t h o t i c a n d f o o t w e a r ex p e r t s ,
Pedorthists work as members of the
h e a l t h c a re t e a m t o a l l e v i a t e p a i n ful or debilitating conditions resulting
from abnormalities or limited actions
of the lower limbs. Canadian Certified
Pedorthists are one of the few healthcare
professionals educated in the assessm e n t , d e s i g n , f i t , m a n u f a c t u re a n d
modification of foot orthotics and footwear.
During his initial pedorthic consultation,
Ms. Simpson took a detailed histor y
of the type of problems Mr. Emmerson
was experiencing with his plantar fasciitis pain. “I needed to find out what
was helping and what was delaying the
healing process,” said Ms. Simpson.
“Mr. Emmerson had different left-toright foot mechanics,” said Ms. Simpson.
“When standing correctly the right STJ
was overpronating while the left was
relatively neutral. When walking there
was limited motion in the STJ and limited dorsiflexion of the ankle during the
swing phase, which could be compensation, made to protect the plantar fascia.”
Canadian Certified Pedorthists create
custom-made foot orthotics to treat many
conditions including plantar fasciitis.
She also conducted a complete pedorthic
biomechanical evaluation that involved
looking at the lower limb static position
including the subtalar joint (STJ) position, arch height, knee position, rear
foot to ground, and toe deformities.
Ms. Simpson also evaluated the nonweight bearing range of motion of the
STJ, ankle joint, 1st ray, 1st metatarsal
phalangeal joint (MTPjt) – along with
additional special tests that focused on
the bilateral heel raise, patella tracking
and twist test. A gait analysis concluded
the hour-long pedorthic evaluation.
The thorough assessment enabled Ms.
Simpson to get an overall picture of Mr.
Emmerson’s lower limb mechanics. She
found the cause of his pain to be the result
of a combination of three factors including overpronation, fat pad irritation and
a rigid dropped 1st ray on his right side.
Orthotic & Footwear Experts
Enhance your team with a Canadian Certified Pedorthist
www.pedorthic.ca
As part of a pedorthic treatment plan,
Ms. Simpson fitted Mr. Emmerson with
a semi-rigid, ¾ length custom-made
orthotic that ended just behind the
metatarsal head with a full length top
cover. The orthotic featured a heel cup
to control his rear foot motions and hold
the calcaneal fat pad in place to avoid
further irritation. The heel cup also provided cushioning to the heel for comfort.
Other additions to the orthotic were a
metatarsal pad, 1st ray cut out and right
medial forefoot and rear foot posting.
The goal of his new custom-made
orthotic was to control excessive right
foot overprontation to lessen the stress
on the plantar fascia, to better distribute plantar foot pressures, to control
calcaneus fat pad position and to accommodate for the rigid dropped 1st ray.
Within a few weeks of being fitted with
his new custom-made orthotics and a
couple of adjustments including the addition of 3mm bilateral heel lifts to lessen
the stress coming from the pull of the
Achilles, Mr. Emmerson was pain-free.
Ms. Simpson also made recommendations on appropriate footwear to ensure
he was getting the maximum benefits
of his new custom-made orthotics.
Focus on Plantar Fasciitis
Family Physicians and Pedorthists
Working Together
As part of the healthcare team, Pedorthists consult with patients based on
referrals from prescribing healthcare professionals.
A C ana dia n Cer tifi e d Pe d or t h i s t i s
one of ver y few healthcare professionals educated and tested in how
to assess, modify, design and fit both
custom made orthotics and footwear.
Canadian Certified Pedorthists are unique
from other orthotic experts because they
do not both prescribe the treatment and
provide the treatment for their clients
– similar to the relationship between a
physician and a pharmacist. This helps
eliminate potential conflict of interest
as a patient can choose who will provide
the treatment recommended by their
physician. Even more importantly, the
collaboration of healthcare professionals from different disciplines ensures
a high-level of quality in patient care.
Plantar fasciitis, heel spurs and heel
pain are some of the most common foot
conditions seen by Canadian Certified
Pedorthists based on referrals from family
physicians. Pedorthists work closely with
family physicians to discuss the patient’s
lifestyle to help determine the cause of
the heel condition and how to best treat
and prevent the problem. This, combined
with a thorough pedorthic assessment
that involves a gait and posture analysis, as well as an assessment of the
lower joints and muscles, help ensure
the best possible course of treatment.
“I had tried a number of treatments in
the past for my plantar fasciitis and they
did not prove to be long term and no one
ever took the time that Ms. Simpson did
to determine what the problem was,”
said Brian Emmerson, a Calgary-based
retiree. This, along with the diligence of
my family doctor, proved to be the best
course of action to help me literally walk
away from the pain of plantar fasciitis.”
physicians it is important to have a
good referring network that they trust
to give expertise, treatment and/or services to improve their patient’s overall
well-being. For the patient these relationships are important because they
will receive the best possible treatment.”
When a custom-made orthotic is prescribed as part of the treatment plan for
the patient experiencing heel pain such as
plantar fasciitis, the family physician and
Pedorthist collectively help to educate the
patient about the new orthotic to ensure
compliancy. This helps the patient better understand the goal of the orthotic
and how the initial break-in period works.
Along with their orthothic expertise,
Pedorthists can also make recommendations on proper footwear. Depending on
the type of treatment plan, Pedorthists
may also make modifications to footwear.
“Communication and teamwork between
healthcare professionals is extremely
important for the success of any treatment,” said Jody Simpson, a Canadian
Certified Pedorthist - C. Ped (C). “Family
physicians are the quarterback for the
overall treatment of their patients. For
Orthotic & Footwear Experts
Enhance your team with a Canadian Certified Pedorthist
www.pedorthic.ca
Canadian Certified Pedorthist,
Jody Simpson discusses different
footwear options with a patient.