Tell me about the typical orthotic patient?
Well, our patients range in age from infants to seniors. We see a lot more pediatric cases in orthotics than we do in our prosthetic practice. Children account for about 25% of our orthotics. We’re dealing with congenital defects, accidents, short-term growth issues, and so on. For the adults, we do a lot of orthotics for bracing for strains, breaks and tears coming from sports or work-related injuries, other types of trauma, or just the aging process.
What conditions are you seeing among kids?
Starting with our youngest group, we see a growing number of infants that suffer from plagiocephaly or brachiocephaly. These are conditions that mis-shape the child skull. Our specially trained practitioners will evaluate and cast these patients to be fitted with a cranial remolding helmet. We do a lot of scoliosis bracing, as well as for children who have club foot or growth plate issues in their lower limbs. We also find that we’re treating a surprising number of children with cerebral palsy who need orthotics. We work with a number of CP clinics. And, we do a lot of sports medicine bracing requiring orthotics for high school athletes and other teens.
Is it important to work closely with parents in these cases?
Absolutely. We need the parents to understand how the orthotic device works, and why the orthotic is important for their child to follow instructions on its use. It’s really up to them to make sure that their sons or daughters are getting the most out of their orthotic device. Sometimes we have to give the parents emotional support – it can be quite challenging.
What do you mean?
Well, an example would be a child born with a misshapen head from conditions like plageocephaly or bracheocephaly. We have an orthotic device – a cranial remolding helmet – that we custom design for the baby, typically when they are 4 – 6 months old. We make a mold by wrapping the baby’s head in plaster. Then, they have to wear the plastic helmet that we make for them for several months.
The parents are already upset and nervous about their child’s condition. Now they have to deal with the plaster mold experience and the whole concept of their child wearing this orthotic helmet. It can be overwhelming. We have orthotic professionals in our practice who specialize in cranial remodeling. They have gone through extensive training to help parents deal with this. They know how to reassure the parents and give them the confidence they need about the orthotic device. We’ve had a lot of success with these children and their parents
How do you work with teens?
Teenagers want to get back to their active lifestyle. They don’t want to wear an orthotic device that makes them different from their peers. Getting them to be compliant is a challenge.
How do you deal with that?
Well, we take as much time as needed to go over the instructions of what their doctor has prescribed. We talk in detail about the functionality and care of the orthotic device they’ve received. We make sure they know how to use the orthotic before they walk out of the office. Then, we encourage them to follow the instructions.
What are frequent questions?
Whether it’s a parent, a teen, or an adult patient, everyone wants to know “How long do I have to wear this orthotic device?” Orthotics are almost always temporary – it can be a long temporary time period– but there’s usually an end point. We stress to the patient that in order to get the full benefit of the orthotic device, they need to be compliant with what the doctor has prescribed and with the instructions for the device.
Another typical question is “What can I do while I’m wearing this orthotic device?” Everyone wants to know what their limitations may be while wearing their orthotic device. We help them to understand exactly what they can and can’t do in order to heal as quickly as possible.
Will orthotics require adjustments ?
Not usually. Orthotics are used for a limited time period, so it’s rare that a patient would experience any changes that would call for an adjustment. But every product that we dispenses has a warranty, so we encourage patients to come back if they gain or lose weight for example and need an adjustment in their device. Probably less than 20% of all of the orthotic devices we dispense end up needing an adjustment.
Do you dispense “off the shelf” orthotic devices as well as custom-made?
Yes, depending upon the situation. We pride ourselves on being one of the leaders in the custom orthotic field, but we do fit our patients with a number of prefabricated off-the-shelf orthotic devices. There have been significant advances in orthotic devices over the last ten years, negating the need for certain custom products.
What about the financial issues of orthotics?
Orthotics are typically covered by insurance. We get all of the pre-approvals and certifications necessary for our patients to make the insurance process easier for them.