Foot Orthosis
A prescription foot orthosis, or foot orthotic, is ordered for a misshapen or deformed foot as well as to help relieve areas of pressure on the foot. It is designed to support the foot by applying pressure to areas to encourage an appropriate gait. Orthoses may be made of a wide range of materials such as firm plastics or semi-rigid material such as crepe, laminate or composite or various density foams. They can be either full or three-quarter length.
Foot orthoses will replace the insole of the shoe and are generally left in the shoe at all times. If the shape and style of the shoes are comparable, the orthoses can be transferred from one shoe to another.
It is important to allow a break-in period of up to three weeks for foot orthoses. During this time, a patient may experience muscle aches or fatigue. This is normal. Do not exceed one to two hours of wear the first time wearing your new orthoses, including sitting and standing. Increase your usage slowly, adding one to two hours each day. Report problems to your ped-orthotist.
Cleaning of the foot orthosis depends on the materials used. Plastics and foams can be wiped clean with alcohol or baby wipes. Leathers can be wiped with a cloth or damp cloth if heavily soiled. Suede can be brushed with a stiff nylon brush. Make sure the foot orthosis is dry before putting it back in the shoe. Harsh chemicals or cleaning solutions may cause a skin reaction and/or damage the orthosis. Keep foot orthoses away from excessive heat to prevent damage to them
The Amfit Orthotic System
The Amfit system offers computer-assisted technology to produce a therapeutic foot orthoses and shoe insert that provides optimum comfort and function. Offered exclusively in the Boise area by Brownfield’s, the Amfit system creates a digitized view of the bottom of the foot without the need of messy time consuming plaster casts. This advanced equipment allows your ped-orthotist to differentiate between hard and soft tissue and design a corrective or protective insert with the appropriate fit as well as enhanced comfort. Amfit is a valuable tool for custom designing foot orthoses for conditions including arthritis, diabetes, pain in the hip, knee and low back, as well as shin splints, gait abnormalities, excessive pronation, heel pain, and leg length discrepancies.
Extra Depth Footwear
For patients with diabetes extra depth footwear is very important, especially if you have loss of sensation (peripheral neuropathy). Correct fit in the correct type of shoes is crucial to preventing or reducing calluses and diabetic ulcers as well as preventing amputations.
People who suffer from peripheral neuropathy often wear shoes that are too narrow or too short because of loss of protective sensation. If you are a diabetic you should always have your footwear fit by a certified pedorthist who is trained to fit you properly.
Extra depth footwear, as approved by Medicare, is designed to relieve areas that cause excessive pressure such as hammertoes, bunions, and extreme foot shapes. They are able to accommodate, stabilize and support deformities. Extra depth shoes will have seamless and deeper toe boxes as well as different lasts or shapes to fit different shapes of feet. Because of their adjustability, they are available in many sizes and widths in order to achieve a proper fit. If necessary, custom fabricated shoes can be ordered that are made from a cast of your feet.
To avoid irritation to the foot, extra depth footwear should be worn with seamless socks that do not have an elastic band at the top. White socks are preferred so that any discharge, indicating a sore, will be seen on the socks.
Brownfield’s is committed to working with your physician to minimize diabetic foot problems and keeping your feet in a healthy condition.
CROW Walker (Charcot Restraint Orthotic Walker)
A CROW walker is prescribed for patients who have foot ulcers or insensate feet. The orthosis has two pieces, like a clamshell, and covers the entire foot and calf of the leg, resembling a ski boot. Although is can be somewhat bulky, the CROW gives tremendous support by preventing foot and ankle movement. It is fully padded on the inside with a removable insert that can be changed or adjusted. A shoes is not worn with the CROW walker.
How to apply the CROW walker:
- Put on a long, thin, seamless cotton sock or cotton stockinette
- Slide the CROW walker into position in front of you placing your heel squarely in the bottom of the footplate. Make sure the heel is all the way back and in contact with the bottom of the footplate.
- Apply the font section of the orthosis, making sure that the sides overlap the bottom section.
- Apply the instep strap on the front of the ankle; then fasten all remaining straps.
- Check the skin for redness that does not go away after 15 minutes. Slight redness is common over the instep and under the ball of the foot.
- Be sure to wear proper footwear on the opposite foot at all times.
On the first day, only wear the brace for one hour at a time. After one hour, remove the brace and check your skin for redness. Some small, light red marks may be noticed on the skin and should go away in 20 to 30 minutes. If the red marks don’t go away in 20 to 30 minutes or if you notice any scratching, bruising or blistering, do not put the brace back on. Call immediately to schedule an appointment with your orthotist.
If the skin is okay, wait one hour before putting the brace back on for one hour at a time for the rest of the first day. Be sure to check the skin after each hour.
On the second day, wear the brace for two hours, remove it and check the skin. If the skin is okay, put the brace back on for two hours at a time for the rest of the day, checking the skin after every two hours. If your skin continues to be okay, gradually increase the wearing time by an hour each day and checking the skin after each wearing time.
To remove body oils and residue from the inside of your CROW walker, spray rubbing alcohol on the interior and wipe dry. You can also use a damp towel and anti-bacterial soap or anti-bacterial moist towelettes. To prevent damage to your orthosis, do not immerse it in water and do not expose it to excessive heat.
