PFA Meeting Attendance Soars
February 2003 Issue
"To move the profession forward and to find new effective treatments and techniques, someone always needs to be pushing the therapeutic envelope"-Ian Alexander, MD, FRCS(c), orthopedic surgeon and keynote speaker at the Pedorthic Footwear Association (PFA) Symposium and Exposition.
Alexander discussed, "Complex Foot Problems: Solutions for Daily Living," the theme of the PFA's 44th annual meeting November 21-24 in Nashville, Tennessee. A record-breaking crowd of over 900 enjoyed a dynamic, wide-ranging program. Sessions examined the "Five Cs" of pedorthic footwear:
- Comfort through pressure and pain relief;
- Control by managing the foot to improve biomechanics;
- Cosmesis with appealing new looks in footwear;
- Choices through being able to select from a wide variety of footwear for daily living;
- Compliancethe result of comfort plus control plus cosmesis plus choices.
Medical professionals are increasingly becoming aware that footwear can give patients more health options by providing conservative (non-surgical) alternatives to foot conditions, it was noted.
Alexander pointed out that the key to effective management of complex foot and ankle disorders lies in a team approach and understanding a plethora of interacting factors. Complex in themselves, these factors include pathological management of the lower limb; focal mechanics in the problem area; predisposing medical conditions, especially neurological conditions; predisposing skin conditions; non-mechanical post-surgical consequences; properties of orthotic materials; the mechanics of orthotic design; and potential shoe design alterations.
After discussing these factors in more detail, Alexander considered some pedorthic principles, such as noting that surgery could be curative or significantly helpful in some cases, and that when a treatment isn't working that reasonably should be successful, noncompliance could be the problem. Pedorthists may need to address mechanical or neuromuscular factors in other parts of the body that could be causing or exacerbating the problem, he said, adding, "Surgery or bracing may make it easier to deal with the foot disorder." Pedorthists should know clearly at the outset the mechanical effects they are trying to accomplish, he pointed out.
Diabetic Foot Screenings Help Build a Practice
Diabetic foot screenings can build a pedorthic practice, as well as being a community service, noted Erick Janisse, CPed, BOCO. Screening involves patient foot history, physical inspection of the feet, worn shoe analysis, Brannock device measurement, monofilament sensory testing, plantar pressure readings, and reviewing these findings with the patient.
What to do with the findings? Janisse said the pedorthist can a) give them to the patient, b) forward to the physician directly, c) and make sure the patient follows up with the physician. However, the physician may or may not agree with the pedorthist, he added.
How does the pedorthist get the word out about this service? Direct mailing, free screening coupons, advertising, participating in health fairs, and signage are all possible avenues, Janisse said. "Adding diabetic foot screenings to your practice will not only benefit you as a practitioner or a business owner, but will also provide a service to your physicians that few other allied health professionals offer and will serve as an aid in the education of the diabetic population in your areapossibly even saving lives and limbs."
Highlights of the clinical and technical sessions included presentations on lower-extremity biomechanics, complex forefoot disorders among athletes, the science behind pedorthics, Charcot foot, and fabricating custom-molded shoes. A sampling of the business-oriented sessions included using visual design to build a practice, Medicare and licensure updates, and sales and marketing ideas.
Next year's Symposium and Exposition is scheduled for October 30-November 2 in Dallas, Texas.