Pedorthics: Both Art and Science

Conversations at cocktail parties usually follow a standard line of questioning. Living in Manhattan affords me the opportunity to participate in this protocol frequently. Normally people begin with a polite introduction and then ask your name. In my case, people are often unsure of how to pronounce or spell what they think they just heard. They rapidly proceed to ask the next question, "So what do you do?" The statement, "I am a pedorthist," receives its fair share of raised eyebrows and vacant stares. It is often greeted with, "How interesting." Few people outside the biomechanics field know about pedorthics. I quickly explain that pedorthics is the science and art of fitting shoes and orthotics to people's feet. I normally find that people are quite interested in discussing what we do. They either have or had foot orthotics, or someone in their family has needed special shoes. Pedorthists can work across the entire spectrum of the shoe and orthotic industry: fitting patients directly in a retail environment, casting and evaluating patients for O & P companies or podiatrists, manufacturing shoes and orthotics in central fab facilities, or doing any combination of these jobs. This makes pedorthists very aware that they are part of an interdependent network that seeks to improve patient foot health. Pedorthics is a science. Pedorthists can take diagnoses, prescriptions, foot casts, tracingsand translate them into a custom foot orthotic or custom shoe. Measurements of range of motion, degrees of varus, patient's weightall assist in determining the durometer of materials, postings, positioning of reliefs, etc. Pedorthics, however, is also an art. The device which is created needs to be compatible with the person's lifestyle. Beyond the theoretical, it needs to be a practical and functioning solution. A well-made shoe or orthotic that sits in the closet is of little use to anybody. Factors such as a person's activity level, sense of fashion, and existing footwear can be of vital importance in developing appropriate solutions. Bulky orthotics will not fit well into loafers, and AFOs will tend to slip out of low-quarter shoes. It is through experience and good communication that pedorthists become a valuable link in the patient care chainrecommending, making, and fitting devices that truly help the patient to walk better, and simultaneously optimizing the practitioner's overall therapy. The ongoing education of the general public regarding foot health and proper shoe fit ensures that there will be plenty of work for all of us to do in the future. This is especially true of the growing diabetic population who are urged to make foot care one of their top priorities. As far as I'm concerned, I always carry a business card with me, and at a cocktail party the two questions that I always answer affirmatively are: "Would you like another drink?" and "Are you wearing orthotics now?" Séamus Kennedy, BEng (Mech) CPed, is president and co-owner of Hersco Orthotic Labs, Long Island City, New York.

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