7/2/2011 7:20 AM
I perform quite a few orthotic modifications each day in the office. These are on over-the-counter orthotics, poorly controlling custom devices, and minor adjustments to otherwise good devices. Sometimes the modification will really change how the foot functions on the orthotic.
Patients often prefer that I don't significantly change their device, so I started using adhesive felt (1/8" and 1/4" thickness) to perform modifications and give patients a taste of what needs to be done. This allows me to modify the orthotic but still give the patient the opportunity to remove it (carefully un-peel it) if they can't tolerate it. I allow patients to use these "test modifications" for 3-4 weeks and then plan a return visit to evaluate and further discuss the changes.
When the patient experiences significantly positive changes, this visit may result in casting for new orthotics. This is often preferable to trying to make these modifications more permanent on the old device. In my practice, patients are far happier with this process since they feel involved in their treatment decisions. This process helps patients better understand what their orthotics can achieve and why I am making certain recommendations.