Meeting a medical standard of foot care

A medical standard of care is defined as the level at which an ordinary, prudent professional with the same training and experience in good standing in a same or similar community would practice under the same or similar circumstances.

With only between 80 and 90 podiatrists practicing in British Columbia at any time, the majority of foot care is delivered by medical professionals that are not as exclusively trained as podiatrists. Because of this, the patients visiting our office for the first time often come in having seen different medical professionals with varying levels of education and competencies. Despite the best efforts of these professionals, some patients on occasion have some erroneous and misguided ideas about what is going on with their feet. While this misinformation can be frustrating for patients, it does not usually cause any negative consequence. Regrettably, charlatans with no medical training looking to make a buck will target the foot. They will set themselves up at different exhibitions and trade shows that travel through different regions of Canada promising to improve your foot health by selling you what they claim to be custom foot orthotics. Do not be fooled by these individuals. Their orthotics are always mass-made products of usually very poor quality that are not custom to anything and will only make you lighter in the pocketbook. Hopefully you have received only evidence based information about your own feet but if not, our office door is open to help you get the information you need.

Why over the counter orthotics are not custom or functional

The foot aisle at your local pharmacy or your nearest shoe store are often the first stops for patients experiencing foot pain.

Sometimes, these over the counter devices work to relieve painful foot symptoms, or at least for a short time period. But more often than not, they do not provide long lasting pain resolution. One of the biggest reasons for this is that they are usually made of accommodative, flexible material that do not control your unique biomechanics. While accommodative orthotics do have a place for certain patients with specific foot pathologies, they very often fail to improve relatively healthy individuals younger than 75 years old with a normal, functioning gait (how you walk). Another reason for over the counter failures is that patients may have an underlying medical condition affecting their feet that will not be resolved by a mass-made product. And just as your right and left eyes often require a different prescription, your right and left feet are not identical either and are very rarely corrected by over the counter devices.

Custom versus OTC Orthotics

How are Custom Foot Orthotics (CFOs) different from orthotics purchased Over-The-Counter (OTC)?

CFOs can only be considered custom if your feet were physically casted with plaster, inserted into a foam box, or scanned electronically. CFOs are also known as functional foot orthotics because they aim to improve and correct your unique biomechanics during walking or running. This is accomplished with a rigid plastic polymer or graphite device. They can also be calibrated to your weight and shoe size.

Conversely, OTC orthotics are pre-made devices made with material varying from plastic to cork to foam and designed to be accommodating – minimizing changes to your foot function while providing comfort and protection. They can be a worthwhile, inexpensive investment for those needing less correction.
While CFOs are well known to help pronators with flat feet in need of greater arch support, they have also been proven to treat heel and forefoot pain of various causes. By distributing pressure more evenly through the bottom of your foot they can also decrease the likelihood of calluses, nerve pain, and diabetic foot ulcers. Numerous modifications of different materials can also be added to different areas of CFOs to treat corresponding foot ailments.