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.

How Orthotics Help Your Knees, Hips, and Back

Can functional foot orthotics reduce the pain in my knees, hips, and lower back?

It all depends on the make up of your lower extremity. Outer or inner knee pain may be caused by increased pressure in that area of the knee joint and functional foot orthotics can help realign you to alleviate that pressure.

The same applies to the hips and lower back. Flat feet and abnormal knee mechanics can cause poor posture when walking and place strain on your lower back. Functional foot orthotics must be made with a rigid or semi-rigid plastic polymer or graphite material to have any impact on your feet and knee mechanics. In other words, even if your feet were casted or molded, if the orthotic you receive can be easily folded or twisted  — that is, not rigid — it will not improve your alignment or mechanics.

Orthotics that are soft and malleable are known as accommodative orthotics and are essentially a soft landing for sufferers of neuropathy from diabetes or those who shuffle from Parkinson’s disease. Seeing your podiatrist will help you solve what is best for you.

Education of Podiatrists in British Columbia

Education of Podiatrists in British Columbia

What are the requirements to become a podiatrist in British Columbia and what level of medical training do podiatrists receive?Podiatry is a branch of medicine devoted to the study of diagnosis, medical and surgical treatment of disorders of the foot, ankle, and lower extremity. It is a four year post-graduate medical degree and graduates are awarded a Doctor of Podiatric Medicine (DPM) degree.

Applicants can choose from nine schools in the United States. There are no accredited DPM degrees available in Canada. Podiatrists entering into practice in BC are now required to have at least two years of post-DPM residency-level training. US residencies are now three years in duration and residents become proficient in performing elective foot surgeries such as bunions and hammertoes, and partial foot amputations for patients with bone infection caused by diabetes.

The ankle is also within the scope of practice in most US states. Podiatry residents rotate through anesthesia, radiology, internal medicine, pathology, and other surgical specialties such as orthopedics and plastics. If you have foot, ankle or knee pain while standing or walking, podiatrists specialize in evaluating the gait cycle and can improve your overall mechanics. No referral is required to see a podiatrist in BC.