It All Starts with the Feet

And not all feet were created equal.  Which is exactly why RVNAhealth is now offering custom and semi-custom orthotics.

The importance of a good foundation has long been established.  Be it a skyscraper, a novel, a wedding cake, or an education, it’s that which comes first that provides structure and stability to that which follows.

The human body is no different, with our feet playing a critical role as our foundation. “The fact is,” says Kate Campbell, DPT, Outpatient Practice Manager at RVNAhealth, “the importance of our feet is paramount, yet they are often overlooked — and entirely unappreciated! Each foot is composed of 26 bones, 30 joints, and more than 100 muscles, tendons, and ligaments. From our very first steps, they bear the brunt of every stride and skip, every leap and bound, every stub and twist. Our entire body lies above them, and any imperfection or deformity in the foot invariably impacts the whole body, often manifesting in pain or issues elsewhere.”

Gigi Weiss, MSPT, RVNAhealth Director of Rehabilitation & Wellness continues, “As physical therapists, our goal — our job —is to resolve the pain and issues of our clients and restore them to optimal strength and mobility. Many times, when a client presents with back, hip, or leg pain — and of course, foot pain —the root issue may lie at the foundation, the foot. In these cases, we can only treat their full condition by addressing their feet.”

For this reason, RVNAhealth has added custom and semi-custom orthotics —inserts placed inside the shoes with the purpose of restoring natural foot function and enabling optimal biomechanics — to our Rehabilitation & Wellness service offerings. “Those who already wear orthotics likely understand their value and how they work,” says Campbell. “But for those new to orthotics, we can help you identify if an orthotic is right for you and walk you through the process from start to finish to ensure a successful end result.  Believe me, the right orthotic can be life changing.”

Here’s everything you need to know to get started:

Does RVNAhealth offer a particular brand of orthotics?
RVNAhealth offers Stride™ Orthotics. Stride is based out of Middlebury, CT, and we think they are the best in the business. We are committed to their product which pairs well with our process of capturing and molding the foot in its natural state, not its deformed state. With this approach, and Stride’s products, we can then build an orthotic that compliments the natural foot to optimize balance and alignment.

RVNAhealth offers both semi-custom and custom orthotics, correct? What is the difference?
Custom Orthotics are built entirely ‘from scratch’ beginning with an extensive evaluation and measurements, molding of the foot, and then designing the orthotic based on the patient’s specific needs (for example, shoe-type like sneakers vs. loafers, or to accommodate specific pains or conditions like diabetes, etc.). Semi-custom orthotics begin with a ‘prefabricated’ Stride orthotic and are customized from there to meet your specific needs. Stride offers six prefabricated models based on six different foot types.

Who needs orthotics? How do I know if I need them?
Honestly, everybody with foot pain, knee pain, back pain, flat feet, too-high arches, shin splints, plantar fasciitis, neuromas, you name it, might need orthotics. Tendonitis, ankle sprainers, Achilles’ heel, etc.  If you are uncertain, we can help you with an evaluation/ consultation.

Why would I get orthotics from RVNAhealth rather than a podiatrist office?
RVNAhealth offers orthotics as a specialty service to help resolve and prevent injury. Our methodology takes time and expertise and includes a detailed evaluation with the gold standard of casting methodology. At an RVNAhealth orthotics appointment, we perform a complete treadmill gait analysis; take digital photos of your feet; review old shoes to see wear pattern; evaluate feet in standing and laying (non-weight bearing) positions. We make a plaster of Paris mold of the foot in a perfect gravity-eliminated state, capturing the foot in its natural state, not its deformed state. Orthotics are intended to prevent further change and deformity in the foot — and in some cases are successful in ‘re-training’ the foot back to a healthier state — and our process successfully supports that intent. The RVNAhealth team currently includes two trained Stride Orthotics Specialists, fully educated on the process with ongoing education and training for the whole staff.

How much do RVNAhealth Stride Orthotics cost?
Custom Orthotics cost $450 and semi-custom orthotics cost $150. Both include evaluation, casting, and follow-up fitting until we know they are right. Re-orders of the same orthotics (for multiple pairs of shoe types) do not require an additional evaluation, hence are significantly reduced. (Actual cost depends on type of orthotic, shoe, etc.)

How long do Orthotics last?
Custom orthotics last for several years if you take care of them or “refurbish” them every year or two. Refurbishment means the orthotic liner is temporarily removed, the orthotic is ‘plumped back up’ and returned to its original shape. Refurbishment is sort of like a tune-up for your car. Semi-custom orthotics ($150) do not get re-furbished. They are replaced every year or two, depending on wear. Semi-custom orthotics are good for kids whose feet grow, and first-time orthotics wearers.

Does RVNAhealth accept insurance for orthotics?
No. Some HSAs and Flexible Spending Accounts, however, do reimburse for orthotics.

How long from my casting appointment until I receive my orthotics?
About 4 weeks.

What if they don’t work?
Getting used to your orthotics takes time and we recommend a staggered wearing sequence for the first few weeks once you start your orthotics. If something still isn’t right after two weeks, it needs to be looked at. We have 90 days to get it right and work with the lab to correct.

Might my child need orthotics?
If your feet are problematic, your children will likely have the same issues. Orthotics are also appropriate for children with Osgood-Schlatter disease; patella tendonitis; flat feet; toe walking; in-toeing; knock knees, and many other issues. If you have concerns, call us at 203-438-7862 and we can work together to figure it out.

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Strengthen core muscles. It doesn’t take a crunch class at the gym to increase core strength (though don’t let us stop you!). Some simple ways to engage core muscles include planks and push-ups (try doing them on the counter if the traditional floor versions are too much. Add an arm lift to the plank if you’re able.

Improve your static balance (your ability to hold our body in a specific position and posture) by standing on one leg. On a flat, stable surface, like while at the sink or on the phone, lift one leg off the floor – even a few inches. Then repeat with the other leg. Do whatever it takes to hold for 30 seconds. Always repeat this exercise more than once. The first time simply wakes up the nervous system, but the second or third round really reiterates the learning and engrains the new pattern.

Walk heel to toe twenty steps forward and twenty steps back to the starting position.  This works on your dynamic balance. Use arms for stabilization, as needed. Then walk on your tippy toes, walk on your heels, walk sideways, and walk BACKWARDS! With caution, please!

Incorporate quality rest. A good night’s sleep improves equilibrium; sleep deprivation can slow the body’s ability to respond, increasing fall and injury risk.

Do Yoga. Regardless of fitness level, yoga is a safe way to improve strength, lengthen muscles, and reduce stress, all which can impact body balance.

Stay hydrated! The Vestibular system in the inner ear relies on a good fluid balance. Being dehydrated can lead to slower reflexes in response to a fall.

Give the brain a good workout.  Yes, the brain plays an important role in body balance because it processes signals from the sensory body systems to aid in movement and balance. Keeping the brain engaged through reading, word/numeric puzzles, other mind-challenging hobbies, listening to music, or trying a new skill can strengthen brain performance which positively affects balance.

If your balance is a concern, contact the RVNAhealth Rehabilitation & Wellness Center at (203) 438-7862 to schedule an evaluation, or attend an upcoming Falls Assessments & Balance Testing program.