Biomechanics, by definition is the art and science of applying the scientific laws of Physics, Architecture, Engineering and Mechanics principles to living subjects.

Chiropody, as a profession and by degree, is the only profession armed with an underlying Functional Lower Extremity Biomechanics core.

As a Chiropodist, I believe it is my duty and privilege to educate and inform individuals, regarding different aspects of foot care; however, due to the vast field of study, I found it paralyzing on which area to begin, until a recent appointment with a patient. The patient was referred by a knowledgeable physician who recognized that the orthotics she was wearing were ineffective.  During the history gathering with the patient, I questioned the method of the impression used to make her orthotics.  She advised that she had stepped into foam boxes.  My opinion was the method used was unacceptable and that it constituted insurance fraud.  The patient stated that her physician had voiced the same opinion of her previous orthotics.  I then questioned the methods utilized for her previous orthotics and she responded that she had stepped on a computer plate.  When I explained that her practitioner was correct, her reaction became the inspiration for this article…. I could see her face reddening, as I informed her that both methods used for her previous orthotics were not functional or corrective and that the only method of correction is to have the patient non-weight bearing. This method allows the feet to be placed in their optimal position and an impression of the foot in this position is the only acceptable remedy. With her arms raised high above her head, she angrily stated, “How am I supposed to know who is telling the truth.”   She of course, was absolutely correct and my response required far more explanation than claims of authenticity…

The answer:

Picture1     1.  View pictures of the differing types of methods of impressions.

2.  Know who the qualified and regulated professionals are.

3.  Contact your insurance companies for verification.

4.  Notify your employers that perhaps 25,000 physicians with very limited biomechanical knowledge may not be the best source of prescription for these devices.

 5.  A patient with prescription in hand, often wander to strip mall shoe stores posing as foot clinics; unbeknownst to the prescribing physician. From this point forward the process very likely illegitimate. Please confirm with your insurance company prior to entering into any agreement with anyone other than a Chiropodist.

6.  A prescription is not required to see a Chiropodist; however, if a physician believes orthotics are necessary they should only refer to the patient to a Chiropodist

 Methods Utilized

I employed the feet of my youngest son who has flat feet.  I drew a bi-section of his lower leg and heel to provide views of the relationship between the leg and the foot in both non-weight bearing optimal position and weight bearing position. I then took a non-weight bearing plaster cast of his feet as well as a weight bearing foam box and computer impressions.   I had them manufactured using the same materials only the impression methods were different.   Please view the following pictures of the methods applied and finally, the results of each method.


Computer Plate










Foam Boxes









 Casting (Non-weight bearing optimal position)


















As you can see the lack of control when the weight bearing methods were employed compared with stability and balance achieved when the non-weight bearing method is applied.   The weight bearing devices are considered arch supports comparable to a device purchased in a pharmacy or shoe store clinics.   The non-weight bearing devices balance your feet and provide a much improved symmetry during the gait cycle. You have been provided with a powerful medical device and pathologically inhibitory aid. A non-weight bearing laser image of your foot is also an accepted method. We have experimented with the laser orthotic and in our opinion, did not find it as successful as the casted method and therefore chose not to employ it at our clinic.   Important points to note:

  • Only Chiropodists are qualified to diagnose and prescribe orthotics.
  • Physicians should refer directly to a Chiropodist, not a prescription which I guarantee will end up at some shoe store posing as a foot clinic.
  • Larger employers i.e.: Police, Firefighters, Teachers, Nurses: Please be suspicious if an individual arrives at your workplace to assess all of you for orthotics and tells you to visit your doctor for a prescription and/or offers you a free pair of running shoes. (SIRENS) 



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