Dr. Allan Horowitz, published newspaper article, The Liberal, Copyright January 16, 1991

In last week’s column I discussed some of the causes and treatments of a common condition known as ‘shin splints’.

One of the possible aids which is often used in protecting athletes from acquiring shin splints is something called ‘orthotics.’ Orthotics cannot only prevent shin splints, but can also be used to treat the various biomechanical conditions which have caused shin splints and therefore are often used when the condition has already become well established.

Orthotic use is often all that is necessary to ‘cure’ the condition and all symptoms might vanish as soon as the orthotics are worn for a few days.

INSERTS

Orthotics are inserts which are placed into the shoe in an attempt to realign and redistribute the weight bearing forces which are transmitted through the foot and ankle.

In those with shin splints there is often a problem with the arch of the foot, or the foot is often falling inward. Orthotics can be made to correct these problems so that the person walks and runs properly and the stresses are no longer being absorbed by the already inflamed tendons. (Those who read last week’s column will understand the pathology of shin splints. Please inform and educate your friends who had better things to do than read last week’s column.)

The question is not ‘Will orthotics work?’ Properly fitted orthotics will almost always help the condition. If they don’t completely cure the problem, they will at least help.

The questions are: “Where to buy orthotics?” and “Can you afford them?” Custom-made orthotics which are molded or casted from your feet are the kind most highly recommended but are also the most expensive.

A podiatrist will usually take foot X-rays, examine the foot and ankle, take a mold of your foot and send the mold away to the lab. These orthotics will usually cost $300 to $500. A chiropractor (and in the past few years more and more family medical doctors have been prescribing orthotics also) will examine the foot and ankle, measure the length of the legs, and also take the health of the back and pelvis into account.

Chiropractors use many different types of molds and some form of imprint is taken of the foot and this is then sent away to a lab. These usually cost between $200 and $300, depending on which style is required.

Some orthotics can be made to fit flat shoes, running shoes, high-heeled shoes, pumps, etc. and the price reflects the materials used and the work that goes into their construction.

There are rigid, semi-rigid and flexible orthotics. Each has its own pros and cons, although I personally prefer the flexible supports for most patients. Most orthotics will be good for several years.

My patients who need replacements usually need them because of loss or convenience (to have another pair) rather than the orthotics wearing out. Маny sports injuries clinics at hospitals and other facilities now prescribe and fit orthotics. Most foot clinics at major hospitals do the same.

If you want your doctor, chiropractor or podiatrist to give an opinion on orthotics ask him/her if he does fit these devices. If not, ask for a referral to someone who does. Do not buy orthotics from fly-by-night operators who set up a booth somewhere, take a footprint, and sell you a pair of ‘custom-made orthotics.’

OUTRAGEOUS CLAIMS

Every year I see these booths at various shows and fairs and I always go up to the ‘expert’ and play dumb. I hear outrageous claims made by those with no diagnostic abilities and see inferior products and, considering that the price of this junk is not much less than a good pair of orthotics ordered by a competent health professional, I see no reason to buy from these groups.

A bit of good news for those of you who might require orthotics but feel the price tag is too high. Most people have extended health benefits at work which allow them dental care, eyeglasses and so on. These plans also cover orthotics. Check with your company first to find out if they cover the entire cost or just a portion.

Allan Horowitz, D.C., it a chiropractor practizing in Richmond Hill and writes this public service column. He will attempt to answer readers’ questions on a variety of topics including back pain, headaches, nutrition, sports injuries and preventive medicine.

Address your questions to Allan Horowitz, care of The Liberal, Box 390, Richmond Hill, L4C4Y6.