A pedorthist is a specialized healthcare professional who focuses on the assessment and management of conditions affecting the foot, ankle, and lower limbs. This discipline is centered on optimizing human movement and alleviating pain through the use of external devices. Pedorthists work to correct biomechanical imbalances that can lead to discomfort or injury throughout the body’s kinetic chain.
Defining the Practice of Pedorthics
The practice of pedorthics is dedicated to the application of supportive devices and footwear to prevent or improve painful conditions of the lower extremities. Certified pedorthists are trained in the anatomy and biomechanics of the lower body, using this knowledge to formulate a non-surgical treatment plan. This treatment often begins with a comprehensive evaluation that includes a gait analysis, which is the detailed study of how a person walks or runs, and a thorough assessment of their current footwear.
The core function of a pedorthist involves the design, manufacture, modification, and fitting of therapeutic devices that directly interact with the foot. These devices are known collectively as pedorthic devices and include custom-made foot orthoses, which are specialized inserts designed to align the foot and ankle into a more anatomically correct position. A pedorthist may also provide therapeutic shoes or make modifications to a patient’s existing footwear, such as adding lifts, wedges, or flares to accommodate deformities or address leg length differences.
Shoe modifications are a unique aspect of the practice, allowing the pedorthist to build structural changes directly into the footwear to improve function and comfort. For instance, a rocker sole modification can assist with propulsion in patients who have limited joint mobility in the ankle or forefoot. The overall goal is to optimize the patient’s biomechanics and redistribute pressure across the plantar surface of the foot, which reduces strain on muscles, tendons, and joints.
Common Foot Conditions Managed
Patients commonly seek a pedorthist’s expertise for chronic pain issues, which often originate from structural or functional abnormalities in the foot. Conditions like plantar fasciitis, characterized by heel pain and inflammation of the thick band of tissue running along the bottom of the foot, are frequently managed with custom orthotics. These devices provide specific arch support and shock absorption, helping to reduce the tension and strain on the inflamed fascia.
Structural deformities are also a major focus, including bunions (hallux valgus) and hammer toes, where foot orthoses are designed to redistribute pressure and provide protective cushioning. By correcting biomechanical imbalances, the pedorthist aims to slow the progression of these deformities and alleviate the associated discomfort. Gait abnormalities, such as excessive pronation (rolling inward) or supination (rolling outward), are addressed by devices that stabilize the foot and ankle, promoting better alignment throughout the entire lower limb.
A significant area of pedorthic care is preventative intervention for individuals with diabetes. Diabetic foot complications, such as ulcers caused by peripheral neuropathy and poor circulation, can be prevented by therapeutic footwear and custom inserts. These specialized shoes are designed with extra depth and seamless interiors to accommodate foot changes and reduce high-pressure areas that could lead to skin breakdown and subsequent amputation.
Pedorthists also manage various sports injuries, including Achilles tendonitis and shin splints. They use devices that correct the underlying mechanical issues contributing to overuse and pain.
Comparing Pedorthists to Other Foot Specialists
The distinction between a pedorthist and other foot specialists, such as a podiatrist or an orthotist, often causes confusion for the general public. A Podiatrist, or Doctor of Podiatric Medicine (DPM), is a physician who can diagnose medical conditions, prescribe medication, and perform surgery on the foot and ankle. In contrast, a pedorthist is an allied healthcare professional whose scope of practice is limited to non-invasive, external treatments involving footwear and supportive devices.
A podiatrist can evaluate a patient with a medical condition, such as a severe infection or fracture, and may then refer that patient to a pedorthist to manage the mechanical aspects of their recovery or ongoing care. The pedorthist’s role is purely technical and biomechanical, focusing on the interface between the foot and the ground. This collaborative approach ensures that the patient receives both medical treatment for the underlying disease and specialized mechanical support for function and mobility.
The difference between a pedorthist and an orthotist relates to the area of the body they specialize in treating. While both professions work with external devices to support or correct body function, an orthotist is trained to provide bracing and support for the entire body, including the spine and upper and lower limbs. A certified pedorthist, often designated with a C.Ped. credential, is specifically trained and certified to exclusively manage conditions originating at or below the ankle.