STEP 2: Patient Adjustment Period
Patients will need time to adjust to their Formthotics, as their shoes may feel different.
How to do it?
Patients should allow time to adapt and ‘break-in’ their Formthotics. Ideally wearing for an hour each day for the first 3 to 7 days. Unlike most orthotics, Formthotics orthotics are heat-moulded to the patient’s feet in-clinic, so they may find break-in periods are shorter than traditional orthotics.
Important notes watch out for
If your patient’s find their Formthotics insoles are causing them pain, blistering, or bruising they should stop using them immediately. Reassess your patient using the 6 Steps and try to identify what caused the issues.
Step 3: Rearfoot Modification
A rearfoot modification is a modification applied medially or laterally to the rear of an orthotic. For example, wedges are used as a means of applying a force to the rear-foot in response to biomechanics or function that has been identified as being as contributor to a patient’s pain or dysfunction.
How to do it?
Usually, a wedge is applied to the underside of Formthotics orthotics, this may be done using glue, adhesive tape, or the self-adhesive backing on the wedge itself.
Important notes to watch out for?
Most commonly, a medial or varus wedge applied to the rearfoot as a means of managing excessive pronation, will yield the most improvement in alignment, function and supination resistance.
Step 4: Forefoot Modifications
Forefoot modifications apply force to the forefoot. The depth of insertion and angle of the wedge determine the force that is applied. Metatarsal domes and bars are also considered forefoot modifications.
How do you do it?
Usually, a wedge is applied to the medial or lateral forefoot of the Formthotics orthotics, this may be done using glue or adhesive tape.
Important notes or things to watch out for?
Commonly, a lateral (or forefoot valgus) wedge will yield the most improvement in the Windlass Mechanism Test and Forefoot Stability Test.
Step 5: In-shoe testing
It is important to check the patient’s stance and gait to assess the functional effects of Formthotics orthotics while the patient is wearing them in their shoes.
Questions to think about are whether the patient finds them comfortable? Are there areas on their foot that might feel as though they will rub? Is there enough room in the shoes for both their feet and the Formthotics insoles? It is important the patient feels comfortable leaving with their Formthotics insoles, or they may be unlikely to use them.
How do you do it?
Ask the patient to take a short walk to see how the Formthotics orthotics feel within the shoe. You may also ask them to perform some of the 6 Tests to see if there is an improvement in the test results that were collated without Formthotics. Tests we’d recommend at this stage include forefoot stability, star excursion, single leg balance and knee bend tests.
Important notes or things to watch out for?
It is important the patient feels comfortable leaving with Formthotics in their shoes, otherwise it is likely they will not use them.
Step 6: Ongoing patient management
While the end point of treatment occurs when the patient can perform their desired daily activities without pain or restrictions to mobility, it is important to continually assess the patient’s orthotics. Booking a review 6 or 12 months after the initial treatment to discuss whether the orthotics are still working or if any changes to the patient’s health might require adjustment to the orthotics.
How do you do it?
Start with a review of existing orthotics. Look at the indentations of toe or metatarsal head pressures on the orthotics. Have a discussion with the patient about whether they feel the orthotics are working or not. Depending on the review it may be necessary to complete the 6 Tests again.
:format(webp))
:format(webp))
:format(webp))