The Pedorthist: A Specialist in Gait and Custom-Made Foot Orthotics
- Josaphine Papadopoulos
- Aug 30, 2024
- 6 min read
A glimpse into the role of a Certified Pedorthist as an allied healthcare professional and how working with one can be beneficial.
An Introduction to the Field of Pedorthics
What is Pedorthics? Pedorthics is a specialised field of study concerning the assessment, management and treatment of conditions related to the foot, ankle and lower limb; as well as the use pedorthic devices such as foot orthotics and footwear to manage and treat such issues.
In Canada, the Diploma in Pedorthics program is offered exclusively through Western University. You must have a degree in Kinesiology—or something equivalent—to be eligible for this program. The diploma is 12-months long and involves both online course work and in-person practicum hours. The program offered distance, and clinic placements are available across Canada making it accessible to students all over country.
What is a Certified Pedorthist? Certified Pedorthists (noun) are experts in postural analysis, musculoskeletal examination, and movement patterns of the foot and lower limbs. They are trained in the manufacturing, fitting and modification of foot orthoses and footwear, as well as the conditions of the foot and lower limb.
The Process to Becoming a Certified Pedorthist. In Canada, these healthcare professionals use the designation Canadian Certified Pedorthist (C. Ped (C)). The main purpose of Pedorthic treatment is to alleviate painful and/or debilitating condition, as well as help manage abnormalities and limitations of the foot and lower limb. Before someone can use the designation, they must have completed a Diploma in Pedorthics (Dip Ped) and passed the licensing exams required by the College of Pedorthics of Canada (CPC). Once successful the individual has to register with the Pedorthic Association of Canada (PAC).
As the regulating body in Canada the CPC not only manages the certification and continued education of Pedorthic practitioners and their practices, but they also monitor and enforce ethical conduct. Their main purpose is to ensure responsible and ethical care for Canadians seeking Pedorthic treatment. Some of the benefits of an affiliation with PAC include:
Practice insurance
Networking with other Pedorthists
Further education opportunities
In other words, their PAC affiliations give Pedorthists the ability to take on clients and keep up to date with current evidence-based research. They also help to create an effective and cooperative health network.
What Does a Pedorthist Do?
Pedorthists are allied healthcare professionals specialising in custom-made foot orthoses and footwear that aide in the management and treatment of various foot related problems. They perform foot and lower limb analyses, as well as work with custom-made foot orthotics and footwear. Pedorthists often fill prescriptions for custom-made foot orthotics and appropriate footwear to accommodate. A few examples of conditions Pedorthists help to treat and manage include, but are not limited to:
Lower back, knee and foot pain
Plantar Fasciitis
Tendonitis (e.g., Achilles, Peroneals)
Metatarsalgia
Bunions, crossover toes
Arthritis (Osteoarthritis, Rheumatoid)
Diabetes, Diabetic Foot Ulcers
Charcot Foot
Multiple Sclerosis
Parkinson's disease
Pedorthists work with people that often struggle with chronic pain related to standing, walking, and/or a specific condition. They also help to manage conditions that impact the lower limbs and feet.
Footwear Analyses, Adjustment and Modifications. Footwear can be an amazing tool to help manage a variety of lower limb conditions and pain. Footwear should have enough room to accommodate your larger foot—length, width, depth, and shape. Off-the-shelf footwear come with a wide variety of features and learning to choose the right fit and features for your current issue and/or activity can make a big difference. What we wear on our feet can often cause new issues or can further aggravate existing ones—especially when our shoes do not fit right, or they are not appropriate for the activity.
On top of including footwear recommendations as part of an exercise prescription, clinicians may suggest specific footwear features to better a person’s foot and accommodate the use of custom-made foot orthotics. If footwear is needed to help manage your foot and lower limb health, it may be important to consider getting a prescription for it. Did you know you that—with a prescription—you can submit (therapeutic and orthopaedic) footwear to your insurance health spending and/or include it on your income tax as part of your yearly medical spending? For example, a client is struggling with painful calf tightness by the end of their work week, in spite of the strengthening and stretching program they have just started doing. In order to help manage this tightness and resulting pain in the interim, they are recommended footwear for work with a higher heel drop (e.g., 8 to 12 mm) in addition to their training program.
Prescribing clinicians writing prescriptions for supportive footwear that assists in movement should say something along the lines of “orthopaedic footwear to help manage foot structure and/or symptoms of diagnosis” or “orthopaedic footwear to accommodate custom-made foot orthotics”, as well as the diagnosis.
Custom-Made Foot Orthotics. Custom-made foot orthoses—also more commonly referred to as orthotics—are medical devices designed to correct the alignment and mechanics of your feet and ankles, supporting the body all the way up to your low back. This, in turn, helps to reduce some of the physical strain from movement. All foot orthotics—both custom and over-the-counter alike—are insoles that go inside your footwear. They come with a variety of features and coverings and in different lengths (i.e., full, sulcus, ¾)—the different combinations meant to address different issues.
Foot orthotics are a non-invasive and effective form of treatment for a wide variety of foot and ankle conditions, with the ability to conveniently transfer them in and out of a variety of appropriate footwear. A few lower limb conditions that foot orthotics are used to help manage include, but is not limited to:
Foot (arch, heel, midfoot, toes, etc.) pain
Knee, leg, hip and/or back pain
Plantar Fasciitis
Tendonitis (Achilles, Peroneals)
Bunions
Shin splints
Amputations (foot, toes)
True custom-made foot orthotics require someone to cast your feet—obtaining a negative foot impression—so that the orthotic can be moulded to match the shape of your feet and their needs. Common casting methods include non-weight bearing plaster casting, semi-weight bearing foam box casting, and 3D digital scanning. The clinician casting your feet will choose the appropriate features to include in your orthotics in order to best address the treatment goal(s).
Did you know most insurance companies cover at least part of one pair of custom-made foot orthotics per year? While some may reimburse only part of the cost, others will cover the full cost. Some insurance providers may only reimburse custom-made foot orthotics made by Podiatrists and Pedorthists, others may include Physiotherapists, and Chiropractors on this list. It is important to check with your insurance provider to see what you qualify for and what is required prior to getting new custom-made foot orthotics.
Prescribing clinicians writing prescriptions for custom-made foot orthotics should say something along the lines of “custom-made foot orthotics to help manage (symptoms of) diagnosis” and include the diagnosis.
Why work with a Pedorthist?
Pedorthists specialise in lower limb analyses, gait, as well as custom-made foot orthoses and footwear. They aide in the management and treatment of various foot related problems, and often help to address the root causes of pain occurring in the feet up to the low back. You should consider seeking Pedorthic treatment if you are experiencing foot and knee pain with standing and movement, are looking to get a new pair of custom-made foot orthotics, and/or want help with proper footwear to accommodate your daily needs.
How to Work with Me. While their primary space is still under construction, the Junction Medical Center is running a pop-up clinic in Winnipeg. Physicians at the Medical Center are accepting new patients and walk-ins, and the Pedorthic department has begun the soft launch!
Interested in seeking Pedorthic treatment of some kind? Reach out to reception at the Junction Medical Center for more booking information!
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References
1. College of Pedorthics Canada. (2024, March 19). Standards of Clinical Practice - The College of Pedorthics of Canada. The College of Pedorthics of Canada. https://cpedcs.ca/registrants/standards-of-clinical-practice/
2. College of Pedorthics Canada. (2015). The College of Pedorthics Canada Code of Ethics and Standards of Practice. https://cpedcs.ca/wp-content/uploads/2015/09/CPC-Standards-of-Practice-2015.pdf
3. Decker, W. & Albert, S. (2002). Contemporary Pedorthics. Sea Script Company.
4. Western University. (n.d.). Diploma in Pedorthics | Western Continuing Studies. https://wcs.uwo.ca/contentManagement.do?method=load&code=CM000455
5. Pedorthic Association of Canada (PAC). (2024, June 11). What is a Pedorthist? The Role of a Pedorthist. Pedorthic Association of Canada. https://pedorthic.ca/insurance-providers/the-role-of-a-pedorthist/
6. Pedorthic Association of Canada (PAC). (2023, May 30). College of Pedorthics – Pedorthics Association of Canada. Pedorthic Association of Canada. https://pedorthic.ca/about/college-of-pedorthics/
Sadler, E. (2024, February 1). Scope of practice - The College of Pedorthics of Canada. The College of Pedorthics of Canada. https://cpedcs.ca/about-the-college/scope-of-practice/
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