There is a revolution in orthopedic insoles? So what exactly is this revolution?
The revolution is the use of a revolutionary new orthotic insole product developed in conjunction with the International College of Biomechanics (ICB) to evaluate and treat patients in a completely different way.
The information I disseminate is based on my clinical experience and my integrated interdisciplinary approach to therapy.
One of the most important things my patients expect is that their doctor will be with them and help them along the road to recovery. Many of my patients need to continue to work to regain the strength, motility and pain relief they used to have. They need the assurance of their primary care physician to explore every avenue to help them regain their health, relieve their pain and never give up!
After gaining the patient’s trust, the patient needs to show patience, understanding and willingness to participate in the prescribed treatments suggested by the physician and work towards a lifestyle that makes the pain go away.
Does every patient I treat make a full recovery?
Of course not! However, we must make every effort to instill confidence in our patients that they are getting better – and as long as they don’t give up, I promise not to give up on taking care of their health and well-being either.
It is very important to work with the patient and try different treatments to help them. When necessary, we may have to modify orthotic insole products to make them “just right. Sometimes all we can offer our patients is balance, control and coordination – which is usually all they need.
I remember a time when I needed to treat a patient from a remote area of New South Wales, Australia. This patient had suffered a very severe discretionary head injury and his wife was caring for him at home. When the family came to my clinic, they explained that the patient’s wife was physically unable to cope with the patient’s inability to stand alone and that his wife needed to pick him up and support him herself. They explained that if I could help the patient gain some balance and stand independently, that would be the most practical help for them.
I used orthopedic insoles, fitted them to the patient’s feet and told them that they would bring a degree of balance, control and coordination.
A few weeks later, the family contacted me and told me that the patient was able to stand almost unaided and move from the bed to the wheelchair without lifting their entire body. It was an amazing result that benefited both myself and the family. All I have been able to give them is some hope and assist the patient in gaining balance, control and coordination. In trying to provide the best treatment for my patients, I felt that I needed to have a product that could be reshaped and modified many times over when needed, and this desire became a fundamental motivation in the process of inventing the ICB orthotic insole.
ICB’s patented dual density technology was designed by physicians and experts in biomechanical engineering from the International College of Biomechanics (ICB) to provide the ultimate orthotic insole solution for patients. The ICB Dual Density Medical Orthotic Insoles offer maximum flexibility for physicians who need to provide “customized” solutions to individual patients across a wide range of allied medical treatments.
The unique dual density 100% EVA (ethylene vinyl acetate) construction allows for a wide range of modifications and offsets to be created and incorporated into the orthotic insoles, making them customizable orthotic insoles, such as the ability to be molded in plaster and fixed directly to the patient’s foot, which is important to understand. Thus providing a simple and straightforward process for physicians to mold and modify ICB orthotic insoles to effectively treat a variety of their body conditions.
The combination of two densities covalently combined in one orthotic insole provides excellent results by offering both support and comfort to the patient.
The ICB orthotic insole is a revolutionary therapy that can be heated and molded into the patient’s foot or into a plaster mold, or it can be sanded and shaped using a tabletop sander, and it can be molded under heat and pressure at a variety of bending angles (which can also be eliminated by heat), all with minimal training.
Finally, this orthopedic insole gives the doctor a renewed ability to treat and turn your clinic into an orthopedic laboratory by using a sophisticated but simple technique.
The orthotic insole I developed incorporates unique angles and curves in its design, and the patented dual density system provides patients with the dual benefits of support and comfort that no previous orthotic product could provide. Combining these unique features in my evaluation system provides the physician with an effective tool to adjust and position the patient’s foundation from the ground up.
Our bodies are designed to be adaptable and able to walk over a variety of different types of terrain. In modern times, however, humans have changed this environment by using hard surface coverings to create new, more “stable” surfaces, such as concrete and slate pavements.
When the ground is too hard to provide any “bounce,” the foot compensates by medially collapsing and flattening the arch in an attempt to gain ground contact – this is called pronation. Pre-rotation is a compensatory mechanism by which the foot makes contact with the ground, and arch collapse usually has a detrimental effect on the body structure as well as the foot and leg.
When we walk on a soft surface, the soft surface provides adjustable compensation by collapsing the lateral side and compressing the medial side. This surface then supports the foot, allowing the foot structure to rotate forward approximately 4 degrees, the acceptable angle of rotation forward needed to absorb vibration. When these natural elements are not evident and the environment does not provide the required surface compensation, our body takes over again and becomes the compensatory mechanism that allows the foot to rotate forward and touch the ground during the mid to late stance to toe off phase.
A difficult problem to solve is that most patients will display a tibial inversion angle or a slightly flexed leg posture. Most textbooks explain that 4 to 6 degrees is the average internal tibial rotation angle in Western societies. This is why I incorporate a 5 degree hindfoot inversion angle (or support) into orthotic insoles.
If you need to reduce the hindfoot angle, simply heat the ICB orthotic insole and then squeeze it firmly – this is one of the significant advantages of 100% vinyl acetate orthotic insoles.
Tibial pronation is important because the tibia flexes slightly, allowing for a gap between the “stride” phase of gait and the ground, and allowing for lateral ground contact angles. However, a hard surface eliminates the compensatory factor that allows the ground to accommodate the curve of the foot. The reaction force of the ground on the lateral side of the foot forces the foot to rotate forward in the mid-stance phase of gait.
When we use orthotic insoles, we are not trying to rigidly control the foot, but rather to reduce the “excess movement” around the subtalar joint (STJ) thus allowing a natural compensatory vibration absorption mechanism to help the patient.
In short, we should not walk on a hard surface like concrete. But this is easier said than done. So when we walk on hard surfaces, we need to use products such as orthotic insoles that modify the hard surface to fit the shape of our foot, allowing us to not over-rotate forward or backward throughout the gait cycle.
What we need to always remember is that both hard surfaces and gravity can drive excessive movement around the subtalar joint, and this happens with additional stress on the knee joint as the tibia will rotate inward at the same angle as the foot! During the contouring process of my orthotic insoles, by scanning thousands of models in the ICB orthotic insole lab in Sydney, Australia, we found a typical contour shape and average arch height and length.
As a trained physician, making the correct diagnosis and then developing the best treatment solution for our patients is the core of our career. Because I encourage you to delve into my evaluation system – the IAS technique allows you to know how to evaluate and treat patients the way you want.
At this point I must emphasize the point that an orthopedic product does not work alone; it is simply a tool that plays a supporting role in the physician’s treatment plan.
First, the orthopedic product has to be integrated with the assessment process, and the assessment system is designed to identify the underlying causative factors that contribute to the patient’s condition.
Second, the wit product assessment system must be used in conjunction with an effective treatment program that includes other tools to help the patient adapt to the new adjustment.
We need to think of the new orthotic insole as a “corrective flow” through the entire body, and I usually tell the patient that the orthotic insole is like turning on a water pipe. As the water flows through the pipe, there is usually a “kink” that blocks the flow of water, so the kink creates pressure to return to the source and the water begins to eject.
This is like an orthopedic insole, a corrective flow from the source (foot) to the leg and superstructure, so the orthopedic insole must be worn gradually. Often tense muscles need to be “untangled” and other means need to be used to assist the orthopedic insoles. When I use this analogy to explain orthopedic therapy, my patients usually understand it very quickly.
I must say that I love treating my patients and have a passion for working to help them live their lives to the fullest without pain.
Usually, if my patients cannot pay for their treatment, I will treat them for free. I believe that while it is important to focus on the management side of the practice, it is also important to manage patients and see the rewards of positive outcomes for them.
Bringing positive results to your patients, no matter what their age, no matter what lower extremity biomechanical abnormalities are diagnosed, will be just as effective in promoting your practice and your medical expertise as an ad in the local newspaper. I know this because I have proven it in my own practice.
I have been asked many times what is the youngest age of the children I have treated, and my answer is simply, “From the time they start walking, about 2 years old!”
If we see a small tree in our garden start to lean, do we let it grow and correct itself? Or do we pick up a stake and tie it to the side of the little tree until it becomes strong enough to grow straight and tall on its own?
For a long time, I have observed super active children with their inner ankles near or touching the ground. From my observations, these children would not correct themselves and needed assistance to correct their posture, allowing the lax ligaments to “tighten” (i.e., tighten the lax portion) as they grew.
This is also true for children who endure painful twisting of the medial or lateral tibia. These children need help correcting the torsion, otherwise their bodies will compensate for the superficial alignment of the foot posture by using soft tissue, which will eventually lead to joint wear and tear that will worsen as they grow. We can design orthopedic products to correct tibial torsion in children, called “gait plates”. I really enjoy this type of work – seeing children corrected and parents excited to see improvements in their child’s walking, running and even social life as they can participate more comfortably in group activities!
Recently, when I was lecturing to orthopedic surgeons and rehabilitation doctors in Taiwan, I reviewed a case of a patient who had undergone ICB orthopedic therapy to treat the results of a surgical intervention for a bunion (transcystic deformity). Unfortunately, the surgery was not successful and left this patient with a great deal of inconvenience in her daily life. However, she did not want further surgery and requested that I try to treat her condition using non-invasive conservative therapies.
The reason I bring up this case is to illustrate that we need to be willing to try everything to help our patients, and usually our good intentions will be rewarded, the patient will benefit from it, and we, as doctors, will benefit from expanding our knowledge and our patients will recommend our excellent medical skills to their friends and family.