Pedorthics: Both Art and Science
By Séamus Kennedy, BEng (Mech), CPed  Conversations at cocktail parties usually follow a
standard line of questioning. Living in Manhattan affords me the
opportunity to participate in this protocol frequently. Normally
people begin with a polite introduction and then ask your name. In
my case, people are often unsure of how to pronounce or spell what
they think they just heard. They rapidly proceed to ask the next
question, "So what do you do?"
The statement, "I am a pedorthist," receives its fair share of
raised eyebrows and vacant stares. It is often greeted with, "How
interesting." Few people outside the biomechanics field know about
pedorthics. I quickly explain that pedorthics is the science and
art of fitting shoes and orthotics to people's feet. I normally
find that people are quite interested in discussing what we do.
They either have or had foot orthotics, or someone in their family
has needed special shoes.
Pedorthists can work across the entire spectrum of the shoe and
orthotic industry: fitting patients directly in a retail
environment, casting and evaluating patients for O & P
companies or podiatrists, manufacturing shoes and orthotics in
central fab facilities, or doing any combination of these jobs.
This makes pedorthists very aware that they are part of an
interdependent network that seeks to improve patient foot
health.
Pedorthics is a science. Pedorthists can take diagnoses,
prescriptions, foot casts, tracingsand translate them into a custom
foot orthotic or custom shoe. Measurements of range of motion,
degrees of varus, patient's weightall assist in determining the
durometer of materials, postings, positioning of reliefs, etc.
Pedorthics, however, is also an art. The device which is created
needs to be compatible with the person's lifestyle. Beyond the
theoretical, it needs to be a practical and functioning solution. A
well-made shoe or orthotic that sits in the closet is of little use
to anybody. Factors such as a person's activity level, sense of
fashion, and existing footwear can be of vital importance in
developing appropriate solutions. Bulky orthotics will not fit well
into loafers, and AFOs will tend to slip out of low-quarter
shoes.
It is through experience and good communication that pedorthists
become a valuable link in the patient care chainrecommending,
making, and fitting devices that truly help the patient to walk
better, and simultaneously optimizing the practitioner's overall
therapy.
The ongoing education of the general public regarding foot
health and proper shoe fit ensures that there will be plenty of
work for all of us to do in the future. This is especially true of
the growing diabetic population who are urged to make foot care one
of their top priorities.
As far as I'm concerned, I always carry a business card with me,
and at a cocktail party the two questions that I always answer
affirmatively are: "Would you like another drink?" and "Are you
wearing orthotics now?" Séamus Kennedy, BEng (Mech) CPed, is president and co-owner of Hersco Orthotic Labs, Long Island City, New York. 
Table Of Contents - November 2002
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