Many patients have difficulty adjusting to orthotics, but soon get used to them. Their ligaments,bones and muscles soon adapt to the changes that are taking place whilst wearing the amazing things that are changing and improving on so many biomechanical faults throughout the musculoskeletal system.
We must realise that this is normal as structures change as the feet are returned to their optimum functioning.
However, there are those patients for whom we scratch our heads and wonder how on earth we can return their very rigid, severely pronated (mid and / or rearfoot ) or elderly foot to its optimum functioning position without causing them many weeks or months of pain .
Simply, we cannot do this in one "hit", as we are expecting a structure that has become accustomed to being in one position ( albeit faulty ) for many years, to instantly be hoisted where we need it.
We cannot expect these types of feet to accustom to full correction of the arch / midfoot / forefoot in one go.
We must slowly correct to allow the ligaments and other musculoskeletal structures to find their new place over a period of time and piece by piece adjustment.
Many years ago, I had a brainwave that I thought was commonsense, but as far as i could ascertain, had not been done before ( ?).
The idea was to introduce the feet to slow changes by way of what I termed "starter" orthotics.
For example, lets take patient A whose full correction requires 5 degrees rearfoot posting coupled with a total arch raising to correct severe pronation.
If we attempted this in one correction, the patient would take forever and a day to become comfortable in their orthotics.
Therefore, a starter orthotic may be employed to help correct the foot in stages. In a severe case like this particular one we may require 2 starter orthotics .
Starter orthotic number 1 may begin with one third of the desired arch height being manufactured into the orthotic, with one degree rearfoot correction.
Starter orthotic number 2 may perhaps be two thirds of the end arch height and 3 degrees rearfoot correction being added.
The final orthotic would then be introduced after the starters had been worn for 6 weeks at a time.
My reason for the 6 week duration of each stage is this is a good time for the structures to adjust before being moved to the next stage.
Obviously individual patients finances may mean we have to skip starter number 2 and adjust our starters accordingly.
Where we have elderly or rigid feet, starters will allow you, as a practitioner, to help a good many more patients than you thought you could before.
If any practitioner wishes to discuss this concept in more detail, I am always happy to be of help. Contact details below.
Les bailey orthotics 2012
Dr Les Bailey phd,DO,acopm,apta ( int part )
Dr Les Bailey phd,DO, acopm.apta(int part), woodmansterne, Banstead, surrey
Email me at drlesbailey@
mobile number 07801418080
Dr Les Bailey started his career in physical therapies in 1981,qualifying in remedial massage,and later qualifying as an osteopath.
He gained his phd from OIUCM for his thesis on the treatment of plantar fasciitis by orthotics
He was awarded a teaching/lecturing diploma from the northern school of osteopaths in 1993.
He also holds a diploma in foot biomechanics .
Dr Les Bailey works from his clinic near woodmansterne / Banstead in surrey.