Are You Putting At Least 50 Percent Of Your Patients In Orthotics Each Month?

Posted on: Tuesday, February 4th, 2014

Many DPMs don’t administer orthotics broadly and some don’t even bother to at all. In this article, we take an in-depth look at using orthotics in a podiatric practice and why some doctors shy away from area of Podiatry.

Our article begins with this intriguing question: “What would you do tomorrow, if you knew you couldn’t fail?”

I believe that this quote is quite apropos to the average podiatrist. Even more so as this one–why don’t you put over 50% of your new patients into orthotics every single month? As the vast majority of Podiatrists don’t do so, chances are that you are not one of the few who do. If you knew you could not fail with your orthotics, you most likely do so.

Every once in a while, I get a response such as “I only administer them to patients who are appropriate for orthotics.” That is a fair enough answer. But if that is your sentiment, I invite you to look at the fact that there are thirty-some diagnoses and orthotic indications that have direct mechanical etiology. Furthermore, well over ninety percent of our patients present with one or more of the following conditions:

The Foot

  • Pes Planus / Pes Plano Valgus
  • Hammer Toe / Hammer Digit Syndrome
  • Hallux Abducto-Valgus (Hallux Valgus, Bunions)
  • Tailor’s Bunions (Bunionette)
  • Functional Hallux Limitus / Rigidus
  • Freiberg’s Disease (also known as Freiberg’s Infraction, Avascular Nescrosis of Metatarsal Head)
  • Metatarsophalangeal joint capsulitis
  • Turf Toe
  • Sesamoiditis
  • Metatarsalgia
  • Morton’s Neuroma (Intermetatarsal Neuroma)
  • Excessive Plantar Callous
  • Metatarsus Adductus
  • Plantar Fasciitis
  • Heel Spurs / heel spur syndrome
  • Sinus Tarsi Syndrome
  • Calcaneal Apophysitis (Severs Disease)
  • “Growing Pains”
  • Posterior Tibial Tendonitis
  • Posterior Tibial Tendon Dysfunction
  • Peroneal Tendonitis
  • Tendonitis / Tenosynovitis
  • Tarsal Tunnel Sundrome
  • Achilles Tendonitis / Enthesopathy
  • Retrocalcaneal Bursitis
  • Haglund’s Deformity (pump bump deformity)

The Leg

  • Anterior Shin Splints
  • Posterior Shin Splints
  • Muscular Leg Cramps
  • Fatigue
  • Sciatica
  • Functional Limb Length Discrepancy
  • Structural Limb Length Discrepancy

The Knee

  • Chondromalacia Patella or Patello-femoral Syndrome (Runner’s Knee)
  • Osgood-Schlatter Disease
  • Medial Compartment Syndrome
  • IT Band Syndrome
  • Pes Anserine Bursitis

Looking over this list, we ask again, why doesn’t the average Podiatrist put over 50% of their new patients into orthotics each month? The simple answer is that they cannot make the orthotics they use work consistently.

As a result, this makes placing large numbers of patients into orthotics each month an unworkable practice. Recurring visits for adjustments begin to stack up in your appointment slots, you get frustrated, and your patients get frustrated. Ultimately, orthotics become more trouble than they are worth!

After this occurs, podiatrist usually begin to “cherry pick” their patients and stay in a very small, but relatively safe percentage of their patient base with specific and select diagnoses such as heel pain. Even with that small a handful of patients, other considerations come into play. Patient weight, activity level, line of work, shoe gear, and more all play a factor. One can now easily understand why a DPM does less than three to five pairs of orthotics fittings per month. The actual truth is that they could be doing well over 20-50, and that is for starters!

As a working philosophy, all patients are orthotic candidates until proven otherwise.

Talking Numbers, Walking The Line

What would twenty or thirty more pairs of orthotics each month do for your practice? What would it do for you personally?

Assuming you were hitting those number consistently and without any guess work or wasted time, with great results and patient satisfaction. That would certainly change the dynamics of your practice and quality of life.

Attaining this for yourself is not just possible in concept; it is easy to do when you have the proper technology to perform a biomechanical assessment. When you can do that, you know exactly what to do in literally any situation. Things not only become easy; they become more enjoyable as you will help more patients.

We have all experienced the “miracle” of changing the way a patient walks and the profound success they achieved. The trick is to do it consistenly and with predictable results.


Today, with Structured Biomechanics, there is no longer a trick to doing this. Our technology provides a solution for helping your patients overcome their pain and discomfort, allowing you to fit more than 50% of your new patients with orthotics each month.

– John Feulner, DPM Practice Solutions