Buying custom-made orthotics – what you should know

If you’ve been prescribed orthotics this information will help guide you through your purchase. It’s important to ask questions and keep yourself informed throughout the process, to help you get a suitable custom-made orthotic.

Who's authorized to prescribe?

Custom-made orthotics are prescribed by specific healthcare professionals, which include physicians, podiatrists and chiropodists. They will diagnose whether or not an orthotic would be beneficial to your situation.

Many suppliers offer orthotics. For all Canadian provinces, except Quebec, podiatrists, chiropodists, pedorthists and orthotists are recognized as foot care specialists.

In the province of Quebec, an eligible provider of orthotics is either a foot orthotist or an orthotist prosthetist working in a laboratory accredited by the Quebec Ministry of Health and Social Services, and is a member of the Order of Professional Technologists of Quebec.

The prescribers and providers listed above are licensed and governed by either a provincial or national body, and are subject to standards of practice. This, along with each provincial body’s Code of Ethics, helps ensure their accountability and your protection.

What to expect for your assessment

After being prescribed an orthotic, you’ll need to visit one of the providers listed above for an assessment.

A provider will guide you through an extensive evaluation to explore whether an orthotic is the best option and if so to properly design it for you. You can expect the orthotic provider to perform the following:

Medical History Review:

a complete investigation and documentation of your medical history, symptoms and previous injuries. He or she will also take into consideration your lifestyle (occupation and activities) as well as your current and past footwear (fit, style, wear and pattern).

Examination:

a hands-on evaluation of the lower limbs including foot structure, alignment, strength, range of motion, soft-tissue damage as well as identifying any abnormalities.

Gait Analysis:

The provider will observe you walking to identify accommodations or abnormalities, such as whether you favour one leg or the other.

Orthotic Evaluation:

The provider will determine treatment options and explain how the treatments can address your specific needs.

Casting:

Taking a mould ensures that your orthotic is made with all of the contours and structure of your foot. A proper cast is essential to create a truly custom-made orthotic.

Casting techniques include: foam box casting, plaster of paris slipper casting, contact digitizing and laser scanning.

  • Having your footprint taken on an inkpad or using your shoe size to provide a prefabricated insole is not considered casting and does not qualify as custom-made.

Manufacturing:

For an orthotic to be eligible for a claim under your benefit plan, it must be constructed from scratch and fabricated directly from your mould. You can expect at least one-week between your initial assessment and your fitting appointments.

Some providers will supply what’s called a “best fit” footbed. These are prefabricated inserts that are matched to your cast, however the cast is never used in the actual manufacturing of the orthotic. These are not considered custom-made and would not qualify under your benefit plan.

Orthotics that aren’t manufactured specifically to your needs can result in pain by overstressing your muscles, bones and joints.

Dispensing:

Custom-made orthotics should be fitted specifically for you and your footwear. The provider should evaluate how you walk while wearing the orthotics. You should also be offered a follow up appointment within 2‑6 weeks of receiving your orthotic.

Education:

The provider should educate you on things like breaking in your new orthotics, lifespan, as well as how they should fit. You should also be made aware of any warning signs that the orthotics are not working properly and instructed to return if you experience any problems.

Be cautious - things to be aware of when buying an orthotic

  • A provider should have the capacity to modify your orthotic.
  • Exercise caution when considering the purchase of orthotics from exhibits at trade shows, home shows or sportsman shows. If there’s a problem with the orthotic, returning it could be challenging, and they likely aren’t custom-made, which would make it ineligible for a benefit claim.
  • Exercise caution when considering the purchase from kiosks or booths in malls, department stores or over the internet for the same reasons listed above.
  • Be wary of people who come to your home, or conduct group screenings of employees or family members without a proper orthotic evaluation.
  • “Two for the price of one” deals or “free giveaways” with your purchase are not allowed under the Code of Ethics that regulated providers and dispensers are bound by. Some providers will use these “freebies” to inflate the price of an orthotic.
  • Be suspicious of any provider that can’t answer your questions clearly or gives vague and ambiguous answers.
  • Be cautious of a provider who strongly recommends you see a doctor of his or her choosing for a referral instead of your family physician.
  • Be cautious of a provider who recommends your whole family could benefit from orthotics without having seen or assessed them individually.
  • Custom-made orthotics for children under 5 are highly uncommon. Skeletal or soft tissue injuries that require orthotic treatment don’t usually present themselves until a person is older. If for some reason they do need an orthotic, a medical doctor or pediatric specialist must prescribe it.
  • Prescribers and providers should have the following designations in their titles.

For all Canadian provinces except Quebec

Physician – M.D.

Podiatrist – D.P.M.

Chiropodist – D.Ch. or D Pod M

Pedorthist – C.Ped., C.Ped. (C), C Ped (MC) or BOCPD

Orthotist – C.O. (C) or CPO (C)

For the province of Quebec

A foot orthotist or an orthotist prosthetist working in a laboratory accredited by the Quebec Ministry of Health and Social Services (MSSS) and who is a member of the Order of Professional Technologists of Quebec – T.P. Podiatrist – D.P.M.

  • Check your benefits booklet to see which prescribers your plan specifies.
  • If you feel pressured to purchase additional products or are uncomfortable with the business practices of the provider, consider another provider.
  • Don’t ever give the provider a signed claim form. You are responsible for that claim submission and the only way to be sure of what is submitted is to complete it and mail it yourself.

Please note that some of the examples listed above may not pertain to your benefit plan. Consult your benefit plan for details.

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