Keynote: Plantar Fasciits Protocol, Colin Dombroski, PhD, C. Ped (C)
Plantar Fasciitis – Does thinking about managing a patient with PF excite or terrify you? Are you dealing with an inflammatory or tissue breakdown disorder? Do you have a plan when things don’t go as well as you’d like? When patients come back for a follow up do you confidently meet their eyes knowing you’ve made a difference, or deep down are you hoping they don’t show up? Throughout my career, all of these questions have reared their head at some point.
The culmination of 18 years, 7000+ PF clients, and pouring though the research lead me to write The Plantar Fasciitis Plan. In this talk, I’ll present my thinking on a step-wise approach to managing all types of clients with PF.
Plenary: Insurance, Gary Askin
This presentation explores the many ways benefits fraud can occur using numerous pedorthic case examples.
- We discuss fraud trends, how to identify when a benefit plan is being attacked by organized criminals.
- How to respond, mitigate and prepare to safeguard a benefit plan from fraudsters.
- We explore delisting and other anti-fraud strategies and their impact on providers, facilities and members.
Plenary: Introduction to Sensorimotor Theory, A. Brian Stoodley, C. Ped Tech (C), C. Ped (C)
Although a relatively new concept in Canada, Sensorimotor Foot Orthotics have been broadly used in Europe for decades. This anecdotal based session is designed to identify to the delegate another tool available for their “Pedorthic Toolbox”.
Goals of the session include the basic concepts of Sensorimotor Theory, applicable case study profiles and an introduction to the clinical skillsets needed when treating your patients.
If your practice includes patients with balance issues or complain of gait uncertainty, make sure to attend this session.
Round Table: How to Maintain Marketing Ethics in Today’s Digital World, Ryan Robinson, C. Ped Tech (C), C. Ped (C)
Finding a way to market your business while following the rules of the code of ethics of your professional college can be difficult. It can be especially difficult in today’s age of social media marketing where misuse, misinformation, and misrepresentation seem to run rampant at times. Attend this “round table” discussion to hear business owners, insurance industry insiders, members of the College of Pedorthics and marketing experts discuss various issues and potential strategies to help navigate the marketing of a professional business both ethically and effectively.
Plenary: Plenary: Staying Connected – The Foot, Ankle and Knee – William Stanish, MD, FRCS(C), FACS, AOA, LLD, Hon. (St.F.X.U), LLD, Hon. (UPEI)
This presentation will address the intimate anatomical and biomechanical relationships in the lower extremity.
Insights will be offered into the new technologies.
This will include:
- The assessment and management of tendinopathies.
- The assessment and management of arthritis.
- The use of modern diagnostic tools.
- Advances in contemporary treatment modalities, including stem cell application, injectables and ingestibles.
Case presentations will be utilized to provide emphasis and illustrate techniques.
Breakout: Custom Toe Splint Fabrication, Andrew Hoar, C. Ped (C)
This presentation will provide participants with an overview of custom toe splints, including their intended uses and expected outcomes. Including will be an interactive presentation with hands-on fabrication of toe splints for conditions such as Claw toe, Hammer toe and Mallet toe deformities, Hallux valgus, over lapping toes and replacement of amputated digits. A demonstration of how silicone compound allows for fabrication of soft and durable custom digital devices will be included, as well as how this non-toxic, hypoallergenic material can be modified to make alterations.
Breakout: Functional Movement Taping, Stuart Currie DC PhD
This course introduces the concept of movement therapy and enhancement via functional taping methods, with emphasis on combining kinesiotaping with orthotic practice. It includes a review of the current literature supporting the theory of kinesiology taping for the purposes of rehabilitation, edema/swelling management, neuropathic pain and postural management along with risk management recommendations.
Attendees will learn:
- The concept of a longitudinal muscle chain approach to elastic therapeutic taping.
- Understand the physiological effects of kinesiology taping.
- Learn functional taping and understand its role and use for the applications of rehabilitation, edema management, and posture
- Understand indication, contra-indications along with taping negotiable and non-negotiable recommendations to increase efficacy and safety of taping applications.
- Introduce a myofascial sequencing model of “taping movements, not muscles.”
All materials will be provided. Participants should present themselves with comfortable clothing to allow for full range of motion and application of tape.
Breakout: Casting Custom Footwear & the Pedorthist’s Experience – Daan Peters, C. Ped (C), C. Ped MC
A hand on session comparing casting versus direct foot scanning. During this session casting for custom made footwear using a STS casting sock followed by taking manual measurements and a footprint will be demonstrated. Different casting scenarios can be discussed or demonstrated at the participants request. By means of using an STS casting sock we will capture the foot shape and the importance of manual measurements and the footprints will be explained. Both scans will be loaded in a CAD program that will show the pros and cons to the participants. Onscreen comparison of the scanned STS casting sock and the direct foot scan will demonstrate the shortcomings in both techniques.
Breakout: The Importance of Work Orders – Alexandra (Dax) Hooper, C. Ped (C)
We are taught in the Pedorthic program how very important our work-orders are. Whether you’re building your own orthotics, using an in-house lab, or outsourcing, our work orders set the tone for the precise nature in which our orthotics will be made. Why is it that once out of school many of us have been guilty of writing words like “make like old” or see example provided without listing what exactly we want? In this presentation Dax plans to explore the importance of the precise nature of this document for the clinicians, technicians and patient care. As well as to facilitate discussion and work in small groups on case studies to review, discuss and share perspectives on the subject.
Breakout: Custom Made Footwear 2.0 – Olav Toornend
The future of bespoke shoes is happening right now!
Traditional shoe making is a rigorous and very manual process that has remained the same for many, many years. In Europe, where the most modern shoe industry is located, techniques and methods have hardly changed in more than a century.
Keeping that in mind, the R&D technicians of Nimco Made4You developed an alternative way, a modern type of orthopaedic shoemaking, MCO.
MCO is the Modern Concept Orthopaedic method, a new vision for the customization of shoes that combines long existing techniques with modernity. Our proposition is to start thinking in a more ecological and rational way, that will save time and money.
Simple, easy, environment friendly and very competitive!
Breakout: A Pedorthist in a Strange Land – Steve Stredulinsky, C. Ped (C)
In this presentation, Steve Stredulinsky will share with you his Pedorthic journey, from graduating at the University of the Fraser Valley, to working at Kintec, Kinemedics and now Karl Hager Limb & Brace. He’ll discuss working within a number of multidisciplinary clinics, working with different clinicians, as well as his time working with National Sports Bodies and Associations.
He’ll go through his own athletic journey, from track athlete to a member of the Canadian Men’s Bobsled Team and share how his own experiences have helped him think outside of the box when it comes to patient care.
Plenary: Hallux Rigidus: Surgeon’s Perspective – Don Brien, MD, FRCS(C)
Hallux rigidus (HR) is the most common arthritic condition of the foot. This condition refers to pain and limited dorsiflexion of the first metatarsophalangeal (MTP) joint. Nonsurgical management is always attempted first and can be beneficial. This includes nonsteroidal anti-inflammatories, cortisone injections, physiotherapy, accommodative orthotics and activity modification.
The surgical management of HR is based on the degree of degenerative changes present the patient’s goals, and lifestyle. Surgical procedures can be categorized as those that preserve range of motion in those that do not. Arthrodesis or fusion is currently the standard of care for managing moderate to severe HR; however, this leaves the patient with no motion through the first MTP joint.
There are numerous joint preserving surgical procedures described. These include various forms of osteotomies which cut or reshape the bones about the joint. Of these procedures, excision of the dorsal osteophyte/ceilectomy has been shown to be effective in the management of the early stages of HR. Various MTP joint implants have been developed with the hopes of maintaining motion. Unfortunately, many of these implants report high complication rates and unpredictable long term results. At this time there does not appear to be clear consensus on the optimal surgical procedure to preserve range of motion in the more advanced stages of HR.
Panel: Fireside Chat on Manufacturing – Brad Gibbs, C. Ped (C)
In this panel discussion, Brad Gibbs will host an informal “fireside” chat with experienced Pedorthists, discussing the relevancy of honing and maintaining the craftsmanship or artisanal approach to casting and manufacturing foot orthoses in pedorthic treatment.
Pathologies will be discussed that have challenged the panel members, while touching on technology and how practitioners can coexist with each paradigm – analog and digital.
Plenary: Feasibility Studies – Yotam Friedman Raz
- The Effect of Midfoot Support Materials for Rigid Shell Orthotics
- Orthotics Made With Different Casting Methods: Analysis of Lower Limb Biomechanical Outcomes
Two feasibility studies will be presented in this session. The first study assessed the ground reaction forces acting on the foot, using an orthotic with different midfoot support material configurations. This study assessed a single foot and a polypropylene shell orthotic with four material combinations. Results showed that supporting the midfoot or leaving the shell unsupported affects the loading response of the foot.
The second study assessed lower limb biomechanical outcomes for orthotics made with different casting methods. Weight bearing, non-weight bearing and a semi-weight bearing casting methods were used to obtain foot parameters and positive plaster casts. Three pairs of orthotics were made by a certified pedorthist, using an identical design. Biomechanical outcomes were assessed on a single foot and compared to a shoe-only control condition.
This session will include an in-depth description of methods and results for both studies, as well as possible clinical implications that may be relevant to pedorthists.
Breakout: Functional Testing – John Hooper, C. Ped (C)
Pedorthists routinely use numerous functional tests in-order to identify specific issues which may lead to our patients’ pain and discomfort. In this session John will facilitate discussion on a few common functional tests; weight bearing, non-weight bearing and basic gait analysis. Participants will work in small groups to review, discuss and share some their perspectives on functional testing techniques; why we use these tests, how do they influence orthotic design decisions and what other test options may be useful. The goal of this session is to give participants an opportunity to share ideas and insights into assessment practices and orthotic design.
Breakout: Pedorthics to Profit – Building a Profitable Business Without Incentives, Discounts or Other Fancy Nonsense – Colin Dombroski, C. Ped Tech (C), C. Ped (C), PhD & Sean MacMillan, C. Ped Tech (C), C. Ped (C)
Let’s face it, running a business is hard work. Most Pedorthists are great at patient care but are not trained in the art of business. No one has given you a roadmap to a reliable, profitable business. Sean and Colin will explore different pedorthic business models, discuss and debate options for determining value, and discuss common pitfalls along the journey that only 4% of Canadian businesses ever realize- the $1,000,000 per year practice.
Owners, solo practitioners, and clinic managers at any size will take away practical business building strategies they can apply Monday morning. Case studies and real world pedorthic-specific examples will be studied and presented. No p-values, we promise.