Pedorthic Services
		Nancy Naftalin, C-PED, SA-C
		Certification Surgical Technology(1981), Bachelor of Science, General Science(1983), Certification Orthopedic Physician Assistant(1993), Certification Pedorthics(1995), and Certification American Board Surgical Assistant(2001).
		Pedorthics is the design, manufacture, modification and/or fit of foot ware, including, shoes, orthoses and foot devices, to prevent or alleviate foot problems caused by disease, congenital defect, or overuse and or injury.

The Orthopedic & Fracture Clinic provides the following in house Pedorthic Evaluations:

• A bunion (hallux valgus deformity)
• Gait Analysis
• Shoe Consultation
• Referrals for footwear, street use and Orthopedic
• Custom Orthotics
• Sports specific custom Orthotics (cycling)
• Recommendations for off the shelf inserts
• Sport specific footwear referrals
• Custom sandals, thongs and footwear
• Custom ankle bracing
• Callus trimming and nails
• Diabetic foot education
• Treatment for ulcer care with Orthotics
• Discounts to local footwear facilities

Our custom footwear collection includes customizing existing name brands with inserts designed specifically for your feet.

Custom thongs and sandals, hand made detailed to your foot type are available in a variety of colors and leather options.

Conditions managed with Pedorthic Care:

PLANTAR FASCIITIS: Pain usually persistent located on the plantar (bottom) surface of the heel and the medial(inside) side of the foot. The plantar surface is a fibrous, tendon-like structure that extends the entire length of the bottom of the foot, beginning at the heel bone and extending to the base of the toes.

In motion, the plantar fascia experiences continuous stress and excessive pulling which results in inflammation and pain. During excessive activity the plantar fascia can even rupture if the area is subjected to repetitive stress. Plantar Fasciitis is a very common foot condition.

PEDORTHIC MANAGEMENT: Footwear plays an important part in prevention and maintenance of heel pain. A goal in the treatment is to reduce torque and redistribute pressure away from the heel, which relieves stress on the plantar fascia. Stability in the proper fitting shoe and frequently orthoses used in the shoe will accomplish this.

METATARSALGIA: It is a painful condition located across or localized to the ball of the foot. It can feel there is a stone in your shoe. Algia means pain and quite frequently is directly related to the bony structure of the foot. For example, a high arch foot, claw toes or hammertoes, and a tightness or deformity in the ankle or hindfoot (tight heel cords) are frequently associated.

PEDORTHIC MANAGEMENT: Supporting the long metatarsal bones with padding in areas of maximum pressure using an orthoses for shock absorption. It is also important to wear proper fitting shoes with quality shock absorbing sole. Frequently additional padding may be applied to area of stress especially surrounding joints.

DIABETES AND YOUR FEET; EDUCATION AND PREVENTION: People with diabetes frequently have a gradual loss of feeling in the feet. This can result in interference with sensory nerves and affects the ability to judge whether shoes fit properly and this loss of sensation makes it difficult to identify whether an object is in your shoe or blisters forming, and if something has penetrated your skin.

DIABETIC ULCERS: May occur in areas of the foot where pressure or friction is creating a callus or blister. If limited circulation is affecting the lower extremities, healing can be impaired with fluctuating glucose levels. Infection can create a very high risk for amputation.

PEDORTHIC MANAGEMENT: Prevention of ulcers is the best way to avoid a high-risk situation. Reducing the friction or pressure points with a full length orthoses to unload these areas is the best method. Properly fitting footwear is vital in prevention.

ARTHRITIS: The most common types of arthritis are degenerative and inflammatory.

DEGENERATIVE ARTHRITIS: Can be a result of wear and tear on the cartilage lining the joints. The wearing can create damaged surfaces to the joint and cause inflammation. In response to damaged cartilage lining the joints spurs or osteophytes can occur around the margins of joints and this can limit motion and cause more pain.

INFLAMMATORY ARTHRITIS: Results from inflammation to the synovial lining of the joint, Synovium serves to lubricate the joint and provides nutrition to other tissue including cartilage. In rheumatoid arthritis the bodies own immune system attacks the synovium which then thickens and destroys other soft tissue and even bone. This can result in pain and swelling and limited motion, the joint can become deformed.

PEDORTHIC MANAGEMENT: Treatment consists of proper footwear and fit and products like orthoses, to relieve any pressure areas of the foot, especially any bony prominences. Orthoses can distribute weight and support arches to prevent friction or ulceration.

FLAT FEET AND HIGH ARCH FEET: Many people have variations of either of these foot types. Flat feet when your wet footprint is continuous (absent arch) there is frequently conditions associated with this foot type. Wear and tear can cause stress to the soft tissue surrounding the joints of the foot and ankle, this results in inflammation and pain in various structures, an absent arch means there is not good shock absorption in the foot. High arch feet when your wet footprint is not connected in the middle also have wear and tear on various structures of the foot. Frequently weight distribution can be mal-aligned and the ball of the foot absorbs more impact then other areas of the foot and pain and discomfort result.

PEDORTHIC VISIT IS GENERALLY NOT COVERED BY MOST INSURANCE. A VISIT FOR CONSULTATION ONLY IS $30 IF A REFERRAL IS MADE TO SEE ONE OF OUR SURGEONS IN THE FIRST CONSULTATION THERE IS NO CHARGE. WE DO BILL SOME INSURANCES FOR CUSTOM MOLDED ORTHOTICS.