The Power of the Feet is In Your Hands!

I want to begin by thanking all ofyou CAs out there who help make the lives of chiropractors like me so much easier. I love my staff and I am quite sure your doctor greatly appreciates the work you do for them. I am so excited to contribute this article to Chiropractic Assistant magazine. I hope you get some value from it. As a CA, you have amazing power in your office, though you may not realize it. Not only do you have the eyes and ears of the doctors you work for, but you also develop a rapport with patients that is different from and, in some ways, even more influential than the doctor's rapport with patients. Patients will often talk to you about recommendations made by the doctor and ask for your honest feedback and opinions. Now, obviously, it's the doctor's job to dispense medi­cal advice (your doing so without a medical license can get you into big trouble!). However, products and certain services sold from your office are a different story. In my office, my staff sells more cervical pillows, lumbar cush­ions, support braces, elastic tape, analgesic creams, and massage therapy visits than I do. You're on the front line as a witness to the efficacy of these products, so it makes sense that patients seek you as a source of wisdom. Individually Designed Orthotics: Their Role in Supporting the Three Arches In many offices, the most effective support products sold are custom-molded foot orthotics. What are they exactly? And who needs them? They're powerful, simple tools that help support chiropractic care, an important inclusion in your doctor's clinical arsenal in treating not only foot pain, but also knee, hip, back and joint pain. Believe it or not, studies indicate that people with better posture have better self-esteem.1 As posture-perfecting aids, orthotics can even help with your patients' emotional well-being. The word "orthotic" seems to conjure up the picture of an elderly person with a walker or cane wearing a pair of ugly shoes. I notice many women have this perception. Their faces will cringe initially at the thought of putting something supportive in their shoes. The truth of the matter is that everyone can benefit from having a pair of custom orthotics—even you! Why? As the body's foundation, the feet absorb an enormous amount of stress. Three functional arches underneath are the main structure of support. Yes, I said three arches, not just one. Are you surprised? So are most patients. You already know of the inside or medial longitudinal arch, but we also have an outside or lateral longitudinal arch, and an arch under the ball of the foot called the transverse or metatarsal arch. Look at the picture below: If you cross your right leg over your left and put your hands on the underside of your foot, you can actually feel the location of these arches. You can also feel the big liga­ment underyourfootcalled the plantar fascia, which acts like a giant, springy rubber band to help keep the three arches supported and intact. When everything is perfect, the plantar fascia absorbs shock from the ground and the body; it keeps the three arches strong and allows you to walk and do other weight-bearing activities with no pain. The three arches are fully formed and mature by age six or seven. From then on, factors such as genetics, poorly supportive shoes, sports, height, and weight-bearing stresses will start to overstretch the plantar fascia, allow­ing the arches to collapse or flatten. Most patients have no idea that this is happening or has happened because their feet do not necessarily hurt. Now, I want you to please stand up for me and do this little demonstration. While you are standing, roll or drop your feet in as far as they will go toward the floor. It might be uncomfortable, but feel what is happening in your lower body. Do you feel the stress on your inner ankle, in­ner knee, hips, and perhaps the pelvis and the lower back? Many locations and types of pain displayed by patients are strongly related to collapsed or overpronated arches. That standing demonstration you just did allows you to feel the pattern of stress and pain experienced by so many of our patients who have flat feet. Flattened or collapsed foot arches can affect patients from the ankles and knees up to the head and jaw. By understanding how flat or pronated someone's feet are, then we can explain much of the pain the patient feels. Of the human population, 80 to 87% of people have arches that are too flat (overpronating), so that means 8 out of 10 patients coming to see your doctor likely have some degree of three-arch collapse. Once someone's plantar fascia ligament has stretched out and the arches have flattened, they can't be brought back. Providing the patient with the very best custom-molded, three-arch, flexible orthotics is the best solution, and your office is the place to provide them. So how do you efficiently teach patients about all of this information? That's easy: use the 3-D, digital foot scanner. The scanner, in its latest form, is cutting-edge technology for foot and body posture analysis. The old way of having people stand in foam casts has been replaced with scan­ning software that makes the analysis and interpretation of results easy for the CA, doctor, and patient. Since flat feet affect so many, it's wise to scan and evalu­ate every new and existing patient. The different screens show a multitude of information designed to educate the patient on posture, the degree of three-arch collapse, and pressure variations between the right and left foot. Also, pictures on the screen illustrate how and where the different joints of the body are stressed and why the patient can feel pain or soreness there. Many doctor's offices have a CA in charge of scanning, interpreting, and explaining findings to the patients. Re­member, you are only explaining what is on the screen, so you are not diagnosing. The doctor will have the final say about results and making sure that orthotics are pre­scribed, if necessary. You can also learn how to properly fit the patient once he or she comes in for orthotics. So now that you are armed with this knowledge, you can help your office educate patients about the arches and the importance of supporting all three of them. Most people we meet, including many doctors and healthcare professionals, believe only the inner arch is problematic. They go through their lives thinking that this is the only arch that needs help, when actually the opposite is true: overcorrecting just one arch can cause even further stress on the joints and body. Don't let patients be taken in by commercials for cheap, crummy orthotics sold off the shelves and in drugstores. Your custom-molded, three-arch, flexible orthotics are the best out there. Let the patients see your office as the expert. Selling these items will be profitable for the office, and they are great at supporting the chi­ropractic adjustments given by your very skilled doctor. To your Success! 1. "Change Your Posture, Change Your Mind and Mood," by Kelly McGonigal, Ph.D., The Science of Willpower, October 5, 2009. Dr. Kevin Wong is an expert on foot analysis, walk­ing and standing postures and orthotics. Teaching patients and chiropractors is a passion for him, and he travels the country speaking about spinal and extremity adjusting. Dr. Wong practices full-time in Orinda, California. Contact Dr. Wong at 925-254-4040 or drkevinwongfcvgmail. com.