Everywhere you look in the profession, you'll see Foot Levelers sponsoring, donating, and giving seminars to chiropractors. So what is it about orthotics that has made Foot Levelers one of the most successful companies in the chiropractic profession? To find out the answer, we went to the man who should know, Kent Greenawalt, President of Foot Levelers, Inc. , MORE ABOUT OUR EXPERT ON ORTHOTICS Kent S. Greenawalt, in addition to being president of Foot Levelers, Inc., is also chairman of Foot Levelers' Educational Division, which presents license-renewal seminars and other programs throughout the nation. Dr. Monte Greenawalt, Kent's father and founder of Foot Levelers, started the company nearly 50 years ago and Kent has been involved with orthotics and the chiropractic profession practically all of his life. In 1991, Greenawalt received the American Chiropractic Association's "Humanitarian of the Year Award" for his service to chiropractic and mankind. In 1999, the AC A bestowed its President's Award upon him for the invaluable educational and fundraising work he has done on behalf of the chiropractic profession. In an interview with The American Chiropractor, Kent Greenawalt (KG) answers our questions on the use and application of orthotics in a chiropractic clinic: 1. Why should chiropractors incor porate orthotics into their practices? Explain how chiropractic goals for preventing and relieving back pain are achieved through the use of orthotics. KG: Treating the entire body as opposed to just certain areas will set the chiropractor apart as a true, holistic practitioner. Orthotics don't just help a patient's feet. Orthotics help to support and balance the body's foundation and this will lead to improvements in other areas of the body. Improving the structure of the body will improve the function of the body. We know that many postural problems being treated in the spine begin in the lower extremities, so this is where chiropractors need to look when they are treating a patient. 2. Who qualifies as an orthotic patient? Do all patients need orthot ics? How does a chiropractor deter mine a need for orthotics? KG: One misconception is that patients with no complaints of pain in the feet will not benefit from orthotics. Actually, many patients who can be helped by orthotics will not have foot pain because their symptoms occur in other places in the body. It is important to remember that the feet are the foundation of the body and they support us when we walk, help us get from one place to another, and help protect our spine and bones from the shock that comes with movement. In order for the feet to be able to do their job, all of the bones, muscles and arches must be in stable positions-any weaknesses can lead to problems in other parts of the body. So, doctors need to keep in mind that, when determining the need for orthotics, they need to look at more than just the feet. Indications for orthotics can include local symptoms like corns and calluses, and more serious conditions, like shin splints, plantar fascitis and stress fractures. Chiropractors can also evaluate a patient's need for orthotics by looking at other factors. Patients who stand more than 4 hours a day, are over 40, play some kind of physical sport, don't hold adjustments well or complain regularly about pain in the ankles, knees, hips or back can also benefit from orthotics. A simple and easy way to evaluate a patient's pedal balance is by looking for "five red flags" during the examination. These are foot flare during gait, bowed Achilles tendon, internal knee rotation, low medial arches and excessive shoe wear. If you notice any of these red flags, the patient will more than likely be a good candidate for orthotics. 3. Once a need for orthotics has been established, how does the doctor determine what type of orthotic to prescribe? KG: Every patient's body is different and no two people's feet are exactly alike. Custom-made orthotics are created for the individual, and they are designed to help adjustments hold more effectively. The shoe inserts that are sold off the rack are not specifically designed for any one person, so they can't give patients the exact support that is needed to keep their feet in the proper positions like custom-made orthotics can. When prescribing orthotics for patients, the doctor needs to consider several factors. The amount of stress the patient's activity level is placing on the body, as well as the patient's weight, age, gender and specific clinical conditions are all factors that should go into the equation of determining what type of orthotic to prescribe. Continued on page 27... ...from page 12 ORTHOTICS I\TER\IEW 4. How does the doctor get paid for orthotics? Does the patient pay out of pocket or can it be billed through insurance? KG: Many insurance companies provide coverage for orthotic prescriptions. Chiropractors need to remember to associate the patient's need for orthotics with the condition being treated when filing claims. Some insurance companies will cover the initial exam and the time it takes to cast, to fit the patient for orthotics and for a follow-up exam. 5. What results can the doctor and patient expect to see/feel with the use of orthotics? KG: The orthotics will stabilize and support the patient's pedal foundation and there are many benefits that come with this. With a balanced foundation, the body's shock-absorbing capabilities will be enhanced and over-use injuries will be reduced. Orthotics will also duce excessive pronation or supination and this will relieve the strain placed on the lower extremities. Using orthotics to eliminate these stresses and strains will give the adjustment the opportunity to do its work. The bottom line is that patients using orthotics are going to feel better, and isn't that the point? They are going to be able to do things that they may not have been able to do in a long time, like taking their dog for a long walk without experiencing any knee pain. Patients are going to be happier because their pain will be lessened and their chiropractic adjustments are going to hold longer, which means they are going to be sure and tell their friends and family members about it. This will lead to more referrals for the doctor. Good chiropractic care and the use of good orthotics are a winning combination for the patient and the chiropractor. For more information on orthotics or to contact Kent Greenawalt, you may
