
- Robert S. Schwartz, C. Ped., Eneslow Pedorthic Enterprises
Response: I would suggest sending her back to her orthopedist and having a dorsal oblique sliding 2nd metatarsal neck osteotomy performed. It can be secured with a Snap-Off screw from Wright Medical or Arthrex. You're battling pressure from "within" and you won't always win with just an orthotic. Good Luck.
- Dave Dickson Ortho PA, C. Ped. WCC, Owatonna Clinic, Owatonna, MN
Response: Your question is too generic, there are too many parameters that have to be filled in to answer your question. For example we need the weight of this patient. What is the foot structure like? For example, what is the arch height? Is the first ray shorter than the 2nd? Any hammer toes that may contribute to met pressure? Is there flexibility in the metatarsals? Do the patient's feet sweet excessively or are the feet very dry? What is the age of the patient? The shoes that were worn that caused the second break down -- what were they? Just some basic --- OTS shoes, or were they measured and fitted?
Yet a response to your question is: the basic modalities you probably are already aware of, such as using met pads, cut outs, rocker soles and - proper evaluated foot orthotics with appropriate material with proper padding. Reduce shear pressure using shear band.
- Scott C. Ped.
Response: Robert, I have dealt with the same issue many times over the years. You say the 2nd met is elongated, is this noted from your cliinical exam or radiographs or by history. The best eval for lesser met length is an MO (medial oblique) radiograph. The best clinical eval is the prominent 2nd MTPJ plantarly, localized swelling beneath the met head (effusion), and a medial drift to the digit with mild hammering of the toe (loss of the capsular integrity and lever arms of the intrinsic muscles).
The ulcer sub 2nd in this situation is often seen with a short or hypermobile 1st met or an elevated 1st ray. Biomechanical approaches would need to address the 1st met elevatus (functional) and overloading of the 2nd MTPJ. I have had some success with loading the 1st ray, and unloading the 2nd as well as a plantarly applied met bar with a dorsal multi-density plastazote-PPT to float the 2nd MTPJ. This will need to be monitored for wear about every 100 miles or 3-4 months. The best approach is to shorten the long/prolapsed 2md met via an osteotomy (Wiel) if the patient can tolerate the surgery which would allow for easier accommodation.
I know there are many approaches to accommodating this problem; these are some ideas that have benefited my patients. I really enjoyed meeting you at Clearwater Beach and visiting with you.
- Michael P Cullen, DPM, FACFAS, DABPS
Question: Any advice on getting correct sizes when you keep no stock?
The American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc. (ABC) has published an update on the organizations ongoing pedorthic activities. This update contains timely information about facility accreditation and ABCs C.Ped. exams, plus news from ABCs continuing education department. Click here to read the update.
Do Your C.Peds need points?
Could your employees use a refresher on their sales training?
The National Shoe Retailers Association is pleased to bring training and CEs directly to you, without the additional cost of travel, food, lodging, registration fees or lost work time.
Our affordable WISER Sales Training DVD makes in-house training easy and theres now an online exam for Continuing Education credits from ABC and BOC.
WISER Sales Training provides quality training for new sales associates and re-motivates experienced sales staff. The DVD format makes it easy for employees to train at times convenient for them, and for employers to offer quality training without hiring outside trainers or taking the most experienced staff off the sales floor.
ABCs Category 1 CEUs for WISER Sales Training total 21.75 credits (2.5 scientific, 19.25 business), good through year 2010.
BOCs credit total is 20.34 (6.42 CPE Category 1, 13.92 Category 2).
Pricing for the program is as follows:
DVD, workbook and guide for trainers Members: $295 (Non-Members $395)
Additional Handbooks: $10 each
Online Test Members: $100 (Non-Members: $200)
For more information or to order, click http://www.nsra.org/wiser_intro.php?ad=pn
or call or email Kim Surasky at 1-800-673-8446, ext. 318, kims@nsra.org.
AETREX ANNOUNCES iSTEP "WEBINARS"

Metabolic syndrome a useless diagnosis
by Dr Linda Calabresi
Diagnosing metabolic syndrome in elderly patients is of little if any clinical value, according to an analysis of two large prospective studies. Published online in the Lancet this week, both independent studies found that a diagnosis of metabolic syndrome was not predictive of cardiovascular events.
There was no increased risk conferred by such a diagnosis over and above that associated with individual components of the syndrome. And, in fact, the researchers said, Framingham-based algorithms were more likely to predict the risk of developing future cardiovascular disease than diagnosing metabolic syndrome. And even though such a diagnosis was associated with an increase risk of developing diabetes, it was no more predictive than a fasting plasma glucose. Full Text
Source: 6minutes.com
BECOMING A CERTIFIED PEDORTHIST
Join A Growing Service Profession: Pedorthics
Pedorthics is a professional field covering the design, manufacture, modification and/or fit of footwear. Pedorthics encompasses shoes, orthoses and foot devices that prevent or alleviate foot problems caused by disease, overuse, injury or congenital defect. Certified Pedorthists work with patients and their footwear to conform to a doctor's footwear prescription as part of the patient's treatment
To become a certified pedorthist, you must take a pre-determined number of course hours in pedorthics and pass a certifying examination overseen by either The American Board for Certification in Orthotics, Prosthetics & Pedorthics® or Board for Orthotists/Prosthetists Certification, Intl. Both the ABC and BOC are independent certification bodies that set standards for the profession and are recognized by the National Commission for Certifying Agencies.
More information, including FAQ's
Board for Orthotist/Prosthetist Certification
For information on the Canadian certifying organization:
The Pedorthic Association of Canada
UPCOMING COURSES AND EVENTS
BECOME A CERTIFIED PEDORTHIST
COURSES
The Robert M. Palmer M.D.,Institute Of Biomechanics "A Not-For-Profit School" has uniquely designed courses to provide pedorthic education for the retail, clinical or biomechanical knowledge seeking pedorthist. Course dates for Levels 1-3 in a variety of locations in the United States, Hong Kong, Mainland China and Korea are available. Click here to view a detailed calendar including dates and locations, information and pricing.
The Pedorthic Footwear Foundation has several scholarships and grants for 2007. Visit http://www.pedorthics.org/ and then click on the "Foundation" tab for more information.
Traveling Courses To Your Area sponsored by The Robert M. Palmer, M.D., Institute Of Biomechanics, Inc. a not-for-profit pedorthic school. Please contact us to discuss your needs at phone: 765-557-7216. Email: pam@pedorthicbiomechanics.org or visit our Web site at: http://www.pedorthicbiomechanics.org/.
CFS Allied Health Education: Pedorthic Certification: Exam Review
This review is focused on supplying the student with the skills and knowledge needed to pass the ABC Certified Pedorthic exam by presenting exam-like questions, exploring possible answers, and discussing rationales for correct and incorrect answers. Contact CFS Allied Health Education at (918) 266-3678 or visit http://www.learnpedorthics.com/ for more information.
*ABC and The American Board for Certification in Orthotics and Prosthetics are registered trademarks of the The American Board for Certification in Orthotics and Prosthetics, Inc., which is not affiliated with CFS Allied Health Education and does not endorse this review.
Oklahoma State University has uniquely designed courses to provide pedorthic education for the retail, clinical or biomechanical oriented individual. Your next course option is to begin by enrolling in our Level 1 Online Program! Then you are required to attend a Level Two: Hands-On program. Once you have successfully completed these courses, you may enroll in our Level 3 Online Program! Contact Information: Jerry Wilson 918-293-5330 or Andrea Autaubo 918-293-5330 or visit our website http://www.osu-okmulgee.edu/ Click here for course listings.
For more information on the Scholl College pedorthic pre-certification course: Contact the Special Programs Office at 847-578-8410, email Ellie.Wydeven@rosalindfranklin.edu or click on www.rosalindfranklin.edu/scpm/ce/.
2008 FOOT SOLUTIONS C. Ped. TRAINING COURSE INFORMATION Foot Solutions is an accredited facility that hold classes three times per year. The company's course will offers the certificate needed in all three levels to sit for the C.Ped Exam. The facility is located at2359 Windy Hill Road, Suite 400, Marietta, GA 30067
July 7-July 18
July 25: 1-day cram session
October 31: 1-day cram session
For application and fee information, contact:
Tracy Strickland 1-866-338-2597 EXT: 206 tstrickland@footsolutions.com
Betty Hubauer 1-866-338-2597 EXT: 201 betty@footsolutions.com
Dr. William Faddock 1-866-338-2597 EXT: 209 bfaddock@footsolutions.com
JUNE 2008
Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science will offer a pre-certification pedorthics course for podiatrists from June 19-23, 2008, which upon completion and passing of the course exams, will allow participants to sit for the ABC certification examination. For more information on the Scholl College pedorthic pre-certification course, contact the Special Programs Office at 847-578-8410, email Ellie.Wydeven@rosalindfranklin.edu or click on www.rosalindfranklin.edu/scpm/ce/.
AUGUST 2008
Eneslow Pedorthic Institute, 470 Park Avenue South @ 32nd Street, New York, NY 10016-6819, Phone: 212-477-2300. EPI Pre-Certification Course: August 11th - August 26th 2008 $3,995
EPI Pre-Certification course is a two and a half week all inclusive course to prepare individuals to become a Board Certified Pedorthist. The EPI course is also designed to help health care professionals enhance their practices (ATC, CO, CPO, DC, DPM, MD, PT). Pedorthic treatment has proven to provide incremental patient benefits, particularly when added to other treatment protocols. The awarding of an ABC/BOC fitter certification provides the certified pedorthist with an appropriate and meaningful recognition of professional competence. Contact Sarah Goldberg at (212) 477-2300 ext 211 or sarah@eneslow.com.
Special Note: Aetrex is offering each Aetrex Customer a special $2,000 savings on Aetrex purchases of $4,000 for each person who attends the Eneslow Pedorthic Institute Pedorthic Pre-certification Course. Enroll Now!
BECOME A THERAPEUTIC SHOE FITTER
For additional information on the Aetrex Worldwide Therapeutic Shoe Fitter Course, please contact the Aetrex Marketing Department at: marketing@aetrex.com.
JUNE 2008
Aetrex Worldwide Therapeutic Shoe Fitter Course: June 6 (Teaneck, NJ), $195.
JULY 2008
Aetrex Worldwide Therapeutic Shoe Fitter Course: July 8 (Detroit, MI), $195.
AUGUST 2008
Aetrex Worldwide Therapeutic Shoe Fitter Course: August 12 (Birmingham, AL), $195.
Aetrex Worldwide Therapeutic Shoe Fitter Course: August 21 (Raleigh, NC), $195.
SEPTEMBER 2008
Aetrex Worldwide Therapeutic Shoe Fitter Course: September 5 (Greenwood Village, CO), $195.
Aetrex Worldwide Therapeutic Shoe Fitter Course: September 14 (Pasadena, CA ), $195.
Aetrex Worldwide Therapeutic Shoe Fitter Course: September 16 (Portland, OR), $195.
OCTOBER 2008
Aetrex Worldwide Therapeutic Shoe Fitter Course: October 14 (Louisville, KY), $195.
Aetrex Worldwide Therapeutic Shoe Fitter Course: October 21(Rochester, NY), $195.
Aetrex Worldwide Therapeutic Shoe Fitter Course: October 27 (Atlanta, GA), $195.
DECEMBER 2008
Aetrex Worldwide Therapeutic Shoe Fitter Course: December 5 (Orlando, FL), $195.
For additional information on the Aetrex Worldwide Therapeutic Shoe Fitter Course, please contact the Aetrex marketing department at (800) 526-2739 or marketing@aetrex.com.
ADDITIONAL COURSES
Oklahoma State University is offering various courses ranging from instruction in shoe fitting to biomechanics and pathomechanics of the foot. To view a complete listing of 2007 courses and dates, please click here.
CFS Allied Health Education is pleased to announce their new ABC Approved Therapeutic Shoe Educational Course. An ABC certified fitter of Therapeutic shoes is an individual trained and qualified in the provision of non-custom therapeutic shoes and non-custom diabetic multi-density inserts. This two-day course fulfills the educational requirements needed to apply for the ABC Certified Fitter of Therapeutic Shoes credential. To learn more, please visit CFS Allied Health Education's website at http://www.learnpedorthics.com/ for course dates or call (918) 266-3678.
ENESLOW PEDORTHIC INSTITUTE 1-on-1 or Group Tutoring Available; Eneslow Training & Tutoring Program, Individual and Small Group Program
WHO SHOULD COME:
Those who wish to improve their pedorthic, sales, retailing, biomechanics and business skills.
Those who need a refresher course; prepare for the Certified Fitter of Therapeutic Shoes or the
Pedorthic Pre-Certification Course and Exam.
SUBJECTS: PEDORTHICS - SALES -RETAIL MANAGEMENT
Pedorthic Assessment - Pedorthic Shoe Fitting - Pedorthic Solutions Footwear - Foot Orthotics
Foot Products - Ready-made - Custom Shoe Constructions and Designs
Shoe Modifications - Casting and Evaluation Techniques for Custom Shoes & Orthotics - Business and Practice Management Finance & Administration
Forecasting & Budgeting - Buying & Inventory Control Marketing & Advertising Professional Responsibility - Safety - Human Resources Biomechanics Pediatrics
Pathology of Diseases and Malalignments
HANDS-ON 1-ON-1 INSTRUCTION
$150/ hour for individual training
GROUP TRAINING
$125/hour per person for two or more participants in the same program at the same time
$100/hour per person for five or more participants in the same program at the same time
Fee: Two hour minimum
HANDS-ON 1-ON-1 TRAINING WITH ROBERT S. SCHWARTZ, CPED, OR DR. JUSTIN WERNICK, DPM, CPED
$250/hour for individual training &
$200/hour per person for group training
Added Value: An insiders look into the retail, pedorthic, sales, store operations, and business management of Eneslow.
ABC and BOC points may be applied for.
ENESLOW PEDORTHIC INSTITUTE, 470 Park Avenue South at 32nd Street, New York, NY 10016
Call for more info (212) 477-2300 (Ask for Sarah Goldberg, CPED) (212) 353-2876 Fax
email: epi@eneslow.com or visit http://eneslow.com/epi
INTERNSHIPS
Internship Course with The Robert M. Palmer, M.D., Institute Of Biomechanics:
Pedorthic Clinical or Manufacturing Internships Available. Daily, Weekly or Extended Internship Courses Available. Experience clinical settings in Orthopaedic, Podiatric, Chiropractic and Physical Therapy Clinics as well as experience in a BAPFOL approved functional foot orthosis laboratory. We specialize in diabetic wound care as well as pediatric and adult biomechanics. Your internship hours can earn you an Associates Degree In Pedorthic Biomechanics or be used as continuing medical education hours. Please contact Pam Haig at 765-557-7216 or pam@pedorthicbiomechanics.org.
Comfort Shoe Specialists, state of the art retail pedorthic facility, offers internships for on the job training requirements in beautiful St. Louis. Room is available as an option. Call Edith James, Certified Pedorthist, at 314-822-3300 -- or email Edith@ComfortShoe.com
ALLIED HEALTH PROFESSIONS
American Orthotic & Prosthetic Association Upcoming Seminars/Courses: Click here for a complete schedule.
AOPA has been delivering successful, cost-effective business products and solutions for 90 years. AOPA knows the business of O&P.
Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science: Pre-Certification Pedorthics Course for Podiatrists - will be held June 19-23, 2008. For more information on the Scholl College pedorthic pre-certification course, contact the Special Programs Office at 847-578-8410, email Ellie.Wydeven@rosalindfranklin.edu or click on www.rosalindfranklin.edu/scpm/ce/.
Editor: Faye Rapoport DesPres, M.S.
| Robert Schwartz, C. Ped. | John S. Mishasek, C. Ped. | |
| Stephen F. Albert, D.P.M., C. Ped. | Jerome S. Klein, C.O., C. Ped. | |
| Edith James, C. Ped. | Erick Janisse, C. Ped. |
Our goal at Pedorthic Newswire is to generate an active online exchange of ideas among those interested in pedorthics. Please send articles, questions, responses and courses listings to editor@pedorthicnewswire.com.
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