Great question. So many variables at play here.
One question that you can ask your patient is this: How long do your shoes usually last?
If they wear through a pair of shoes each year, they will probably wear their orthotics out sooner than most people do. Serious runners, high impact athletes and children may fall into this category.
Some say that orthotics last about 2-5 yrs. That may be right, but I’m not sure the patient will get much out of that answer. It may be more helpful to ask them to come back once a year to have the orthotics checked. Some people are harder than others on the orthotics.
Another way to answer the question may be determined by the materials that the orthotics are made of.
Are there softer materials on the orthotics? Or firmer?
Is the core of the orthotic made of plastic or some sort of crepe or eva? If the orthotics do not have a core plastic shell, I would say that the orthotics will last a year or so.
If there is a core plastic shell, they will last longer.
With medium to firm density posting and support underneath the shell, and padding and topcovers made of medium to high density materials, the average patient may have them last closer to five years.
If the shell and support on bottom is made of medium to high density materials but the topcovers are soft, I would tell the patient that the orthotics may last a few years but the topcovers may need to be replaced within a year.
So this begs the question…what do you do when…
The patient walks in with a pair of used orthotics with some history behind them. They love them and can’t live without them.
They look to you, the expert, to give them some options.
What can you offer so that in the end, they walk out committed to you. You took care of them. You gave them options, that no one else has. When they have a need in the future…they are coming back to you.
Aside from immediately putting the orthotics in a ziplock bag so that you can breath again, I would like to give you three options to have your patient walking out feeling like their old orthotics are as good as new again:
Recover
This is just as it sounds, you can have your Pedorthist or Lab replace the topcovers and bottom covers while leaving the plantar posting and support intact. This is useful when your patient is very sensitive to the feel of the posting and would react negatively to even the slightest change in posting angle.
Any lab can recover orthotics made by someone else. You don’t have to worry about who originally made the orthotics.
Refurbish
In addition to a recover, this option would repost and rebuild the support under the orthotic core piece. The end result would be a new orthotic except for the core shell piece.
Make sure to get the original posting numbers from their records. This helps restore the original angles to the forefoot and rearfoot posting.
If those records are not available, a good orthotic craftsman should be able to estimate those numbers after the device is stripped apart. Be sure to save the new specifications when the devices are returned for the future.
Custom Copy
Now this option will make you look really good!
This is when a new pair of devices can be made off of the old pair. In the process of recovering or refurbishing, a duplicate pair can be made off of the old pair, without having to recast the patient.
How is this done?
To recover the devices, the original topcovering has to be stripped off. Before adding the new covering, the dorsal surface of the shell can be used to make a positive plaster model of the shell. The positive model can be used to make a new pair.
No casting of the patient is needed.
You can offer this in two ways:
- You can offer to make a Custom Copy when you need a new pair made and you don’t want to cast the foot again. The patient can end up with a duplicate pair and a refurbished original pair.
- You can offer to have a Custom Copy cast made whenever you send an original pair to be recovered or refurbished. The cast can be taken home and saved for later use. In the future, they can send the casts in and wear their old pair while the new one is being made. Then they can send the old pair in to be recovered or refurbished while they are wearing the new pair.
Final Tips:
- Whenever you are spending time with an old pair, check to see if insurance can be billed using a repair/adjustment code. This code might be used to bill for your time assessing and adjusting an existing pair of orthotics. It usually allows you to bill for multiple 15 minute increments.
- Keep in mind, each time the orthotic is adjusted or redone in any way, the integrity of the core piece is diminished. Each time the core shell is smoothed out and applied to machinery, it thins out slightly. We are talking about miniscule amounts here, pretty much unnoticeable. Nonetheless, after several adjustments the orthotic should be assessed for possible replacement.
What other tips do you have for dealing with old devices?
