Differences between Podiatrists, Orthopedists, Orthotists?

[Query]

Just curious, since I maintain a page on boot fit.

All these people make orthotics (orthoses?) for feet. Is there any logic about which athletes should go to, or is it more a matter of finding the right individual than the right medical speciality?

Also, is there a difference between an orthotic and an orthosis?

[CoachPA]

Podiatrists commonly deal with corns, calluses, ingrown toenails, bunions, heel spurs, and arch problems; ankle and foot injuries, deformities, and infections; and foot complaints associated with diabetes and other diseases. They are able to prescribe drugs and physical therapy, set fractures, perform surgery, fit orthotics, design plaster casts and strappings to correct deformities, and design custom-made shoes. Podiatrists may practice other specialties, such as sports medicine, pediatrics, dermatology, radiology, geriatrics, or diabetic foot care. These are the doctors that you'd consider a "foot doctor".

An orthopedist (ortho-"spine", pedia-"child"), on the other hand, is a doctor who specializes in the musculoskeletal system or bones. They tend to treat a variety of musculoskeletal issues, so I don't believe this doctor is necessarily limited to the foot.

As for which one to see, I'd probably start with a podiatrist. If the foot problem is very severe, he/she would probably refer to an orthopedist, although it seems as though a good podiatrist would be able to deal with a variety of foot issues within his/her specialty.

[AgnesNitt]

I agree with CoachPA description of a podiatrist.

I'd like to expand on her description of 'orthopedist'.
These are surgeons, who specialize in the musculo-skeletal system. They are MD's or DO's with many years of specialist training. There are orthopedic surgeons who specialize in feet as well as other parts of the body-hip, hand, knee, and spine are common specializations. There are also generalists who sort out broken bones, etc. The doctor who sets your broken arm in the ER is likely to be a generalist OS.
I think the term 'orthopedist' or 'orthopaedist' is british usage.

Health insurance may or may not cover foot treatment by a podiatrist. However, insurance is likely to cover treatment by an orthopedic surgeon. It's worth checking before going on a long course of treatment.

An orthotist is a person who makes the orthotic inserts. This is usually a technician.

[Query]

An orthotist is a person who makes the orthotic inserts. This is usually a technician.

Can an orthotist make an orthotic insert without a prescription from an MD or DO?

Can certified physical therapists (PTs) or athletic trainers (ATCs) legitimately prescribe or make orthotics? Who else can?

Actually I think ordinary unlicensed skate and ski bootfitters modify boots and add inserts. Maybe there are no legal requirements.

[froggy]

[QUOTE=Query;381392]Can an orthotist make an orthotic insert without a prescription from an MD or DO?

Can certified physical therapists (PTs) or athletic trainers (ATCs) legitimately prescribe or make orthotics? Who else can?



I can only answer for what goes on in ny state, an orthotist needs a Rx to fabricate an orthotic as well as order for the client a prefabricated orthotic. PTs cannot perscribe- only a doctor, PAs (physician assistants) and nurse practitioners. there are many prefabricated orhtotics that can be ordered on your own (ie: sammons preston website among many others). Not all PTs have the training and materials to custom make orthotics, if they do, they will probably want a Rx. A prefabricated orthotic that is not complicated may be given and fitted without a Rx by a PT.

Anyone technically "can" make an orthotic-but thats like saying anyone "can" do your electric work (obviously you'd want someone with experience and licensed), imo athletic trainers do not have the training at all to make one and certainly cannot perscribe, athletic trainers may be licensed but their services are not covered by any insurance. You are best off having one done by an orthotist.

Occupational therapists can also fabricate orthotics (with a Rx) but their training and expertise is more in the upper extremities.

imo as a therapist with knowlege/experience of orthotics I would recommend if someone has a foot related issue that is affecting their movement patterns to meet with both a physical therapist and a very good orthotist to come up with the best orthotic (with your MD's Rx). if it is more of a medical condition/ailment a PT will prob not be needed in that situation.

(the orthotist is an expert with the kinetics of the lower body as well as having great ingenuity and creativity; a PT is an expert in the kinetics/movement and physiology of the entire body--the chain of mvmnt head to toe)

[Isk8NYC]

I've never heard of an orthotist - interesting.

I have heel spur syndrome in both feet (arrrgh), so I took someone's advice and went to an podiatrist. After several shots of cortisone in both feet and a very expensive pair of custom orthotics (not covered by insurance and they usually are NOT), I'm much better.

When I had my orthotics replicated for my skates' insoles, the skatemaker remarked that an orthopedist would have been better since I'm athletic.

[Query]

[QUOTE=Query;381392]Anyone technically "can" make an orthotic-but thats like saying anyone "can" do your electric work (obviously you'd want someone with experience and licensed)

Most electrical work requires a license, at least in Maryland. But many athletic coaches and people who work in ski and skate shops have informal, unlicensed training to do it, and do, so I assume that doesn't apply.

But perhaps "orthotic" and "orthosis" (identical meanings??) might be legally restricted to licensed practitioners?

Anyway, the real question is which practitioners yield the highest success rates. Perhaps asking other skaters makes the most sense. Absent such referrals, I'll try to take into account what you folks have said, on my web site.