1 00:00:02,840 --> 00:00:05,840 Hi, Doctor Pelto here. I'm going to go over a little 2 00:00:05,840 --> 00:00:08,880 bit about the the self pay products that we have in the 3 00:00:08,880 --> 00:00:12,600 office. This is for 2024. 4 00:00:13,040 --> 00:00:16,720 We have a lot of different items and I think this will help the 5 00:00:16,720 --> 00:00:20,000 staff and also some of the new doctors coming in to kind of 6 00:00:20,000 --> 00:00:22,720 explain what we have. This is a list of everything and 7 00:00:22,720 --> 00:00:29,120 I'm going to go through these things one at a time here all 8 00:00:29,120 --> 00:00:31,120 the way up to EU shaped bone pad. 9 00:00:31,120 --> 00:00:32,439 So let's talk a little bit about this. 10 00:00:33,160 --> 00:00:35,480 The first one is an Achilles wedge. 11 00:00:36,120 --> 00:00:40,520 This is used, you can see here it has different levels and this 12 00:00:40,520 --> 00:00:43,640 is kind of like an adjustable heel lift for your shoe, but 13 00:00:43,640 --> 00:00:47,200 it's used in a walking boot. In a Cam boot, you put it in the 14 00:00:47,200 --> 00:00:50,640 bottom of the Cam boot, it lifts up the heel quite a bit and this 15 00:00:50,640 --> 00:00:56,240 reduces the pull on Achilles if someone has an Achilles tear and 16 00:00:56,240 --> 00:00:57,880 they want non surgical treatment. 17 00:00:57,880 --> 00:01:00,840 So by lifting up the heel that much it's going to allow the two 18 00:01:00,840 --> 00:01:05,920 ends of the Achilles to come together and this can be used, 19 00:01:05,920 --> 00:01:09,520 it reduced the pull and it can also be used after surgery as 20 00:01:09,520 --> 00:01:10,800 well. This is something that we use 21 00:01:10,800 --> 00:01:13,720 for those types of Achilles and then you slowly reduce the 22 00:01:13,720 --> 00:01:18,040 levels that go into there. That's how this Achilles wedges 23 00:01:19,680 --> 00:01:25,560 A Mara gel care lotion. This is a that we call it a Mira 24 00:01:25,560 --> 00:01:27,600 gel blue. It's a lotion that patients can 25 00:01:27,600 --> 00:01:32,160 put on their on their feet at. The nice thing is it's it's safe 26 00:01:32,160 --> 00:01:35,440 to use between the toes. Not safe, but safe between to 27 00:01:35,440 --> 00:01:37,160 use the toes if you have diabetes. 28 00:01:37,360 --> 00:01:39,440 So it's not going to get it very damp between there. 29 00:01:39,760 --> 00:01:42,440 It's good for the dark coloration on the legs. 30 00:01:42,440 --> 00:01:45,560 Those are called hemociterin stains in the front of the legs. 31 00:01:45,560 --> 00:01:48,160 It's good for that venous dasis dermatitis. 32 00:01:48,440 --> 00:01:51,480 It's just a daily lotion that can be used. 33 00:01:52,240 --> 00:01:55,480 I think it's better than some of the other ones that can you can 34 00:01:55,480 --> 00:01:58,680 buy commercially and it's good for cracked heels if you have 35 00:01:58,680 --> 00:02:01,080 really, really fissured and really, really thick. 36 00:02:01,080 --> 00:02:03,120 There's something else that's a little bit better than this one. 37 00:02:03,120 --> 00:02:06,160 But this is, this is good for dry skin, cracked heels and 38 00:02:06,160 --> 00:02:07,360 things like that. OK. 39 00:02:07,360 --> 00:02:09,039 I'm called the Mira gel blue patients. 40 00:02:09,039 --> 00:02:12,440 They can just get it on the way out of the office here. 41 00:02:12,440 --> 00:02:15,880 Mira gel red. This is used for kind of wounds 42 00:02:15,880 --> 00:02:18,680 and ulcers, whether it's the ones that we make when we remove 43 00:02:18,680 --> 00:02:22,400 a wart or whether someone has a diabetic ulcer pressure ulcer, 44 00:02:23,080 --> 00:02:25,360 cutter abrasion. So you can use this on diabetic 45 00:02:25,360 --> 00:02:29,720 ulcers that are small. You can also use it if you're 46 00:02:29,720 --> 00:02:33,600 going to be doing like in a matrixectomy type of procedure, 47 00:02:33,960 --> 00:02:36,440 something where you're going to be creating a wound and you're 48 00:02:36,440 --> 00:02:37,960 going to want that to heal quicker. 49 00:02:38,160 --> 00:02:39,760 OK. So that's where you use these 50 00:02:39,760 --> 00:02:43,040 for matrixectomies in this kit specifically. 51 00:02:43,040 --> 00:02:46,000 So in this kit, this is called an Ameri gel post op kit. 52 00:02:46,920 --> 00:02:50,520 It has the Ameri gel wound dressing, It has a wound wash 53 00:02:50,520 --> 00:02:54,520 which is like a saline wash It has gauze pads and it has band 54 00:02:54,520 --> 00:02:57,640 aids and you kind of put those together and you put those on 55 00:02:57,640 --> 00:02:59,520 the on the toe. So you can use this for 56 00:02:59,520 --> 00:03:01,560 different things. We specifically use it for 57 00:03:01,560 --> 00:03:04,840 matrixectomy and what removes. It has a whole, It has enough 58 00:03:04,840 --> 00:03:08,080 for the whole post op period and it's easier than soaking twice a 59 00:03:08,080 --> 00:03:11,720 day, which is what what typically happens and it's good 60 00:03:11,720 --> 00:03:14,680 for wounds so they can use it anywhere they have a wound. 61 00:03:14,680 --> 00:03:16,120 You don't have just have to use it on the foot. 62 00:03:16,120 --> 00:03:18,240 You can use it afterwards anywhere that you want. 63 00:03:20,040 --> 00:03:23,800 Biofreeze this can either come as a gel roll on or a spray. 64 00:03:24,160 --> 00:03:27,240 Biofreeze is used for pain reduction for arthritis and 65 00:03:27,240 --> 00:03:29,920 other types of foot pain. It gives a temporary reduction 66 00:03:29,920 --> 00:03:34,600 has kind of like a menthol smell to it patients. 67 00:03:34,680 --> 00:03:36,720 They they like the way it feels, make it feel better. 68 00:03:37,080 --> 00:03:40,120 I think it it kind of takes away the pain feeling and gives it 69 00:03:40,120 --> 00:03:42,880 that cold feeling. So it kind of masks that that 70 00:03:42,880 --> 00:03:46,200 pain for for a period of time. This is something that patients 71 00:03:46,200 --> 00:03:50,400 can get in the office as well. Body Glide. 72 00:03:50,400 --> 00:03:53,760 This is used on the foot specifically or in other parts 73 00:03:53,760 --> 00:03:56,680 of the body it use. It's used to reduce friction, so 74 00:03:56,680 --> 00:03:59,920 you can put it on the bottom of the foot if there's calluses 75 00:03:59,920 --> 00:04:02,240 that are there. You can also use it between your 76 00:04:02,240 --> 00:04:07,400 legs, armpits and other areas of chafing for runners and for 77 00:04:07,400 --> 00:04:09,480 other types of athletes, but it can be used also in the bottom 78 00:04:09,480 --> 00:04:13,160 of the foot if there's painful rubbing causes in these 79 00:04:13,160 --> 00:04:19,480 calluses. Bromi talc is a basically just a 80 00:04:19,480 --> 00:04:23,000 talc for for dampness for people that have hyperhidrosis or 81 00:04:23,000 --> 00:04:26,680 dampness in their feet. Athlete's foot have odor 82 00:04:26,680 --> 00:04:29,280 problems in their shoes. You can use this type of a talc 83 00:04:29,920 --> 00:04:35,720 for that bromi lotion. This is used with excess 84 00:04:36,200 --> 00:04:40,600 perspiration or hyperhidrosis, and it's an antiperspirant 85 00:04:40,880 --> 00:04:43,200 lotion that you could put on the skin as well. 86 00:04:45,200 --> 00:04:49,000 So a booten splint. There's a couple of types of toe 87 00:04:49,000 --> 00:04:51,120 pads that we use in the office. This is one. 88 00:04:51,120 --> 00:04:54,560 It either comes in a single strap or double strap and it 89 00:04:54,560 --> 00:04:58,160 would it used to pull down hammer toes, so it reduces the 90 00:04:58,160 --> 00:05:00,800 pressure to the front of the foot because of this padding. 91 00:05:00,960 --> 00:05:03,920 But it also kind of relocates that hammer toe that's stuck up. 92 00:05:04,160 --> 00:05:06,840 It pulls down the hammer toe so it can fit easier in shoes. 93 00:05:06,840 --> 00:05:09,640 So some patients that just can't fit things and shoes, they wear 94 00:05:09,640 --> 00:05:11,560 these. It pulls over the toe to make 95 00:05:11,560 --> 00:05:15,200 sure it's. But yeah, this is something it 96 00:05:15,200 --> 00:05:17,560 goes over the toe but you want to make sure it's not too tight 97 00:05:17,560 --> 00:05:20,440 especially in patients that are diabetic because you don't want 98 00:05:20,440 --> 00:05:22,440 to cut off the circulation. So you have to make sure that 99 00:05:22,440 --> 00:05:25,800 these aren't too tight. These last, you know depends on 100 00:05:25,800 --> 00:05:29,480 how often they wear them, a couple of weeks and then you can 101 00:05:29,480 --> 00:05:32,000 you can do other things. But this is kind of a non 102 00:05:32,000 --> 00:05:34,880 searchable approach for bringing those second toes back down and 103 00:05:34,880 --> 00:05:39,080 some of these other toes Cam Walker sole cover. 104 00:05:39,560 --> 00:05:42,960 This is used for someone has a walking boot and they want to 105 00:05:42,960 --> 00:05:45,480 keep it dry in the rain or the snow. 106 00:05:45,880 --> 00:05:49,000 This is something that patients can get us an additional add on 107 00:05:49,000 --> 00:05:52,320 for their walking boot. This is also another add on that 108 00:05:52,320 --> 00:05:55,320 can go both into The Walking boot or into the surgical shoe. 109 00:05:55,640 --> 00:06:00,400 It's called a peg assist. So this peg assist, what it is 110 00:06:00,400 --> 00:06:03,920 it, it has these little pegs that can be pulled out in areas 111 00:06:03,920 --> 00:06:09,240 of high pressure such as ulcer areas and then it can be put in, 112 00:06:09,240 --> 00:06:11,600 it's used to offload them. Here are some instructions. 113 00:06:11,600 --> 00:06:13,600 I'll give you guys the slides if you want to look at those. 114 00:06:13,600 --> 00:06:16,080 Those different instructions on their website. 115 00:06:17,120 --> 00:06:20,240 Carbon fiber plate, there's different types of carbon fiber 116 00:06:20,240 --> 00:06:21,840 plates. There's some that only go to the 117 00:06:21,840 --> 00:06:25,720 toe and have the back end. There's some that go totally 118 00:06:25,760 --> 00:06:32,640 these fit in the shoe and these used to reduce jamming in the 119 00:06:32,640 --> 00:06:34,840 joint, especially for people that have house limited. 120 00:06:34,840 --> 00:06:37,880 So when they're walking it makes it nice and rich in the front so 121 00:06:37,880 --> 00:06:40,320 it doesn't bend. This can be used for any part of 122 00:06:40,320 --> 00:06:42,040 the foot that you don't want the foot to bend. 123 00:06:42,280 --> 00:06:46,920 Another way of doing this is with a hard soled shoe such as 124 00:06:46,920 --> 00:06:48,840 like a running shoe or a hiking shoe. 125 00:06:49,640 --> 00:06:52,440 That can be beneficial with these carbon fiber plates or 126 00:06:52,440 --> 00:06:57,120 just like a really stable shoe. These can go on people's shoes. 127 00:06:57,720 --> 00:07:00,720 These are the Canterbury laces. These are laces that have these 128 00:07:00,720 --> 00:07:03,480 little balls on them. And these little balls, what 129 00:07:03,480 --> 00:07:08,080 they have is a rubber core that allows the elastic to kind of 130 00:07:08,080 --> 00:07:11,240 pull back and forth. And you put these in your shoes, 131 00:07:11,240 --> 00:07:15,800 you put them out one end and it keeps like an the same type of 132 00:07:15,800 --> 00:07:19,120 tension across it. It's good if people have like 133 00:07:19,120 --> 00:07:20,960 bone spurs on the top of their foot. 134 00:07:21,480 --> 00:07:23,840 It's easier than tying your shoes and and they say it 135 00:07:23,840 --> 00:07:27,080 improves circulation. So there's no numbness on the 136 00:07:27,080 --> 00:07:29,760 top of your foot when you're wearing the laces, it doesn't 137 00:07:29,760 --> 00:07:33,960 over tighten that area. They're called Canterbury laces, 138 00:07:35,440 --> 00:07:38,840 cluffy wedge. This is something that goes in 139 00:07:38,840 --> 00:07:41,680 the shoe and it goes underneath the big toe joint. 140 00:07:42,880 --> 00:07:46,720 So you have the the hallux, the big toe and it actually lifts up 141 00:07:46,720 --> 00:07:49,560 the the toe and it allows the bone to drop down. 142 00:07:49,920 --> 00:07:51,280 You put this underneath the big toe. 143 00:07:51,280 --> 00:07:54,080 This can either be added to an orthotic or just added to a shoe 144 00:07:54,440 --> 00:07:56,600 and this is made to reduce joint jamming. 145 00:07:56,600 --> 00:08:01,000 Once again for someone that has Hallux Limitis or reduced range 146 00:08:01,000 --> 00:08:03,640 of motion in the big toe joint or functional Hallux Limitis 147 00:08:03,640 --> 00:08:06,440 where it's not moving as well. So this is something else that 148 00:08:06,440 --> 00:08:09,360 we have here in the office. This can be either added to an 149 00:08:09,360 --> 00:08:12,720 orthotic or it can just give out solely. 150 00:08:13,080 --> 00:08:16,360 These are our CMP socks. I think it's good to show these. 151 00:08:16,680 --> 00:08:18,840 These are usually given along with a water bottle to those 152 00:08:18,840 --> 00:08:20,480 that get orthotics. They can be purchased. 153 00:08:20,640 --> 00:08:23,000 They're a good sock. They have a compression in them, 154 00:08:23,000 --> 00:08:25,560 so they're very comfortable. They're like a running sock for 155 00:08:25,560 --> 00:08:29,760 patients Cobanth, 3 inch and one inch. 156 00:08:30,160 --> 00:08:35,400 So patients are getting these to splint, sorry not Sprint. 157 00:08:35,400 --> 00:08:38,559 They're used to splint the toes together with a fracture or 158 00:08:38,559 --> 00:08:41,480 instability. You can also when you drain a 159 00:08:41,480 --> 00:08:43,919 cyst you can wrap it around so that cyst doesn't fill back 160 00:08:43,919 --> 00:08:47,400 again fill back up again and it used used for toe band which is 161 00:08:47,400 --> 00:08:51,040 in the three inch Co band is used after draining A cyst or 162 00:08:51,040 --> 00:08:53,520 hematoma used to reduce swelling as well. 163 00:08:54,120 --> 00:09:00,640 And this can also be used you know as a dressing for for 164 00:09:00,640 --> 00:09:05,080 patients and if you have like a a fracture or a a toe that 165 00:09:05,080 --> 00:09:07,640 you're wanting to buddy tape 2 toes together that can help for 166 00:09:07,640 --> 00:09:09,600 that. This one inch coban you have to 167 00:09:09,960 --> 00:09:13,400 be careful when we do flexor tenotomies in the office then we 168 00:09:13,400 --> 00:09:15,400 use the one inch coban afterwards to keep that toe 169 00:09:15,400 --> 00:09:16,480 straight. Once again, you want to be 170 00:09:16,480 --> 00:09:19,280 careful with patients that have poor circulation that is not on 171 00:09:19,280 --> 00:09:22,520 too tight or not on too long. That could cause circulatory 172 00:09:22,520 --> 00:09:25,360 problems. Corn pads. 173 00:09:25,360 --> 00:09:28,880 Here's an example of a corn pad. It goes right in the side, can 174 00:09:28,880 --> 00:09:31,360 either go on, on the outside of this would be like for a 5th 175 00:09:31,360 --> 00:09:33,400 digit, it can go between the toes, could be on the top of the 176 00:09:33,400 --> 00:09:36,040 toes. They have adhesive on one side. 177 00:09:37,040 --> 00:09:39,320 They're used to offload painful corn areas. 178 00:09:39,960 --> 00:09:43,200 We usually use them in office with selenocane if we're doing a 179 00:09:43,200 --> 00:09:45,920 porokeratoma. So we're going to put selenocane 180 00:09:45,920 --> 00:09:48,280 inside of this little hole and then put a Band-Aid on it and 181 00:09:48,280 --> 00:09:49,840 that's going to Slough off some of the skin. 182 00:09:50,600 --> 00:09:53,400 It can be used for painful calluses between the toes as 183 00:09:53,400 --> 00:09:57,640 well to to space them out. Here's an example of correct 184 00:09:57,640 --> 00:09:59,600 toes. So correct toes are to be used 185 00:09:59,600 --> 00:10:02,360 to space out the toes, if they can be used. 186 00:10:02,360 --> 00:10:04,160 They're supposed to be using wish shoes. 187 00:10:05,360 --> 00:10:07,280 They they come in different sizes. 188 00:10:07,280 --> 00:10:10,040 They help stabilize the toes and prevent worsening of hammer 189 00:10:10,040 --> 00:10:11,680 toes. Bunions they don't. 190 00:10:11,760 --> 00:10:14,840 I don't say that they reverse them, but they can help prevent 191 00:10:14,840 --> 00:10:17,280 the worsening of them. They're made to wearing shoes 192 00:10:18,320 --> 00:10:20,480 for many patients that wear toe socks along with them. 193 00:10:21,040 --> 00:10:22,720 Go slow when you're starting out with them. 194 00:10:22,720 --> 00:10:25,360 I usually say one hour per day, very similar to breaking in an 195 00:10:25,360 --> 00:10:28,320 orthotic, and it's common to have tendon pain when wearing 196 00:10:28,320 --> 00:10:29,640 them. Even painted to the front of the 197 00:10:29,640 --> 00:10:31,480 legs if you're not used to wearing them, because it's going 198 00:10:31,480 --> 00:10:33,840 to kind of stretch out everything when you're not used 199 00:10:33,840 --> 00:10:35,240 to it. And many times it might be 200 00:10:35,240 --> 00:10:36,720 modified. To put some videos here. 201 00:10:37,560 --> 00:10:40,160 There are modification instructions of the most common 202 00:10:40,160 --> 00:10:42,680 modifications and also when they get them. 203 00:10:42,680 --> 00:10:45,560 There's AQR code that has some interesting modifications. 204 00:10:45,560 --> 00:10:49,920 The most common modification is trimming out this little area 205 00:10:49,920 --> 00:10:52,440 here on the 5th toe because it pushes the 5th toe over a little 206 00:10:52,440 --> 00:10:55,680 too much. Crest pads. 207 00:10:55,680 --> 00:10:58,800 These are pads that are going underneath the the toes right 208 00:10:58,800 --> 00:11:01,520 here. The and it straps on the 3rd 209 00:11:01,520 --> 00:11:03,440 digit. It's It's made for hammer toes. 210 00:11:03,440 --> 00:11:06,600 This can also be added into an orthotic called the Crest pad. 211 00:11:07,320 --> 00:11:09,480 It's used to support hammer toes to not hit the front of the 212 00:11:09,480 --> 00:11:10,480 ground. So basically if you have a 213 00:11:10,480 --> 00:11:13,440 really painful callus to the front of the toes, it can help 214 00:11:13,440 --> 00:11:16,760 or ulcer to the front of the toes, make sure it's not too 215 00:11:16,760 --> 00:11:19,840 tight once again and mostly you put this on 3rd digit. 216 00:11:19,840 --> 00:11:22,000 Now how do you tell what side is what? 217 00:11:22,240 --> 00:11:25,960 Usually the big side goes towards the big toe, so the big 218 00:11:25,960 --> 00:11:29,320 side goes towards the big toe. If you're looking of if you're 219 00:11:29,320 --> 00:11:31,520 unsure what is right, what is the right one and what's the 220 00:11:31,520 --> 00:11:36,160 left one on the for the foot. Custom diabetic inserts. 221 00:11:36,240 --> 00:11:38,720 These are inserts. They're called multi density 222 00:11:38,720 --> 00:11:41,160 because they have three different densities or two 223 00:11:41,160 --> 00:11:44,720 different densities of material and this difference in density 224 00:11:45,200 --> 00:11:47,440 allows less friction on the bottom of the foot. 225 00:11:47,440 --> 00:11:50,040 It's used to offload calluses or high pressure areas. 226 00:11:50,640 --> 00:11:53,120 It's it's not used when an ulcer is open. 227 00:11:53,120 --> 00:11:56,080 When an ulcer is open, normally people are in a walking boot or 228 00:11:56,080 --> 00:11:59,800 a surgical shoe. You can sometimes do a custom 229 00:11:59,800 --> 00:12:02,440 orthotic because it does a better job at offloading. 230 00:12:02,920 --> 00:12:05,880 These ones, they they collapse down in the edge, so they're not 231 00:12:05,880 --> 00:12:08,600 really made for really big people because they're going to 232 00:12:08,600 --> 00:12:10,000 squish them right down. They're not going to do 233 00:12:10,000 --> 00:12:11,720 anything. I find a custom orthotic or 234 00:12:11,720 --> 00:12:14,400 something that has a better shell that's made of a harder 235 00:12:14,400 --> 00:12:17,720 material works better. These tend to be prescribed with 236 00:12:17,720 --> 00:12:20,040 diabetic shoes. We no longer do diabetic shoes 237 00:12:20,040 --> 00:12:23,880 in the office but we do sometimes order these for for 238 00:12:23,880 --> 00:12:27,080 patients. Digipads here is an example of 239 00:12:27,080 --> 00:12:30,880 some Digipads that are used. These can go on the on the on 240 00:12:30,880 --> 00:12:33,120 the toes. So they have this the gel part 241 00:12:33,120 --> 00:12:37,760 right here and they have this almost like a a a woven sock 242 00:12:37,760 --> 00:12:40,360 that goes so there's a hole here and you put it on the toe. 243 00:12:40,720 --> 00:12:43,240 This can go on any of the toes that have painful calluses and 244 00:12:43,240 --> 00:12:46,440 helps the toes not to rub together where there where there 245 00:12:46,440 --> 00:12:51,040 is pain even up. This is used with a The Walking 246 00:12:51,040 --> 00:12:52,080 boot. You can see someone with a 247 00:12:52,080 --> 00:12:54,160 walking boot here and it throws the hips off. 248 00:12:54,160 --> 00:12:56,840 This is the even up with The Walking boot. 249 00:12:56,960 --> 00:13:00,720 Their hips are more aligned and their gait is aligned. 250 00:13:01,080 --> 00:13:03,240 It's offered with everyone that's getting a walking boot. 251 00:13:03,280 --> 00:13:05,680 We recommend it. The staff are the ones that 252 00:13:05,680 --> 00:13:08,160 usually talk about it. It helps to avoid hip and knee 253 00:13:08,160 --> 00:13:11,400 issues due to walking with the boot being higher on one side 254 00:13:11,400 --> 00:13:13,800 than the other. Another option is to wear a shoe 255 00:13:13,800 --> 00:13:16,640 that has a higher heel. So some females that can wear a 256 00:13:16,640 --> 00:13:19,840 high heel, higher heel shoe, but a lot of people don't want to 257 00:13:20,040 --> 00:13:23,080 wear that all the time so that's called an even up formula. 258 00:13:23,080 --> 00:13:26,040 Seven. This is the the the medication 259 00:13:26,040 --> 00:13:31,920 that we have in the office, that's it's a it's anaphylate, 260 00:13:31,920 --> 00:13:34,000 it's 1%. It's an antifungal solution. 261 00:13:35,240 --> 00:13:39,560 It's used for nail fungus. You apply it twice a day and 262 00:13:39,760 --> 00:13:41,800 it's dispensed only in a doctor's office. 263 00:13:41,880 --> 00:13:43,480 So it's it's the one that we carry. 264 00:13:43,960 --> 00:13:46,560 We don't carry a lot of things for nails. 265 00:13:46,600 --> 00:13:49,440 We tend to do more like oral medication and things like that. 266 00:13:49,440 --> 00:13:52,520 But this is if someone who doesn't isn't a candidate or 267 00:13:52,520 --> 00:13:55,040 they want to do something in combination with the oral or 268 00:13:55,040 --> 00:13:56,760 laser treatment, they can do this. 269 00:13:56,760 --> 00:13:59,160 We're going to get into some of the pads. 270 00:13:59,160 --> 00:14:00,760 There's a lot of different pads that we use. 271 00:14:01,600 --> 00:14:04,600 This is called the the ball of foot cushion. 272 00:14:04,640 --> 00:14:07,400 This is used for metatarsalgia or pain to the ball of the foot. 273 00:14:07,960 --> 00:14:11,280 It's used for pain for pain for calluses. 274 00:14:11,800 --> 00:14:13,440 It doesn't work specifically on calluses. 275 00:14:13,440 --> 00:14:15,760 Usually have to trim the calluses down first if there's 276 00:14:15,760 --> 00:14:17,640 callous to trim and then you can put it on. 277 00:14:18,280 --> 00:14:21,400 If there's a really big callus, you have to take that off first. 278 00:14:21,400 --> 00:14:23,800 If there's a prominent bone in the bottom of the foot because 279 00:14:23,800 --> 00:14:25,560 of lack of fat pad, this can help as well. 280 00:14:25,560 --> 00:14:28,080 So for example, if the patient has a has hammer toes that kind 281 00:14:28,080 --> 00:14:31,080 of go up and there's a prominent bone there, or you can feel just 282 00:14:31,080 --> 00:14:33,480 the bone instead of the fat that's usually on there, you can 283 00:14:33,480 --> 00:14:35,440 use these. These can also be added to an 284 00:14:35,440 --> 00:14:40,080 orthotic, these metatarsal pads, that's what they're called, ball 285 00:14:40,080 --> 00:14:42,440 of foot pads. There's also arch pads, so these 286 00:14:42,440 --> 00:14:44,360 can be used if someone has a painful arch. 287 00:14:44,640 --> 00:14:47,640 They have high arch, weak arches, low arches, things like 288 00:14:47,640 --> 00:14:48,440 that. They can be. 289 00:14:48,480 --> 00:14:50,440 These are reusable. That's the benefit of this pad 290 00:14:50,440 --> 00:14:51,960 as well. These are reusable. 291 00:14:52,280 --> 00:14:55,040 What you do is you wear them and then you pull them off at night 292 00:14:55,280 --> 00:14:57,760 and then every few days it's going to get stuff stuck on 293 00:14:57,760 --> 00:14:58,960 them. So you wash them with soap and 294 00:14:58,960 --> 00:15:00,960 water and the stickiness will come back to them. 295 00:15:00,960 --> 00:15:02,600 All these gel pads are the same way. 296 00:15:03,760 --> 00:15:05,880 They they work well. Once again, this tries to lift 297 00:15:05,880 --> 00:15:08,280 up the arch a little bit. Once again, it can be done in 298 00:15:08,280 --> 00:15:10,080 orthotic as well. These are all like temporary 299 00:15:10,080 --> 00:15:13,000 things that you could try before you would make some unorthotic. 300 00:15:13,600 --> 00:15:17,280 Same thing, Same idea, but this is called the gel U pad. 301 00:15:17,280 --> 00:15:21,080 This is AU because of the area of pain you would cut out right 302 00:15:21,080 --> 00:15:22,680 here. So if there's a painful callus 303 00:15:22,680 --> 00:15:24,080 this would go all around that callus. 304 00:15:24,080 --> 00:15:27,240 You would trim the callus or the poral keratoma off. 305 00:15:27,560 --> 00:15:31,440 You could also use it to offload an ulcer, but usually an ulcer 306 00:15:31,440 --> 00:15:34,000 or you may be used for a pre ulcerative callus. 307 00:15:34,000 --> 00:15:36,560 That means a callus that's could be an ulcer in the future. 308 00:15:36,720 --> 00:15:38,880 Usually for an ulcer you're going to offload them in a 309 00:15:38,880 --> 00:15:43,920 surgical shoe or a walking boot heel cups. 310 00:15:43,920 --> 00:15:47,800 These are used for cracked heels along with some of the the heel 311 00:15:48,080 --> 00:15:49,880 sleep, heel socks and urea creams. 312 00:15:49,880 --> 00:15:53,240 They can also be used for for painful heels to offload to 313 00:15:53,240 --> 00:15:56,320 change the the pressure point. So a heel that is lacking some 314 00:15:56,320 --> 00:16:00,240 fat on the bottom so it's a a fat pad atrophy or just a a 315 00:16:00,240 --> 00:16:02,000 painful heel that you want to try to squish it. 316 00:16:02,000 --> 00:16:04,640 Some patients do well with this, some kids with severs do well. 317 00:16:04,920 --> 00:16:07,640 Some kids with some people with plantar fasciitis do well with 318 00:16:07,640 --> 00:16:11,680 these just to change the pressure point of of the of the 319 00:16:11,680 --> 00:16:14,320 heel and it kind of puts the pressure more to the sides than 320 00:16:14,320 --> 00:16:17,960 in the center. There are small and and large 321 00:16:17,960 --> 00:16:22,400 sizes and the the way to remember it is there's a sticker 322 00:16:22,400 --> 00:16:24,440 on them and you always step on the sticker so that when you 323 00:16:24,440 --> 00:16:27,440 tell patients they know what side to put up that the bottom 324 00:16:27,440 --> 00:16:29,280 part is the one where the sticker is OK. 325 00:16:29,320 --> 00:16:31,160 That's the easiest way to remind patients. 326 00:16:32,520 --> 00:16:34,880 Adjustable heel looks similar to what we looked at with the 327 00:16:35,040 --> 00:16:38,040 Achilles tendon. There is the adjustable heel 328 00:16:38,040 --> 00:16:42,640 lift as well, and this has three different levels you can see 329 00:16:42,640 --> 00:16:46,080 here, and you take these out, you can leave it in for a week 330 00:16:46,080 --> 00:16:47,880 or a month, it depends on how long you're going to be using 331 00:16:47,880 --> 00:16:50,520 it. It's it's used to reduce some of 332 00:16:50,520 --> 00:16:55,360 the pull on the Achilles and there's three levels used for 333 00:16:55,400 --> 00:16:57,920 Aquinas and Achilles tendon. You gradually reduce the height 334 00:16:57,920 --> 00:17:00,760 every two to four weeks and it can also be used for a limb 335 00:17:00,760 --> 00:17:03,320 length discrepancy. So if someone has a a longer 336 00:17:03,320 --> 00:17:05,400 limb you can put this in one of the shoes and not the other 337 00:17:05,400 --> 00:17:07,760 shoe. It's called the adjustable heel 338 00:17:07,760 --> 00:17:09,839 lift. This is a more expensive version 339 00:17:09,839 --> 00:17:11,480 of this one. This is a PPT lift. 340 00:17:11,480 --> 00:17:14,319 It's just instead of there's three levels right here you can 341 00:17:14,319 --> 00:17:18,200 see this one only has one of those levels and it's it's PPT. 342 00:17:18,200 --> 00:17:21,359 So it it it has a cushion to it so it's going to kind of bottom 343 00:17:21,359 --> 00:17:25,640 out can be used for them length discrepancy and it's it's 1/4 344 00:17:25,640 --> 00:17:29,560 inch so it's smaller heel so smooth. 345 00:17:29,560 --> 00:17:32,280 These are heel socks that we use for patients that have really 346 00:17:32,280 --> 00:17:36,200 bad cracked heels. We talked before about the Amira 347 00:17:36,200 --> 00:17:38,440 Gel blue. You can use Amira gel blue, but 348 00:17:38,440 --> 00:17:40,920 this really works better if there's bad cracks. 349 00:17:40,920 --> 00:17:44,840 So used for cracked heels, use this in conjunction with urea 350 00:17:44,840 --> 00:17:46,960 cream. So you can either put these on 351 00:17:46,960 --> 00:17:49,280 by themselves at night and then in the morning put on the urea 352 00:17:49,280 --> 00:17:50,800 cream. You can put them on together. 353 00:17:50,800 --> 00:17:52,600 If you put them on together though, it makes it dirtier 354 00:17:52,600 --> 00:17:54,920 because of the the cream that goes with the sock. 355 00:17:54,920 --> 00:17:57,960 But it's really good for dried cracked heels, the heel. 356 00:17:57,960 --> 00:18:02,560 So smooth heel sleeves, this is the other aspect to that. 357 00:18:02,560 --> 00:18:07,160 It's called a Cara combo. It's a pumice or pummy bar along 358 00:18:07,160 --> 00:18:09,640 with the Kara 42. This can be used along with this 359 00:18:09,640 --> 00:18:13,520 other sock. OK it the the cream is used to 360 00:18:13,520 --> 00:18:16,720 reduce callousing as well as cracks or fissures into the 361 00:18:16,720 --> 00:18:18,720 heels. It can be used with the pumice 362 00:18:19,160 --> 00:18:20,920 one to two times a week after showering. 363 00:18:20,920 --> 00:18:22,680 So you use the pumice, usually in the shower. 364 00:18:23,160 --> 00:18:25,560 And the pummy bar does not 'cause friction as a pumice 365 00:18:25,560 --> 00:18:27,800 stone does. Be careful though. 366 00:18:27,800 --> 00:18:30,560 If you use it all the time, it's gonna cause skin sloughing, so 367 00:18:30,560 --> 00:18:31,720 the skin's gonna be sloughing off. 368 00:18:31,720 --> 00:18:33,800 The patients might come in wondering why their skin is kind 369 00:18:33,800 --> 00:18:36,640 of sloughing off. This is the cream by itself, so 370 00:18:36,680 --> 00:18:38,080 there's a combo. There's a little discount if 371 00:18:38,080 --> 00:18:41,520 they do it with the combo. This is the cream just itself. 372 00:18:41,920 --> 00:18:48,960 OK, here's Cara nail gel. So Cara nail gel is used for 373 00:18:49,080 --> 00:18:51,560 thick toenails. It makes it easier for them to 374 00:18:51,560 --> 00:18:53,680 trim. It's made of tea tree oil 375 00:18:53,720 --> 00:18:57,000 menthol and it just makes it easier for it to trim it. 376 00:18:57,160 --> 00:19:01,320 I don't, I don't say it, it clears the fungus, but it just 377 00:19:01,320 --> 00:19:03,600 makes it easier to trim for some patients that have really thick 378 00:19:03,600 --> 00:19:07,000 nails that have a hard time trimming them on their own. 379 00:19:07,320 --> 00:19:12,720 That's the care and nail gel. Carey Flex This is an example of 380 00:19:12,720 --> 00:19:16,280 how to do Carey Flex. You take a a bad looking nail, 381 00:19:16,280 --> 00:19:18,720 you trim it all the way back and you make a kind of a fake nail 382 00:19:18,720 --> 00:19:21,400 on top of it. There's different steps to it 383 00:19:21,440 --> 00:19:23,000 usually stays on about three months. 384 00:19:23,840 --> 00:19:26,680 For the return application. There's usually a reduced price 385 00:19:26,680 --> 00:19:28,440 for the second application and the kit. 386 00:19:28,440 --> 00:19:30,040 The patients can bring it back themselves. 387 00:19:30,040 --> 00:19:33,400 Usually does 2 to 3 nails. Most patients come in the spring 388 00:19:33,400 --> 00:19:36,920 and the summer for this and they can apply nail Polish and use 389 00:19:36,920 --> 00:19:39,960 acetone remover afterwards. So it's a real simple thing Here 390 00:19:40,920 --> 00:19:43,840 there is an example of how to do this with this video. 391 00:19:43,960 --> 00:19:47,000 If you want to watch this video, you can you can do this. 392 00:19:47,000 --> 00:19:48,800 This kind of explains how to do it. 393 00:19:48,800 --> 00:19:52,520 You have the nail that you trim off all the way back to where 394 00:19:52,520 --> 00:19:55,160 it's attached. The first part you do is you 395 00:19:55,400 --> 00:19:58,240 there's a bonding agent. You apply the bonding agent and 396 00:19:58,240 --> 00:20:01,240 then use a little light and then you do the resin. 397 00:20:01,240 --> 00:20:04,480 You do a first application a little bit and then you put it 398 00:20:04,480 --> 00:20:08,160 underneath the light for usually 30 seconds initially just to 399 00:20:08,160 --> 00:20:10,400 harden it. Then you do another second step 400 00:20:10,760 --> 00:20:13,640 as well to make it look pretty and then afterwards you grind it 401 00:20:13,640 --> 00:20:16,360 down to make it look more like a a normal nail. 402 00:20:16,480 --> 00:20:19,120 So and then you. And then you put the light on 403 00:20:19,120 --> 00:20:21,040 again. So that's how you do it in the 404 00:20:21,040 --> 00:20:23,320 office. There's a couple of different 405 00:20:23,320 --> 00:20:24,960 types of lights that you can use. 406 00:20:25,720 --> 00:20:28,680 We have two different lights. One is the carry flex light and 407 00:20:28,680 --> 00:20:30,960 the other one is for the Anifix with the kind of two different 408 00:20:30,960 --> 00:20:36,760 lights that we use for this. KT taping is used to reduce 409 00:20:36,920 --> 00:20:39,880 strain on tissue. What it does is it actually 410 00:20:39,880 --> 00:20:43,360 lifts up the skin to allow increased blood flow to the area 411 00:20:43,360 --> 00:20:46,560 and reduces muscle soreness and provides flexible support. 412 00:20:46,560 --> 00:20:48,760 So we can use this for the Achilles for the plantar fascia, 413 00:20:49,000 --> 00:20:54,040 we do have KT tape in the office for for patients Lems. 414 00:20:54,040 --> 00:20:56,520 These are shoes that we sell. We sell these. 415 00:20:56,520 --> 00:20:59,560 We have usually the basic colors, but they can order them 416 00:20:59,560 --> 00:21:01,560 through it through US. No one else really has them. 417 00:21:01,560 --> 00:21:02,800 So we're one of the distributors. 418 00:21:03,160 --> 00:21:05,680 It's a zero drop shoe. It has an anatomic toe box. 419 00:21:06,120 --> 00:21:08,800 It's lightweight, it's good if a patient likes to go barefoot, 420 00:21:09,320 --> 00:21:12,560 and it can be worn with some orthotics, but many do not wear 421 00:21:12,560 --> 00:21:16,240 with orthotics and we sorry, we carry them in the office. 422 00:21:16,640 --> 00:21:19,280 There are different types of shoes that we recommend. 423 00:21:19,280 --> 00:21:21,440 Usually it's ultras, Topos and Lens. 424 00:21:21,440 --> 00:21:22,840 They're more of an anatomic shoe. 425 00:21:23,760 --> 00:21:27,120 This is a like that other pad that we saw before, the gel pad. 426 00:21:27,120 --> 00:21:30,760 This is a metatarsal pad. It's APT the same thing as that 427 00:21:30,760 --> 00:21:34,520 other lift that we saw, and it it used to offload painful 428 00:21:34,520 --> 00:21:36,520 metatarsal region. It this is applied directly to 429 00:21:36,520 --> 00:21:39,400 the shoe, though the other one was applied to the foot itself, 430 00:21:39,800 --> 00:21:42,280 it's stuck on. This one sticks to the liner and 431 00:21:42,280 --> 00:21:44,400 once again it can be incorporated in an orthotic. 432 00:21:44,400 --> 00:21:46,680 If someone has an orthotic or you want to test it out on top 433 00:21:46,680 --> 00:21:49,920 of their current orthotic and you have to determine what's 434 00:21:49,920 --> 00:21:51,880 right and left, this is always a struggle for the staff. 435 00:21:52,040 --> 00:21:53,440 This is an example of the right one. 436 00:21:53,560 --> 00:21:57,160 Once again, the bigger part goes on the medial side or towards 437 00:21:57,160 --> 00:21:59,120 the big toe. That's how you can tell the 438 00:21:59,120 --> 00:22:02,240 larger part indicates the the medial part or the part that 439 00:22:02,240 --> 00:22:04,920 goes towards the arch region is the bigger part for you when 440 00:22:04,920 --> 00:22:06,240 you're looking at the right or left. 441 00:22:07,640 --> 00:22:10,040 This is an example of a metatarsal pad that can be 442 00:22:10,040 --> 00:22:13,200 applied similar to the gel one that we saw before, but this is 443 00:22:13,200 --> 00:22:15,640 a felt one and this is attached to the foot. 444 00:22:15,640 --> 00:22:17,560 I find the gel one just work better because they can be 445 00:22:17,560 --> 00:22:19,720 reused. This is more of like a temporary 446 00:22:19,720 --> 00:22:23,880 thing. Mycol Mist is used to spray our 447 00:22:23,880 --> 00:22:25,600 shoes, the shoes of the patients. 448 00:22:25,920 --> 00:22:28,680 It's less harmful than Lysol. You spray it in the shoe and you 449 00:22:28,680 --> 00:22:30,960 put them in a plastic bag overnight and we tend to use 450 00:22:30,960 --> 00:22:33,160 this in conjunction with the shoe sterilizer. 451 00:22:33,160 --> 00:22:36,040 For patients that are dealing with athlete's foot or nail 452 00:22:36,040 --> 00:22:40,840 fungus, it's called Mycol Mist splay or Naboso splay. 453 00:22:41,240 --> 00:22:42,920 These are similar to the correct toes, but they're 454 00:22:42,920 --> 00:22:47,120 one-size-fits-all and they don't have different sizes they're 455 00:22:47,120 --> 00:22:48,760 used to wear with anatomic shoes. 456 00:22:48,760 --> 00:22:50,840 They're less expensive than the correct toes, and here's some 457 00:22:50,840 --> 00:22:53,920 links to some webinars if you want to learn more about them. 458 00:22:55,400 --> 00:22:58,040 Northwest Dress Sets. These are some dress orthotics 459 00:22:58,040 --> 00:23:00,360 that we do for patients. Let's say they wear a dress shoe 460 00:23:00,360 --> 00:23:02,560 or they wear flats. This is an example of one that 461 00:23:02,560 --> 00:23:05,440 you can put in their flat flats. This is one for there's high 462 00:23:05,440 --> 00:23:07,840 heel one as well. They take up less room than 463 00:23:07,840 --> 00:23:11,480 normal orthotics and they can be used for under 3 inches, which 464 00:23:11,480 --> 00:23:14,520 is this one, or over 3 inches, which is this higher one. 465 00:23:14,920 --> 00:23:17,160 If you want more information from Northwest, you can click 466 00:23:17,160 --> 00:23:22,160 the link that's there as well. These are prefabricated 467 00:23:22,160 --> 00:23:23,640 children's orthotics that we have. 468 00:23:23,640 --> 00:23:26,440 They come based on colors and you hold them up to the arch of 469 00:23:26,440 --> 00:23:31,960 the foot and they have, they have a deep UCBL type of device 470 00:23:31,960 --> 00:23:33,920 for for a flexible fat flat foot. 471 00:23:34,360 --> 00:23:36,880 Once they don't fit then we get the patients into a custom 472 00:23:36,880 --> 00:23:39,040 device. We see the patients back usually 473 00:23:39,040 --> 00:23:41,120 yearly to make sure they're fitting well and then they can 474 00:23:41,120 --> 00:23:43,360 get the next size up that usually it's every year to year 475 00:23:43,360 --> 00:23:44,680 and a half they're going to go up a size. 476 00:23:45,160 --> 00:23:48,320 When the arch is is hitting too far forward, it's time to get a 477 00:23:48,320 --> 00:23:50,720 larger size. So when this arch right here is 478 00:23:50,720 --> 00:23:53,320 fitting, hitting too far forward and their foot, they'll be in 479 00:23:53,480 --> 00:23:56,200 for a new pair. But now when I use tell 480 00:23:56,200 --> 00:23:58,040 patients, they don't create an old arch. 481 00:23:58,040 --> 00:24:01,040 I tell the parents that they just really give us stability 482 00:24:01,040 --> 00:24:03,840 for the heel region and they help the the foot to function a 483 00:24:03,840 --> 00:24:05,720 little bit better. This is an example of some of 484 00:24:05,720 --> 00:24:07,400 the orthotics. Now we have two different 485 00:24:07,400 --> 00:24:08,920 friends that we normally use in the office. 486 00:24:08,920 --> 00:24:11,880 One's called forward motion and one is called a Northwest. 487 00:24:12,720 --> 00:24:15,400 For all the orthotics, I tend to say that they last about five 488 00:24:15,400 --> 00:24:17,040 years. This one's a little bit less 489 00:24:17,040 --> 00:24:18,520 expensive than the Northwest one. 490 00:24:18,840 --> 00:24:22,440 That Northwest, some of them can be a larger device and we use a 491 00:24:22,440 --> 00:24:24,200 foot scanner. Here's a link to their website. 492 00:24:24,200 --> 00:24:27,360 This is an example of one from forward motion. 493 00:24:27,360 --> 00:24:29,000 A lot of times we use a full length one. 494 00:24:29,880 --> 00:24:33,560 This is their prescribing paper. I just wanted to go over this a 495 00:24:33,560 --> 00:24:38,800 little bit because when we're filling this out for patients, 496 00:24:39,160 --> 00:24:41,480 we want to know if we're going to do a functional orthotic and 497 00:24:41,480 --> 00:24:43,760 athletic address an accommodative. 498 00:24:43,760 --> 00:24:47,480 This is like with for the diabetic ones, the accommodative 499 00:24:47,560 --> 00:24:50,800 similar and then there's some children's, this UCBL and some 500 00:24:50,800 --> 00:24:53,920 of these gate plates. So this is all in the app that 501 00:24:53,920 --> 00:24:55,880 we have now. But this is just an example to 502 00:24:55,880 --> 00:24:58,200 kind of explain things. There's different shells that we 503 00:24:58,320 --> 00:25:00,720 we might want to do like a graphite is a typical one, or 504 00:25:00,720 --> 00:25:03,880 polypropylene which are common ones that we do. 505 00:25:04,240 --> 00:25:09,120 Then we put the arch height that we want, low, medium, high or 506 00:25:09,120 --> 00:25:12,960 total contact if it's a very high arched foot flanges, which 507 00:25:12,960 --> 00:25:15,760 are little extensions that can go both on the inside medial and 508 00:25:15,760 --> 00:25:18,320 lateral. A mild medial is good, a bit 509 00:25:18,320 --> 00:25:20,720 whole medial might be really hard for someone to fit. 510 00:25:21,200 --> 00:25:23,560 There's a lateral, a deep heel cup. 511 00:25:24,400 --> 00:25:25,800 Then you want to talk about the heel cup. 512 00:25:26,000 --> 00:25:28,680 Usually we do the the deeper the heel cup, the more stability the 513 00:25:28,680 --> 00:25:32,200 foot gets. The OR thought of width most are 514 00:25:32,200 --> 00:25:35,920 normal but if there's a really wide foot we'll do a wide and 515 00:25:35,920 --> 00:25:37,640 then there's different postings that you do. 516 00:25:37,640 --> 00:25:40,240 You might want to do extrinsic posting. 517 00:25:40,240 --> 00:25:45,040 Most of the time we do intrinsic posting unless it's a very flat 518 00:25:45,040 --> 00:25:47,560 foot and there's different top covers. 519 00:25:48,480 --> 00:25:52,680 Eva Vinyl leather neoprene is one for like athletes, diabetic 520 00:25:52,680 --> 00:25:56,720 micro pores at Cushionier one and you can see these all on 521 00:25:56,720 --> 00:25:58,720 their website. And then the top cover length 522 00:25:59,400 --> 00:26:02,120 you can either go just the shell only like this previous picture 523 00:26:02,120 --> 00:26:03,720 I showed you. This is the shell only. 524 00:26:04,120 --> 00:26:06,640 You can go to the sulcus which is underneath the toes or you 525 00:26:06,640 --> 00:26:09,440 can go full length and there's different types of padding that 526 00:26:09,440 --> 00:26:11,040 you can put in there. And then these are different 527 00:26:11,040 --> 00:26:13,640 accommodations similar to the accommodations we talked about 528 00:26:13,640 --> 00:26:17,920 before that we can put on the on the shoes or on the foot. 529 00:26:17,960 --> 00:26:20,720 There's metatarsal pads, arch pads. 530 00:26:20,960 --> 00:26:24,000 First Ray cut out to help the first Ray move better morning's 531 00:26:24,000 --> 00:26:29,720 extension to to not allow the big toe joint to move as much 532 00:26:31,000 --> 00:26:34,000 for metatarsal cutouts, for painful calluses, arch 533 00:26:34,000 --> 00:26:38,600 reinforcements, amputee sponge fills, dancers, pads, those are 534 00:26:38,600 --> 00:26:40,600 to offload the different areas of the foot. 535 00:26:40,640 --> 00:26:43,440 So that's that's an example of the forward motion. 536 00:26:43,440 --> 00:26:45,680 Here there's an example of the Northwest orthotics. 537 00:26:47,200 --> 00:26:48,840 These once again used the last five years. 538 00:26:48,840 --> 00:26:50,800 They're a little bit more expensive than forward motion. 539 00:26:51,640 --> 00:26:54,280 The carbon fiber is very comfortable for our patients, 540 00:26:54,280 --> 00:26:57,080 takes up less space in the shoe. They have a very good posterior 541 00:26:57,080 --> 00:26:59,880 tibial tendon or very for flat feet is a very good device. 542 00:27:00,320 --> 00:27:04,800 Here's a link to to those ones. They have a little bit more of a 543 00:27:04,800 --> 00:27:08,680 complex prescription, but they do have these. 544 00:27:09,160 --> 00:27:11,400 You can select like what they're being used for, like if they 545 00:27:11,400 --> 00:27:13,560 have flat foot or plantar fasciitis, you can just pick 546 00:27:13,560 --> 00:27:16,040 this and it'll put in all the other things for you, which 547 00:27:16,040 --> 00:27:18,400 makes it a little bit easier. If you want to use one of their 548 00:27:18,400 --> 00:27:22,440 setups, they have one very good super glass, one for posterior 549 00:27:22,440 --> 00:27:25,600 tibial tendon or flat foot that that's a very good one for our 550 00:27:25,600 --> 00:27:26,880 patients. They have dress ones. 551 00:27:27,240 --> 00:27:31,760 You can pick once again the type of foundation, the type of top 552 00:27:31,760 --> 00:27:34,120 cover, the types of cushions, which is very similar to the 553 00:27:34,120 --> 00:27:37,920 other ones. Here are the activity like on 554 00:27:37,920 --> 00:27:40,400 what's included in the orthotics and here's all the different 555 00:27:40,400 --> 00:27:42,840 pads that you can add to that. We'll do a different one later 556 00:27:42,840 --> 00:27:43,840 on. That's going to explain a little 557 00:27:43,840 --> 00:27:47,560 bit more about that. We have an offer with a second 558 00:27:47,600 --> 00:27:50,240 pair of orthotics within six months at $200 off. 559 00:27:50,240 --> 00:27:53,600 This goes in with every orthotic that patients get and then put 560 00:27:53,600 --> 00:27:56,840 it in there so they can use this for dress shoes, gym shoes, 561 00:27:56,920 --> 00:27:59,280 soccer cleats, golf shoes, ski boots, cycling boots. 562 00:27:59,440 --> 00:28:02,040 So something that the staff should offer to the patients. 563 00:28:03,360 --> 00:28:06,080 They extend this for six months helps increase compliance and 564 00:28:06,080 --> 00:28:09,760 and improvement and it's good for for a lot of our patients. 565 00:28:09,760 --> 00:28:11,600 So you can just be offering that to them as well. 566 00:28:13,600 --> 00:28:15,640 There's some orthotic add-ons I want to go over. 567 00:28:16,120 --> 00:28:18,880 There is refurbishing so many times the top cover gets worn 568 00:28:18,880 --> 00:28:24,720 out and it usually about a hundred $100 and then but it's 569 00:28:24,720 --> 00:28:26,680 less than the price of a new pair. 570 00:28:27,600 --> 00:28:29,840 The orthotics are protected against cracking, so usually 571 00:28:29,840 --> 00:28:32,920 they do a new pair for free if it cracks, but if they just need 572 00:28:32,920 --> 00:28:36,160 to refurbish they drop it off and many times we'll scan them 573 00:28:36,160 --> 00:28:38,520 for a new pair, get them a new pair and then refurbish the old 574 00:28:38,520 --> 00:28:39,960 pair so they'll have a second pair. 575 00:28:40,880 --> 00:28:43,240 There's a rush charge if they want quicker production, like if 576 00:28:43,240 --> 00:28:46,280 they're traveling or going to school, there's an orthotic scan 577 00:28:46,280 --> 00:28:48,840 only, and this is for for example, Pediatrics. 578 00:28:48,840 --> 00:28:52,640 If they outgrow the orthotics, they they don't have to pay for 579 00:28:52,640 --> 00:28:55,000 the whole device, they're just a scanning fee and there's an 580 00:28:55,000 --> 00:28:56,720 orthotics or shoe shipped to the home. 581 00:28:56,720 --> 00:28:59,360 So this is usually for students or people living in another 582 00:28:59,360 --> 00:29:02,360 state another part of the year so you can ship things to them. 583 00:29:02,360 --> 00:29:04,240 There's a little add on fee for that. 584 00:29:05,000 --> 00:29:06,400 This is a plantar fasciitis sleeve. 585 00:29:06,400 --> 00:29:09,080 This is a compression sleeve that can be used around the 586 00:29:09,080 --> 00:29:11,280 foot. This is the proper way of 587 00:29:11,280 --> 00:29:13,360 putting it on. It comes in different colors. 588 00:29:13,400 --> 00:29:14,560 It can be used for plantar fasciitis. 589 00:29:14,560 --> 00:29:16,360 It's called the plantar fasciitis sleeve, but it can be 590 00:29:16,360 --> 00:29:17,680 used for anything where they're swelling. 591 00:29:17,680 --> 00:29:22,000 You can use different fractures for tendonitis for swelling, and 592 00:29:22,000 --> 00:29:24,080 you can even use it to transition after they're in. 593 00:29:24,080 --> 00:29:25,800 An ankle brace for an ankle sprain. 594 00:29:29,000 --> 00:29:33,520 Here is an orb massage ball. So this is a massage ball that's 595 00:29:33,520 --> 00:29:37,680 used to reduce soft tissue tightness, Helps improve soft 596 00:29:37,680 --> 00:29:40,680 tissue recovery for the quads, IT band and hamstrings. 597 00:29:41,920 --> 00:29:44,600 Here's an example of a pro tech Achilles sleeve. 598 00:29:44,600 --> 00:29:49,120 This has some these bladders here of of air or cushion that 599 00:29:49,320 --> 00:29:51,760 help reduce by putting compression on the Achilles. 600 00:29:51,920 --> 00:29:54,680 It's for non insertional Achilles pain to make it feel 601 00:29:54,680 --> 00:29:56,760 better. This is an example of a foam 602 00:29:56,760 --> 00:29:57,760 roller. There's a couple of different 603 00:29:57,760 --> 00:30:00,680 types of foam rollers. This is a contoured foam roller 604 00:30:00,680 --> 00:30:02,120 that penetrates a little bit deeper. 605 00:30:02,200 --> 00:30:05,040 You can use it for the calves, for the quads, the IT 606 00:30:05,160 --> 00:30:08,000 hamstrings, things like that. This is one that's a little bit 607 00:30:08,000 --> 00:30:11,080 easier to travel with because it has a hollow roll in it, hollow 608 00:30:11,080 --> 00:30:13,960 hole and you can when you travel, you can put your clothes 609 00:30:13,960 --> 00:30:16,840 in there and it's easier to fit in there, but it's the same 610 00:30:16,840 --> 00:30:19,200 thing as the other one. This is a just a mini ball, but 611 00:30:19,200 --> 00:30:22,240 this is more of the foot or different areas of the calf that 612 00:30:22,240 --> 00:30:24,760 prototes flexibility. And this one you can heat up so 613 00:30:24,760 --> 00:30:28,080 it has some kind of softens the soft tissue as you do it. 614 00:30:29,000 --> 00:30:31,800 Here's an example of the pummy bar that we use similar type 615 00:30:31,800 --> 00:30:34,880 where it buffs off as you're using it, it will disintegrate. 616 00:30:35,160 --> 00:30:36,680 OK, you use this along with the cream. 617 00:30:37,480 --> 00:30:40,040 It doesn't really 'cause friction in using the shower to 618 00:30:40,040 --> 00:30:41,680 remove any of the dry callous skin. 619 00:30:41,680 --> 00:30:44,200 Once again, if patient's a diabetic, you have to be careful 620 00:30:44,200 --> 00:30:46,640 not to cause any sores if they scrub things too much. 621 00:30:48,680 --> 00:30:50,080 Here's an example of the Shoos app. 622 00:30:50,080 --> 00:30:51,720 This is the one that we're using currently. 623 00:30:52,280 --> 00:30:55,600 Use it for 15 minutes and it's usually done with nail fungus 624 00:30:55,600 --> 00:30:57,640 treatments like Luneola or Lamisil. 625 00:30:58,600 --> 00:31:02,000 It can help kill the fungus and bacteria that cause athlete's 626 00:31:02,000 --> 00:31:06,200 foot, fungal nails, foot and shoe order and and diabetic 627 00:31:06,200 --> 00:31:07,960 infections. So here's some example. 628 00:31:07,960 --> 00:31:10,640 You can go to their website to look more about it, but it's 629 00:31:10,640 --> 00:31:13,960 helpful for for patients for their shoes versus buying new 630 00:31:13,960 --> 00:31:17,040 shoes all the time. This is an example of a shower 631 00:31:17,040 --> 00:31:18,720 bag. This can be used for both a cast 632 00:31:18,760 --> 00:31:21,560 and also if patients have surgery and they have sutures or 633 00:31:21,560 --> 00:31:24,120 stitches. My patient, our patients usually 634 00:31:24,120 --> 00:31:27,160 leave before they have surgery with these and that I recommend 635 00:31:27,160 --> 00:31:29,440 they try these on before surgery to make sure that there's no 636 00:31:29,440 --> 00:31:31,520 leaks. It doesn't leak in. 637 00:31:32,200 --> 00:31:33,800 This is an example of a toe alignment split. 638 00:31:33,800 --> 00:31:35,840 We don't use this that often, but occasionally with a bunion 639 00:31:35,840 --> 00:31:37,560 or a hammer toe, we want to hold things in place. 640 00:31:37,880 --> 00:31:40,040 And these are little straps where you can kind of pull the 641 00:31:40,040 --> 00:31:43,200 toe down and stabilize it to this Velcro piece right here. 642 00:31:43,480 --> 00:31:46,040 So it can it can stabilize A bunion or a hammer toe or a 643 00:31:46,040 --> 00:31:49,240 tailor's bunion. Here are some toe caps. 644 00:31:49,240 --> 00:31:52,640 These are gel toe caps. These are good for the big toe 645 00:31:52,640 --> 00:31:56,000 and the smaller toes. They can be helpful for painful 646 00:31:56,000 --> 00:31:59,720 calluses on the tops or the tips of the toes, and they can reduce 647 00:31:59,720 --> 00:32:02,480 pressure. They're not directly supposed to 648 00:32:02,480 --> 00:32:05,000 be used on ulcers, but they're usually used to prevent the 649 00:32:05,000 --> 00:32:08,480 ulcers from happening. Another type is a silicone tip 650 00:32:08,560 --> 00:32:11,920 once again for a painful callus or an ulcer region that you want 651 00:32:11,920 --> 00:32:14,480 to a pre ulcerative callus that you want to reduce that rubbing 652 00:32:14,480 --> 00:32:18,200 from toe spreader. This is used to spread between 653 00:32:18,200 --> 00:32:20,040 the 1st and 2nd toe. The biggest problem what this is 654 00:32:20,040 --> 00:32:22,720 it falls out all the time so you have to put socks on and try to 655 00:32:22,720 --> 00:32:25,880 find it if you lose it but it works quite well just to space 656 00:32:25,880 --> 00:32:27,160 out. Some people feel better if you 657 00:32:27,160 --> 00:32:30,200 just space out the bunion from the second toe, just pushes it 658 00:32:30,200 --> 00:32:33,000 over a little bit, helps realign the joint and makes some people 659 00:32:33,000 --> 00:32:36,240 feel better. This is a gel. 660 00:32:36,240 --> 00:32:40,160 This is AU pad that's made out of felt that we have. 661 00:32:40,160 --> 00:32:42,600 I think we have the felted ones or foam ones in the office and 662 00:32:42,600 --> 00:32:46,520 you stick it to the bottom and instead of felt it's foam. 663 00:32:46,920 --> 00:32:49,960 We have this felt and it sticks on the bottom of the foot and it 664 00:32:49,960 --> 00:32:52,600 offloads areas the similar to the gel one, but this is just 665 00:32:52,600 --> 00:32:55,440 made out of a different fabric. It usually has adhesive on one 666 00:32:55,440 --> 00:32:58,200 side and it can be placed also on the on the sock line or in 667 00:32:58,200 --> 00:33:02,400 the shoe for the patients. So the next one we're going to 668 00:33:02,400 --> 00:33:04,640 go over is durable medical equipment, but we're going to 669 00:33:04,640 --> 00:33:05,880 stop this one for now.