After completing my Master’s degree, my goal was to become certified as a Pedorthist. The field of Pedorthics is small and is based almost entirely on hands-on experience. The only way to become a Pedorthist is to work as a Pedorthist. I had to collect 1,000 patient treatment hours under the supervision of someone who was already certified as a Pedorthist. I was also required to complete some online and in-person classes through an accredited pre-certification program. I wasn’t worried about the classes, but I knew that it would be hard to find a good place to do my apprenticeship.  I was hoping to work in a small facility that would have both a clinic and a lab on site so that I could learn both ends of the industry. I also really wanted to work for someone who had been in the business for years and years and would be able to teach me all the best tricks.

Miraculously, I found a place that met all my requirements, and I went to work for a Pedorthic facility called Richelson’s Feet First in Plymouth, NH. What a great learning experience!  Paul Richelson, the owner, is an ABC certified Pedorthist and also a MasterFit ski boot fitter. He has been making orthotics for over 30 years, and he is great at it. Even before I was hired, I had determined that I wanted nothing to do with the ski boot side of the business (for one thing, I don’t ski; for another thing, it is a big deal if you make a mistake on an $800 ski boot).

Paul working on a ski boot (candid shot – sorry Paul…)

 

Paul decided that it would be OK if I worked only on the “street” orthotics (meaning the people who need orthotic correction in their everyday lives, either to treat or prevent injury).  For the first couple of weeks, I stood behind him and listened while he evaluated patients and modified orthotics. One thing that Paul always included in the appointment was a careful gait analysis. We would sit on our little exam stools at the end of the “runway” (which is just the long open space at the front of the office) and watch the customers walk back and forth. From day one, Paul tested me to see if I could detect the problems in a patient’s gait. It turns out that I had what he called “a good eye” for picking up irregularities in the way someone was walking. Paul is so proficient at this skill that he can tell exactly what area of the orthotic needs to be adjusted based on the patient’s foot strike pattern. He patiently pointed out what he was seeing, and soon I was able to do it too (although it will take me 30 more years to be as practiced at it as he is).

The main patient area

 

After a little time of “shadowing” Paul, I was ready to start doing some parts of the evaluations on my own. Paul supervised me carefully at first to make sure I didn’t skip any steps. As I got more comfortable with the job, we developed a system of “tag team” where I would begin the appointment and do most of the evaluation, and then Paul would come in and check things over and finish up with the patient. This was a really good system because it made sure that the quality of care did not decline as Paul integrated me into the practice.  I really appreciated this because it didn’t put too much pressure on me all at once, and I am sure that the patients were glad that they weren’t being used as guinea pigs to train the new girl. After a few months of tag teaming, I was ready to see patients on my own, but if I ever needed anything all I had to do was call for Paul’s help and he would bail me out.

My little exam room

 

Because I came to Feet First with a background in Sports Medicine and Kinesiology, I had a good base of knowledge about the workings of the foot and ankle as well as an understanding about the entire “kinetic chain” which is a shorter way of saying “how all of your muscles and bones move and work together”.  Paul and I soon figured out how to combine our different areas of expertise to tackle the most difficult problems. He would call me over to talk about chronic muscle soreness and I would borrow his expert eye to adjust a particularly difficult orthotic.

Meanwhile, Marie, who is the office coordinator/ secretary/ organizer of things in general, must have had a terrible time trying to figure out how to schedule patients so that we would not run over the allotted time. I was really slow at first and she had to calculate that I would take twice as much time as Paul for any given task, but practice makes perfect, and after a while I could finish with a patient after the prescribed 30 or 60 minutes.

Marie at “Mission Control”

 

At Feet First, all of the custom orthotics are made from scratch in their own little lab. This gave me great practice seeing and performing each step of the orthotic fabrication and fitting process. Plaster molds of each patient’s feet are created so that we can shape the orthotic exactly to fit them. Raw materials are cut out on a band-saw and heated to a high temperature before they are vacuum pressed onto the plaster mold. After the molding process, large grinders are used to shape the orthotic and adjust it to fit into the patient’s shoe. All of these steps take a certain amount of skill and finesse that can only be acquired by practice. Paul and Marie and Joe (who works in the lab and is, as he puts it “a shaper of materials”) taught me how to do each stage of the lab work. My two favorite parts of the lab work were the vacuum forming and the grinding. It was so fascinating to see flat, basic materials take on the shape of an orthotic – and it was even cooler to see how much of a change I could make in the way someone walked. Talk about a rewarding job.

Joe in the lab

 

While I was working at Feet First, I also started taking my Pedorthist classes. I chose to take the courses offered by the Robert M Palmer Institute of Biomechanics. I began doing the online component last February, and flew out to their school in Indiana for 10 days of in-person instruction in March. It was during these classes that my doom came upon me (just being overdramatic in case you had started falling asleep)…I realized that I love school. I had thought that I was tired of being a student, but I was wrong. I had planned to eventually, possibly, someday, go on to get my PhD. But while in Indiana, I realized that this was something that I actually wanted to do – like soon. Part of this realization came because I noticed that the materials we were studying were ridiculously outdated and substandard. This means that the field of Pedorthics needs some new researchers and textbook writers. I could do that.  I also had been aware of “missing” the rest of the body. I do find the foot and ankle complex fascinating – but what about the knees and hips and back? I discovered that I want to fix more than just feet.

When I came back from Indiana I told Paul the bad news. I was going to have to move on. I was really torn about this decision because I loved working at Feet First. But I was excited about the possibilities that might open up for me in the future. I knew that it would take me a while to figure out what my next step would be, so I decided to work at Feet First through the fall. This would give them enough time to find someone to replace me, and I could continue working until I completed my Pedorthist certification.

Well, I passed my BOC Pedorthist exam in September. Yay! I am now all official and certified. I can fabricate and fit custom orthotics and AFOs (which stands for Ankle, Foot Orthoses).  Paul and Marie found a guy named Geoff to work at Feet First. He started “shadowing” me during November and he is learning quickly. He will be up to speed in no time.

Geoff in the lab.

 

 I finished my last day of work at Feet First on the Tuesday before Thanksgiving.  Paul and Marie and Joe and Geoff sent me off with a delicious goodbye dinner and huge basket of snacks and goodies. I am going to miss those guys. But I feel like a recent graduate. Like there are endless possibilities in front of me. I am shopping for university programs and looking for jobs near schools that offer PhDs in my field. Who knows what the future may hold!

Don’t worry, I am going to continue this blog…you will be hearing from me.

Walk well.

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