I agree the potential for abuse exists in the sale of orthotics. As usual "caveat emptor" is good advice. However, I found it ridiculous that you would expect a company (the orthotic manufacturer) to NOT run ads that show the business benefit of reselling their product. Also, I thought the attack on the "ethical" chiropractor to be unnecessary as well - You sent a spy in (let's discuss ethics here) with good feet who did complain of a sore back. After he was examined, the chiropractor recommended orthotics as another method of assisting with back pain, which seems logical. No crime transpired and who knows, maybe the guy with good feet will have improved function with his back - or was that also a lie? Posted by: Jacqueline | Feb 20, 08 07:53 PM

I agree that abuse in the orthotic industry is rampant. However, I think the real question is when is the prescription of orthotics warranted and who is qualified to prescribe them? No profession can agree on medical indications for orthotics, therefore the insurance companies side with the professions that prescribe less and do not dent their bottom line. Posted by: Andy | Feb 20, 08 08:40 PM

Where can I buy the $ 12.00 cables? Posted by: John Boorsma | Feb 20, 08 08:53 PM

My chiropractor explained the benefits of orthotics and was very happy to perform the mold procedure. However, MOST extended health care plans in Canada DO NOT cover orthotics UNLESS the diagnosis, assessment and mold procedure are done by a registered foot doctor. I had to fight to get my $300.00 back. Chiropractors should not be recommending this procedure to be done by themselves, but to make a referral to a registered foot doctor. Posted by: Kari Boult | Feb 20, 08 09:55 PM

The program was a gentle warning to consumers about the financial pitfalls of orthotics . I would like to see a follow up with the physical damage that can be done as a result of incorrectly fitting orthotics. It would also be beneficial to understand the different functions of podiatrists vs. other foot experts and where to go for help to undo the damage. I have permanently deformed feet because of this. Muscle spasm, toe, foot, hip and knee pain, back pain. I spent close to $900 with my original podiatrist and easily another $1000 with physiotherapy, consultations with other podiatrists, chiropractors, over the counter aids, etc. The Quebec podiatrist association's solution is to take the podiatrist to court. Posted by: Sharon Rundle | Feb 20, 08 09:58 PM

The abuse of orthotic prescription and dispensing has been a common problem for years in all healthcare disciplines. The truth of the matter (and this has been argued among all foot care specialists including, podiatrists, chiropodists, pedorthists, orthopedic specialists, sports MDs and doctors of chiropractic) is that there is no current "gold standard" for the examination, assessment, prescription and manufacture of orthotics. All studies to date suggest there is no difference in effectiveness of orthotics produced by casting by foam or plaster in the traditional "subtalar neutral position" vs that of gaitscan technology which includes a thorough examination and foam casting in subtalar neutral position (which in itself is debatable if it even exists). The gaitscan is not a diagnostic device but a tool to be used as part of the entire examination to pick-up discrepancies that the eye does not see. Unfortunately this chiropractor has been highlighted in this segment but there are just as bad examples that occur at the hands of other specialists prescribing, and selling comparable orthotic devices for more than a $1000.00 dollars. Now that is truly a crime. I am a healthcare professional who has experienced these techniques and devices and none are any good unless the professional does a complete and competent examination. What it boils down to is that all healthcare disciplines need to monitor the behaviors of its members and adequately police the individuals perpetuating unethical behavior. Posted by: Annonymous | Feb 20, 08 10:03 PM

While your segment seemed to be a "passive attack" on chiropractors who use Gait Scan in their practice, what I believe you failed to address was that many practitioners actually utilize a combination of visual gait analysis, orthopedic physical testing, functional movement screens, plaster casts, AND Gait Scan when assessing the need for the use of orthotic devices as a clinical management tool. However, in my opinion the problem does NOT lie in the medical professionals themselves but in those who prescribe orthotics that ARE NOT medical or allied health professionals. As a health care practitioner who has the privilege and 11 years of relevant post-secondary education to prescribe these orthotics, I am disappointed in the orthotic manufacturer(s) who allow business people who have little to no training in any health care field (other than a weekend seminar) to have equal rights to dispensing these products. In a future segment, I highly suggest you investigate this sub-population of privileged orthotic dispensers. Posted by: Anonymous | Feb 20, 08 10:04 PM

Thank you so much for your expose of the orthotics industry. Seeing people who have been ripped off by shady "practitioners" is part of my daily life as an orthotist. This field is truly buyer beware. There are no laws preventing anyone from providing the service, regardless of their lack of knowledge and training in anatomy, biomechanics and pathology (let alone fabrication). Until 3rd party payers understand that there IS a difference in service, we will not see any dramatic changes. Anyone who can write a prescription for an orthopedic device, as well as provide them, I would be wary of. It would be like visiting your family doctor, and having to pick up your tylenol 3's from his receptionist! Your story is a step in the right direction. I found it especially comical that the gentleman from the Orthotic Group mentions 4 types of practitioners who they encourage to use their product (chiropractors, physical therapists, podiatrists, chiropodists), and fails to mention the TWO fields who ARE nationally recognized as the specialists in foot orthotic design (pedorthists, orthotists) I suppose this is because anyone who truly knows about the foot and the mechanics of the foot would not affiliate themselves with companies such as the Orthotic Group. Thanks again for this story. Jen Halliday BSc CO(C) Posted by: Jennifer Halliday BSc CO(C) | Feb 20, 08 10:08 PM

Regarding the use of foot orthoses as a treatment for low back pain. This notion is often stated as "fact" by some health care practitioners. In reality, there is currently little, if any, evidence in the peer-reviewed medical literature to directly support this association. Accordingly, ethical (and well-read) practitioners would not likely make such a claim. Posted by: Leslie | Feb 20, 08 10:36 PM

Several years ago I saw a podiatrist about a small blister-like cyst on toe. The cyst got drained. My walk was observed and I was ‘prescribed’ orthotic inserts. As added incentive I was told that they would probably help my lower back pain. I felt uneasy when I saw that more than half a dozen impressions had already been made that day. How could so many clients' problems be solved by inserts? And at $350. per client. Wow. The cyst returned a few times. I self-treated. Daily yoga has practically cured my sciatic pain. Should I sell the inserts through the Bargain Finder? Or will the Sally Ann sell these in their thrift store? Money lures ‘experts;’ experts lie to their clients for the money, then lie to themselves to ease their consciences. Posted by: jane | Feb 20, 08 10:49 PM

It's unethical to send it an undercover camera to a doctor's office. I hope the person you illegally taped sues CBC. This show was probably put on by the Pedorthic Association who is trying to corner the market. Doctors of Chiropractic are well qualified to prescribe orthotics. They spend 4 years in professional school and most DC have a bachelor degree. This adds up to 8 years of post-secondary education. This show is nothing put an attack on the profession. Why doesn't CBC show the side of the industry where anyone can open up an orthotic store and sell orthotics. This includes all the franchises or individuals such as Happy Feet. These non health care professionals dispense orthotics and their customers have MD prescriptions. You tell me who is abusing the industry. What about the people who sell orthotics at malls and fairs. In fact the Pedorthic Association can't even control their own profession. There are people in Canada pretending to be Certified Pedorthists and the association doesn't even do anything about them. How can the Pedorthic Assocation make comments about the chiropractic association. Lastly most of the labs manufacturing orthotics are owned by Podiatrists. Posted by: Kevin | Feb 20, 08 11:34 PM

I am overweight, and I was offered orthodics by my chiropractor. I think that they specifically target larger people, claiming that it will "prevent back pain in the future". I would have loved to actually seen the identical orthodics, if they are all truly the same. Posted by: Reginald Phibbs | Feb 21, 08 12:00 AM

I am a chiropractor. We DO have advanced training in biomechanics....with emphasis on the spine, and to a lesser degree of the feet. Orthotics CAN help with chronic low back and hip problems. What would you think of a proctologist if he/she wanted to listen to your heart and lungs? Surely he has had the training to do this....it just isn't his specialty. In my opinion, we should specialize in what we work on - protecting the spinal cord and restoring joint function to the spine and let the pedorthist or orthotist specialize in the feet. Posted by: Paul | Feb 21, 08 09:39 AM

I rarely watch CBC, and this illustrated exactly why. This was nothing but a pre-meditated attack on orthotics dispensers. While there is potential for the system to be abused (and I'm pretty sure it happens), there were a few flaws with the documentary. Not one orthotics user was interviewed, and asked whether it actually helped them or not. The chief at the Ontario Chiropractic Association was interviewed, and although he specifically said that HE WAS NOT AN EXPERT in orthotics personally, words were being put into his mouth in an argumentative fashion. What nonsense. Is this what journalism is about, really? I was told by my chiropractor that orthotics "MIGHT HELP" - I was never told I'd become Superman after wearing them. I use them, and they've helped. They were gone through the GaitScan, and they may not be "perfect", but they're close. I'm challenging Wendy to wear my orthotics for a few days, then come back and tell me that she wasn't uncomfortable WEARING MY ORTHOTICS CREATED THROUGH THE GAITSCAN, SINCE THEY ARE DESIGNED FOR ME. Posted by: Sanjay | Feb 21, 08 10:07 AM

The only experts in foot care are Podiatrists NOT Orthotists or Pedorthists. Neither of them are Doctorate degrees. Family docs have no rights to prescribe them as they are not trained in them. Besides insurance companies are wasting provincial health care dollars by requiring an MD prescription. Posted by: Bob | Feb 21, 08 10:29 AM

Ok, enough already! How many more grainy "hidden camera" ambush interviews must viewers sit through? Perhaps when 60 Minutes was pioneering this tactic, decades ago, it made for fresh, compelling tv. Sadly, this tired premise used today is little more than a cheap stunt, leaving viewers with empathy for the show's intended 'targets' and contempt for the show's once venerable host. Perhaps there's merit in the show's message, but as viewers are forced to peer through peepholes, out from open gym bag zippers, or from beneath a CBC intern's 'hat cam', Marketplace's focus is irredemably blurred! Not even hdtv can clear up a moral compass this fuzzy. Posted by: Danny | Feb 21, 08 10:36 AM

I was very disappointed with this program. In my opinion, a negative predisposition set the tone for the entire piece. The "experiement" was based on one "foot expert's" opinion that the subject did not require orthotics. That "expert" does assessments on behalf of an insurance company!! Electronic scanners are the only method of accurately measuring DYNAMIC gait patterns, as the foot moves faster than can be measured with the human eye. My gaitscan orthotics are far superior to others I had made through casting. I believe that your "foot experts" fear becoming obsolete, as "full-body expert" chiropractors can prescribe orthotics that better benefit their overall health. Posted by: Mike | Feb 21, 08 10:39 AM

In 2001, I began experiencing pain in my left foot which got progressively worse. I used anti-inflammatory drugs, underwent extensive physiotherapy, tried an insert which I bought from the Shopping Channel - nothing helped. My physician referred me to an orthopedic specialist who diagnosed the problem. Essentially it is a deteriorating tendon on the inside of the foot between the ankle and the heel. He prescribed orthotics. I purchased them from a health store which sells prosthetics and other devices. The fitting for them involved a process similar to the Gaitstride machine. When they arrived, at a price of $225, I was not very impressed. They were very similar to the Orthotics Group inserts - not in any way a "custom fitted" insert. I wore them for period of time with some slight initial improvement, then worsening. After 3 years of treatments, including being in a cast for 6 weeks, undergoing bone scan and MRI, and with surgery the next option, I found a qualified pedorthist. He fitted me with the actual custom fit inserts, using a static foot molding process The difference is amazing- I am now pain free most of the time and able to walk normally. Interestingly enough, I do see a chiropractor sporadically for back problems, but he never once suggested orthotics. He avoids any potential conflict of interest by not selling any products from his office. He will suggest and recommend, but does not sell. I am a firm believer in you get what you paid for, except in this case, where I vastly overpaid for an inferior, essentially useless product. Posted by: DENISE | Feb 21, 08 12:05 PM

I was disappointed to see what could have been a very good segment on the need for orthotics and as in all industry, the potential for abuse, seemed to be nothing but an attack on chiropractors. In Ottawa, the largest medical chain uses the exact same technology and yet there was no mention of this apparent abuse by MDs even though it is in fact rarely the MD who does the actual fitting. The testing, diagnosis and fitting of orthotics DOES fall within the scope of chiropractors by law given their training and education and when related to the rest of the body goes beyond your so called expert. In fact, I have personally fitted people who were extremely dissatisfied with the orthotics received from their podiatrist and pedorthist. There IS scientific evidence on the use of custom orthotics and had you bothered to look (or ask a professional who is familiar with it) your agenda may have changed. Given that you are CBC "MarketPlace", it should be no surprise that there is a business side to ALL healthcare. There are good and bad orthotics, good and bad orthotic labs and good and bad health professionals in all fields. The past prime ministers and gold medal sprinters I have fitted are thrilled with their custom orthotics which were prescribed after thorough examination and only if they were necessary as is the case with the vast majority of chiropractors. Next time may I suggest an honest, more open look into the facts. Posted by: Dr. John Zielonka | Feb 21, 08 12:51 PM

I watched your program tonight, and feel that you have done a disservice to a superb Toronto chiropractor. As with all shows of this nature, you look for someone to be painted in a light of your choosing, and then turn it on bright. This was very underhanded; ethics anyone? Why single out chiropractors from a group of health care professionals who provide orthotics. You could have easily found a physiotherapist or podiatrist to flog. The very nature of orthotic prescription is not a hard science, there is no one specific test that will conclusively determine if someone is a candidate for orthotics, but rather an amalgamation of pertinent clinical information; subjective, objective, orthopedic, and a sound clinical knowledge of anatomy and mechanics, all of which orthotics providers should possess. Once gathered, this information will assist the provider to determine whether or not the patient would benefit from orthotics. The chiropractor was using the tools available to him, and determined that this individual needed orthotics, just as your professional determined that the patient did not. The argument here is over opinions, and ultimately, who pays the bill. You asked the Orthotic Group representative what orthotics cost wholesale. When was the last time you went shopping and DEMANDED to know what the seller pays wholesale? That’s not how it works. When you purchase a product like an orthotic, you are also purchasing the accumulated knowledge of the individual, and trust that they are providing you with a service that does have a price. Your dentist cleans your teeth and charges you $100, why not demand your dentists wholesale cost? At the end of the day, they are just little pieces of plastic and cloth that thousands of Canadians greatly benefit from. Did you really have to pick on one chiropractor to show us that they cost too much? Posted by: John | Feb 21, 08 12:57 PM

Can we assume that all journalists are dishonest given that Wendy sent a "patient" into a health care provider's office and had the "patient" lie to the health care provider about low back pain? In this situation the provider is expected to do something that may assist the "patient". Unfortunately, the practitioner assumed the patient was telling the truth. Given that the patient likely was a pronator (many of us pronate to some degree), this may have been a reasonable prescription on the part of the practitioner Posted by: anonymous | Feb 21, 08 01:35 PM

"Anyone who can write a prescription for an orthopedic device, as well as provide them, I would be wary of." Be would be wary of anyone who recommends a pair of Custom Foot Orthotic devices to every person who is sent to them. Be wary of anyone who only provides one type of orthotic device to everyone they see. Ask to see samples. Be wary of anyone whose idea of a dispense visit is passing you the devices over the counter in the reception area. Ask around and get feedback from someone who went to the same place you are considering. The analogy to medications is faulty. I believe only the prescribing professional can design and dispense. There is much more to an orthotic than a scribble on a page. The fit of the orthosis must be checked. It has to be evaluated to decide if it meets the patient’s needs. If I made an error on the order form or sent someone out with the wrong orthotic, it could cause injury. This would be my fault for neglecting to check final fit. I would not send someone to an alternate provider for assessment, design, manufacture/dispense service; it is my reputation on the line when I prescribe. I would use a good local pedorthist to manufacture orthotics to my specification for a fee for labor/material; some pedorthists do work in this capacity but I dispense what I prescribe. I am qualified to prescribe and provide custom foot orthoses in Ontario. I do not recommend them to all of my patients. I rarely cast at the first visit. I place padding in shoes to mimic the desired correction, and ask clients with mild problems to try an over-the-counter arch support if the felt padding is helpful. If their shoes are too worn or inappropriate, they will also get footwear advice. If mild cases do not achieve desired results with an OTC, then I will go ahead with a custom device. I prescribe different devices for active/runners, rigid arthritic feet, sensitive feet, hypermobile feet, and have samples in my office. Posted by: anonymous | Feb 21, 08 05:39 PM

Am I supposed to feel sorry for the insurance companies despite their record breaking profits? So what if I spend $400 a year on my feet. I work hard for my benefits and I'm on my feet all day and they hurt without orthotics. I've tried orthotics from cast and from the gaitscanner and both methods performed well. Posted by: GREG | Feb 21, 08 06:24 PM

The segment on orthotics was confusing. One professional's conjecture against another is hardly high grade journalism. What exactly is the research? The show did little to explain the intended purpose of orthotics. If I wanted to watch hidden cameras and biased editing I would have watched Jerry Springer. Posted by: ted | Feb 21, 08 07:26 PM

I have been watching Wendy for many years and I must say that this particular "expose" on orthotics and Chiropractor-bashing sincerely disappointed me. As a government funded, people-funded television station, I think that you owe your viewers researched and professional journalism rather than a witch hunt! You failed to show a proper history and physical examination on the "perfect foot" patient with the initial "foot doctor". Perhaps her examination was flawed on the "perfect-foot" patient. Do you not think that it would have been wise to get more than one opinion as to whether or not this patient had a "perfect foot". As it stands right now, it is the word of one healthcare professional versus another. This has completely discredited your documentary. Tax dollars well spent CBC! Posted by: Sony | Feb 21, 08 08:32 PM

Kevin states: "Chiropractic are well qualified to prescribe orthotics. They spend 4 years in professional school and most DC have a bachelor degree." Tell me this Kevin: How much of that 4 years is spent focusing on the mechanics of gait and the foot? I was informed by a Chiropractor that they focus less than 1 day of education in Orthotic design. Amazing! Chiropractors can learn in 1 day what a Pedorthist spends years to learn. The president of your professional organization even states that your members are highly qualified....you're kidding yourselves. Posted by: Anonymous | Feb 21, 08 08:42 PM

Sanjay: I'm challenging Wendy to wear my orthotics for a few days, then come back and tell me that she wasn't uncomfortable WEARING MY ORTHOTICS CREATED THROUGH THE GAITSCAN, SINCE THEY ARE DESIGNED FOR ME. Huh? Your "gaitscan" insoles could be given to 20 people with your shoe size, and they'd fit everyone about the same. People who have a relatively normal foot get along quite well with a generic design. People who actually have biomechanical issues with their feet will NOT do well with a generic design. I would say Sanjay, that you could go to Shoppers Drug Mart and be happy with a pair of 25 dollar insoles...they'd probably not be perfect, but they'd be pretty close too! Posted by: Anonymous | Feb 21, 08 08:56 PM

Thank you for running this program. I almost felt like crying watching it due to the frustration. I'm constantly being ripped off when it comes to orthotics. Over the years (I'm only 29) I've walked seen countless orthopedists and chiropractors who were so quick to offer me results, always with the same mould or scan. After they got my money and I had new pain from ill fitting orthotics, they could do nothing more for me. I realized that the mechanics of my feet involve the rest of my body and muscles and just want them to look at the problem. Instead they get can make a quick $400 for having me step in styrofoam and are gone to the next patient in 5 minutes which anyone off the street could do! I'm afraid to get older because I can't run anymore without pain, and after getting about 7-8 different orthotics that caused more harm over the years with all doctors being as arrogant and oblivous to doing any real work instead of making a mold, I really cant afford to throw away money to just anyone anymore. Posted by: Aaron | Feb 21, 08 08:59 PM

Yes, the patient was a pronator, but his pain was only while sitting, not while standing. Pronation is a normal motion, as long as it is not excessive and is present in the proper part of the stance phase. To the Podiatrist who feels an MD is required to dispense an insole, do you require an MD to supply physiotherapy or occupational therapy to an individual? Orthotists and Pedorthists are allied health professionals. A Certified Orthotist and Certified Pedorthist focus only on orthotic design, and manufacture. THEY are the specialists. Posted by: J | Feb 21, 08 09:09 PM

Competent Podiatrists will never promise custom made orthotic devices will solve any back problems. Back pain is a very generic term and may have many many different causes. Custom made orthotic devices are employed to correct biomechanical abnormalities of the feet and legs. It is all about angles and proper measurements. Most people who have limb length differences will experience back pain. Orthotics or heel lifts will solve that problem. Orthotics will not solve back pain from herniated discs, degenerate vertebral arthritis or nerve impingements. Computerized gait scan is an old technology which measures pressure points. It is flat and two dimensional. It can not measure the height and contour of the arch. Plaster casting is the most common, effective and accurate method to properly cast for orthotics. Currently, three dimenional LASER scanning technique is being developed and standardize. The words of advice are SECOND OPINION. If you don't understand your professional advice, get a 2nd opinion. If you have questions, ASK. If you are still not sure, get a 2nd opinion before you commit. Posted by: Ed (Podiatrist) | Feb 21, 08 10:15 PM

Speaking as a Biomechanics undergraduate, and a current Chiropractic Student, I have been in the most advanced labs in the country, and am privy to the best technology and research in the field. I have seen hard data on the kinetic benefits of Orthotics before my eyes and become published in medical journals. Orthotics can offer many benefits including; improved proprioception, reduced pressure and improved mechanics for the foot as well as alignment and force transmission throughout the body. All the benefits of orthotics were not just ignored, but these devices were downright defamed! Orthotic companies (and professionals who offer them) are business, and as with any other business, do need to make money. I honestly believe business’ primary goal is to help the population, not to take them for all they’re worth. As with absolutely every profession, there are those who are not at the utmost of integrity, but it is unreasonable to make a case from outliers. In my humble opinion this is uneducated, unscientific, erroneous, sensationalist based reporting. Posted by: Edward | Feb 22, 08 12:52 AM

Chiropractors have been trying to find respectability in the healthcare industry for years and now I feel they are making a very bad impression. I bought orthotics from a chiropractor for my daughter who is suffering with knee problems. They do seem to be helping but I wish I had seen this show first. We may not have the correct fit or maybe this isn't the best solution. My insurance company paid and did not question anything but they will only pay for one pair in a lifetime. This seems to be an example of private practice at its worst. If there is an easy way to make money my health is put at risk. Posted by: Merna | Feb 22, 08 04:52 AM

I find it interesting that people have to argue back and forth as to who is the most qualified provider of foot orthotics. If you want to have you feet properly assessed, go see a foot doctor. As to who is qualified to fabricate the device....I'm willing to say that the orthotist is, as this is what they are trained exclusively to do. Let's not make this issue too complicated. If you wanted you Car fixed would you bring it to a Carpenter?! These Chiropractors are doing orthotics to make the bottom line bigger, no if's and's or but's about it. These professionals are supposed to be the holistic approach to general medicine. You would never see a medical doctor doing orthotics. But then again, they never have a problem filling their schedule with patients!! Posted by: Geoff | Feb 22, 08 07:06 AM

I would like to question how one determines in 3 minutes that orthotics will help someone who has “tension in his shoulders from sitting at his computer”. How does the structure and posture of the foot transfer up through the butt to affect the shoulders while sitting? And even if Robert did have poor foot mechanics and experienced discomfort on standing or walking, the first line of treatment for shoulder tension would NEVER be orthotics. I would also like to know how this “tool”, the gait scan which is basically a 2 dimensional pressure mat, “said that Robert was a mild case” leading to the decision that orthotics were needed. If this professional is truly as honest and ethical as he claims, then the only other explanation for his recommendation that orthotics will address “tension in the shoulders while sitting at a desk” points to a lack of training and incompetence in assessing the need for them. This is why assessment and provision of foot orthotics should be left to those specifically trained in the field. I can only speak for myself but if I had a heart problem I certainly wouldn’t see a brain surgeon. Specialization in any field helps to ensure expertise, and those with expertise in their field have no reason to practice beyond their scope. As an individual with 22 years experience in the profession of pedorthics, I think you will agree that I am qualified to make this observation. Posted by: Kim | Feb 22, 08 09:45 AM

I have purchased orthotics from my local chiropractor and I paid a nice sum of money for them. That being said I have never felt better on my feet and my doctor knew exactly what I needed. Your show did not paint a positive picture whatsoever. The show didn't mention from the onset that the two ladies who were the negative forces against chiros worked for insurance companies. I think that was a pretty important piece of information that you guys did a nice job of scrubbing out. As well I think it was completely unethical with respect to sending a faux patient into that doctor's office with a spytech camera. What kind of operation do you guys run? Paying a hefty sum for your health is what life is all about. Why would someone pay exorbitant amounts of money for prescription glasses? Orthotics work the same way. And to pick on a chiropractor the way you guys did does not depict the way all professionals practice. Posted by: annonymous | Feb 22, 08 10:00 AM

Many people do not understand that a Gait Scan cannot make a custom orthotic. I think the general public who bought these orthotics are to put it mildly STUPID if they are still defending their purchase through a Gait Scan. The expose shows conclusively that anyone getting an orthotic from a GAIT SCAN has been fraudulently sold a "custom" orthotic! Chiropractors are peddling a device they have no idea is a prefab because they themselves have no idea how they are made; even though the science of making an orthotic is not by 2-Dimensional plane! That's why a cast is important. It is also for that reason Chirpractors should not be selling these unless they truly understand what a custom orthotic is. It is 3-Dimensional! Not just pressure points! Posted by: Allan | Feb 22, 08 10:01 AM

Would you do a story on how awful the automobile is, how unreliable, poorly designed, and dangerous it is, if you were really only talking about the Yugo? I am an orthotist (advanced degrees, certifications and all that) and I design and make orthoses (the plural of orthotic) so that children with CP can walk and run; For babies with spina bifida so that they can grow straight and protected; young men with spinal cord injuries who need to stand and walk to support their families; old ladies with hip replacements to reduce their pain and maintain alignment; and for many many other conditions. To paint all ORTHOSES (the plural of orthotic) with the same brush by calling FOOT orthoses 'orthotics' is not only painful to my profession, it doesn't make yours look too bright either. Being an Orthotist is a fantastic and very satisfying branch of the medical field. When you call those shoe inserts 'orthotics' and try to show what a rip off they are (I don't agree) that is all your audience hears of orthotic, orthoses or Orthotists. Should we judge all TV persons by Geraldo Rivera? Who is and who isn't qualified?, how much are they worth? Does anyone have the appropriate training? All of that is fine to discuss BUT please, please, please call those things "FOOT orthoses", even "shoe inserts". Thank you. Posted by: Sam | Feb 22, 08 01:31 PM

What was not addressed in this otherwise revealing program was that there needs to be a prescriber gatekeeper in all of this. this should be the family doctor. They can prescribe, but not manufacture an appliance. This for the most part makes the doctor a less biased prescription source, and less prone to financial conflict of interest, as so clearly seems to be the case with chiropractors and other prescriber/manufacturers. The doctor is in a good position by virtue of their medical training to assess and refer a patient with a prescription to a certified orthotist or pedorthist (and perhaps chiropodist) for further assessment of the patient's feet, and manufacture (using evidence based mehtods) appropriate custom foot orthoses, that I am sure any insurance company would be happy to pay for. It has been my professional experience that these practitioners are the only ones who have historically, upon seeing my patients, assessed them, provided custom devices, and sent me a thorough consult note back, explaining exactly what was found on exam, and what device was provided. this creates a professional collegial relationship that benefits the patient, and allows the lines of communication to be open, especially if there are pre-existing, relevant medical issues. I cannot say that this has been my experience with other para health professionals, especially as it pertains to orthotics. Posted by: brenda | Feb 22, 08 02:28 PM

As chief podiatrist at Mt. Sinai Hospital I really appreciated your segment on orthotics. Your information on the show was excellent. It's about time somebody exposed the overprescription of orthotics by chiropractors. As a podiatrist I see their mistakes often. Chiropractors have little formal training in footcare yet their college allows them to advertise themselves as foot specialists. You often see foot logos on their storefront offices and some even sell shoes, because orthotics are profitable. In my own podiatry practice I prescribe very few orthotics. Often, the problem is with the footware and proper shoes can resolve many foot problems. it was apparent that the chiropractor you featured has little knowledge of feet. He recommended orthotics for a little bit of foot pronation when, it fact, some pronation is normal for shock absorption by the feet. So you can just imagine how many would be honest chiropractors are unknowingly prescribing orthotics based on the foot scan because they have very little understanding of the biomechanics of the foot.Thanks again for a great show. Posted by: Alan Silverstein, DPM | Feb 22, 08 03:57 PM

this was my first time being exposed to CBC Marketplace - to be honest I don't plan to watch again. I watched this expose on orthotics and chiropractors and saw one sided journalism. You are insulting the intelligence of your viewers. Provide well balanced, well researched information and let the viewer make up their mind. I have no bias toward or against orthotics and chiropractic but I do stand up for quality journalism. On a related note, scroll down the page of past shows - you'll realize that every show is bashing one profession/supplier/company or another. In this case chiropractors just pulled the 'short stick'. No big deal, only lay people who already have it out for chiropractors or orthotic providers will take this interview to heart - I, on the other hand, will do my own research and discount that of Marketplace. Thank you for your time. Posted by: first and last time viewer. | Feb 22, 08 08:22 PM

As a concerned viewer I must add it is a HUGE conflict of interest that a health care practitioner both prescribe and distribute a product (IE chiropractors with orthotics). It seems this point has been lost in all the arguments. The second issue I have is with Gaitscan. Where is the evidence that a 2-dimensional image of the foot is superior to a 3-dimensional mould of the foot? So for all those people with the "evidence" proving 2 dimensions are better then three, I am still waiting for your sources. Somehow I think I will be waiting forever. Posted by: Greg Stewart | Feb 22, 08 08:41 PM

The fraud perpetrated upon the public by unscrupulous providers of various orthotic devices is wrong, but the public bears some level of responsibility. We want instant fixes to what ails us and technology has progressed to allow almost anyone to "fabricate" a quick fix to "satisfy" our need. Add to this the fact that we eagerly overeat, get very little exercise and wear stylish but terribly unsupportive footwear and you have a charlatan's dream. Custom orthotics are appropriate and necessary for individuals that have documented (read "diagnosed") structural, neurologic and traumatic disorders of their feet. Notice I said diagnosed. Don't treat yourself! If your feet hurt, visit a podiatrist, orthopedist or orthopedic foot and ankle specialist to determine what is wrong AND the correct solution. Then see a qualified provider; either a Certified Pedorthist or Certified Orthotist to be measured and fit for the appropriate orthotic. These professionals make their living providing relief in the form of custom orthoses and their reputation and livlihood depend upon the outcomes. It's not a cash cow, but a profession. Some physicians and podiatrists provide orthotics in their offices, and in some cases this may be fine. But beware of providers who diagnose you and have a readily available solution that comes out of a box. They may be simply augmenting their income with a convenient, quick fix. For sure, some disorders are easily relieved with off-the-shelf orthotics found at a variety of venues, but don't buy a solution off the internet, from a television ad or magazine. Often though, the appropriate "treatment" is a few stretching exercises and/or temporary cessation of the offending physical activity. Don't judge the science and profession of providing appropriate orthotic care on the basis of a small number of unscrupulous vendors. Be smart with your health and with your feet as well! Posted by: Jim Rogers, CPO, FAAOP | Feb 23, 08 12:02 AM

I'm disappointed by the approach the Ms. Mesley and the CBC took about the orthortic story. The heavy and unnecessary piece on chiropractic doctors could have also included physiotherapists, medical doctors, and any other health care professional that prescribes orhotics. First, GPs have no real training in neuromusculoskeletal assessment, diagnosis and management and should not be the gatekeepers for the prescription of ergonomic devices. DCs, PTs, physiatrists and other physical medicine specialities have more than adequate training to make a judgment call as to whether or not the patient's function in general will improve. Also, this piece completely neglects that the gait scan forms but ONE component of the clinical exam; orthopaedic testing, kinetic chain functional evaluations, muscle testing, joint play and many others forms the basis for the diagnosis and subsequent plan of management. To posters here who take a harsh tone on DCs and their ability to accurately diagnose and treat neuromusculoskeletal dysfunctions, your opinions are not valid based on current research. Chiropractic care is as effective and at times exceeds conventional medical management for various mechanical back disorders, joint pain, headache treatment and there is promising research suggestion it may be effective for non-musculoskeletal conditions as well. Contemporary, evidence-based chiropractors in trained in Canada are solid clinicians, diagnosticians and manual therapists and hopefully readers do not get swayed by this poorly done "investigation". I won't even comment on the ethical breaches the CBC did on this one. Posted by: Marc | Feb 23, 08 02:04 AM

I have been a practicing chiropractor for over 15 years...8 of those as a locum chiropractor taking over chiropractic practices for vacation and emergency relief. In that time I never came across a chiropractor that has a policy to put everyone into orthotics for monetary gain exclusively. While I do think there is abuse that goes on, I think it is perpetrated by practioners of questionable ethics, not all chiropractors. I only hope that people have the ability to think critically when watching a program like marketplace and question the sensationalistic motives of this 'news program'. Further, I feel that the approach employed by the marketplace producers was ignorant toward the chiropractic profession. This approach by the media is partly responsible for the 8-10% utilization rate by the public of the chiropractic profession.....what a shame. On the other hand, a message to those in my profession that are perpetrating orthotic and practice standards that are questionable....smarten up! You are also responsible for the public's poor utilization rate of our profession. Also, the average person who pronates bilaterally can improve their biomechanics by utilizing generic $30.00 inserts and doing foot exercises like the 'short foot' position. Posted by: Ron | Feb 23, 08 10:02 AM

It is about time that there was more public education done with respect to orthotics. This is a good start; however it seemed like the documentary was a little biased against Chiropractors. Note that I am not a chiropractor, nor do I use one. However, having been in the orthopaedic devices health care service for about 25 years now, I can say that there are always bad apples in any basket - meaning that there are bad professionals in any group of professionals. What did disappoint me was the comments by the Chiropractor Colleges director - that really did NOT come across well at all. I do feel very STRONGLY on the issue of conflict of interest that needs to be addressed very seriously. This is where abuse has the most potential to occur. Just as physicians are disallowed to fill their own prescriptions by "selling" the drugs out of their offices; orthopaedic devices should not be allowed to go through a similar process - no health care provider should be allowed to prescribe as well. AS professionals in the various different disciplines, we should be confident in our "specialization", while respecting the other professional in his/her specialization. If we could design services that complement what we do and cross refer accordingly; the patient would benefit most. At the end of the day, this should be the uppermost interest in our mind and our ethic of practice. Professional associations and colleges should work on screening individuals on this ethic to the best of their abilities; as well as monitoring those in practice accordingly. Overall; good start, but more work needs to be done as this kind of abuse is also prevalent in some of the physicians' practices, as it is in all the allied health professionals. All health professional associations need to be wary of this and uphold their true virtues. Posted by: Minaz | Feb 23, 08 12:04 PM

Thanx brenda you are obviously an orthotist or pedorthist. Physicians have no training at all in the use of foot orthoses or biomechanics. They prescribe drugs because they have a thorough background in chemistry, microbiology, pathology, pharmacology and medicine. Orthotics are a form of treatment not a device. The only practitioners qualified to provide this treatment are Canada's regulated foot specialists. Podiatrists and Chiropodists. It is not a conflict of interest for an Orthodontist to prescribe a dental appliance and then receive payment to continue the therapy, nor is it a conflict for a surgeon to do a surgical consult and then perform the surgery. That's the difference between a commercial enterprise and a pfrofessional practice. Most pedorthists are involved in commercial enterprises. i.e. shoe store franchises that claim to be foot care clinics. Pedorthists are holding themselves out as health professionals by claiming they belong to a College. The college is located in a province that has no legislation to prevent this deliberate attempt to hold oneself out as a regulated health professional. By the looks of the posts a pedorthist is editing them, so I am probably waisting my time on this post. Posted by: Dave | Feb 23, 08 05:01 PM

Thank you so much for showing this episode. As a chiropody student, I feel frustrated when I hear that people stand on a "mat" or step in foam to get orthotics created and more so that orthotics are being handed out like hotcakes. There are SO many things that can be wrong with a foot before orthotics should even be considered and more over, there are several tests that must be performed to see if orthotics will even be useful (see hubscher maneuver, for example). I know first hand, because my mother made the 'mistake' of going to a chiropractor for nerve pain in her leg, and he made her stand up and right away diagnosed a pronated foot and prescribed orthotics. He charged my mother the amount covered by her work insurance. I was furious. In chiropody, we use low-dye taping to first hold the foot in a favorable position to test if the addition of an orthotic will be helpful or not. This is inexpensive and avoids the cost of creating an orthotic espescially if this does not address the problem, which in many cases it does not. Please go to a Chiropodist, Podiatrist, or any other qualified FOOT specialist for your feet; remember that there are numerous reasons, be it primary, secondary or tertiary that are causing a foot problem, and orthotics is in NO WAY the only solution. Great program. Posted by: Sameer Sekhon (B.Sc, D.Ch - Chiropody Candidate - 1st Year) | Feb 23, 08 09:19 PM

Anonymous writes "How much of that 4 years is spent focusing on the mechanics of gait and the foot? I was informed by a Chiropractor that they focus less than 1 day of education in Orthotic design. Amazing! Chiropractors can learn in 1 day what a Pedorthist spends years to learn. " This is a ridiculous statement. Chiropractors learn about foot mechanics, anatomy, orthopedics, diagnosis, joint-play assessment, manipulation/mobilization, soft tissue techniques and ergonomic prescription as part of their 4 year curriculum. Your comments are disingenuous and not factual. Correctly prescribed orthoses can help relieve many mechanical pains along the lower kinetic chain as well provide preventive measures by ensuring correct biomechanics and load distribution. In the future, I would suggest that posters conduct a bit of research before misrepresenting the educational standards of other health professionals. Posted by: Marc | Feb 24, 08 03:44 AM

Having been an avid watcher of Marketplace for many years, I am saddened to see content that is very biased in nature. My fiancee and I just turned OFF the television after completion of your orthotics segment on Feb 24, 2008. We cringed at the quality of investigation shown in this episode. You knowingly sent a "healthy" person in to see what consultations they would be provided knowing from a FOOT doctor that her opinion was he did not require orthotics. Now, what we noticed was that he went to CHIROPRACTOR's to consult on OTHER health issues, that he knowingly did not have. You did not go into this segment to see who could give the best advice, you went in to tarnish someone's reputation. What SHOULD have been done is sent in an individual who actually HAS health issues, compared the consultations and THEN get the CORRECT specialist supported by Marketplace to assess which doctor gave the correct advice and those who did not. How can a doctor's reputation be tarnished when the PATIENT is not being truthful to him. It made is sick to our stomach's to see Dr. Feldman put in that situation for shock value and not unbiased journalism. You should encourage your viewer's to maintain an open mind, and simply state facts. The show should educate consumers because every individual situation is different. We all acknowledge that there will always be people who take advantage of the industry, from BOTH sides of caregiver AND patient. This segment is one in a string of segments that has left us wondering if it is worth watching your show at all as the validity of your journalism is quite questionable. (The gift episode REALLY made me wonder if you were just short on content for the week) Posted by: Greg | Feb 24, 08 12:34 PM

Bravo Wendy and Marketplace. We were pushed into buying expensive othodics that I really did not want and made no difference to our health. I felt embarrassed that we were had and wondered how many others fell into the same trap. So, when this show aired I applauded Wendy and Marketplace for striking back on behalf of the public. I have come to know many more families that found little to no value for the money. I don't doubt that many 'professionals' in the business will be posting negative comments discouraging Wendy and the brave Marketplace folks from standing up for the consumer. Posted by: Ric | Feb 24, 08 12:40 PM

I saw your show on buying an HDTV and all the accessories they try to dump on you. I'd like to share a pleasant experience we had with an electronics store in Winnipeg, Manitoba. The store is "Advance Electronics" on Portage Ave. They have been in business longer than I can remember, and I'm 56 years old. The salesman carefully explained the difference between plasma and LCD, asked us about our preferred tv viewing, made recommendations, and then left us to decide. After we decided, he informed us that the tv we chose was on sale, processed our payment and scheduled delivery and setup of the unit for the next evening. He suggested that we may need a different cable for the hookup. He recommended one worth $87.00 but if we don't need it, we can return it. The gentlemen arrived the next evening at the scheduled time, moved our 12 year old tv to a location I chose, and set up our new 42" HDTV. They said my existing cable was more than adequate and I should return the new one which I did. One month later, Advance called us to ask if the unit was working fine and if we were satisfied with the service. We always hear about the bad experiences people have with businesses, I just wanted to share a good one for a change. Posted by: Stephen Fedun | Feb 24, 08 06:59 PM

The public needs to be aware that anyone in Ontario can use the title foot specialist as it is not a protected title, and that anyone in Ontario can sell an orthotic as the Ontario government has not placed any restrictions on who can do so. The so called foot specialist in your program is a pedorthist which is NOT a profession regulated by the Ontario government. Chiropodists/Podiatrists are the ONLY regulated health professionals in Ontario that are exclusively trained in the treatment of foot conditions. The public and CBC marketplace need to be more aware of whom the real "foot specialists" in Ontario are. Posted by: John | Feb 25, 08 03:11 AM

What a terrible disgrace to journalism. Rather than give the viewer an opportunity to see the big picture regarding orthotics, you have simply singled out chiropractors. You missed the point on the benefits of orthotics for certain conditions, well researched in the literature (perhaps you did not see that or speak to a health care professional that read this literature??) As a chiropractic patient, I must say that my doctor has never pushed orthotics on me. On the contrary, my previous physiotherapist did. This kind of abuse on the system is apparent in all professions, but is not the norm. Couldn't it also be true that your 'foot expert' made a mistake in the 2 minute examination she performed? Perhaps the chiropractor that had seen your patient found something in the several visits that he saw and assessed this patient, that your 'foot expert' did not in her mere 2 minute assessment? You also touched on monetary value....chiropractic care, physiotherapy, Medical Doctors, Dentists -- guess what, they are all businesses. They are all selling a service to make a living. Posted by: anonymous | Feb 25, 08 07:43 AM

I would like to have seen the 2 professions that are licensed by the RHPA represented in this segment, Chiropodists and Podiatrists. I am a licensed Chiropodist. The Chiropody program (Michener Institute, Toronto Ontario) does teach a standard way to assess and treat the public. We pay $900 per year to the College of Chiropodists of Ontario which is mandated to protect the public. Our 2 professions are in fact the only ones that do prescribe and dispense orthotics with a license. As this modality is not a controlled act, any one can do this and seems to be doing so! It is interesting to note that chiropractors claim to ascribe to the "spinal subluxation theory" as the book, Spin doctors : the chiropractic industry under examination / Paul Benedetti & Wayne MacPhail (ISBN 155002406X pbk.), has elucidated. If one can "fix" all health problems through manipulation of the spine, why would you need to prescribe orthotics? Posted by: Joseph | Feb 26, 08 12:05 PM

Orthotics which my Chiropractor prescribed 2 years ago have been fantastic for me. I have no knee problems now. I thought your report was extremely biased. It also tried to paint the picture that all chiropractors are scam artists. I am nothing short of grateful for what my chiropractic treatments have done for my general well-being. And I was a skeptic when I went in. Posted by: Jeff Gibbons | Feb 26, 08 12:10 PM

Your foot specialist claims that a 2D image cannot be used to reconstruct 3D data. If this is true, how do cartographers construct topographical maps from satellite images - and why does Google Earth give us such shatteringly real images of 3D surfaces? I strongly suspect that both the casting and the scanning methods have uncertainties and errors, and that a full gait scan of the moving foot in tandem with the posture of the rest of the body, as well as the load distribution on the foot in a standing position is what we will eventually use to fit orthotics. It would have been interesting to compare the markup on orthotics to the markup on prescription drugs - another industry which has a significant component of marketing mixed in with (often marginally beneficial - and in some cases very damaging) promises for health benefits.... Disappointing quality of reporting, and disappointing depth of technical understanding from all of the professionals involved. Posted by: Anonymous | Feb 26, 08 12:26 PM

I find it quite interesting that most of the support found in the above comments are from actual foot specialists. People who are formally trained in biomechanics and foot structure praise the piece. The complete opposite can be said about chiropractors. They all seem to be furious at the thought of losing this golden meal ticket that is prescribing orthotic devices. I find the controversy that this little 20 minute segment has created quite comical. I have insight from both sides of the fence. I have seen poorly prescribed devices that were a wasted 600 dollars. I have also met the people that are getting tremendous relief from such a product. They do work... when done properly (that last part is important). So do not discredit foot orthoses all together. Casts must be taken and a proper assessment performed. The provider needs to actually touch your feet and watch you walk, they need to discuss your daily life and find out what hurts and where it hurts. I cannot help but chuckle at a 2 dimensional scanner making "custom orthotic devices." Isnt it ironic how a computer sold to you by a company that manufactures orthoses will tell you that you need their product? Give me a break. Who didn't see that one coming? The industry desperately needs regulation and the insurance companies ultimately have the final say in who can prescribe this product. The ball is in the patient's court. It is up to them to ask questions to the provider! and if they seem as if they have no idea what they are doing maybe you should consider seeing someone else. Posted by: Laughing from the Sidelines | Feb 26, 08 04:46 PM

Thanks for bringing awareness to some of the “commercialized in foot orthoses”. This big business approach has brought a myriad of problems for everyone providing foot care to those who really need it. Most insurers will not pay for the pressure scan foot orthoses and because of over-prescribing some will not pay for foot orthoses for those who legitimately need such treatment. I am a Certified Prosthetist and Orthotist (Canadian Board for the Certification of Prosthetists and Orthotists) and have worked in rehabilitation clinics in 4 provinces for over 33 years. My experience leads me to believe that medical devices such as orthoses are better provided through a multidisciplinary medical clinic. Where the prescriber is also the provider there is always the possibility for a conflict of interest. There are many foot conditions which can be legitimately helped with careful assessment and the provision of properly fitted foot orthoses. The evidence for treating other conditions up the “kinetic chain” is not so well supported and is more in the realm of baffle the patient with jargon. This Gait Scan is very impressive but is best used only a good assessment tool. Research has proven that a three dimensional shape cannot be extrapolated from two dimensional pressure sensing. To capture the three-dimensional shape of a foot, a plaster cast is the gold standard. As Ms Trotted pointed out, most orthoses made this way are pre-molded, sized blanks which are then customized to a specific order; not custom molded. One more thing. The word “orthotic” is not a noun. It is actually an adjective as in “an orthotic device“ which is correctly called an orthosis. I have also heard in media people referring to a prosthesis as a prosthetic. This incorrect usage also seems to have come about through big business promotion and marketing and has stuck. Please add this to Orthotics 101. Posted by: Seth | Feb 27, 08 12:25 AM

Basically orthotics do help certain foot conditions. And so do over the counter arch supports. It all depends on the degree to which the condition needs. The difference is that when something is CUSTOM MADE of course it costs more. It is custom made to your foot and cannot be used to benefit anyone else's foot. It is prescribed with certain features to specifically address the conditions of your foot - just like prescription eyeglasses. The OVER THE COUNTER/ PRE FABRICATED orthotic or arch support is not custom made and can cost anywhere from 20$ - 150$ The fact that there is no regulation on standardization - anyone can use the name "orthotic" and charge custom made prices for over the counter moulds. This is robbery and a disservice to the practice. The public should be protected from this scam by allowing only registered foot specialists prescribe for these devices. And also Insurance companies should also be informed of this instead of cutting back on benefits due to the unethical practices that drain their funds. They should red-flag these people who are doing such things and report them to their college or the ministry of health. Cutting back on benefits does a disservice to many who are in need. It is not the public's fault for being taken advantage of. And mind you - it's not only unethical Chiropractors that do this, it is also those within the field and physiotherapists and anyone off the street that can make or provide an orthotic device - this is because it is not regulated. Posted by: Jane | Feb 27, 08 05:09 PM

It was about time somebody did a story about the abuse of prescribing orthotics. I've been experiencing foot pain for some time. I went to my MD for some help and she prescribed orthotics. I ended getting two pair and noticed no change. After spending close to a $1000 dollars, I decided enough is enough and went to a podiatrist. The podiatrist was helpful in assessing my problems and prescribed a proper orthotic that is easing the pain away. I thought I could trust my MD for help but ended being ripped off with something that potentially could have created more problems. I am a believer that it is a conflict of interest for a MD to dispense orthotics. I don't expect my podiatrist to give me medical advice beyond what he or she is trained to do so why would I expect my MD to be an expert on podiatry. Obviously, there are no proper guidelines on who should be prescribing these devices and I blame the medical establishment for that. Posted by: Kasia | Feb 27, 08 05:35 PM

Wow. Never have I been so disappointed with CBC. This program left me questioning the validity of your programming. Who should be prescribing orthoses is a big issue in the world of feet right now. Unfortunately, rather then presenting a well researched, unbiased piece to the public, you targeted one profession and one company with your negative view. Many people are able to prescribe orthoses – MD’s, physiotherapists, chiropractors, chiropodists, podiatrists…Many who deal with the whole body choose not to prescribe foot orthotics and refer patients they believe may benefit to professionals who with more knowledge of the foot and its biomechanics. Many do and are amazing at relieving pain and preventing future problems. Within any profession you will find people who are good and bad at what they do and people will practice with good and bad ethics. Everyone makes mistakes; no one should judge someone who’s been set up to make one. Who’s to say your pedorthist’s opinion is any more valuable then the chiropractor’s (aside from editing) and why were chiropodists and podiatrists (the foot specialists with the most amount of training) not even mentioned. Finally, anyone who uses a system such as the gait scan knows it has pros and cons and realizes it has its place. It would be used to confirm a full biomechanical assessment and gait analysis, not replace them. Few professionals use this to send a patient’s foot to the lab and rely on more proven methods such as the foam box or the plaster casting. I guess I now know to only watch CBC when I have the time to research the issue myself so I can get a fair view from ALL sides. Posted by: CBC is more like CNN everyday... | Feb 27, 08 08:25 PM

You've got to be kidding me! The Chiropractor in question is not a major player in the orthotic industry. He may do less than 10 per month. Is that abusing the system? Did they check out physio centres? Why sand bag the chiropractors? Their premise was completely ridiculous. Of course the orthotic company would advertise in a trade magazine. Have you checked out other trade magazines? Every one of them offers ways to increase revenues. I really wonder the agenda of the so called experts they had. Are they threatened by the orthtic group? Does their expert understand the connection between ankle, knee and foot? The interviewer seemed to think it was ridiculous to give them to someone with no pain. Would she wait until he developed knee and hip problems? Health is not the absence of symptoms and the interviewer seemed completely ignorant. How about doing thorough back ground work and not using hidden cameras. The reason they are so expensive is due to the cost of equipment and training of the provider. How much does the medical equipment cost to do most surgeries? Probably pennies to make, so how do they justify thousands of dollars for the surgery? Possibly due to the training they received? Posted by: Mark Halpern | Feb 28, 08 04:53 PM

I have pain in my back and shoulders, I have been to a number of MDs for referrals and each recommended physio and not chiro because they did not believe they are credible. This segment is another example of how a profession struggling for recognition shoots itself in the foot by extorting patients and insurance companies alike. Let's not forget every time an orthotic device is purchased through insurance it is paid at the expense of other options that are more urgent for an individual. Posted by: Jason | Feb 29, 08 11:05 PM

If chiropractors are experts of the neuromuscular system and are extensive in their training for foot devices like orthotics, why are they only dealing with foot orthotics? Why not orthotics for the rest of the body? By definition an orthotic is a device or support that is used to relieve or correct an orthopedic problem. So why are they so into feet, and not back braces or arm braces or leg braces? It's because they see an easy cash grab. The only people in Ontario that are able to make these devices properly and have the EXCLUSIVE training is podiatrists, chiropodists, pedorthists and orthotists. These practitioners are all doing it the way it it needs to be done. That's not to say that there aren't bad practitioners in those four professions who may make you bad orthotics, but your safest bet is with them. Posted by: Stephen Chang | Mar 5, 08 06:25 PM

I believe this report is blatant sensationalism fabricated by extended health insurance companies or certain foot specialists whose business is slow and would like to discount the services offered by other health professionals. Certain people stand to benefit from the demise of credibility of other professionals. There is much research to support the effectiveness of orthotic devices when prescribed properly. Your feet are connected to the rest of your body including your spine, knees, and hips. Would your trust simply a foot doctor with being able to properly perscibe a solution to these types of problems. Posted by: annonymous | Mar 14, 08 04:46 PM

I have a belief that someone who is caring for your health should not be a retail outlet. I try to find chiropractors who are not selling stuff at their reception desk and I don't like going to a doctor who has boxes of samples to hand out. I need orthotics or inserts - what ever you want to call them- and i buy Bergals. they are 40$ and can be found at SHOE stores (not walmart but a SHOE Store Like Tootsies). They are sized like shoes and you do not need to remove the inside of the shoe to add them, the take up very little room in the shoe and they make all the difference in the world. Sure they don't correct the fact that i roll my foot to the exterior but they support my arches and reduce my foot and back pain. Anyone who expects perfect health results from any product deserves to pay what they do. Posted by: C. Patterson | Mar 26, 08 06:10 AM

Re: picking on one chiropractors. Somebody asked "why did they pick on this one chiropractor?". I am sure they did not have to search very long to find this one chiropractors that was trying to treat shoulder pain with orthotics. Myself personally went into a chiropractors office with a stiff back. Within 5 minutes, I was on the gait scan and being asked if I wear orthotics, and he even asked me to call my insurance company to ask them who can dispense them. Also To draw a comparison, Massage is in the scope of practice of Physiotherapists, they can use it as a modality, but do not advertise it, and sell it. I think the same should apply to chiropractors, they should be able to recommend them, use over-the-counter orthotics like powerstep, spenco, dr. scholls or whatever. But leave the custom orthotics to the professionals that actually make the orthotics themself, and don't just ship it off to some factory that wont even let you see how they are made......Why are we so gullible? We sometimes put to much trust in people, and don't second guess or get second opinions. I actually don't know any physiotherapists, massage therapists, osteopaths, that do custom orthotics, although I feel physiotherapist are more qualified than a chiropractor. It's just a money grab. Thats just my opinion. Posted by: David | Mar 27, 08 12:40 AM

Overpriced orthotics are a waste of money. I get my orthotics from The Orthotic Shop (www.OrthoticShop.com). They have custom made orthotics from a quality lab for just over $100. Additionally, they carry some over-the-counter models that are well known such as Lynco and the CustomSelect line. Posted by: Marcus | Mar 31, 08 01:58 PM

There is no such thing as a bargain when dealing with custom orthoses, period. Biomechanically our chiropractor friend failed to mention that if one foot pronates more than the other a functional leg length discreprency may have been the root cause leading to back pain which may occur anywhere in a weakened kinetic chain. I am a Pedorthist Tech and build orthoses for a living. For the mainstream of people suffering from plantar fasciitis an orthotic support to the non weight bearing arch is the answer. By there very nature custom foot orthoses are custom. This means individually tailored to the clients needs. When considering an orthotic chiropodists, orthotists, pedorthists and podiatrists are the only people to consider. We not only know how to but can personally build foot orthoses but this is our speciality. (This list is alphabetic) The listed professions all have labs and the personal ability to construct these. Where Chiropractors come in is to recognize this LLD (Leg length discrepancy) which causes spinal curvature and they try to correct it biomechanically. If a chiropractor does not have the means to correct abnormal biomechanics they often are cross referred to an allied profession. If it is a simple matter of correcting a dropped arch then a manufacturing lab is often employed. Is this wrong? No, as a spine specialist wanting to aid their clients its often worth a shot. Most Chiropractors will immediately recoginze a proper leg length discrepancy and take the proper measures to order a heel lift. Let's not bash a reputable group of people on the basis of one expose. Just for the record you can not build a 3D corrective medial device from a subjective 2D scan. A weight bearing measurement will not solve a problem but merely accomodate to the point wear the pain exists. Cheers PS evryone pronation in midstance is normal it is how we adapt to changeable terrain : ) Posted by: J, McCormack C Ped Tech (C) | Apr 2, 08 10:34 PM

As a person having 44 years experience in the area of orthopaedics, I understand that changing a long standing practice is extremely difficult, and requires very deep critical analysis. The orthotics offered to people, in many cases do not correct the foot abnormalities, but may even worsen it. They do not take into account deformation of the spine, body pressure on the sole, and role of muscles. Anatomically foot has three spots of support: heel and heads of st and 5th metatarsals (ball), which create three arches. When specialists talk about arch, they usually mean only one—the medial longitudinal. Subtalar joint softens forces of inertia in motions; it loses this function when rigid support inserted under medial arch. Unfortunately, most orthotics are manufactured today are rigid. They are not allowing foot muscles to work properly. Feet on these orthotics loose amortization function. Such orthotics should not be called orthopedic. I mean that orthotics should not be rigid neither soft, but rather “resilient”. Muscles are only responsible for blood and lymphatic circulations (heart is a muscle too.) Properly designed insoles can normalize blood circulation, and as a result, other conditions and diseases (diabetic sole, posture, varicose, and improve functions of internal organs. Unfortunately, many operations on ankles, knee replacements, and hormonal pain killer injections are done to patients without knowledge of possibility to treat orthopaedic diseases by different methods. Using different method of diagnostic and treatment, on my account thousand people were successfully treated even after unsatisfied visits to other foot specialists and after surgeries. In my opinion, improving of professional training should include modern knowledge of the human physiology and a role of muscles in the human body, including compensating effects on deformational forces, and preserving the sole functionality. Posted by: Valentyn Gusyev, prosthesist, biomechanical engineer | Apr 17, 08 02:23 PM

How would other allied healthcare professionals react if orthotists and pedorthists added ultrasound, and other therapeutic modalities to their list of services? One could come in for orthotic assessment and while waiting can receive ultrasound for that sore knee, and pay extra. Posted by: Aaron | Apr 19, 08 12:54 AM

This piece is unfair and unethical. Larry's been my chiropractor for a few years now, and he has helped me considerably with back and shoulder pain. After many sessions, I was the one who initially approached him on the subject of orthotics. He gave me the Gait Test, and he told me I was a mild pronator, which I am. He also did a cast of my feet -- your program implied Larry only relies on the GT, which is false. Lastly, when the orthotics came in, he made very sure they were cut correctly and were comfortable. Which they were, and are. Larry's a very good, conscientious chiropractor, and I would refer him to anybody. As Ted writes, above, "one professional's conjecture against another is hardly high grade journalism. What exactly is the research?" Your test subject may (or may not) have had good feet, but he was clearly baiting these professionals by complaining about his back pain. Posted by: peggy | Apr 25, 08 10:12 AM

This CBC Marketplace piece was excellent! It went out there and said what many think: "Chiropractors don't know much". I guess the chiropractor named Larry really has ethical problems or just doesn't really understand anything. And I loved the part when they talked to the Head of the chiropractors of Canada. Posted by: Nameless | Apr 27, 08 03:03 PM

I was prescribed orthotics by my chiropractor just a little over a year ago. I had been having trouble with the joints in my toes, as well as suffering from knee, hip, and lower back problems due to mild arthritis. About two weeks after receiving the orthotics, I noticed that the toe problem was gone. During the year of wearing the orthotics, I have had very little trouble with my other joints. I think the CBC needed to talk to some people like me who have found the orthotics prescribed by my chiropractor very helpful. Let's get both sides of the story. Posted by: Ruth Quiring | Apr 27, 08 05:23 PM

I am an occupational therapist who has been making custom foot orthotics since 1983. By "making", I mean assessment, casting, manufacture, and fitting of the device. I hope this qualifies me to comment on your recent investigation re: orthotics, and I would like to say THANK YOU for reporting on what is, in my opinion, a major scam in the health care field. There are so many people involved in the production of one pair of "computer generated" orthotics (99% of whom have neither spoken to nor assessed the client), that it is inevitable that most of these devices are of little value and cost in excess of $450.00. Having said that, it is equally important to emphasize the benefits of a correctly made orthotic, which can improve your health and quality of life. Please allow me to make the following points: 1)biomechanics of the foot can be altered by many things, both within and beyond the foot. Feet are the body's foundation, and their malalignment affects every other part of the body. Imagine a house foundation that is not level. 2)a 3-dimensional orthotic cannot be custom made from a 2-dimensional computer printout 3)molds made from weightbearing impressions will have the malalignment built into them 4)a correctly made orthotic should NOT have to be "Broken in" - it should feel great immediately, and should continue to feel good with wear. 5)clients should never have to pay for adjustments - that is an entire scam in itself - problems with fit are not the client's fault. Thank you. Posted by: S. Kirkland, O.T. | Apr 27, 08 07:13 PM

I too agree that once again the CBC's ethics are in question here. If they wanted to show a fair and balanced segment they would have also sent someone in who has a legitimate foot problem, and waited to see if the orthotics provided by the chiropractor made a difference. Myself, suffering from planter fascitis, had consulted a podiatrist, and in ten minutes had orthotics ready the next day. Still having pain, I asked my chiropractor if he offered the service, which he did. Note, I asked him. He did a gait analysis, and my orthotics were available a week later. Included with them was a written analysis and prescription for the orthotics by a licensed podiatrist. I have not had foot problems in five years due to these ones. I believe this is more a case of podiatrist protecting an industry that they themselves have controlled and abused themselves for years, not wanting to share any of the pie. Also, doesn't even the mention of the insurance business make you cringe and question the validity of the segment? Posted by: steve | Apr 28, 08 01:06 AM

I went to a foot specialist for Plantar Fasciitis. He of course wanted to sell me the expensive orthotic shoes. It wasn't until I did my own research that I discovered that Plantar Fasciitis can be related to a lack of blood circulation which in my case it was. But no one ever mentioned this to me. I found ways to increase my circulation and volia: The "Plantar Fasciitis" that was causing me so much pain for months completely disappeared within 3 days. NEVER to return...and it's been almost 3 years. It's always about discovering the root cause. ALWAYS. Posted by: AJ Reid | Sep 2, 08 10:33 PM

I have read the items contained in this segment, and truly wonder if the investigators really understand the product that is being produced. I would have thought the segment would truly be about ' how can a 2 dimensional pressure over time measurement ' produce the 'custom orthotic' the company supplies. there is a good amount of input by Leslie Trotter, also much advertising for her clinic both in the article and in the links ?? not sure motive, is she the only person who does this? Finally, the clients using companies such as this are being dooped in the fact that the item is not custom made, and in many cases the Practitioner is in the same boat, as many firms claim to be custom made. In the end the product may work for many, but it should not cost that amount of money because it is not custom made. Posted by: oscar | Sep 24, 08 10:53 AM