Orthotics

More Information

Orthoses are prescribed for many reasons. They can control the movement of specific joints, provide support, reduce pain, improve function, make walking safer, make activities easier, reduce pressure and skin issues, or delay the progression of deformities. They are sometimes referred to as braces, splints, callipers, or supports. The purpose and design of orthoses often changes over time, to make sure that they are always meeting the patient’s needs. The orthotics service provides many different products, including:

• Insoles
• Orthotic Footwear (also known as orthopaedic footwear)
• Footwear Adaptations
• Ankle Foot Orthoses (AFOs)
• Knee Ankle Foot Orthoses (KAFOs)
• Knee braces
• Spinal braces
• Upper limb orthoses

Insoles:

Insoles can help to improve the position of the foot and leg, and move pressure away from painful or damaged areas. A good foot position can help you balance when walking, and help to spread your body weight evenly across your joints to reduce stress building up in one area. Please refer to our insole advice leaflet.

Orthotic Footwear (made to measure/ Orthopaedic):

Orthotic footwear is provided to patients who are unable to find suitable footwear in shops. This may be because of the shape of their feet, because they need extra support, or because extra space is needed for another orthosis such as an AFO. New designs with extra depth or stretchy materials mean that most people can now find suitable footwear in shops. Your orthotist will be able to advise you on suitable styles. Please refer to our footwear advice leaflet.

Footwear Adaptations:

Footwear can be adapted to allow for different leg lengths, improve stability and foot position, reduce pressure in particular areas, or allow an orthosis such as a calliper to be attached. Only shoes with firm soles can be adapted. Please refer to our footwear adaptations leaflet.

Ankle Foot Orthoses (AFO):

An Ankle Foot Orthosis or AFO surrounds the foot and ankle, keeping the joints in this area more stable and less painful when walking. Please refer to our AFO advice leaflet.

Knee Ankle Foot Orthoses (KAFO):

A Knee Ankle Foot Orthosis or KAFO gives support to the knee, ankle and foot. KAFOs can stop joints in your leg and foot from moving too far in any direction, improving balance and making walking easier, safer, and less painful. Please refer to our KAFO advice leaflet.

Knee braces:

Knee braces help to reduce painful or unstable movements in knees and kneecaps. They can reduce pressure on arthritic joints or injured soft tissues like tendons, protect the knee after surgery or injury, or help to stretch tight or contracted muscles.

Spinal braces:

Spinal braces can be prescribed for protection after surgery or injury to your back, to help with posture, or to slow down the development of spinal curvatures (scoliosis). Information leaflets for scoliosis braces are available on the Scottish National Spine Service website.

Shape Capture for Custom-Made Orthoses:

Orthoses can be off-the-shelf stock products or custom-made. Custom made items will need measurements, casts, drawings, impressions or scans taken of the affected body part at your initial assessment. Your orthotist will decide which device is most appropriate for you during your assessment.

Meet the team

Our team of 14 Orthotists and 5 Orthotic Technicians is based at the Astley Ainslie Hospital in Morningside. We treat ward patients and hold outpatient clinics at several other sites around Lothian. Unfortunately, during the COVID-19 pandemic we have not been able to offer outpatient appointments at all sites.

Meet Jess one of our current Modern Apprentices working for the SMART Service based in Edinburgh as an Orthotics and Prosthetics Technician. Jess provides an overview in the video below of what she does at work and at college to help you decide if this is a career for you.

Useful links

Please refer to the links below for further information on:

• Orthotic service for children and young people:

https://children.nhslothian.scot/departments-services/?_sft_category=orthopaedics

• Orthotic service for the Scottish National Spine Service:

https://services.nhslothian.scot/scottishnationalspineservice/brace/Pages/SNSDSbrace.aspx

• If you have an appointment booked for the Orthotics NearMe Clinic please click the following link:

Video call setup – Attend Anywhere

Patient entitlement:

Insoles

One pair of insoles will be supplied initially; these can be moved between different pairs of shoes. A second pair may be provided based on clinical need; this will be discussed at your review. The patient, or their carer or guardian, is responsible for keeping the insoles in good condition, and for letting us know if they are damaged, uncomfortable, or no longer supportive. See repairs below.

Orthotic Footwear

Patients are normally entitled to one or two pairs of orthotic footwear, based on clinical need. Orthotic footwear is replaced when it can no longer be repaired, or when the orthotist feels it is clinically appropriate. The patient, or their carer or guardian, is responsible for keeping the footwear in good condition, and for letting us know if they are damaged, uncomfortable, or no longer supportive. See repairs below.

Footwear Adaptations

Footwear will only be accepted for adaption if the soles, heels, and upper (the leather or material) are clean and in good condition. The style of the footwear must be suitable for the patient’s feet: well-fitting, stable, and supportive. We cannot adapt slippers or sandals. Some adaptions, like calliper sockets, need footwear with heels of a particular thickness or material. Your orthotist will give you specific advice.

Normally, one shoe or one pair of shoes will be adapted initially. Once the patient and orthotist are confident that the adaption is suitable, the Orthotics Department will adapt a total of three single shoes or three pairs of shoes every 12 months. If the adaption needs to be altered, or if a child outgrows their shoes, we will alter another three shoes or pairs and restart the 12 month clock. The patient, or their carer or guardian, is responsible for keeping the footwear in good condition, and for letting us know if the adaption is damaged, uncomfortable, or no longer appropriate. See repairs below.

Unless there is a clinical need, patients wanting any further shoe adaptions will be need to arrange and pay for these themselves with a cobbler or orthotic contractor.

AFOs, KAFOs, Spinal braces, Knee braces

Patients are entitled to one of each item, with the exception of KAFOs, when there may be a clinical need for two. These items are replaced as required, for example if there is a change in the patient’s needs, a change in body shape, growth in children, or if the device is beyond repair. The patient, or their carer or guardian, is responsible for keeping the orthoses in good condition, and for letting us know if they are damaged, uncomfortable, or no longer supportive. See repairs below.

Repairs

The patient, or their carer or guardian, is responsible for keeping their orthoses in good condition, and for letting us know if they are damaged, uncomfortable, or no longer supportive. Repairs might include re-heeling footwear, or replacing Velcro straps. This service is free of charge for items prescribed and fitted by our service. If you have footwear adaptions, we can repair the adaptions but not the footwear that you have supplied.

Some repairs can be carried out at the SMART centre while the patient waits. You must contact the Orthotics Department in advance to arrange a specific date and time for this service. Items needing more complex repairs will need to be dropped off and collected another day. Repairs should be done on a regular basis to prolong the life of the orthosis and to allow the orthotist to check that they are still suitable.

If you would like advice, a repair, or a review, please contact the Orthotics Department on 0131 537 9418.

Contact

The Orthotics Service can be contacted on:
0131 537 9418.