Tips for Diabetic Foot Care

The nerve and blood vessel damage caused by diabetes can become a problem for your feet if you develop neuropathy, which occurs in about 70 percent of people with diabetes. To ensure the best possible foot health, follow these easy tips to keeping your feet healthy longer.

  1. Inspect your feet daily for changes in color, sores, or cracked skin. A mirror on the floor can help with getting a better look.
  2. When stepping into hot water, such as a bath, hot tub, or shower, use your elbow to check the water temperature. Because people with diabetes tend to develop nerve damage in their feet, they may not realize if the water is too hot and could therefor scald themselves.
  3. Look for shoes with more depth in the toe box and good coverage on both top and bottom and without seams inside the shoe that can rub on your foot.
  4. Wear shoes at all times—even inside the house. With neuropathy, it’s difficult to feel small cuts, scrapes, or other hazards that might harm your feet. Worse, you might not notice the damage until a minor injury becomes infected.
  5. Avoid high-impact exercises that include bouncing, jumping, and leaping. Instead, consider walking or swimming to avoid putting too much pressure on your feet.
  6. Quit smoking! The dangers of smoking run from your head to your feet. The nicotine in a cigarette can decrease the circulation in your skin by 70 percent. If you smoke, you’re depriving your feet of the nutrient and oxygen-rich blood that keeps them healthy and fights infection.
  7. Consider investing in a pair of orthotics or extra depth shoes. A properly fitted pair of orthotics or extra depth shoes can prevent foot wounds by improving fit and reducing pressure, pain, and the chance of deformities.

Managing Phantom Limb Pain

It’s not uncommon for an amputee to experience residual limb sensation, also known as phantom limb pain. Phantom limb pain is the feeling that the amputated body part is still there. The very real condition is described as feeling tingling, itching, twisting, cramping, pins-and-needles, stabbing pains, pressure, or a sense of fullness where an amputated body part once was.

Phantom limb pain is caused by the series of connected nerve pathways from each area of the body to the brain. As you remove a limb or a piece of the body, those pathways still exist, which confuses the brain because it’s no longer getting input from that area.

It’s no fun living with phantom pain, and while there’s no single solution for getting rid of it, there are several ways to reduce and relieve it.

Solutions include non-invasive therapies, such as heat, cold, manual manipulation, TENS, acupuncture, and mirror therapy, which is where the patient watches in a mirror while receiving physical therapy to revamp the brain’s neural pathways so it registers that the limb is no longer there. With these non-invasive therapies, it’s really trial and error. What works for one patient may not work for another.

Allen Orthopedic Labs encourages patients to treat phantom limb pain by envisioning the limb and firing the muscles in that limb. For example, stretch fingers and toes while imaging the limb responding.

If the above therapies don’t work, there are some minimally invasive procedures that may relieve your pain, including injections, nerve blocks, and surgical intervention.

Have more questions about phantom limb pain? Contact Allen Orthopedic Labs. As experts in the field, we’ll find a solution that works for you.

When You Might Need a Foot Orthotic

1 Nov 2019 Orthopedics

If you suffer from foot pain or other types of discomfort, you might need foot orthotics.

The following conditions are telltale signs you may benefit from orthotics:

Pain in your foot that lasts longer than two weeks.
Pain lasting longer than two weeks could be an indication of an injury. It would be a good idea to talk to your doctor about any ongoing foot issues. Orthotics can help manage pain for a range of different conditions such as metatarsalgia and shin splints.

Heel Pain
Severe pain in the heel is not normal. If you’re experiencing pain, particularly in the morning, it could be the sign of a foot condition, like plantar fasciitis. Plantar fasciitis can be treated with orthotics, metatarsal pads, stretching, and lifestyle changes.

Over or Underpronation
Our feet naturally have a turn to them. But sometimes, this can be over or under what is normal. When this happens, the conditions are called over-pronated or under-pronated and can cause significant pain and exhaustion. You will need foot orthotics to help with either of these to correct your feet.

Not sure if you suffer from over or underpronation? Try the Wet Test. With wet feet, stand on a piece of newspaper or paper towel and then examine your footprint. A footprint without a c-curve in the arch could signify a pronator, and a prominent c-curve could suggest supination or underpronation.

Knee Pain
Foot orthotics can change the distribution of force through the foot and ankle, resulting in a change in the distribution of force through the knee.

They can act as cushions to reduce the force through the foot and ankle, which can result in a reduction of force through the knee.

Foot orthotics can also change the alignment of the foot and ankle, which can result in a change of alignment at the knee. For example, they can control overpronation (rolling in) of the foot, which can result in patellofemoral pain, iliotibial band syndrome, or increased pain from some types of osteoarthritis worse. As the foot overpronates, the lower leg and knee internally rotate. Orthotics can help control overpronation of the foot, which in turn, improves the alignment of the knee and thereby reduces knee pain.

Medicare Coverage for Therapeutic Shoes, Inserts, AFOs, and KAFOs

Health insurance is a complicated business, and Medicare is no exception. If you’re a Medicare recipient and in need of therapeutic shoes, inserts, an AFO, or a KAFO, follow the guidelines below to ensure you get the coverage you need.

Diabetic Shoes and Inserts

Medicare recipients are entitled to one pair of custom-molded shoes with inserts or one pair of extra-depth shoes each calendar year. Medicare also covers two additional pairs of inserts each calendar year for custom-molded shoes and three pairs of inserts each calendar year for extra-depth shoes.

However, to receive this coverage, a podiatrist or qualified doctor must prescribe these items. Patients must also have been seen by the doctor treating their diabetes no more than 90 days prior to receiving the shoes.

If you meet the above requirements and your provider accepts Medicare, you’ll pay 20% of the Medicare-approved amount with the Part B deductible applied.

Don’t let a missing document stop you from getting the diabetic shoes or inserts you need. Review this Medicare document checklist to make your order easy and painless.

AFOs and KAFOs

Medicare will also cover AFO and KAFO prescriptions, although additional documentation and notes are necessary to receive full benefits.

Documentation from the ordering physician, such as chart notes and medical records, is required for coverage. Other required details include the history of the injury, illness, or condition, description of limitations of a typical day, status of the current orthosis, and reason for replacement.

Don’t forget any of the paperwork required for your AFO or KAFO. Review this list of documentation required by Medicare.

Know Your Durable Medical Equipment (DME) Coverage Terms

Jeez, health insurance coverage is a complicated business. However, knowing a few key terms can go a long way to making it more understandable. Take a look at the following terms. With these in your arsenal, you’ll confidently navigate your way through insurance documents.


The amount the policy-holder or their sponsor (such as an employer) pays for a health plan.


The amount the insured (that’s you!) must pay out-of-pocket before the health insurer pays its share. For example, policy-holders might have to pay a $500 deductible per year before any of their health care is covered by the health insurer. It may take several doctor’s visits or prescription refills before the insured person reaches the deductible and the insurance company starts to pay for care. Some plans may have separate deductibles for specific services.


The amount the insured person (you, again!) must pay out-of-pocket before the health insurer pays for DME. For example, an insured person might pay a 20% co-payment for an orthotic device.


Exclusions are services that are NOT covered. Insured are generally expected to pay the full cost of non-covered services out of their own pockets. Please note that foot orthotics are often excluded unless the patient has a diabetes diagnosis.

Coverage Limits

Some health insurance policies only pay for health care up to a certain dollar amount. The insured person may be expected to pay any charges in excess of the health plan’s maximum payment for a specific service. In addition, some insurance company plans have annual or lifetime coverage maximums. In these cases, the health plan will stop payment when the benefit maximum is reached and the policy-holder must pay all remaining costs.

Out-of-Pocket Maximums

The insured person’s payment obligation ends when they reach the out-of-pocket maximum, after which the health insurance pays all further covered costs. Out-of-pocket maximums can be limited to a specific benefit category or can apply to all coverage provided during a specific benefit year.

In-Network Provider

In-network refers to providers or health care facilities that are part of a health plan’s network of providers with which it has negotiated a discount. Insured individuals usually pay less when using an in-network provider.

Prior Authorization

A certification or authorization an insurer provides prior to medical service stating it will cover a percentage of the cost. This is often required for DME.

Explanation of Benefits

A document by an insurance company to a patient and the provider of service explaining what part of the medical service was covered.


A written order from your primary care doctor or specialist that is always required by our office. In many Health Maintenance Organizations (HMOs), you need to get a referral before you can get medical care from anyone except your primary care doctor. If you don’t get a referral first, the plan may not pay for the services.

Standards of the Orthotic and Prosthetic Profession

The term “professional” makes you think someone has a specialized education, demonstrated skills, and proven experience. This is especially true for orthotists and prosthetists. Like their counterparts in the allied health professions, O&P practitioners are evaluated against exacting stan­dards of education, clinical experience, professional knowledge, and demonstrated competence.

The following are three areas in which orthotists’ and prosthetists’ standards are measured:


Nine U.S. accredited programs offer formal O&P education with credentials ranging from bachelor’s degrees to master’s degrees. The instruction in these programs places particular emphasis on anatomy and physiol­ogy, patient management skills, clinical practices and professional­ism, fabrication, and fitting tech­niques.


Board certification of practitioners establishes and promotes the highest standards of organizational and clinical performance in O&P service. The American Board for Certification in Orthotics and Prosthetics serves as the comprehensive credentialing organization for establishing individual and organizational performance standards in orthotic and prosthetic care.

ABC certification is well-recognized and highly respected in the O&P field. To earn it, orthotists and prosthetists must meet well-defined educational and experience requirements and pass a rigorous written examination, written simulation, and two-day clinical exam.


Despite the existence of national O&P certification and accreditation programs, various underqualified providers continue to deliver substan­dard orthotic and prosthetic care, resulting in negative consequences. To combat this, 14 states now require licensure for orthotists and prosthetists.

Allen Orthopedic Labs is an ABC certified office with ABC certified practitioners.

Common Usages of Ankle Foot Orthoses

1 Sep 2019 Orthopedics

Ankle-foot orthoses (AFOs) are the most commonly used orthoses, making up about 26% of all orthoses provided in the United States.

AFOs are externally applied and intended to control position and motion of the ankle, compensate for weakness, or correct deformities. AFOs can be used to support weak limbs or to position a limb with contracted muscles into a more normal position. They are also used to immobilize the ankle and lower the leg in the presence of arthritis or fracture and to correct foot drop caused by a variety of neurological and musculoskeletal disorders.

In fact, AFOs are sometimes referred to as the foot drop brace. Foot drop or “drop foot” is a condition where a person has difficulty lifting the front part of the foot. If you have foot drop, you’ll tend to drag your toes across the ground while walking. You may compensate for this problem by lifting your knee higher. In mild cases of foot drop, you will hear and feel your foot “slap” the ground while walking.

Allen Orthopedic Labs can effectively treat foot drop with the right ankle-foot orthosis. Contact us to learn more.

A typical AFO creates an L-shaped frame around the foot and ankle, extending from just below the knee to the end of the foot. AFOs can be purchased off-the-shelf or custom molded to an individual wearer.

Allen Orthopedic Labs has the latest technology and can fit you with an off-the-shelf solution or custom fabricated design tailored to your exact condition. Contact us and begin healing today.

The Importance of Weight Maintenance with Your Prosthetic Socket

The absence of a limb and a portion of the muscular-skeletal system can cause physical strain on the rest of the body, not to mention the emotional strain of adapting to limb loss. Both your initial recovery and long-term wellness will benefit from committing to a healthy lifestyle.

During rehabilitation and beyond, it’s important to eat as healthily as possible and to remain active to keep your weight stable. Maintaining a consistent, healthy weight is important for everybody. But for those who have lost a limb, it’s even more important for the following reasons:

  • To reduce the energy required to use your prosthesis
  • To prevent or reduce secondary conditions, such as back pain
  • To control diseases such as diabetes and high blood pressure
  • To improve your mood and mental health

Most importantly, weight maintenance will help ensure a proper fit of the prosthetic socket attached to your residual limb.

Gaining weight can make the socket tight and uncomfortable; losing weight can cause it to be loose and more difficult to control. In either case, it’s sometimes necessary to fabricate a new socket to accommodate the changing dimensions of the residual limb.

Getting used to a new prosthesis is a physical and psychological challenge involving a partnership between the patient and their prosthetist. Connect with Allen Orthopedic Labs. We’ll work with you through every stage of the process, from choosing the best prosthesis for your needs to helping you learn how to operate your new limb and tackle new challenges.

How to Find the Right Shoes for Your Child’s AFO

Lots of questions are sure to arise when having to buy shoes for your child’s AFO. From types of shoes to fitting techniques and everything else in between, Allen Orthopedic Labs has the answer for you.

Don’t dismay! Here are our tips for buying shoes that fit your child’s AFO:

  • Your child may not want to go shoe shopping, and that’s fine. Just be sure to have the brace with you to fit into potential shoes
  • Wider shoes work best with AFOs
  • Buy two different sizes if necessary – HINT – Nordstrom Department Store will sell a left and a right shoe in different sizes for the cost of one pair of shoes
  • Sneakers are the most compatible shoe with AFOs
  • Consider pulling the insole out for a better fit
  • Look for shoes with a wide toe box
  • Cut away the fabric attaching the shoe tongue to the shoe if applicable.
  • Pick shoes with laces instead of Velcro because they provide a more secure fit
  • For shoes with Velcro, consider getting strap extensions to ensure a better fit
  • Instead of shoving your child’s foot in, try rocking the shoe heel back and forth, which will help it slide on more easily

Contact Allen Orthopedic Labs and we’ll answer any additional questions you might have about buying the right shoes for your child’s AFO.

There are a lot of great shoes out there, but these companies offer those that work best with AFOs:

  • Hatchbacks and Surestep because they design with orthoses in mind
  • Nike FlyEase
  • Answer 2 Shoes for AFOs
  • New Balance and Saucony because they offer extra wide sizes