Custom Orthotics from a Chiropractor? For $150? Sign Me Up!

ATTENTION: Unfortunately, we longer provide the service of creating custom orthotics. The equipment we were using broke down and the manufacturer went out of business. We are still looking for a comparable system. Thank you for your understanding. 

At the behest of many of my patients who didn’t know but now do, I offer custom orthotics in my office. I feel compelled, however, to educate you on what a good orthotic is  and how you could benefit from it.

There are 3 different types of orthotics, generally speaking: non-custom, custom casted for the perfect stance, and custom evaluated for the perfect gait.

The first is the non-custom orthotic. These are the Dr. Scholl’s, SuperFeet or the kind from the Good Feet Store. Some can be a very good and beneficial product. Dr. Scholl’s are mostly just a padding to decrease shock absorption. SuperFeet and orthotics from the Good Feet Store are a lot more substantial and can

actually improve the way you walk or stand. The only issue I have with the Good Feet Store is the cost. You are paying custom prices (very expensive in my opinion) for non-custom or semi-custom orthotics. The semi is just because they have a wide selection for the salesperson to fit you as best as possible.

Custom orthotics created to mold the foot into the perfect stance is by far what most podiatrists use. They manipulate the foot and hold it in what is called taler neutral, basically, the ideal position of the foot. Then they make a cast which will be the mold to create the orthotic. Another method is to have you stand on a plaster or foam mold from which they create an orthotic. Typically, the orthotic is made of a hard plastic with no flexibility to keep the foot in the same position.

Either way, this method, in this doctor’s opinion, is outdated and shortsighted. The foot is designed to be flexible. When we walk, the perfect gait is for the heel to strike. Then, the arch flattens out while the foot pronates (flattens inward). Ideally, the flattening of the foot stretches the plantar fascia which creates a taut spring. When the pressure is released, the spring

pushes off  the big toe to the next step. When you put in a piece of hard plastic, you negate the action of the foot. Essentially, you make your foot into a post. You take away the foot’s ability to absorb shock or act as a dynamic player while walking or running. The shock has to be absorbed by something. If the foot cannot absorb shock then it will certainly transfer to the knee, hip, or low back. Plus, it forces those other structures to compensate for the altered mechanics. Who cares if the foot is in a perfect position when you stand still? We are mobile creatures who need to move and function.

The best type of orhtotic and hence, the type I offer in my office, is the kind that corrects the gait. Often times, for various reasons, the foot doesn’t perform the way it should. It makes sense to me to help it work the way it was intended and designed. When we create an orthotic we take into consideration the stance and the gait. We have a digital plate that captures the pressure and the pattern of your stance and your gait. The goal is now to create a flexible and dynamic orthotic that will assist your foot in behaving the way it should.

Not everyone needs orthotics. Every time you add external devices there will be secondary and tertiary reactions. It is difficult to account for all of them. I have had plenty of patients who were wearing orthotics and complaining of all sorts of issues. I told them to take out the inserts and things resolved.  My first course of action when someone asks for an orthotic is to discuss why. Sometimes just adjusting the foot will take care of the foot issue. I also like to look at value. If a patient can resolve their issues with non-custom orthotic for $35, then paying $150 for a  custom pair might not seem worth it. That saying, if you need a custom pair of orthotics, they can be of tremendous benefit and can really preserve not only your foot but your knees, hips, and back, as well.

Post Script: Don’t let the price fool you. I could easily charge $300-600 for these orthotics (everyone else does). These are made by the same types of labs that do work for every doctor who works with orthotics. I keep my prices low because if people need them I want them to be able to afford them. Do I make much money from them? No. For now I am going to keep them at $150. I actually dropped them down from $200 because I switched to a direct lab and they only charge me around $100 per pair. If you want some, act quickly because the time it takes to gather the information is substantial and I will probably go back up to $200 again, soon (which is still a bargain).

It’s Not All About Pain, People!

Pardon my rant for moment and please consider what I am about to say. Pain is a symptom or an indicator. Pain is annoying. Pain can be frustrating. Pain can even be debilitating. Treating for pain, however, is a terrible way help someone get out of pain.

The origins of pain are not well understood and can be a very deep topic. That saying, from my study, most of our pain is distributed through the limbic center of the brain. The limbic system is really the emotional center of the brain. So, to me, pain is an emotional response. Ever notice that some people have a high pain threshold and others have little to none? Likewise, some cultures are very stoic about pain while others are extremely passionate. The very same stimulus can be applied but the reaction is completely different.

Don’t get me wrong. Pain is very real. I am not suggesting we write off anyone in pain with the idea that it is all in their head. What I am suggesting is that we keep pain in perspective. Bad pain does not always mean horrible damage. Likewise, some of the most serious damage to the human body can display very little pain. Furthermore, pain can be a good thing when it gives a warning that something can be harmful. Have you ever stepped on hot sand and immediately pulled away so you didn’t burn your feet? What if you were a diabetic with poor blood circulation and therefor poor feeling in your feet. Would you say that it was a good thing to burn your feet because you couldn’t feel it? Of course not!

Rather than focus on the pain of an injury, I like to focus on the rehabilitation or function. If we only treated for pain, very few people would ever recover. Rehabilitating an injury whether chronic or acute can be painful. Let me say that again, TREATMENT CAN BE PAINFUL!  Sometimes we have to break down a lot of scar tissue. This will be painful. When you are dealing with functional and physical medicine, like chiropractic, the end result is to get you functional which will eventually lead to less pain. By the way, this takes time.

Please don’t kid yourself that you can rehabilitate an injury without pain or discomfort. It is just not how the body works. Would you expect to work with a personal trainer to get in shape and never feel soreness or fatigue? Instead, focus on improving function and accept pain for what it is. In the words of the Dred Pirate Roberts aka Westley from The Princess Bride, -“Life is pain, your highness. Anyone who tells you differently is selling something.”

Ice or Heat?



I get asked quite frequently whether to use ice or heat on an aching joint. When in doubt, use ice but use it properly. I have outlined protocols for icing below. That is not to say that there are not times when heat is appropriate, but icing is almost always beneficial if done right, whereas heat can cause problems on a new or inflamed injury.

The rule of thumb is that if the injury is acute or new within the last 6 weeks or if it is an exacerbation of an injury, use ice. Heat is good for loosening up sore muscles and stiff joints. If you need to get things moving, heating for 20 minutes can be very therapeutic. Be careful though. If you heat an inflamed joint, it will feel better while it is on but the heat will increase the inflammation and not only cause more discomfort but also prolong your healing. As a precaution, I typically recommend using heat only if you are going to be moving around (ie. never before or during bed time). If you are going to use heat before bed, follow it up with ice. That way you won’t wake up feeling like you were hit by a train.

Icing is not as simple as just putting something cold on you for a little while. If done properly, it can be extremely beneficial. If done improperly, it will have little to no benefit. So, here are the rules to using ice properly.

1. Cover the affected area. Not using enough ice will not drive the inflammation away enough to make it worth the pain of icing. A nice big ice pack for big areas like the back, legs and arms is critical. Conversely, for feet and hands an ice pack might not be good at all. I usually recommend an ice bucket if the body part fits. ***I will explain those protocols below.

2. Make sure the ice penetrates. Too often, people will put a bath towel between the ice pack and the affected area. Their excuse is usually that it is too cold. They are missing the point. It is supposed to be cold! You should only use a paper towel or thin t-shirt in between.

3. Let it go numb. If the area you are icing doesn’t get numb you really haven’t done it right. When icing you should feel it get cold which should then start to burn. (Be careful not to get an actual ice burn. On rare occasion if the ice pack is too cold and it is up against sensitive skin it can burn the skin. This shouldn’t happen with most ice packs and if you have a paper towel between.) After the burning feeling, the area should start to ache until it goes numb. Once it is numb, you are done!

4. Never ice longer than 20 minutes. After 20 minutes the body sends out a signal that the area is developing frostbite and will send more blood to the area. As icing helps to drive blood/inflammation away, sending more blood in is a bad thing. If after 20 minutes the area never got numb, take it off and wait 40 minutes to ice again.

5. Wait 40 minutes before you can ice again. Make sure the affected area is back to regular body temperature before you shock it again with ice.

***Ice Bucket Protocol: Use an ice bucket for ankles/feet and hands/wrists. This is by far the best way to drive out inflammation from these areas.
1. Get a bucket big enough.
2. Put as much ice in it that will cover your affected extremity.
3. Fill it with water to the same level.
4. Cover fingers or toes with a sock.
5. Immerse the extremity.
6. Keep it moving gently to keep the water immediately surrounding from warming up.
7. Ice until numb (usually around 5 minutes).
8. Repeat once the limb is back to body temperature.

10 Things To Do If You Get In An Auto Accident!

auto-accident1. Make sure you and the other driver are safe before getting out of the car. If you are in a busy intersection move out of harm’s way (if possible). Make sure you pull as far as you can to the side of the road.

2. Check for injuries. Most people don’t feel injured immediately after an auto accident because of the adrenaline rush. Be cautious. With every auto accident you are going to have an injury; the forces involved are just too great not to. If an ambulance comes, the EMT’s will check things out. They usually recommend you come with them. If you feel like you can drive home then tell them. If not, go. Better safe than sorry. It will be a pain to deal with the ambulance bill when it comes and your claim hasn’t been paid, but your health is worth the hassle

3. Exchange information. At minimum, you should get their name, telephone numbers, license plate and card numbers, and their insurance information. One of the more innovative things I would recommend besides writing down the above information is to take lots of pictures. Most cell phones these days have cameras. Take pictures of the accident but also take pictures of their driver’s license and insurance card.

4. Call the police. Do this just in case. Truth is, most of the time they just tell you to exchange information. It may not feel necessary to call but you never know. If you call and they can’t help you in time then call back later and file a police report. This will help protect you.

5. Inform your and the other driver’s insurance company. The quicker you get the ball rolling the easier it will be for you. There are two sides to an auto accident claim, the property damage and the bodily injury. The car they should fix quickly. Taking the time to see a doctor about the bodily injury before any decisions are made is important (will discuss next). If the accident was not your fault, you should still let your insurance company know. They can back you up if the other person is either under insured or just a pain to work with. You may also have Med-pay which is an extra writer that covers injuries regardless of who may be at fault.

6. See your chiropractor! Chances are you have some pain or discomfort. Even if you don’t have pain, get an exam. In every auto accident you are dealing with forces that cause tissue damage. Sometimes you don’t feel the problems until months later when weak scar tissue tears and starts the inflammation again. In addition, it is tough to argue with insurance companies unless you get checked out soon after the accident.

7. Ice. The protocol for icing should be 20 minutes maximum on the affected area. You want to feel the cold then burn then ache before it goes numb so only use a paper towel or thin t-shirt between your skin and the ice pack. NEVER USE HEAT after an auto accident. This will feel good while it is on but bring a lot more blood to the area and make the inflammation worse. Increased inflammation will slow down the healing process.

8. How should you pay for your care? This could be its own blog post but I will keep it short. If the accident was not your fault you shouldn’t have to pay anything out of pocket. I am happy to treat people on a lien until is settles. If it is your fault you either have to pay for it yourself or have Med-pay on your auto insurance policy. Besides Med-pay, if you are not at fault, retaining an attorney can save you a lot of hassle and stress and should help you get a little extra money for all the things you will have to deal with on your road to recovery.

9. Journal. The more information you have the better. Take note of your aches and pains, when you have to take pain meds, times when you get headaches, days/hours missed from work. One of the most important things you can document is what you cannot do anymore as a result of your injuries from the auto accident. Detail will help convince the insurance adjuster that your injuries are legitimate.

10. Get better. Healing takes time. It is a roller coaster ride that can be frustrating. Don’t stop treatment too early or it could come back and become chronic. Remember, a positive attitude goes a long way to healing.

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Proprio…What? or, Are You Coordinated?


One of the best ways that chiropractic can help everyone from everyday folks to elite athletes is by improving proprioception (pronounced:pro-pre[long “e”]-o-sep-shun).

Proprioception has to do with coordination and position sense. Try this experiment. Close your eyes and touch the tip of your nose with your finger tip. Were you able to do it? The highest number of nerve receptors that sense movement are in the neck, hands and feet. All joints, however, have their fair share. The better these receptors work, the better the body can respond.

Let me give you an example. If a person sprains his or her ankle, they are more likely to sprain it again and again. The reason this happens is because first, the ligaments are weak but more importantly because with injury the proprioceptors become dull. It doesn’t have to be injury either. Posture changes proprioceptors, as well.

The danger of having dulled proprioceptors is a much broader topic than you probably want to delve into at this time. Suffice it to say that if your proprioceptors are not working well, you leave yourself very susceptible to injury. Likewise, pain sensation travels on the same nerve fibers so pain increases as proprioception decreases and vice versa.

The trick to getting these proprioceptors to wake up? Get the joint moving. Lack of motion or improper motion scrambles the receptors. Proper stimulation through movement, improves their function. Chiropractic adjustments and activities that challenge us physically both in strength and coordination are the best ways I can think of to accomplish this goal.

Mesothelioma Pain Management through Chiropractic Care

Chiropractic care is typically administered to treat and prevent pain and disorders pertaining to the musculoskeletal system that controls the body’s movement, including the spine. However, it is often sought as a form of alternative medicine and complementary care to coincide with traditional medical treatments.

In order to help manage pain and relieve headaches, tension and stress, many cancer patients have included chiropractic care in their course of treatment. Patients interested in alternative treatment, who strongly believe in the body’s ability to heal itself, may find chiropractic care particularly appealing. Alleviating severe headaches and movement pains during cancer treatment may make the treatment process more comfortable for cancer patients, including those fighting mesothelioma.

Mesothelioma is a type of cancer that is mainly cause by exposure to asbestos, a naturally occurring mineral that was used in a number of military and industrial applications throughout the 20th century. The symptoms typically take 20 to 50 years to become noticeable and by this time the disease is usually in advanced stages. Treatment options are often limited as the cancer is diagnosed late in development.

Two studies published in the Journal of Manipulative and Physiological Therapeutics examined the cases of two patients combating cancer. A 57-year-old man diagnosed with terminal pancreatic cancer experienced significant pain relief and was able to reduce the amount of medication needed following chiropractic care. He also reported an increase in his quality of life during his journey with the cancer following a visit to a chiropractor.

A 54-year-old man diagnosed with lung cancer (a cancer sometimes linked to asbestos exposure) began seeing a chiropractor after experiencing little pain relief one year after he underwent surgery to combat his cancer. The man experienced pain relief immediately after beginning chiropractic care and discontinued use of all pain medications after two visits to his chiropractor. The Journal noted, “These clinical examples offer two specific instances of how chiropractic may improve the quality of a cancer patient’s life.”

Note: Though I am not the author of this blog post, I fully endorse its message and the benefits of chiropractic for patients suffering from mesothelioma. I would also add that in my office we have seen great success helping people who are suffering from a variety of cancers and their subsequent treatment protocols (radiation, chemotherapy, etc.) with both chiropractic and hyperbaric oxygen therapy. –Dr. Thomas

Spinal Stabilzation Exercise Bird Dog (#2/4)

In this video, I explain how to perform the “The Bird Dog.” This is not a difficult exercise but it does require some coordination. It helps facilitate the erector spinae muscle which are the long muscles that run on either side of the vertebrae. I recommend doing this daily 10-20 times after doing the Cat/Cow.