Orthotists, physiotherapists and podiatrists are all concerned with the treatment of injuries or health conditions and the three professions require extensive medical training. However, while the exact nature of their work differs in many ways, the occupations also have areas where they overlap, which can cause a certain amount of confusion.

Here, we take a look at some of the key differences between the three disciplines.

Physiotherapist

Physiotherapists, sometimes known as physical therapists, are trained medical professionals, who are licensed to evaluate, diagnose and treat physical issues like injury or disability in patients. Crucially, a physiotherapist will usually have a broad range of knowledge and will not specialise in treatment of a single body part.

Treatments performed by a physiotherapist can be roughly divided into three categories:

• Movement and Exercise Therapy – The physiotherapist teaches the patient a number of different movements or exercises, which can help to improve the injured area and restore normal musculoskeletal function.
• Manual or Manipulative Therapy – The physiotherapist performs ‘hands on’ techniques like massage or joint manipulation, improving blood flow and interstitial fluid dynamics, in order to alleviate pain and stiffness.
• Other Techniques – This includes a range of evidence-based treatments like ultrasound therapy, thermotherapy and cryotherapy, as well as treatments which fall under the ‘alternative medicine’ banner, like acupuncture.

Most physiotherapy is performed within the NHS, although the discipline is practised privately as well. In most cases, it is carried out post-operatively, but physiotherapists are able to play a preventative role to some extent, and many patients choose to book regular check up appointments for this reason.

Podiatrist

Unlike a physiotherapist, a podiatrist specialises in treatment of a specific area of the body – the feet and ankles. Essentially, they can be thought of as ‘foot doctors’. The terms ‘podiatry’ and ‘chiropody’ are interchangeable, meaning they may also be referred to as chiropodists.

Generally, a patient will be referred to a Physiotherapist, Orthotist or a Specialist Podiatrist if they have a muscle, bone, tendon, joint or ligament condition in their foot, ankle or lower extremities. Some common examples include foot fractures, sprains and arthritis. However, podiatrists also treat patients experiencing problems with their toenails, or suffering from foot-related skin conditions, with examples including corns, callouses and severe blisters.

In many cases, patients will be referred to Podiatrists or Orthotist as a first port of call, or if their condition fails to respond sufficiently to physiotherapy. In addition to traditional techniques, very specialist podiatrists are able to carry out injection therapy and various minor surgical procedures.  Both Orthotists and a Specialist Biomechanical Podiatrist are qualified to perform in-depth gait analysis.

Orthotist

Finally, orthotist’s specialise in the creation and application of devices which are used to support or control body parts. Such devices are often referred to as ‘orthoses’ and the medical field concerned with them is called ‘orthotics’. Usually, an orthotist will be responsible for prescribing orthoses, manufacturing them and managing their use.  A foot and ankle specialist orthotist will be qualified to accurately assess and diagnose injuries of the foot, ankle and lower limb.  They have extensive knowledge of whole body biomechanics, which is how the joints of the entire body are aligned and function.

The practice of orthotics can be applied to various body parts, although many orthotists specialise in treating specific areas of the body, such as the legs and feet. Professionals working in this field are required to combine knowledge of physiology and the anatomy with elements of engineering and biomechanics.

Orthoses may be given to patients for a whole number of reasons, including:

• To immobilise a part of the body in order to allow it to heal
• To assist movement or offer support
• To correct the shape or function of a body part
• To limit a body part’s possible directions of movement

Examples of orthoses used to treat foot and ankle conditions include ankle braces and arch supports. Typically, these will be custom made, after a comprehensive biomechanical assessment has been carried out.

Quite often, patients will be referred to an orthotist in order to treat an existing condition, as orthotics are excellent for assisting in the rehabilitation of injuries, or for reducing pain associated with long-term health problems.

However, one of the key benefits of orthotics is its ability to prevent injury from occurring in the first place. For instance, long-distance runners may be advised to visit an orthotist in order to obtain advice regarding footwear, foot orthotics or foot mobilisation treatments. This can be customised based on their exact measurements and gait, in order to reduce the stress placed upon the joints.

If you are feeling foot, leg or back pain get in touch with The Foot and Leg Clinic. We can perform aspects from all of the above, for instance foot and leg mobilisation techniques, video gait analysis as well as manufacturing orthotics.

Book an appointment today