You go to the doctor for foot, ankle, or knee pain and he gives you a custom foot orthotic prescription. What is the next step? Give us a call! Bioworks accepts most health insurance plans and some insurances cover foot orthotics. We can help start you on the road to recovery. Foot orthotics do require at least two appointments with one of our certified orthotists or pedorthists.
What to Expect at Your Foot Orthotic Evaluation:
If your physician prescribes you custom foot orthotics, it is a two-step process. First you come in for a no cost evaluation. Our orthotist or pedorthist will evaluate your feet, watch you walk, and discuss the goals you would like to achieve. At this appointment, we will also discuss insurance; there are certain insurances we know will not cover orthotics (Humana and Medicare), but do not fret we do offer orthotics at a discounted rate. Typically, we bill insurance between $375 and $400 but if we know insurance will not pay we drop the price down between $250-$275 depending on the orthotic received. We also allow for patients to go on payment plans; it’s never a set payment, just what you feel comfortable paying that month.
Once you have your evaluation you do not have to have the orthotics fabricated; we can check your benefits, call you with the information, and then you can decide. If it is not the right time for you to get them or if you just don’t think orthotics will work for you, there is no charge for anything. We only bill insurance or you, if a product is received. The information we obtain from your evaluation is good for 3 months before you would have to come in for another evaluation. If you would like us to bill insurance we will need a prescription from your physician.
What to Expect at Your Foot Orthotic Fitting:
Fitting usually takes place between 1 or 2 weeks of the evaluation, depending the orthotics fabricated. We ask that you bring the shoes that you wear the most. We will take those shoes into our lab and grind the length of the orthotic to fit inside. Next, we will have you walk and make sure they feel comfortable. If there is something that is uncomfortable, we can fix it right then and there. Once you are fitted for the orthotics, we suggest weaning onto wearing them all day. This may take a couple weeks, it could take a couple days.
What to Expect After Your Fitting:
Depending on your activity level, your orthotic may wear down and feel different than when you were initially fit. We offer free adjustments for the life of your orthotics. If you are wearing them and something doesn’t feel right or you are getting blisters, give us a call and we will gladly set you up with an appointment for an adjustment. Most orthotics should last 2-3 years, depending on your activity level. If your top cover has worn away and it has been less than a year, we will replace for free; if it has been over a year it is a $25 self-pay charge.
Walking around with foot, ankle, and knee pain is never fun. Let us help you gain a pain free lifestyle. Give us a call at (513)793-7335 or fill out our appointment request online and we can get started today!
You can request a foot orthotics appointment if you have a prescription from your doctor.
We’ll confirm your request within one business day.
Elbow Surgery (Tommy John) – Ulnar Collateral Ligament
Contributed by Stephanie Thomas, COF
To coincide with 2017 Opening Day, we decided to shed some light on a procedure we see quite often that is related to baseball and more specifically pitchers. In fact, a professional pitcher was the first person to have this elbow surgery about 40 years ago.
Who is Tommy John?
In 1974 Los Angeles Dodgers’ pitcher Tommy John was having a great 11th season in the Majors, starting 13-3. Many believed he would eventually be a Cy Young Award winner, but he damaged his ulnar collateral ligament (UCL), which is a ligament of the elbow. He was adamant about returning to baseball. John went to the team physician, Dr. Frank Jobe and asked him to develop an elbow surgery that would fix his UCL and allow him to pitch again. Dr. Jobe developed a technique that allowed John to return to pitching in 1976. Since then there have been different techniques developed to help repair the UCL.
Original Procedure – During Dr. Jobe’s procedure, he would harvest the patient’s palmaris longus in the wrist. It is important to note that not everyone has a palmaris longus; if the patient doesn’t have this ligament the surgeon may opt to harvest a different autograft (from patient’s body) such as the gracilis, plantaris, or a strip of the Achilles to complete the elbow surgery.You can test yourself by touching your thumb to your ring finger and twisting your wrist. The ligament will pop out (like the photo) if you have it.
Dr. Jobe utilizes the Figure 8 technique where he would drill two holes in the medial epicondyle and two holes into the ulna and feed the palmaris longus through. Then he would suture the tendon to itself. He also had to detach the flexor-pronator musculature at its origin which would cause the ulnar nerve to transpose.
Docking Technique – This technique, developed by Dr. David Altchek, it is different from the original technique in many ways. First it does not detach the muscle group, instead, it uses a muscle splitting technique. This procedure also does not drill as many holes, and the tendon is shaped into an “elongated D” instead of a figure-8. The tendon graft enters the humerus but never exits and is sutured to the bone.
What are the Signs and Symptoms of Ulnar Collateral Ligament Injury?
You may feel a “pop” on the inside of the elbow that is accompanied with pain and possible swelling. You could also notice that you are weaker when throwing. Always make sure you have your injury evaluated by a healthcare professional; an MRI may be ordered to determine if there is a tear in the ligament that requires elbow surgery.
Who should have “Tommy John” elbow surgery?
Surgical intervention should be discussed with your physician. There are conflicting ideas on how early is too early to for an athlete to have this procedure. Many believe that high school athletes should not have the surgery due to some athletes still growing, where others believe it is ok. You should also ask the doctor what type of technique he/she will be performing.
Treatment and Rehabilitation
If you decide to have “Tommy John’s” elbow surgery, you will be placed in an elbow range of motion orthosis, after the procedure, (we use the Breg T-chek, seen below) to help protect the elbow and to eliminate movement. The orthosis is also adjustable to allow for a controlled range of motion. When the time comes, you will begin physical therapy and rehabilitation to get back to throwing again. This whole process can take over a year. Discuss the timeline with your doctor.
Our specialists can answer questions about the The T-chek Brace
Just call us or complete our contact form and we’ll get back with you within 24 hours.
 Ellattrache N; Harne C; Mirzayan R; Sekiya J. Surgical Techniques in Sports Medicine. Lippincott Williams and Wilkins. 2007.
 Vitale M. Ahmad C. The Outcome of Elbow Ulnar Collateral Ligament Reconstruction in Overhead Athletes: A Systematic Review. Am J Sports Med. 2008;36:1193-1205.
 Borak T. Ulnar Collateral Ligament Reconstruction: A Look Inside Tommy John Surgery. The Surgical Technologist.2009;41:163-172.
When you can’t get orthotic shoes from a specialist, you can use these tests and choose the best shoes to support your feet and provide the best support for your knees, your back, and your posture.
Tammy Daulton, Our Licensed Pedorthist has simplified this process with 3 easy tests to select the best shoes:
Heel Test – Hold the shoe in both hands; place one hand on the bottom of the front of the shoe.
Push the heel of the shoe toward the inside of the shoe with the other hand. If the heel is easy to push down it won’t provide good support for your heel. The best shoes have a sturdy heel to support the entire foot and ankle.
Toe Test – Hold the shoe in both hands; place one hand at the toe of the shoe and one and on the heel of the shoe. Push the toe of the shoe up to try to bend the front of the shoe up. If the shoe is easy to bend anywhere but where the toes meet the foot, it will not provide good support. The best shoe will have very little bend anywhere but right where the toes connect to the rest of the foot.
Twist Test – Hold the shoe in both hands with one hand gripping the heel and one hand gripping the bottom of the front of the shoe. Twist the heel to the right while twisting the front of the shoe to the left. The best shoe will be difficult to twist. If the shoe is easy to twist it will not provide good support.
The next time you go shoe shopping, take these tests with you to choose the best shoes. These tests will help you find shoes that will reduce foot and knee pain caused by wearing non-supportive shoes.
If you have any questions about choosing the best shoes you can send an email to email@example.com.
Cranial Remolding Helmets for plagiocephalyhave become more and more in demand since it has been known that it is safer for an infant to sleep on his/her back. During the early stages of development, the skull is vulnerable to any outside pressure, causing it to change shape. My hope is to educate you more on what to expect if your pediatrician/specialist has recommended or prescribed your child a Cranial Remolding Helmet and answer any questions you may have.
When is a cranial remolding helmet necessary?
A doctor or specialist typically prescribes a helmet because the child has been diagnosed with the following:
Plagiocephaly: typically the result of torticollis of the neck and the infant is usually laying with their head always to the same side
Brachycephaly: caused by infant laying on his/her back and the back of the head becoming flat
Scaphocephaly: infant’s head is constantly rolling side to side, causing the head to be elongated
If your child is diagnosed with plagiocephaly, brachycephaly or scaphocephaly, therapy may be prescribed for infant, as well as changing of the sleeping arrangements. Both of which should be discussed with the pediatrician/specialist.
At what age does a child wear the helmet?
Most of the infants we see range in age from three months to nine months. The younger the patient the more potential there is for head growth during the therapy. Since there is more growth at a younger age, the child may not have to wear the helmet quite as long as they may have if they were older. Another factor to consider is that older children have a greater ability to grab and possibly remove the Velcro® strap holding the helmet together (Note: helmet will not fall off if the strap is removed but will not be closed completely).
Does Insurance Cover cranial remolding helmets?*
It is very common that insurances do require conservative treatment before they will provide coverage for the Cranial Remolding Helmet. They typically require at least six weeks of conservative treatment which can include re-positioning in the crib and therapy. Therapy can include a physical therapist and/or occupational therapist stretching the neck muscles so the infant does not tend to turn to one side or the other.
Insurance also bases coverage on whether or not the measurements of the infant’s head fall into the moderate to severe range on the Cranial Vault Asymmetry Index (CVAI). If your child’s measurements are in that range then there is a good chance the helmet will be covered. These measurements would be taken at your first evaluation (which is free!).
What does an appointment entail?
During your first appointment, we go through the history of the pregnancy; we also ask about any complications during delivery. After the history is taken, then measurements of the head are recorded. Next, a stockinette is placed on the child’s head and the orthotist uses a laser scanner around the head to obtain a 3-D picture.
Based on the measurements, we then decide if a helmet is necessary; if not, we can set up another appointment to re-evaluate and see if the condition has worsened. The scans are only viable for 2 weeks; after that time, if a helmet is to be ordered, new measurements and scan must be obtained. Once the measurements and scan are collected and the child’s measurements fall in the moderate-to-severe range. then we order the helmet.
How is a helmet fitted?
Once the helmet has been received from Boston Brace, we set up the fitting as quickly as possible. After the first fitting, we setup up bi-weekly appointments for either new measurements and/or scans to check progress. Adjustments of the helmet are then made at that time. Typically the helmet is not needed once the patient has measurements in the mild-to-moderate range and/or the parents are satisfied with the results.
*All helmets require a signed prescription from a physician or specialist. Coverage is based on individual plans and may be subject to a deductible.*
We are glad to answer your questions about plagiocephaly and other conditions that are treated with Cranial Remolding Helmets.
Bioworks is eager to help you save time and money and make optimal use of your health insurance. However, with the complexity of health insurance policies today, and the constant changes made by insurers and employers, keeping up-to-date on every policy is difficult for us. When possible, we do let you know what we know about certain carriers or policies, even when a certain product or services is not covered.
So we are encouraging you to understand the limits and requirements of your health insurance. This is critically important when you are or a family member is referred to a durable medical equipment (DME) supplier.
How Health Insurance Deals with DME
Many DME referrals require prior authorization by your insurance company, which means that your insurance company may reject the cost of the merchandise provided to you, unless they have been notified and provide approval in advance. Many carriers no longer allow you to obtain the DME before notifying them and get authorization later. Many insurances are denying “retroactive” authorizations.
Not only do virtually all insurance companies differ in their requirements and coverage, but their policies and procedures are constantly changing. While we try our best to keep current with developments in health insurance, you are the only person who can know everything about your particular policy at any given time and with particular treatments are equipment.
How You can Avoid Health Insurance Issues
Please review your policy and become familiar with all its requirements. Call your insurance carrier whenever you are going to the doctor or you are anticipating needing to make a DME claim. Our insurance and billing staff will be available to you as you need services and DME from Bioworks.
If you have any questions, call us at 513-793-7335. Thank you!
The carpel tunnel is where the median nerve, various tendons, and muscles cross over the palmar side of the wrist and hand. Since it is such small space, once one of these structures is irritated numerous problems can arise.
The most common symptoms of Carpal Tunnel Syndrome (CTS) are numbness and tingling in the hands and fingers as well as pain on the palmar side of the wrist. There are varying degrees of severity of CTS but, if found early, conservative treatment can be an option.
Is Surgery the Best Option?
Anytime your doctor mentions the word surgery, there are so many questions that need to be answered:
How long will I be under anesthesia?
What are the risk factors?
Will it be worth it?
Will it work?
Will I be off work? If so how long?
How will this affect my daily life?
With all of these uncertainties sometimes surgery does not seem to be the best option at that time. Sometimes we want to explore the more conservative treatment options because choosing to have surgery is a major decision. Depending on the severity of your symptoms, surgery may be the best way to relieve your symptoms but there are other ways to manage the symptoms of carpal tunnel syndrome and talking to your doctor about your situation will help you determine your needs.
Managing Carpal Tunnel Syndrome
The most common management of the symptoms is to wear a wrist brace. It needs to be a Wrist Cock Up Splint (WCUS) that keeps the wrist in a neutral position (slightly extended). This will help keep the median nerve from being pinched or compressed to alleviate any irritation. Most people wear the wrist brace(s) while sleeping since we like to flex our wrists when we are asleep. If you are having pain while awake or with activity it is okay to wear the brace(s) then.
Other treatment techniques that can help manage your pain, along with the wrist brace, are yoga, hand therapy, and ultrasound therapy. You can also use these daily movement/stretching techniques offered by sportsmedpress.com:
Movement: Gently move your wrist from side to side in a handshake motion. Hold for 5 seconds on each side. Repeat 10 times. Do 3 sets.
Strengthening: With a rubber ball in your palm hold a squeezing grip around the ball for 5 seconds. Repeat 10 times.
Stretching: Place both palms on a flat surface. Gently lean body forward over your wrists and hold for 20 seconds. Repeat 3 times.
If you have questions, you can call Bioworks at 513-793-7335 or complete our <a href=”https://cryptnsend.com/bio1/bio1.php”>contact form</a>.<em> As always, you should consult your primary care physician before beginning this or any treatment or exercise routine. </em>
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