Based in the picturesque village of Lound, just outside Retford, Nottinghamshire (UK), we walk into The Lakes Orthotics to meet with Jo Lucas, Phits Expert and the Orthotist behind this clinic.
“The clinic is in a converted annexe to my own home, so I don’t have a very long commute.” Jo welcomes us smiling. “We live in a quiet village with very little traffic – in fact due to the equestrian centre at the bottom of our garden, you are more likely to see lots of horses instead of cars! We are surrounded by the Idle Valley Nature Reserve – perfect for walking, biking, bird watching, and getting some good countryside air.”
Jo is one of the Phits pioneers in the UK, but her career path is rather remarkable: “Prior to becoming an Orthotist I was in the Intelligence Branch of the Royal Navy. I left to pursue a career as a Prosthetist but as our UK degree is in Prosthetics and Orthotics it gave me an insight to the world of Orthotics. I liked the highly technical nature of orthotics – my military background gave me quite a technical mind. I also liked the vast subject area, meaning I would never be bored in my job!”
Before she established her private clinic, Jo worked for a number of years in the NHS, the UK’s public health system. “I found the pressure of juggling work and childcare extremely difficult. Due to restricted budgets I wasn’t able to do my job as well as I would like, and wasn’t able to access the absolute best in orthotics that the industry had to offer. I set up The Lakes Orthotics in 2014 to allow me to work around my family life and give my clients the best service I could, allowing me to spend quality time assessing, planning and treating.”
It took her some time to find the right tools that matched her mindset: “I was originally looking for a scanning system to allow me to stop using foam impression boxes or plaster casts and I stumbled across Footscan at the BAPO Conference in 2017. I am a bit of a technophile and I’m drawn towards anything that can make things easier and more streamlined. I love using Footscan as it gives me a much clearer clinical picture and picks up gait anomalies that I may never see with my own eyes.”
The footscan not only empowers herself as an expert, it also helps her clients: “I find the footscan analysis really engages the client as they can see the images and they want to know more about what is going on with their gait. I have always found that the more understanding of the condition a client has, the more compliant with their treatment they are likely to be.”
Asked what the major advantage of the footscan is, Jo is very clear: “I personally think dynamic gait analysis is the absolute best basis for prescribing foot orthotics. By mapping the precise movements of the foot during gait it allows me to pinpoint where I want corrections to be to achieve the desired result. The Root Theory in which I was trained is still relevant but it does not form the basis of my orthotic design. Static scanning is much less accurate and doesn’t give any indication of what the foot is actually doing during gait. Knowing what is happening with the foot at one particular point in the gait cycle can only give us a tiny bit of information. Knowing the precise kinematics of the foot from the moment of heel strike to the point where the foot leaves the ground gives me far more relevant information and allows me to finetune the prescription and ultimately design the best orthosis for the client. The human foot is in contact with the ground for such a short period of time with each walking step, so getting as much information as possible is essential. Footscan gives me detailed information about each step allowing me to design the most accurate insole possible and also ensure the prescription is specific to the left and right foot.”
Jo also takes the time to guide her clients through the results of the gait analysis. “Following the scanning I always sit down with the client to go through the results. I choose the most important information and the information that the client is likely to relate to in terms of their condition.”
“My experience is that the clients like to see what is happening with their feet, and if they can have more of an understanding of what is going on during their gait, and the reasons for the problem they are having, they are more likely to be compliant with their treatment and have a more successful outcome. My clients often come to me after using orthotics previously and not having a good result. I usually explain the difference between static analysis and dynamic analysis and the reasoning for using the dynamic method and the usual response is ‘that makes much more sense’.”
Clients really appreciate this extra information and although it might seem pretty obvious to engage the client, a lot of healthcare experts don’t have that time with their clients because they spend too much time in their workshop (re-)working handcrafted devices or of talking back and forth to a central lab. Which brings the subject to 3D printing.
“I had never considered 3D printed insoles until I purchased my footscan system. The little ‘Phits’ tab in the software intrigued me so I questioned George Cummins (Director at Gait and Motion Technology, the UK footscan and Phits Distributor), who installed the system. After his explanation and some research in the techniques I knew I had to get them in my clinic. In my opinion the benefits were huge – lightweight, very slim, and super strong and hard wearing. These were all things that my clients are constantly asking for and with Phits I can now provide that. The majority of the insoles I provide are Phits 3D printed insoles but I do use others for certain cases.”
Jo also points at other perks of the Phits services: “The software is really well designed and very intuitive, which makes ordering very easy. I love the amount of corrections available and also the fact I am actually putting in these details myself. Previously I would write a paper prescription and explain on paper what I am trying to achieve, for the technician to then interpret this and create the orthotics. I have much greater control over the orthotics now and I know that what I’ve ordered is exactly what I am going to get.”
A quick look in her clinic tells Jo’s love of ice hockey, and in particular, the Sheffield Steelers. That passion is also reflected in her professional activities as an orthotist.
“I treat a lot of figure and hockey skaters and I find they are having much greater success with Phits 3D printed insoles. Ice skates, particularly figures skates, are very narrow and many skaters wear them much smaller than their regular shoes. So getting a custom made insole to fit inside the skate and be supportive enough was always a challenge. I have found the Phits Nordic ski device suits my skaters perfectly as they are very narrow and the full foot style means they are easier to get into the skate. Skaters generally need a slightly different design of insole due to the positions the feet are getting into for the various skills. The Phits design software allows me to increase the flexibility in key areas and reduce bulk as much as possible, allowing the skater to achieve the edges that are required when ice skating, but still provide the correction and support needed.”
It’s been 12 years since Jo graduated as an Orthotist and she has seen a lot of innovation and improvement over the years: “I have seen so many changes in manufacturing techniques and materials and these have all been for the better. When I look at what we were giving out when I first started out in my career to what is available now, it doesn’t seem possible that it has happened in just 12 years. I am constantly searching for new techniques that will improve life for my clients, after all, the clients are why I do my job and it is them that I want to give the very best to.”
Will 3D printing become a game changer in her industry? “3D printing has been around for some time now but it is definitely building momentum and I wanted to be one of the first to offer it, particularly as the benefits they offer are things my clients have been requesting on a daily basis. I think there is still some resistance to the technology in the industry as clinicians have been treating patients successfully for many years, so why change.”
In the end, it’s a simple rationale: innovations have to offer better results at a reasonable price. If it is nothing more than a copy of any traditional manufacturing method, it doesn’t make sense. It’s the reason Jo Lucas puts her trust in Phits: “When I, and all other clinicians examine a patient, we make our decisions regarding orthotics prescription on the things we see and feel so some may say why do we need all the extra data and graphs? I say the more information we have, the better decisions we can make, and the better the orthotic device will be. As 3D printing is definitely making big strides in the orthotic world, there are lots of companies promoting their devices. As a clinician this can get a bit overwhelming as you don’t know where to go for the best. Having seen and used many different orthoses over the years, I can safely say that Phits 3D printed insoles are the best I have ever used and would recommend them to clinicians and clients alike.”
“After seeing so many changes within the orthotic industry I have no doubt that the direct milling of insoles will be replaced by 3D printing in the next 5-10 years within the private sector. Backed by companies like Phits and Materialise, there is no need to purchase and have the room to accommodate huge printers, so for me, investing into the technology is cost effective and will add huge value to clinics and patients. I suspect the NHS will take a little longer to take on the technology, mainly due to the fact that most trusts produce their orthotics in-house. However I feel that the long terms benefits of using 3D printed orthotics, in particular more successful outcomes and longer lasting orthotics, will mean that the value of utilizing 3D print technology will become clear and eventually it will be available to all.”
More info about The Lakes Orthotics? www.thelakesorthotics.co.uk
Interested in becoming a UK Phits Expert? Contact the UK Phits Distributor www.gaitandmotion.co.uk
Any other inquiries about Phits or RS Print: firstname.lastname@example.org