Something to lean on

Orthotic service provides braces for the whole body - except the teeth

Monday October 29, 2001
Joanne Shuttleworth
The Guelph Mercury

Makes Braces For Health Problems - Fred Rayner has owned Applied Biomechanics Custom Orthotic Services Inc. for six years. He makes braces to help people with arthritis, cerebral palsy, carpal tunnel syndrome, those who need orthopedic shoes or temporary braces after accidents. (Joanne Shuttleworth/The Guelph Mercury)

As they say in the orthotics business -- brace yourself.

Fred Rayner, a certified orthotist and owner of Applied Biomechanics Custom Orthotic Services Inc., guessed that 80 per cent of the general population would not get that joke.

"Most of my clients had never heard of orthotics until they needed them. Then they're really glad to know me," explained Rayner, who has been in business in Guelph for six years, recently moving to larger quarters at 34 Harvard Rd. from his former location on Norfolk Street.

Larger quarters means Rayner can now do more custom work, assessing patients, fabricating and fitting their orthotics -- braces to the layman.

"We do bracing for the whole body, from head to toe. Everything except teeth," he said.

And Rayner is bracing himself for a busy future.

With the aging baby boom population comes fallen arches, arthritis, and hip and knee replacement surgery.

The working world is grappling with repetitive strain injury and carpal tunnel syndrome. Athletes and couch potatoes-gone-vertical are prone to sports injuries.

Children are born with cerebral palsy and spina bifida, which can also require special braces.

A great number of Rayner's clients have been in car accidents that require temporary braces as well.

"It can be a congenital defect, a vocational injury, a car accident or a need for orthopedic shoes. There are many conditions that bring patients through my door," he said.

The mainstay of Rayner's business are clients with foot problems that require corrective inserts in the shoe. With his newfound space, Rayner now carries a line of shoes designed for comfort and with room to hold foot orthotics.

He said he would send patients on a massive quest to find a specific shoe, only for them to return empty-handed.

"So few shoes are commercially produced that will fit orthotics or braces. Now, we can provide a full-service package. No more five-day quest," he said.

Orthotists must be fully-trained and certified to practise in Ontario. Rayner studied human kinetics at the University of Guelph and then did his postgraduate degree in orthotics and prosthetics.

Creating prosthetic limbs -- artificial arms and legs -- is a whole other specialty within the field of orthotics. Rayner said it's nearly impossible to be an expert in both.

He interned for two years at Westpark Hospital in Toronto and became director of orthotics at a private clinic in Calgary.

He returned to Ontario where, for five years, he taught the postgraduate course at George Brown College/Sunnybrook Health Sciences Centre.

He decided to open the clinic in Guelph to save himself the daily commute and to foster the creative, hands-on side of his work. Each brace is designed to serve a specific purpose and compensate for weakened muscles that can't do the job themselves.

In a way, Rayner is an inventor, turning plastic, metal and fabric into a comfortable and practical support.

The Ministry of Health and Long Term Care covers the cost for certain devices and levels of impairment, through its Assistive Devices Program (ADP). Recent changes in the OHIP payment schedule -- audiology and physiotherapy services are no longer covered -- have orthotists wondering if the ADP might also be in peril.

"Right now we're working on a price schedule that's eight years old. And we're obligated to make devices at a price set by the ADP. The private practitioner has to be shrewd to make ends meet," he said.

Advances in technology mean braces are lighter and more comfortable to wear. What was once an iron and leather contraption strapped to the leg (think of Forrest Gump in his younger years), is now made of lightweight carbon graphite and aluminum titanium.

The Dynamic Digital Scan is a relatively new diagnostic tool that helps orthotists measure pressure points and the gait of one's walk. This, in turn, helps Rayner determine where problem areas lie and how to make a brace to correct the defect.

Once he determines what the problem is, Rayner will take a plaster cast of the affected area and make a mold. With that, he creates a brace that, after an adjustment or two, will fit the client.

Foot orthotics are not covered by the ADP but are often covered by workplace benefit packages, much like eyeglasses are.

Although they can be expensive -- prices range from $300 to $500 a pair -- those who get them find they make such a difference to their feet as well as knee and back pain.

"I call the foot the foundation of the house. Like a weak basement, bad feet impacts everything else -- ankles, knees, back, neck. Even headaches," he said.

There are only about 100 orthotists across Canada and most of those are located in large, urban centres. Rayner said his clients come from Guelph, Fergus, Rockwood and Milton.

"There are no services in the northwest area of the county."

Standing in the corner of the exam room is the brace for a child with cerebral palsy. It's rather formidable looking with its pink straps, flesh-tone plastic and shiny hardware. It's an old model -- newer materials would be used today -- but it would enable a child with no leg muscles and little upper body control, to walk upright.

Rayner calls it "the humbler."

"This business is my livelihood, but I'm genuinely thrilled to help. It's satisfying, but humbling," he said.

"I know a four-year-old with CP who is determined to walk. That spirit, that determination helps put my own aches and pains in perspective."

©Guelph Mercury 2001
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