For More Information!
Practitioners may Download the Order Form on any page and fill it out and fax it to the number on the form, email it to orders@nolaro24.com, or call to re-order. If you do not already have an account set up with us, you should call Bert Parsloe at 203.725-6179 to set up your account and first order. If you have specific questions on using the order form please call us and we can help you out. On our order form you will see that each Orthotic design (Quad) is available in five or six sizes (refer to the sizing chart) and two widths, Regular or Narrowed. The Narrow design is ¼” narrower and works well in Cleats or Fashion shoes. Generally women prefer the Narrows unless they have wide feet. Dispensing a Narrow orthotic will allow women to wear their orthotics in a greater variety of Fashion shoes.
You may contact our Education Department. They may set up a private webinar or let you know more about our upcoming courses or webinars . Email: education@nolaro24.com, phone 877-792-4669.
You can refer to our Fitting instructions, or refer to our Break-In Instructions. You can also take a picture of the patient’s feet standing on the orthotics and our experienced technical team can give you advice on fit or other recommendations. Email any questions to education@nolaro24.com. We pride ourselves on giving great technical support and are happy to answer any questions.
You may print information from our Dowloads pages to hand to your patient. For QUADRASTEP® CLICK HERE, for littleSTEPS® CLICK HERE.
A trick we have learned is that you can take a dryer sheet and put it inside your shoe under your orthotic. The noise is usually slight movement, so if the dryer sheet doesn't work, there are some other things to consider as well. If it is a short orthotic (blue, green, or purple), you can leave the lining that came with the shoe in there under the orthotic (as long as it doesn't have a large arch bump) so the orthotic doesn't move. Even the longer ones can move sometimes (yellow, red, orange). If they have a topcover (the black and gray swirled cover glued onto the orthotic), they should be trimmed using the lining that came with the shoe as a template so that they fit snugly in the shoes. Sometimes you have to get your hands in there to feel if they are curling up inside, and adjust by cutting the ends a little more.
It can be hard if you are switching between shoes, since many shoes are not shaped the same! But they should be close. A proper fit should prevent any movement. Make sure your shoes aren't too narrow, which will cause your orthotic to "float" some in the shoe and the movement from that can cause squeaking.
Another think you can try is to rough up exteriors edges with sand paper to take off the shine.
If you are using your orthotics as a fitting tool, please disinfect with any topical disinfectant you are currently using between patients. Once your patient has purchased their orthotic, they can be cleansed with soap and water. Please advise the patient that hot water should never be used because it may melt and deform the orthotic.
Unused product, in its original packaging, may be returned for credit within the first 30 days of invoicing. Shipping will also be credited to your account for any returns due to our error, otherwise shipping is your responsibility. Customized product may not be returned.
Depending on usage and body size, a pair of our orthoses should last approximately 1-2 years. You should check you orthotics every few months for signs of wear and tear that might change the way your orthotics are supporting your feet.
Yes our orthotics grind easily and many customizations can be made to them. Additional information about customizing our orthotics can be found on our Customization page, and how to videos can be viewed HERE. Note that our orthoses are composed of a thermoplastic rubber and cannot be heat adjusted except for spot adjustments. The most common adjustments are to the length or width, heel- cup adjustments, adding full-length covers or liners, additional padding, and only for QUADRASTEP® orthoses - metatarsal mounds/bars, extra posting or heel-lifts. If you’re not equipped to make these adjustments in your office, we can easily do these adjustments for you to get a more customized orthotic device, for an additional fee. If you would like to make minor adjustments yourself such as met mounds and wedging, you can try our WIDGET KIT to make those adjustments in your office.
SEE our How-To Videos on customizing orthotics
Please refer to our page on customizing your orthotics HERE, there you will find a full description of what is included in a Widget Kit and how to use it.
Our orthoses are manufactured from an injection molded thermoplastic compound that has the unique combination of strength and soft edge feel, providing optimal patient comfort. The strength of the material used is a feature that has been specifically matched to the amount of support each foot type requires.
While it is possible to add a lift to a QUADRASTEP® orthotic, it's generally advisable to avoid adding more than a 1/4" lift, as exceeding this measurement can lead to shoe fitting problems and create a noticeable sagittal pitch to the device. For instance, if I recommend a 3/8" lift as part of a patient's treatment, I usually opt for an extended lift to the ball of the foot. This lift would start at 3/8" at the heel and gradually taper towards the sulcus of the toes. This approach helps to soften the sagittal pitch and extends the corrective effect across the entire foot. These specific lifts can be ordered from Stride, our custom lab, at a cost of $45. However, do note that they require larger athletic shoes or hiking boots for proper fit.
Keep in mind that these lifts are crafted by hand, so expect a turnaround time of at least a week. We'll need to know the shoe size and whether it's for the left or right foot. Ideally, a shoe tracing would be most helpful. Be aware that children's shoes usually aren't suitable for larger lifts, and some adult shoes may also pose challenges. In such cases, consider approaching a shoe repair shop that can externally add a lift to the sole of the shoe.
A medical skive enhances the pronation controlling ability of a foot orthotic. It involves selectively removing small amounts of the medial portion of the plantar heel of the positive cast of the foot to create a unique varus wedging effect within the heel cup of the foot orthosis. The resulting increase in supination moment across the subtalar joint axis of the foot clinically produces significantly improved pronation control on pediatric flexible flat feet, posterior tibial dysfunction, and other types of excessively pronated feet.
If you are familiar with our 4 step assessment process you can begin to understand that foot morphology (created by step 1 and 2) dictates gait (step 3) and therefore causes a particular set of symptoms and calluses (step 4). If you comprehend this then the orthotic design process can be easily understood and isn’t so mysterious. Ask yourself, what is this patient’s problem? Then what is happening during gait and when is it occurring during the gait cycle that is causing that problem. Once you understand the ’what’, ’when’ and ’why’ of the gait pattern, you will begin to understand how to design effective orthoses. For help with Foot Typing, try our Easy Foot Typing Tool!
We recommend that you use our 4 Step Assessment which consists of:
1: Assess arch height
2. Use Toe-sign to assess forefoot alignment
3. Functional gait assessment
4. Check callus pattern
To make this easier you can use our Easy Foot Typing Tool. On that page you can also download our iFootType App on your smart phone or tablet.
If you still aren’t certain we are happy to help you out. We also recommend taking advantage of our many training opportunities from webinars to in person training. For more information visit our Education page.
You may also email us some pictures of your patient’s feet. Ideally a picture taken from behind that shows the back of the heels in relaxed calcaneal stance position and one taken from the front that shows their medial arch height in relaxed stance. A few minutes’ video of the patient walking is also helpful. We have a team of highly skilled and experienced practitioners that make up our technical support team and we are more than happy to help you work out the correct Quad and which orthotic would work best for your patient.
We have a team of highly skilled and experienced practitioners that make up our technical support team and we are more than happy to offer advice and answer specific questions. You can call us or send an email with as much information as possible. Attaching pictures and even a short 2 minute video of the patient walking will help us fully understand what you are trying to address and enable us to give you the most accurate advice and help. Feel free to take advantage of our technical team of practitioners from different specialties with many years of experience. Be sure when sending pictures that no identifying information is visible, such as a patient's face or name.
We have had a lot of concerns about the misappropriate use of Toe out Gait Plates for kids. Yes, we have Toe out Gait Plates. They are used for kids with true toe out gait. With that in mind, if a child (or adult) is walking toe out, they likely have external tibial or femoral torsion and a supinated foot. See below…
This is from an article by Volpe:
“A gait plate to induce in-toe is rarely used. The biomechanical concept is the same with the distal angula-tion in the reverse direction. It is most appropriate for a child with an external femoral or tibial torsion without pronation of the foot. However, using an orthosis to control motion of the foot in a child with compensatory pronation will sufficiently reduce abduction and out-toe in most cases.”
http://www.podiatrytoday.com/article/894?page=3.
So our concern is that practitioners not confuse an abducted forefoot (associated with foot pronation), with a truly toe out gait from external torsion.
Yes, you can, but there are several things to keep in mind. First of all littleSTEPS® are made from a very comfortable material and do not need to be topcovered. They are easy to clean and care for as is and this should be a consideration.
Another consideration is that a topcover takes up room in the orthotic by as much as 1/8 to 1/4", decreasing the width of the orthotic. You might want to do this if you have a child with a very slender foot that is moving in the orthotic and you need to take up room, but if the child has a normal width foot it may not fit in the orthotic correctly anymore. So be very careful when considering a topcover for tiny feet!
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