AADL? What does that mean?

AADL? What does that mean?

By Ryan Cochrane on December 17, 2020 in Health & Care, Health Treatments, Post Surgery

Alberta Aids for daily living

Many Albertans are not aware of the extra coverage that the Alberta government offers. We are very fortunate to have over and above funding for certain medical devices. One of the most common government bodies is Alberta Aids to Daily Living (AADL) 

Alberta Aids to Daily Living, more commonly known as AADL, is used to help fund medical equipment and supplies to Albertans who qualify. This helps individuals live more independent lives. Listed below are 6 of the most common questions, I will try to answer about AADL:

1. Who is Eligible?
2. How to Use AADL Benefits?
3. What is Covered?
4. Cost Share
5. Approved Vendors
6. Forms

Who is Eligible?

  • Must be an Alberta resident with a valid Alberta Health Care Number
  • Must require assistance for 6 months or more with chronic, long-term, or terminal illness or disability
  • You can not have comparable coverage through any other funder

HOW TO USE AADL BENEFITS?

  • You must be seen by a health care professional and be provided with a prescription for the device
  • The health care professional should give you three approved facilities to go to
  • Choose which approved vendor you wish to use and make an appointment to be assessed for the device or benefit needed.
  • The approved vendor will submit your claim directly and will only bill you for your patient portion if there is one.

What is covered?

COST SHARE

  • AADL will cover 75% of device or supply
  • Patients under the age of 65 years of age will cover 25% of the cost up to $500
  • Patients who are receiving custom footwear are responsible for 25% of the cost no matter their age
  • Patients with lower income can qualify for Cost-share Exemption

APPROVED VENDORS

  • As stated above you must go to an approved vendor to be eligible for coverage. 

FORMS

If you are uncertain whether you qualify, please take your health care card to an approved vendor and they can look it up in the AADL system. It’s always best practice to ask a lot of questions so that you can be certain you are receiving the best service possible.

Should Pregnant Women Wear Compression Stockings?

Should Pregnant Women Wear Compression Stockings?

By Ryan Cochrane on September 8, 2020 in Health & Care, Health Treatments

Pregnancy

Becoming a mother is a very exciting chapter in a women’s life. The expectant glow, feeling the first kicks, and thicker hair are all exciting aspects of pregnancy. Growing your new addition can be very strenuous, especially on the veins in the legs. Hormone changes are one factor but blood volume increases roughly 45%. During pregnancy, women can experience swollen, achy, and tired feet and legs during which increases the risk of thrombosis (blood clots) and venous deficiencies. Furthermore, sitting for long periods, standing, pre-existing venous conditions, and multiple pregnancies can increase the risk of venous disorders. In a study published by the Journal of Vascular Surgery, they found that women who have a history of pregnancy have an 82% increased risk of varicose veins.

The Answer is yes!

With each new pregnancy, the risk of venous disorders increases drastically. So the short answer is yes, women should wear compression during pregnancy. It is ideal that you wear full-length compression as varicose veins can develop in the upper legs during pregnancy. Wearing compression during pregnancy prevents swelling and the overall feeling of heaviness. Compression socks are one of the leading preventions for venous disorders. Graduated compression socks work by helping move blood flow back to the heart instead of pooling in the legs. Keep in mind, it’s important that you are measured early on in your pregnancy so that you can keep your legs from swelling.

Healthy Legs today and tomorrow

Pay attention to your legs and not only in pregnancy. If you or someone you love is complaining of leg pain daily, talk to them about compression. We have lots of options available on our website but if you need medial grade (20 mmHg or higher) compression stockings, please book an appointment with our certified fitter in order to get you your correct size.

Private insurance: Will they cover the cost of my device?

Private insurance: Will they cover the cost of my device?

By Ryan Cochrane on July 22, 2020 in Health & Care

What is Private Insurance?

Alright you beautiful people, let’s talk Private insurance. Now I know BORING, but we receive hundreds of questions on the subject, so I will try to provide insight into what we have learned over the years. 

For most people, private insurance means a payment comes off my paycheque, and the next time I go to the dentist it only costs me $20 instead of $100. The majority of places can direct bill for you, whereas, in our field, this is not always the case. Unfortunately, the larger private insurance companies decided that clinics like ours would no longer be allowed to direct bill as there are too many products to regulate. Over the last few years, we have discovered the ins and outs for most insurance companies (until they change their rules again). We can help you navigate your insurance, even though we are unable to directly bill them.

Most of the information providing to us is VERY general. We can advise you on what questions to ask your insurance company before proceeding with a device. This way you can be assured you are covered. Private Insurance companies very rarely allow us to talk to them directly to get the information needed regarding our patients, so you must call them to clarify your coverage.

Common Devices that are Covered: What information do they need?

  1. Foot Orthotics 
  • Usually, a new pair is covered every 1-2 years, ranging coverage between $200-$400. 
  • 2-page “PAID” invoice
  • A prescription from your family physician
  • Biomechanical assessment
  • GAIT analysis

     2. Compression socks

  • Medical-grade compression is only covered, which means the pressure gradient has to be over 20 mmHg. 
  • For most Blue Cross plans the pressure gradient has to be over 30 mmHg (except Registered Nurses)
  • The number of pairs covered per year varies greatly between all the companies

    3. Custom & Non-Custom Bracing, & Prosthetics

  • Most companies will pay a maximum of $500.00 at 80%.
  • Must have a prescription with a diagnosis in order to claim it through your insurance

There of course are some insurances that only require a receipt, for example, ASEBP (Alberta Teacher’s Benefit). We do not know all the ins and outs so if all else fails give your insurance company a call. 

Direct Billing

Most insurance companies require you, the patient, to pay for the device and then submit it to your insurance yourself. The only insurances at this present date that allow us to direct bill are:

  1. ARTA (retired teachers plan)
  2. Green Shield
  3. Veterans Affairs
  4. Chambers of Commerce

Websites of Common Insurance Companies

We understand that it is challenging to navigate through your insurance and can be downright discouraging. We are here to answer any of your questions to help you get your money back as easy as possible.

This is a lot of information and not exactly something you wanted to read, but if you have any questions, please do not hesitate to call the clinic.  We are here to help no matter what it is regarding.

The Facts About Plantar Fasciitis

The Facts About Plantar Fasciitis

By Ryan Cochrane on June 27, 2020 in Health & Care

What is Plantar Fasciitis?

Plantar Fasciitis is an inflammation of the plantar fascia which is located on the bottom of your foot. It’s the most common cause of heel and arch pain and can be downright debilitating. The thick band of tissue connects your heel to your toes and is extremely important for proper gait patterns. Symptoms can vary slightly but the most common are:

  • Start-up pain
  • Burning or sharp shooting in the heel or arch
  • Increased pain with increased walking or standing
  • Pain is usually worse after exercise versus during

Common Causes

While causes for plantar fasciitis can vary, there are some notable factors that can increase your risk of developing this condition.

They include:

  • Shoe Choice – some shoes are better than others. There are different shoes for different activities and the right shoe choice can affect your overall foot health.
  • Foot Type – people have feet that usually fit into 3 categories, high arched, low/flat arch, or medium arch. The right height arch helps with overall foot mechanics.
  • Certain Exercises – such as long-distance running.
  • Obesity – excessive weight can put more strain on your arch.
  • Occupation – jobs that require you to stand for long periods such as nurses, teachers, and construction workers.

Treatments

Experiencing pain like plantar fasciitis can really inhibit you in your daily life and if you’ve had it long enough, you are probably thinking, will it ever go away? I’ve seen cases where plantar fasciitis has lasted over 15 years and their pain was so bad they had a hard time walking even to the bathroom. It’s important that you try one solution at a time for about a month. This helps determine what is working for you as it can be a re-occurring problem.

Some of the options to try are:

  • foot orthotics
  • new shoes
  • massage
  • shockwave therapy
  • ultrasound
  • night splints
  • plantar fasciitis sleeves
  • physiotherapy

If you ignore the symptoms you are experiencing, it can become chronic and inhibit you from the activities you enjoy. Start with stretches and if that does not work, reach out to a specialist in your area to get their advice on the best course of action.

Here are some product options on our website that can help decrease your pain.
https://adaptive-technologies-inc.shoplightspeed.com/foot-ankle/plantar-fasciitis-supports/

Plantar Fasciitis Stretches

Will my Knee Brace cause weakness or muscular atrophy?

Will my Knee Brace cause weakness or muscular atrophy?

By Ryan Cochrane on May 25, 2020 in Uncategorized

The simple answer? Yes…and no!! This question, my friends, is a difficult one to answer. However, I hear it a lot when seeing patients with knee problems. The reason it is a difficult question is that it really depends on multiple factors including:

  • Style of Brace
  • Reason for Wearing Brace
  • Activities
  • Patient age

I will try to explain different scenarios that may or may not cause muscle atrophy and will touch on one scenario where, I believe, knee bracing will actually increase strength and cause muscular hypertrophy.

Knee Brace Style

The style of a brace is the largest determining factor in causing your muscles to become weak. Simply put if the brace is restricting any part of your range of motion then you are going to get weak in that range. If you have ever seen a Zimmer Splint, which holds your knee in full extension, then you can imagine what I am talking about. If you have ever had to wear one, you can almost watch your muscles melt away.

On the flip side of this, a knee sleeve that provides compression and warmth to the knee, generally will not limit any range of motion and are not likely to cause any atrophy at all.

The most controversial brace style, when talking about muscle atrophy, is the functional knee brace. The functional knee brace is designed to protect injured ligaments. These may be prescribed pre or post-surgery. The trouble with these braces is that they need to stay in place in order to work properly. This means they are generally snug-fitting and that the top calf strap must be done up quite tight. Although, these measures prevent the knee brace from sliding down your leg, consequently, they also can prevent you from achieving full knee flexion. So, if we are limiting the range of motion then we are going to be causing a certain amount of muscle atrophy and weakness. Depending on the reason for wearing the brace, this may be a side-effect we are willing to accept.

Reason for Knee Brace Use

There are 5 main reasons you may wear a knee brace.

  • Ligament Injury
  • Patellofemoral Injury or Dysfunction
  • Meniscus Injury
  • Osteoarthritis (OA)
  • Prophylactic Use

Generally speaking, braces used prophylactically or due to meniscus injury are sleeve style braces that provide warmth and compression. These style of braces normally allow full range of motion, therefore will not cause muscle atrophy or weakness.

Braces used for ligament injury, patellofemoral injury, and OA span a large range of styles depending on the severity of the injury. Patellofemoral bracing ranges from simple straps that change the angle of pull of the patella tendon, to sleeves with a lateral buttress to maintain patella (knee cap) tracking, all the way to hinged knee braces that may incorporate a lateral buttress or a web design.  Braces for ligament injury and OA can also range from simple sleeves to custom hinged knee braces depending on the severity.

When it comes to OA, I believe, that knee bracing can actually increase muscular strength. In practice, I have seen patients who are in a terrible pain cycle and it goes like this. Their knee starts hurting so they stop exercising. Next, they gain weight due to their exercise routine being gone. With their increased weight, their knee starts hurting more. And round and round we go. The unfortunate thing for people is that every pound of bodyweight we gain it equals 4 times as much weight on the knee. The nice thing is that knee bracing can break this pain cycle. I have had patients who, after receiving their knee brace, have been able to start exercising again and they begin shedding the weight. This scenario is always one of the most rewarding things to witness!!

ActivitieS

The activities you perform in daily life is another factor to consider when choosing a knee brace. If you are working at a desk job and not exercising the brace you need will be different from someone who works construction and plays basketball every evening.  Even if these two people have the exact same knee issue or injury. Generally, the rule is that the riskier the activity, the more support or protection you require to protect the knee following an injury.

Patient Age

Finally, as with activity, patient age can be a factor in determining what style of knee brace we will provide. Younger individuals will tend to heal faster than those that are older, so they don’t require as much support for the same knee injury. Also, as we get older we tend to lose hand strength so ensuring the brace is easy to apply is another important factor in this population.

As you can see, there are extremely wide ranges of options available for knee bracing. Hence, we always recommend a consult with a physician and/or physiotherapist who specializes in joint injuries. Luckily, here in southern Alberta those who injure their knee can access the Southern Alberta Acute Knee Injury Clinic and be assessed by a qualified team that will help determine what your needs may be. Of course, there is always the option of seeing one of our Certified Orthotists for a no-charge initial assessment.  

 

The Benefits of Compression Stockings

The Benefits of Compression Stockings

By Ryan Cochrane on April 15, 2020 in Health & Care, Health Treatments

How they work?

Compression stockings apply graduated pressure that promotes blood flow from your legs back towards your heart. From there the oxygenated blood is re-circulated throughout the body.

Why use them?

Compression stockings have changed a lot over the year and are not the plain beige socks that your grandma use to wear. It’s unbelievable how many colors, textures, lengths they come in so you can wear them with any outfit or activity. Most of the time you hear people wearing them due to medical reasons but they provide benefit with daily use as well. Especially, if your job requires you to sit or stand for long periods of day. When your calf is not moving, blood can pool in your legs which is why the use of stockings becomes so important.

Benefits

  • Decreases swelling
  • Decreases lactic acid build-up in exercise
  • Can help with shin splints
  • Prevent and maintain varicose veins
  • Decreases tiredness and achy legs
  • Prevents ulcers
  • Prevents DVT’s (deep vein thrombosis)
  • Decreases risk of venous insufficiency

Contraindications

Whether you are active, inactive, have a physically demanding job, most people could benefit from compression. The only contraindications to wearing them is arterial deficiency, meaning your blood has a hard time getting to your extremeties. Your doctor will check if  prior to prescribing you compression stockings, if they have any reason for concern. Remember, it is always best to check with your health care provider prior to using medical grade compression stockings.

Insurance Coverage

Many insurance companies will cover compression stockings but it is always best to check prior as the stockings can be quite expensive. In addition, the amount that insurance will cover depends on compression level.

Compression Levels

15-20mmHg compression is considered non medical and can be purchased without a prescription, but be mindful as they sometimes do not fit as well as the medical-grade. https://adaptive-technologies-inc.shoplightspeed.com/compression/

20-30mmHg compression is considered medical and should be measured by a certified fitter.

30mmHg and above is strongly recommended that you seek medical advice before wearing that level of compression.

The Takeaway

Compression stockings can be very beneficial for multiple reasons when used properly. Follow instructions provided by your certified fitter on how to put them on and off as well as skin should be checked frequently for irritations.

Compression stockings are an aid that help you improve your well-being in life. Try a pair today and see how they can help change your life for the better!

Concern for your child’s flat feet

Concern for your child’s flat feet

By Ryan Cochrane on January 14, 2020 in Health & Care

A guide to the growth of children’s feet

They grow so fast!

There is nothing cuter than baby feet! But who am I kidding everything is adorable in a smaller version. Before you know it they will be stomping around the house with feet either the same size as you or bigger. At times, you are baffled as you just spent money on new shoes that are already too small. Unfortunately, it’s necessary during those growth spurts to update their footwear to ensure healthy growth. One concern I get is parents who worry whether their child’s flat feet are normal, so I’ve tried to summarize a guide to healthy foot growth. Hopefully, your kids will grow into happy healthy adults with minimal foot problems.

Unfortunately, you can come across many conflicting studies and information on the internet regarding children’s feet. Some of them say to wear shoes, others say to go barefoot! Which is the best?

Barefoot

Going barefoot at a young age helps develop muscles in their feet as well as allows them to feel different textures and temperatures as they walk around. Of course, shoes have their place but when young children are learning to walk, the shoe should be flexible and provide an ample amount of wiggle room for their growing toes. With this in mind, shoes during childhood until age 6 are most important to protect them from sharp objects on the ground.

Correct Shoe Size

I cannot stress enough on shoe size! Such a simple concept but it can go unnoticed. Even I have been guilty of letting my own child wear a pair of shoes too long!

Be sure to have your child’s foot measured regularly as you may be unaware that their shoes are too small before it’s too late. Expensive shoes do not always mean better quality. It is important that not only does your child want to wear the shoes you buy but the shoe fits and has some of the key structure points. Hopefully, in your local area, there is a shoe store that has the tools to measure their feet. If they don’t, I recommend, if possible, pulling out the insole and have your child stand on it. There should always be a thumb space from their longest toe to the end of the shoe. This is a simple way to ensure that the length is correct if you are unsure.

Age 0-5

When buying shoes for your pre-school aged child these are some points to keep in mind:

  1. Shoes should be comfortable in length and width – the rule of thumb is always a thumb width from the end of their longest toe to the end of the shoe
  2. Flexible and flat (should have enough bend in the toes)
  3. Plenty of wiggle room for the toes
  4. Laces or straps to keep their feet from moving around in the shoe

Age 5 and up

By the time your child starts going to school their arch should be developed. Below are certain precautions you must take.

  1. The heel counter, the back portion of the shoe, should be a bit stiffer to prevent the ankles from rolling in or out. As kids tend to play on harder surfaces now that they are attending school this is necessary to keep their alignment straight.
  2. Laces are better- they ensure that the heel remains in the back of the shoe
  3. Slightly more stiff sole to prevent unnecessary wear on the shoe and improper wear

If your child is like mine, these guidelines are important to follow. Their feet tend to roll in and their shoes will wear to the point they can end up walking on the inside material. If their alignment looks like this (see below picture), it is important to consider foot orthotics. Take note that the ankles are rolling in and they will be prone to premature shoe wear and pain.

Is your child complaining of pain (growing pains are never normal) or have premature shoe wear? It is best to get your child’s feet assessed by a professional. Sometimes a little bit of arch support and some exercises help keep feet on track.

The best advice is to check your children’s feet regularly! Feet are important and must be able to carry you through the rest of your life.

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