Importance of Following the Break-In Instructions
Because PCIs have a significant impact on posture and muscle use, getting accustomed to the PCIs is necessary. Failure to follow the break-in instructions may cause discomfort, and may cause the patient to discontinue using the PCIs. Instruct the patient carefully and obtain their commitment to following the instructions.
“Any time you try a new exercise, or use muscles you are not using regularly, you may experience sore and tender muscles. Posture Control Insoles™ change your posture by enhancing the biomechanical function of your feet. This posture change causes you to use different muscle groups, particularly in your legs, so don’t become alarmed if you experience some tenderness. To acclimatize your body to your Posture Control Insoles™ with the least effort, please observe the break-in procedure.”
Go through the break-in process with the patient:
Allow your muscles to adjust gradually. On the first day, use your Posture Control Insoles™ for
2 hours only. Observe this even if the insoles feel perfectly comfortable.
Increase the use of your PCIs by 2 hours each day until you are wearing them all day. If you experience discomfort or muscle soreness, discontinue wearing the PCIs for the day. Reduce wear time the next day by 2 hours.
Maintain or reduce wear time until discomfort has subsided. Once the discomfort has subsided, increase wear time again by 2 hours each day until you are wearing the insoles full time.
If you experience prolonged or objectionable discomfort wearing the PCIs, discontinue wearing and call the office for an appointment.
Instruct the Patient on How to Observe Changes and Use the Patient Diary
The patient diary is divided into two parts. A time log and an event log.
For the first 6 days, instruct the patient to use the time log to note how many hours they wore the PCIs and any positive changes, reduction in pain or discomfort they noticed. After 6 days the patient should be using the PCIs full time.
During the 6 day break-in period, instruct the patient to use the event log, noting positive changes, pain reduction or discomfort on the date it occurred. Request that the patient use the event log to make notes regarding reduced use of the PCIs because of discomfort.
Review the diary with the patient at the next appointment.
Issue another diary if you make changes to the insoles (change ground forces, add or remove arch support).
Record and Share Your Expectations with the Patient
Make notes in the patient records as to what your expectations are for the patient being fitted with PCIs.
These expectations are not limited to reduction in pain, but may include postural changes and increased mobility, better response to soft tissue and structural therapy.
When you recommend PCIs to your patients, demonstrate how the change in posture will benefit them. Explain how the PCIs will cause the center of gravity to shift posterior, and how that will impact posture and will enhance other therapies you are providing. Set an expectation to evaluate against.
Strongly encourage the patient to use the Patient Diary (PD). Once pain goes away it is amazing how quickly patients forget where they came from. Setting expectations and using the Patient Diary makes it easier to measure progress.
It may also be desirable to tell your patients how your short term expectations will impact their long term health in terms of postural improvements and injury prevention.