Q+A with orthotist ~ Jarrod Cahir
We are lucky to partner with some incredible industry professionals to offer our clients a quality and holistic service and tailored outcomes. One of those is the very talented Jarrod Cahir from Therapy Tracks, who we often collaborate with to supply Ankle-Foot Orthoses to some of our clients. We sat down with Jarrod recently for a Q+A to get to know him a little better.
What is an orthotist and how do you become one?
An orthotist is a healthcare professional who specialises in the design, fabrication, and fitting of custom-made orthopaedic braces, prosthetic limbs, and other supportive devices. We work closely with patients who have physical disabilities or injuries to help them improve mobility, range of motion, protect their joints and bony structures and increase participation in their daily activities. To become an orthotist in Australia, you complete a university degree in Clinical Orthotics and Prosthetics, which typically takes four years to complete. The degree program covers subjects such as anatomy, physiology, biomechanics, orthotic and prosthetic design, materials science, and patient assessment and management. During this time, Orthotists gain theoretical and hands-on experience in the profession and develop practical skills in designing and fitting orthotic and prosthetic devices.
When and why did you start Therapy Tracks?
I have spent most of my career working in country SA and in the NT at both Alice Springs and Darwin Hospitals, as well as out remote with the NDIS. I’ve been lucky to do some extra studies and meet some incredibly passionate people along the way who wanted to improve health outcomes in regional and remote areas. Therapy Tracks started in 2020, with Emily, an OT in Alice Springs and Oskar an Orthotist in Broome whilst I was working in the UK learning about digital health options in the industry such as 3D scanning and printing, CAD/CAM as well as assisting with research in the field of prosthetics and orthotics. The experience allowed me to trial and gain an insight into some of the technology currently available and brainstorm ideas with colleagues about the huge upside to its use in regional areas, where there were previously very limited options for Orthotic and Prosthetic services.
This digital workflow allows us to take our workshop anywhere and provide a consistent, objective, evidence-based service with our clients in regional and remote parts of Australia. What is a career highlight to date? I’ve been fortunate to have a broad range of experiences to date. Highlights involve working in Indonesia training clinicians at a disability NGO, before going to London Orthotics Consultancy (one of the best Orthotic Clinics in the world), where in both cases I worked alongside enthusiastic people eager to think outside the box and constantly improve outcomes for the end user. I’ve also worked with Paralympians and love the opportunity to travel through the NT and Kimberley – it’s a pretty great job!
How often do you visit Darwin?
We’re currently visiting Darwin once or twice a month throughout the year, working with a number of local providers as part of the multidisciplinary team. Hopefully, as the rate of orthotic referrals continues to grow, we’ll be able to have a more permanent presence later in the year, which is exciting! What is an Ankle Foot Orthosis? An ankle foot orthosis (AFO) is a medical device that is used to support and stabilize the lower limb, ankle and foot. It is worn on the lower leg with various designs wrapping around the tibia and controlling the metatarsal phalangeal joint, to provide additional support and protection for people who have difficulty walking or standing due to conditions such as cerebral palsy, multiple sclerosis, spinal cord injuries, stroke, or other neurological disorders. AFOs can be customized to fit an individual's specific needs by adjusting the shape and design to optimise the position of the ankle, degrees of flexibility, stiffness, alignment and lever arms. They can improve balance, support muscle weakness, promote building strength in the proximal musculature and help people with mobility impairments to move more easily and safely. We take a modern approach, and enjoy working as part of the multidisciplinary team, to utilise AFOs as another rehab tool for the client to work towards their goals.
How do I know if my child needs an AFO?
Some general signs that may indicate that your child needs an Ankle-Foot Orthosis (AFO) include:
1. Difficulty walking or standing without support
2. Frequent falls or trips whilst walking or running
3. Abnormal gait, such as toe-walking or excessive pronation/supination of the feet
4. Muscle weakness or spasticity in the lower limbs
5. Joint instability, hypermobility or contractures
6. Structural abnormalities in the foot/ankle, such as flat feet or high arches
Whilst not an exhaustive list, AFOs can be a useful tool, when designed correctly to assist children to increase strength and improve alignment of their lower limbs to facilitate gross motor function. This complements a lot of the work being done by physiotherapists and has been show to reduce the risk of future surgery, reduce pain into adulthood, sustainably improve function and change a child’s level according to the Gross Motor Function Classification System (GMFCS).
How many patterns do you have for kids to choose from? What is your favourite?
We love making fun devices, that people are proud to wear and show off part of their personality. We have over 100 different patterns to choose from and have recently started further customising AFOs and Prosthetic Limbs with vinyl stickers and incorporating designs like footy teams and colours into the final product. We also have the option for more cosmetic devices if that is preferred.
Why is prescription of a shoe with the AFO so important?
I describe the shoes for your AFO like the tyres for your car - You can have a well-designed 4WD but if it has the slick, city tyres on, the outcomes are suboptimal than the off-road pairing. Similarly, shoes come with a range of different heel heights, stiffnesses and shapes on their sole, that affect the alignment of the lower limbs and trunk. Evidence shows that AFOs must be designed with the shoe in mind to ensure appropriate alignments of the ankle and tibia, that flows on effect to the upper body to increase stability, direct forces and activate muscles around the hips, glutes and quadriceps. We generally modify the sole of the shoes and design the AFO to match the needs of the child at the time, then follow the child’s journey to often reduce the required amount of support as their gait pattern, range of motion, strength and confidence improves.
What is your favourite thing to do in the NT?
I love the outdoor lifestyle, hiking and camping in the national parks, running along the bike paths in Darwin and mountain biking the trails in Alice Springs. Everyone’s always ready to give things a go outside of their comfort zone which which leads to some pretty awesome stories and NT adventures!
