Nolaro24™ LLC maker of QUADRASTEP® and littleSTEPS® families of foot orthotics
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FAQ


General Questions

 

HOW DO I ORDER OR RE-ORDER?

Practitioners may Download the Order Form on any page and fill it out and fax it to the number on the form, or call or email us 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.

 

HOW DO I LEARN MORE?

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@thequadrastepsystem.com, phone 877-792-4669.

 

HOW DO I KNOW IF I'VE GIVEN MY PATIENT THE CORRECT FIT/SIZE FOOT ORTHOTIC?

You can refer to our Fitting instructions. Or you can take a picture of the patient’s feet standing in the orthotic and our experienced technical team can give you advice on fit or other recommendations. Email any questions to education@thequadrastepsystem.com. We pride ourselves on giving great technical support and are happy to answer any questions.

 

WHAT KIND OF INSTRUCTIONS DO I GIVE MY PATIENT?

You may print information from our Dowloads pages to hand to your patient. For QUADRASTEP® CLICK HERE, for littleSTEPS® CLICK HERE.

 

SHOULD I DISINFECT FOOT ORTHOTICS BETWEEN PATIENTS?

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.

 

MAY ORTHOTICS BE RETURNED?

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.

 

HOW LONG WILL QUADRASTEP® OR littleSTEPS® ORTHOTICS LAST? WHEN SHOULD THEY BE REPLACED?

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.

 

CAN I CUSTOMIZE QUADRASTEP® OR littleSTEPS® ORTHOTICS?

Yes our orthotics grind easily and many customizations can be made to them. 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.

 

WHAT IS A WIDGET KIT AND HOW DO I USE IT?

Please refer to our page on customixing your orthotics HERE, there you will find a full description of what is included in a Widget Kit and how to use it.

 

WHAT IS THE MATERIAL THAT QUADRASTEP® OR littleSTEPS® ORTHOTICS ARE MADE OF?

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.

 

I’VE DECIDED WHAT SIZE ORTHOTIC MY PATIENT NEEDS BASED ON THEIR SHOE SIZE — IS THAT ALL I NEED TO DO?

In most circumstances getting the patient’s shoe size is all you need to do to determine which size orthotic they need. But you should always check the orthotic on the patient to ensure they fit correctly. Shoe sizes are a guideline but feet come in many different shapes and sizes and your patient may not actually be wearing their correct shoe size. Some of our C orthotics run a bit small and the patient may get a better fit with the next size up. A correct length for ¾ length orthotics (B, C, D) has the anterior edge of the orthotic end just before the metatarsal heads when the patient is standing. For our extended length orthotics (A, E, F) the extrinsic forefoot posting ends at the sulcus and either the 1st or 5th Metatarsal head falls into the cut-out.
Please refer to our sizing tips/fitting guides if you’re not certain on how to correctly fit our orthotics.

SEE our How-To Videos on customizing orthotics

QUADRASTEP SYSTEM® Questions

 

WHAT IS THE 3 ’W’ METHOD OF ORTHOTIC DESIGN?

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.

 

HOW DO I DO AN ASSESSMENT ON MY PATIENT TO BE SURE I'VE CHOSEN THE RIGHT QUAD?

We recommend that you use our 4 Step Assessment (see page 6) 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.

 

THE QUADRASTEP® ORTHOTIC IS THE RIGHT LENGTH BUT IT SEEMS TOO NARROW, HOW CAN I ADJUST THIS?

If the QUADRASTEP® orthotic is the right length but doesn’t appear to be wide enough, try the next size up. As the models get longer they also get wider. If the next size width looks good, then check the length, if the length is too long then the shell can be shortened to the right length. If you are not set-up to make orthotic adjustments, we are happy to make these adjustments for you along with many other customizations as needed. Just note which size QUADRASTEP® model is the right width and then note how much needs to be taken off to make it the correct length.

 

THE QUADRASTEP® ORTHOTIC IS THE RIGHT LENGTH BUT IT SEEMS TOO WIDE AND DIFFICULT TO FIT IN SHOES

Our QUADRASTEP® orthotics are available in two widths: Regular or Narrowed. The Narrow orthotics are ¼” narrower and are designed for cleats or fashion shoes, and often work better for women or people with narrower feet. As a general rule your patient will have less shoe fit problems in a Narrow orthotic. Just keep in mind that if you reduce width too much you can reduce function, so an assessment needs to be done to make sure that the fit is correct and function hasn’t been compromised.

 

I’VE TRIED QUADRASTEP® ORTHOTICS ON MY PATIENT BUT THEY HAVE UNIQUE PROBLEMS AND I FEEL LIKE THE ORTHOTICS NEED TO BE ADJUSTED AND I’M NOT SURE WHAT TO DO. IS THERE SOMEONE WHO CAN GIVE ME ADVICE AND ANSWER SPECIFIC QUESTIONS?

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.

 

little STEPS® Questions

 

THE littleSTEPS® ORTHOTIC IS THE RIGHT LENGTH BUT IT SEEMS TOO NARROW, HOW CAN I ADJUST THIS?

If the littleSTEPS® orthotic is the right length but doesn’t appear to be wide enough, try the next size up. As the models get longer they also get wider. If the next size width looks good, then check the length, if the length is only slightly too long then we recommend you leave it alone as the child will likely grow into it rapidly. If it is way too long, estimate how much too long, 1/8” or 1/4” and the shell of the Little Step orthotic can easily be cut or ground shorter, so it’s the right length and width. If you are not set-up to make orthotic adjustments, we are happy to make these adjustments for you along with many other customizations as needed.

 

The littleSTEPS®ORTHOTIC IS THE RIGHT LENGTH AND WIDTH, BUT IT SEEMS A BIT TIGHT AROUND THE HEEL CUP, CAN THE HEEL CUP FIT BE ADJUSTED?

The littleSTEPS® orthotic heel cup can be flared out with a heat gun to make it wider (please see our How-To Video page). If you’re not set-up to make this adjustment, we can do this for you. Let us know if there is a particular spot where it seems too tight, for example the lateral heel cup. Or take a picture of the child in the orthotic and email it to us, so we can visualize exactly where and how much to flare the cup.

 

I HAVE A PATIENT AND THE littleSTEPS® ORTHOTIC LENGTH IS CORRECT BUT THEY HAVE NARROW FEET AND THE DEVICE SEEMS TOO WIDE, ESPECIALLY AROUND THE HEEL CUP. CAN I ADD A LINER TO REDUCE THE WIDTH?

Adding a liner is a good way to fill up the heel cup for narrower feet. You can line with 1/16” EVA covers (snugs up about 1/8” total since you are lining both sides of the heel cup); or with 1/8” liner which snugs up about 1/4” total. So, just estimate how much snugging you need and let us know if you’d like us to add a liner for you.

 

HOW DO I KNOW IF A TOE-OUT GAIT PLATE IS APPROPRIATE FOR MY PATIENT?

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.  See the images to right:  The first picture shows a pronated foot, with flat arches causing an abducted forefoot (ie NOT TRULY TOE OUT).  The toe out picture on the right show a true toe out (in this picture would look like external tibial torsion).  If the tibia or femur has external torsion, that would supinate the foot and raise the arch.


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Nolaro24™ LLC - Make of The QUADRASTEP® SYSTEM and littleSTEPS® Foot Orthotics

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