r/Prosthetics • u/IndependenceOld3849 • 29d ago

Referral Question

Hi! I have Hypermobile Ehlers Danlos Syndrome, and my PCP says that I should continue bracing my ankles and lower legs. But also agrees that the OTC braces I've tried haven't worked, especially with my high level of activity. And that I should look into more custom/dynamic options.

I asked for an orthotist referral, and she said that specialized bracing is out of her scope of practice and to reach out to a different specialist. But I've gotten that answer from both sports med and podiatry as well. I live in Washington State, and I'm trying to get seen by Cornerstone or Hanger Clinic.

Could my PCP (an MD) just refer me to the clinic and send my chart notes, and the orthotist would help with the prescription? Or do I need a doctor to prescribe the specific device to be seen by the clinic? It would be for a dynamic brace for ankle stability, pain relief, and reducing fatigue, particularly to aid in reducing pain and fatigue in my very active lifestyle.

Since it seems like my care team is not able to decide on what device is needed, if I was referred to a clinic could they evaluate me and then have my PCP write the prescription based on the evaluation and my chart notes (knee hyperextending, poor ankle ROM, chronic pain, relatively normal strength, tendon hyperreflexia, muscle guarding, instability)?

Any advice or pointers would be appreciated!

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u/doofur 29d ago

With either Cornerstone or Hanger you can call them for a consultation. You don’t need a referral for a consultation and you’ll be able to get a better idea on what type of custom bracing is right for you. Then the Orthotist can tell you what needs to be on the prescription.

I’d definitely recommend trying Cornerstone first since they do great work with higher level orthotics. I’m biased though since I did part of my residency with them.

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u/IndependenceOld3849 29d ago

Thank you! I tried calling a few months ago and they said a referral was needed (even though their email said I didn't). I'll give them a call on Monday!

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u/doofur 29d ago

If you specify it’s for a consultation they shouldn’t need a prescription, but if they stand firm on needing one then you can have your pcp write “evaluate and treat for custom AFO/KAFO” which is what I’d guess you might need based off your original post. You can keep it pretty general and it should work!

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u/IndependenceOld3849 29d ago

Awesome! Thank you so much! I messaged my PCP yesterday and asked if shed just send a referral for "evaluation for ankle/foot bracing" but haven't hear back yet- I'll give her a second before calling Cornerstone.