For New Patients

If you have pain or discomfort in the lower limbs, or you have other symptoms that a clinician you’ve seen suspects are caused by your lower limb function, then please get in touch and come and see us.
Appointments are best made over the phone. We’ll take a few details, get you registered and schedule the soonest available appointment that’s convenient for you.
Ian Sadler is our Clinical Director, and all new patients are seen by him for their initial appointment. You may see other similarly qualified clinicians for follow-up, and your progress will be evaluated and monitored carefully by Mr Sadler for the duration of your treatment.
There’s no difference; the terms are completely synonymous.
For new patients, we offer two appointments: a “BxInsight” appointment and a “BxDiscovery” appointment. BxInsight appointments are used when patients want a screening, or if they’ve had an accident, like a fall and there’s an injury that needs attention. For conditions thar require investigations, the BxDiscovery appointment affords enough time to get to the cause of the problem. When we first speak, we’ll advise you as to the most appropriate appointment.
We’ll start by listening to what’s brought you to us, then examine you as appropriate and treat accordingly. This might mean coming back for further care appointments, or if necessary, being referred for specific investigations.
The appointment comprises three parts: Firstly, we’ll start with a traditional GP-style consultation, where we’ll go through your completed patient history questionnaire and take the time to understand exactly what’s brought you to us. This may involve going back over the events of several years. We’ll also want to know what your normal activities are. That might be walking, jogging, running, or any sports you may be involved in. It’s important that we understand the impact your symptoms are having on these activities and what your goals, aspirations and expectations are. It’s our goal to support you to continue your favorite activities, wherever possible.

Once we have a good understanding of you, we’ll go through a series of tests and assessments; each appointment is different. As appropriate, we’ll assess you from your hips and pelvis to your toes, see how much range of movement there is in each of your joints and how they’re being supported. We’ll perform tests with you lying on a treatment table, standing up and moving in ways that are normal for you. Comparing the difference in the results gained during each position builds a picture of your biomechanics. Each appointment is different, as we perform whichever tests are necessary on a patient-by-patient basis. If it’s appropriate, we’ll use our ten-metre diagnostic walkway to perform a gait analysis, and if your normal activities include them, we’ll want to see you walking, jogging and running, to determine how you gait changes as your movement differs.

When tests are complete, we will present our findings to you and discuss a treatment plan with you. We’ll take your lifestyle into consideration and will adapt our advice, wherever possible, to best suit you.

Gait is a term used by academics and clinicians to describe the way one moves on foot. As we understand more and more about human physiology, it’s clear that there’s more to it than simply the bones: muscles, ligaments, and fascia all work together and gait analysis is a means by which your movement is analysed to determine why you are experiencing your symptoms. There are various means available today for studying gait, but we use human eye, pressure plate analysis, and sometimes fast frame video.
In short, as long as it needs to be – we never clock watch! We allow up to 30 minutes for BxInsight appointments and 90 minutes for BxDiscovery appointments. This gives us enough time to see you, and record the necessary journal entries in your notes, too.
Give us a call and we’ll find a convenient time for you in the diary. We’ll then send you an email confirming the appointment. You’ll also be guided to the relevant information necessary to prepare for and make the most of your appointment. We ask all patients to complete a patient history questionnaire in advance of their appointment so that we know a little about you before you arrive. If necessary, this enables us to do any research or reading to understand you and your health and study any scans or reports if they’re available.
Ideally, every patient should bring a pair of shorts to change into, but trousers that will comfortably roll up to the knee are also acceptable. Jeans and skirts are not appropriate for clinical examinations. For initial appointments, bring a few pairs of your most often worn footwear, including any work or hobby-related shoes such as: walking boots, golf shoes, dancing shoes, trainers or running shoes, dress shoes. If you have footwear that you’d like to be able to wear again, but you are unable to wear at the moment, bring these, too, so we can fully understand your goals.
Yes, there are changing facilities available in the cloakrooms. We don’t have lockers, and whenever practical it is advised to come to your appointment already changed.
We’re easily accessible by foot, cycle, car, and public transport. Have a look at our contact page, which has maps and a journey planning facility.
Yes, there are three allocated spaces nearest the front door and a cycle-store to the side of the building. In the very rare case that the car park to the front of the building is full, a large overflow car park is available to the rear of the building. The main entrance is at the front of the building; just push the button marked and labelled “BxClinic”.
You may have been sent an email with a link to a Patient History Questionnaire. If this is the case, please complete it online as soon as possible, so we’re able to read about your history in advance of the appointment. Please clean all shoes that you are bringing into the clinic, paying special attention to removing any mud. Clean feet, with no moisturisers applied, are most easy to assess.
You’re very welcome to bring someone to your appointment to support you. Sometimes patients like to bring their personal trainer, physiotherapist, or other health practitioners with them. Whilst we always support these requests, we would ask that you make a request in advance should you wish to bring a professional with you, so that we can talk to them in advance to determine clear professional roles and understand their needs and wishes.
If you are unable to keep your appointment for any reason, we would ask that you inform the clinic (either by telephone or email) as soon as possible, so that the appointment may be offered to another patient. We avoid charges; we require a minimum of 24 hours’ notice (not including weekends) for appointments held in our Norwich clinic, and one week’s notice for appointments booked in satellite clinics (such as those held from time to time at the Body Control Pilates Centre in London). Whilst we will always be understanding in times of emergency, we will charge a fee of £40 for patients who do not attend without informing us, and of £20 for those cancelling without sufficient prior notification. For appointments where payments are taken in advance, these are non-refundable should patients not attend without giving sufficient prior notice. We do not provide refunds for products or treatments. We will, however, offer a credit note where patients return products, with proof of purchase, within three days of purchase, as long as the product is unopened and is not damaged in any way.

For Returning Patients

We send out emails yearly suggesting you come in for a BxReview appointment. These half-hour appointments are completely voluntary, and their purpose is simply to determine that any regimes (i.e. stretch programmes or orthotics) that have previously been prescribed are still optimal for you. If we haven’t seen you for two years, we’ll insist on a BxReview appointment to check everything’s OK before making a repeat prescription.
They may well do. Operations such as hip and knee replacements will certainly have an effect on your gait, and your orthotics may no longer be necessary, or your prescription may need modifying. We usually schedule a BxReview for when you’re discharged from your surgeon and we’d recommend getting in touch before your surgery so we can plan the best course of action for you.
Yes, some manufacturers of custom-made orthotics offer us a discount for making additional pairs, and we pass these on to patients.

About Costs

BxInsight appointments have a fixed fee of £40. BxDiscovery appointment charges are variable, as we have no way of knowing in advance which assessments will be performed, or precisely how long the appointment will last. Consequently, we have a modular pricing structure, with tests, assessments and time being added to invoices as they are used. There is a cap of £125, and all patients are advised to expect a charge of this amount. However, it is often the case that bills are considerably less if, for example, gait analysis or biomechanics assessments are not necessary.
We allow 30 minutes for most treatment (BxTreat) appointments. Our charges vary slightly depending on the treatment being offered but are generally in the range of £35-£40. From time-to-time patients come in for BxReview appointments, which may last ten, twenty, or thirty minutes and for which charges are between £20 and £40.
As explained in the ‘About Orthotics’ questions, we have all bases covered regarding orthotics therapy technology. We sell orthotics as part of Treatment Packages which include casting of the foot where necessary, a pair of orthotics, a fitting appointment, a 2-month clinical review appointment, and service and support to ensure you are well looked after as you get used to them. Our prices for these packages are between £160, £230, and £360 (with the difference in costs related to the construction methods used in producing the device). Some are ready-made (pre-fabricated as a stock item), others are milled from a block of material having taken a cast or impression of a patient’s foot, and many are hand-made by building layers of different materials together. The latter two options are handcrafted, finished and inspected. We believe our prices represent exceptionally good value-for-money given the complexity and nature of the labour-intensive processes employed.
Cash and UK debit cards are preferred. We also accept international, credit and American Express cards, but there is an additional processing fee of £1.50 applied to those transactions.

About Assessments

No. We especially chose a clinic location that has a ten-metre room to be able to use a fixed pressure plate walking assessment system. There is enough evidence that the way we walk on a treadmill differs from the way we walk on normal ground to convince us that it is currently a poor clinical tool. It is our observation that the way one moves on a treadmill, where the ground is being pulled from underneath, is sufficiently different to the walking step over the ground, that fixed plate gait analysis is the preferred and most sophisticated means of assessment currently available.
Like GPs and the majority of the healthcare profession, we don’t currently provide reports as part of our standard service, but they can be prepared for you. Should you like a report, please ask at any time during your visit and we’ll set aside time to write one for you. It’s important that we understand for whom it’s intended (e.g. yourself, your insurance company, GP, osteopath, physiotherapist, sports massage therapist) as the language we use may vary accordingly. Often reports such as these lead to further phone calls and letters, and we levy a one-off charge for writing a report, including follow-up, of £30. You may prefer to bring a pen and paper with you and take notes.

Orthotics

The terms insoles, orthotics, orthoses and shoe inserts are commonly used by patients and therapists alike to describe the devices which we prescribe. While the terms are interchangeable, wherever possible we use the words orthotics and orthoses to describe objects whose primary purpose and function is a medical and biomechanical one and other terms such as insoles and inserts when the purpose is non-medical (i.e. where comfort is the primary purpose).
To be clear, foot-shaped products that are readily available for purchase on the high street, or alongside trainers, are insoles, being designed for comfort and shock absorption.
Absolutely not! While we use them extensively, orthotics are not an appropriate solution for everyone and some patients may only need to wear them as a temporary intervention. We have a range of treatment protocols and while looking at our treatment pages will give you an indication of the sorts of options available to us, these are only a guide. Your clinician will explain clearly at the end of your initial appointment the plan we would advise for you.
We have a separate section on this website dedicated to educating about orthotics and how we use them. In brief, though, there are a few different types of orthotics available, and we use all of them, as and when appropriate. We’re not bound to one particular supplier. We take a cast of the foot when necessary and can make orthotics of all sizes, lengths, materials, and clinical requirements. We lecture nationally on gait biomechanics and the use of orthotics as medical devices, and when writing prescriptions we take many variables into consideration. Such considerations include the lifestyle of the patient and the demands that will be placed upon the orthotic, as well as the type of footwear the patient intends to wear.
No, not for new prescriptions. Our orthotics are fitted by a clinician (in a dedicated 30 minute appointment) for a number of reasons: sometimes, when a patient stands on an orthotic for the first time, it’s immediately apparent to us that it’s not having the effect we would want. In rare cases such as these, the orthotics are returned to the manufacturer for modification. We’ll also ensure the orthotic fits in your shoes, and that you understand how and when to wear it. Repeat prescriptions can be posted, though.
Wherever possible, we make every effort to fit orthotics into your existing shoes. Ideally, orthotics would be a device that fits into any shoe, takes up no space and transforms the life of its wearer instantly. Unfortunately, orthotics are medical devices that address very specific conditions, and as such, there may be a compromise necessary regarding footwear, for a period of time. This might mean having to wear slightly larger shoes, or having the shoe manufacturer’s insole removed to be replaced with ours. We ask patients to bring examples of their most often worn shoes with them to BxDiscovery and fitting appointments so that orthotics can be trimmed appropriately. It is important to understand that some compromises may be necessary for some patients with regard their footwear.
As with shoes, this will vary from person to person, depending on the usage, the prescription, and the way patients walk. However, as a guide, we tend to say they’ll last between 2-5 years. We can refurbish most prescriptions.
Yes, making orthotics is one option. For some patients, for whom the prescription requires it, we make orthotics ourselves here in Norfolk. We also use several different manufacturers in the UK if having a custom-made, bespoke orthotic is required. The manufacturer is chosen based on the prescription required, as each manufacturing process will have its strengths and weaknesses. Sometimes though, the best orthotic for a patient is one that can be bought as a stock item, and if that’s the case, we use those.

We don’t scan your feet and send images to other countries, where clinicians who have never met you are allowed to make decisions about your prescription. We’ve visited all our manufacturers’ factories, and know all of their teams personally.

Yes, certainly. We have a repeat prescriptions free-phone number (0800 133789) where existing patients can leave their details and ask for an additional pair to be made. If you’re a new patient, we’ll assess you and produce the most appropriate device for you.
We never suggest you buy more than one pair, but many patients request further pairs, mainly for convenience. For example, golfers often favour having their orthotics permanently in position in their shoes, stored safely in the boot of their car! While we recommend against having a range of orthotics for different activities, sometimes a half-length and slightly modified prescription might be appropriate for a lady’s court shoe and we are certainly used to solving challenges such as these.
All our devices are guaranteed by their manufacturers against structural imperfections. When cared for and cleaned regularly their lifetime can be maximised, but of course, over time, they will wear out and perform less well. When wear-and-tear associated with their use degrades the aesthetic or performance, we can refurbish them. Each manufacturer charges differently for these services and our costs vary accordingly. We’ll assess their performance at review appointments and can make suggestions as appropriate to minimise your costs.
All new prescriptions are collected by patients, in person, at a 30-minute fitting appointment. For reasons of clinical governance and good patient care, we won’t post them out, and they are not left in reception for you to collect. They’re fitted by a trained clinician, where the prescription and how it’s performing is assessed when you stand on them. Despite having gone through our quality assurance and evaluation procedures before your appointment, sometimes (albeit very rarely) orthotics aren’t correct when patients stand on them and they are returned to the lab for modification. We are always sure that our patients are walking on the orthotics that we intended for them.
At the fitting appointment, all patients are booked in to attend a two-month review; it’s included in the price of your orthotics, is the last appointment we insist upon, and is the time when we evaluate a device’s performance, how you have responded to it, and ensure that the improvements we had expected are being achieved. We may make modifications or adjustments to the prescription at this time, or change an exercise regime that was previously given. Each patient’s plan is individual, and it’s reviewed at this time to ensure we’re making the progress we desired. The results of this appointment will differ for each patient, but typically we won’t need to see patients for further follow-ups. They are contacted on the anniversary of their first appointment, inviting them to come in for a review to assess further progress, and to ensure the prescription is still the most appropriate.
Initial reactions to standing on orthotics will vary widely. Some patients find that they give immediate relief and they never have any discomfort, while for others it can be quite an uncomfortable experience for a period as the body adapts to its new surroundings. While we appreciate that comfortable feet is something we often take for granted and seek out when that condition changes, orthotics are primarily a medical device and adjusting to them may take a little time. We have access to the widest range of materials for orthotics manufacture and will do all we can to ensure that your comfort is also addressed. Understanding and taking into consideration each patient’s biomechanics, we’ll always consider how much a patient will be able to tolerate if the desired prescription is effecting a considerable change. We may decide to make small changes over a longer period, for example.
All orthotics come with a patient information leaflet advising the best way to adjust to their use. We suggest a break-in period of a week, during which time their usage is increased by no more than one hour per day. At the end of that time, when they can be comfortably be worn all day, orthotics can be used during sports and other strenuous activities. This protocol is for all orthotics, irrespective of whether patients have worn them before, and even includes repeat prescriptions.

About Footwear

Yes, absolutely. If you’re considering new trainers or other footwear, book in for a BxInsight appointment. We’ll look at what you’re currently wearing, listen to your requirements and difficulties in choosing, and come up with some suggestions regarding the sorts of properties you might consider. We avoid advising particular makes and models, because manufacturers modify their ranges frequently. However, we have worked with several local shops to produce a “Footwear Recipe” and they are familiar with the language we use to describe requirements to our patients. In short, we’ll help you make the best decisions you can for your footwear, with your anatomy and requirements taken into consideration.
We wish this were a straightforward question to answer, but it’s not! The science of biomechanics interprets forces which are passing through individuals as they move. We are all constructed differently and thus for some of us a raised heel works with our body, and could be considered beneficial, and yet for others, the same size heel could cause aches, pains, and injury. We’ll gladly advise on the most beneficial footwear for you.
See the answer about high heels; the answer’s the same! It depends on how you’re put together, and the terrain you’re planning to interact with. If you’re a healthcare professional, we’re running special training days about just this subject!

General Clinic Questions

We have clinics each day from Monday to Thursday and some Saturdays. For up-to-date scheduling, please see our Contact page. Green text at the top of each page indicates whether we’re open at the moment, too, so give us a call if you’d like to check.
Sometimes patients come extremely long distances and in cases such as this, we’ll always do whatever we can to facilitate them. While it’s not a service we offer as a matter of course, we’ve opened early and closed late on such occasions. To help plan your journey, please use the map on the Contact Us page and if you need additional help making arrangements, even with hotel recommendations, don’t hesitate to give us a call.

Before Appointments

We send out appointment confirmations immediately upon booking, which will outline any steps required before coming to see us. Typically, there’s a patient history questionnaire to be completed online, which gives patients the opportunity to tell us about what’s brought them to us and to outline their medical history. It also affords us the time to understand and read in greater depth about your medical history and in particular any surgeries you may have had, helping us to offer you the best service possible.
Until the catchment area that most of our patients come from has a reliable mobile network signal, we have taken the decision not to do so. Additionally, emails give us the ability to send interactive messages, giving our patients a better overall experience. As technology and the networks improve, we may re-evaluate this decision.

Technology and Security

We’re concerned about it, too. In fact, our Practice Manager has a background in IT consultancy and places great importance on security, above and beyond our legal requirements. We are registered Data Controllers, and have many and varied security protocols in place to protect your data. All connections to our website (not just the forms and questionnaire you complete) are secured – just look in the footer of this website for some of the accreditation logos representing our commitment to internet security.
No. Whilst they are widely used and very convenient, we don’t use file storage services provided by companies such as Dropbox or Google, as they simply aren’t able to assure us of the levels of security we demand for patients’ data. Any data and electronic records that are available for staff to access when not in the office are delivered using a private (zero knowledge), encrypted storage solution provided by Canadian company, Sync.
Yes, and No! As the commercially available systems improve, we are moving towards a completely digital practice that will comprise electronic records that can be intelligently reported on. We’re not there yet. In the meantime, our clinical notes are paper-based, and stored in locked cabinets, in a locked room.
Our email provider is Zoho, a highly respected and ethical company whose attention and management of security issues we find admirable.
No. Card details are not stored in any of our systems. Our card payment machines are provided by the Elavon payments network, a part of Santander and are managed completely independently. To be able to provide this service, our internal network is regularly scanned for security weaknesses, and to assure our PCI compliance. The Trustwave logo in the footer of this website shows our up-to-date compliance status.

About This Website

Reading through long web pages is seldom a luxury we can afford, and we’ve employed experts in their fields to design this site so that it’s easy on the eye, rich in information and straightforward to navigate. However, to hone in directly on the information you’re interested in, please consider using the website’s search engine (click on the little spyglass at the top right of each page) and type the text you’re looking for.

In producing this list of frequently asked questions, we’ve done our best to categorise the questions in a way that is most useful for our patients, but please submit any further questions you may have, or suggestions for changes, using the contact form and we’ll make additional improvements.