How Is A Custom Orthotic Made? By: Manuel and Matt
Every custom orthotic begins with a referral from a physician, nurse practitioner, or other prescribing health care professional. Your Canadian Certified Pedorthist will provide you with a thorough assessment during the first visit. The assessment includes a detailed relevant history, a biomechanical evaluation, a gait analysis and a treatment plan. The history is taken to determine possible causes, to identify any underlying medical conditions and to determine the area of concern. During the biomechanical evaluation, any structural deviations from an ideal position are recorded and a range of motion test is performed on relevant joints. The gait analysis observes the dynamics of the foot. Based on the information gathered, the treatment plan outlines the specifics of orthotic manufacturing and any other recommendations to address the concern, including footwear advice and suggestions for alternate and/or supplementary care.
To begin the manufacturing process, an accurate 3-D cast of the foot is taken. This comes in the form of a non-weight bearing slipper cast in a subtalar neutral position to capture the shape of the foot. Slipper casts are the preferred method of casting when the aim is to control motion with a functional orthotic. Alternatively, the pedorthist may choose to get a foam impression of the foot, when the aim of the orthotic is accommodative, or when slipper casting is not possible. The negative impressions are filled with plaster and possible alterations are done to the positive model of the foot.
A variety of factors determine the material choice for the orthotic shell. Whether the shell is a type of thermoplastic or an EVA compound does not change the manufacturing process. The chosen material is heated until pliable and then molded over the positive model of the foot. The shell is trimmed and ground to the desired height and width and stabilizers are placed at the heel and forefoot, at times angles to offset a varus or valgus deformity. Finally, the devices are completed with a full length cushioned top covers and any additional offloading pads, as indicated in the assessment.
Please remember, custom orthotics function best with proper footwear for the condition. Your pedorthist will complete the process with footwear recommendations at dispense time.