When trying on and buying shoe after shoe and the foot pain doesn’t improve; when an over the counter arch support just isn’t enough to give relief- it is time to see your podiatrist and consider a specific prescription orthotic for your foot. Many people just accept and tolerate daily foot discomfort not knowing much about orthotics. However, a custom orthotic is often the final solution to address chronic pain.
A custom orthotic is created from an impression of your foot. Many experts still feel the casting technique is the most accurate method to take the impression of the foot, as compared to the pad pressure scans. Of course the casting technique may require more time from the doctor and the staff will have some clean up afterward, but the impression is more accurate. There are many casting techniques and skill can vary between providers based on their experience.
Once the impression is made, the next step is for the doctor to write a prescription, which gives detailed, specific instructions on the fabrication of an orthotic. The negative cast mold, along with the prescription is sent to the orthotic lab. Labs vary from large-scale operations where many people are involved in an assembly line process, to small labs where only a few people, sometimes only one person, hand makes the custom orthotic.
After the negative cast arrives at the lab, the plaster is then mixed and poured into this cast. The result is a positive mold of the patient’s foot. The corrections to balance the foot are added based on the prescription. When the mold of the patient’s foot is ready, the orthotic fabrication process begins. There are so many materials to choose from in this day and age. A variety of polymers and graphite materials can make the decision challenging. There are also a variety of top coverings and pads which will be added depending on the foot problem.
The doctor examines the foot and the mechanics, but there is also important information the patient will report that will help in the fabrication of the orthotic. Type of shoe styles the patient wears will determine space available for a device. Other important information includes: the patient’s lifestyle, occupational demands and recreational activities. An executive who wears dress shoes the majority of the time may have little room for anything more than a graphite device, compared to someone who spends most of their time in sport style sneakers, where there is much more space. Some devices are fabricated specifically for a sport like running, biking, skiing or even golf.
As you can see, there are many steps and factors involved in the fabrication of a custom orthotic. At the lab, the materials selected are cut, heated, shaped, ground, glued, and smoothed with adherence to the measurements directed by the doctor’s prescription.
Orthotics are not a panacea for any painful condition. A good evaluation is a prerequisite to determine whether they are indicated.
Dr. Fritz , a former Navy Seal who understands the demands that can be placed on feet. Dr Fritz is a podiatric physician and surgeon, He is also a certified pedorthist who has experience in orthotic fabrication. Dr Fritz served as a podiatric consultant taking some of the most difficult and challenging cases.
He is part of a Team of foot and ankle specialists at Allentown Family Foot Care.
