Custom Foot Orthotics

By: Nipissing Orthopaedic Laboratory  09-12-2011

The art of treating patients with custom made foot orthotics since the late 70's is a growing field of practice, where a skilled practitioner can literally change the life of a person suffering from musculo-skeletal strain and pain with properly fabricated foot orthotics. These devices are literally small braces for your feet and have beneficial effects for the entire body.

Custom foot orthotics can be best described when placed in two broad catagories. The catagories are:

1) Functional foot orthotics: which counteract biomechanical imbalances of the feet which, if left untreated, can cause connective tissue strain and degenerative joint changes throughout the lower extremities and back. Functional foot orthotics are typically made of more rigid materials in order to properly oppose the biomechanical misalignment that is evident of the involved segments that lead to problems further up the kinetic chain.

2) Accomodative foot orthotics allow for off-loading and dissipation of pathological forces associated with conditions seen with more rigid foot deformities. Typically, an accomodative foot orthotic is softer and allows the practitioner to protectively house the foot within the client's footwear.

Custom made foot orthotics from Nipissing Orthopaedic Lab are in almost all cases, hand made from cast of the patients feet. The casting technique of choice is the slipper cast technique which involves wrapping the feet in plaster of Paris and manipulating the feet into optimal alignment while the plaster sets. For more flexible feet, corrected or even mildly over corrected alignments can be maintained in the cast and in the orthotics. As clinical presentations reflect more rigidity and deformity, less correction in the alignment is maintained and more accomodative casts and orthotics have to be produced. Most adults and seniors fall into this grouping.

Material construction is also of prime importance in the conceptualization process during the foot assessment. Having good knowledge of materials and the physical properties that these materials impart is imperative. Our orthotic appliances vary from very soft to very firm, with a sandwich or blend of material being the norm for most foot orthotics. Our current number one favorite consists of a dense base using a variety of foam and rubber materials, a middle layers of shock absorbing foam and a durable top cover.

Successfull treatment of musculo-skeletal ailments with foot orthotics involve follow up where the effectiveness of the appliance is reviewed. Modifications and fine tuning at the follow up appointments is the norm. Because we make our own foot orthotics in house, most servicing and adjustments are done while you wait. With maintenance, a well made custom foot orthotic can last for years.

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