Methods of actually producing custom made orthotics vary widely. Many methods work satisfactorily, but the key to success is having a wide range of techniques and materials to manage the variety of conditions and individual needs we are challenged with every day. There are over thirty-five steps in manufacturing one pair of orthotics, and every step counts from the Pedorthic assessment to the final dispensing of the devices to the patient.
CWG Footcare is proud to be associated with one of the finest orthotics laboratories in North America, Paris Orthotics, Vancouver, a PFOLA member. We feel that if your orthotics are made by PFOLA standards then you are receiving the correct medical devices your referring practitioner expected you to receive.
Orthotics manufacturing is divided into two components, the casting of the foot itself and the manufacture of the actual custom made supports.
While several methods exist for making orthotics, including some that are computer generated, the majority of foot care professionals consider the plaster slipper cast taken with the foot in a non weight bearing position, to be the gold standard. However a poorly taken slipper cast is not superior to a well taken cast of other means.
Advantages of slipper casting in non-weight bearing are:
1. The non-weight bearing foot does not capture its structural defects; for example if the arch flattens excessively (hyperpronation, pes planus) then this occurs when the weight is on the foot. This is why most of us believe that our arches are fine - we look at them when there is very little weight on them, for example when we are sitting.
2. Precise positioning of the foot; the pedorthist can hold the joints including the ankle, subtalar (below the ankle), midtarsal (bones in the middle portion) and the forefoot. Positioning the forefoot up or down can increase or decrease the height of the arch and the overall correction of the foot. Most other casting methods cannot provide this degree of flexibility of " intrinsic " cast correction.
The use of multiple lasers to create an electronic 3-dimensional image is evolving and will likely be capable of equaling the flexibility of slipper casting in the coming years. Any casting method can be satisfactory in skilled hands however, and alternative casting techniques are often superior in specific conditions.