When I first graduated almost 30 years ago, not many people had even heard of orthotics much less knew what purpose they served or where they could get them. In those days, there were only a handful of orthotic manufacturing companies and as student interns in the school Chiropody Clinic, we were tasked with evaluating, prescribing, casting and hand manufacturing all types of orthotic devices for our clinic patients. This was a very practical skill that certainly did not come easy for all students to learn, but it did provide us with a very comprehensive understanding of how orthotics could alter outcomes and make a real difference in treatment.
In those days, orthotics where more commonly referred to as insoles because they were made to be worn inside the shoe on top of the inner sole. Today, the manufacture of orthotic devices has become more technologically sophisticated. Thinner, stronger and lightweight materials have made orthotics easier and more comfortable to wear and they can easily fit in more shoe styles. Traditionally, a Chiropodist or Podiatrist would make a cast of their patient’s feet using moistened Plaster of Paris bandages which would then quickly harden and set. These plaster slippers would be carefully removed from the patient’s feet and then filled with liquid plaster which would solidify and leave us with a 3-D duplicate model of the foot. The Chiropodist/Podiatrist would use these plaster models of the foot to create modifications or accommodations with the intention of either partially/totally compensating, accommodating or correcting the shortcomings in foot structure or function. The orthotic was then made by heating, gluing and molding different materials together over the modified plaster foot casts. A top layer of material would be applied to line, cushion or provide additional shock absorption and the device could then be dispensed. An orthotic typically took several days to completely manufacture due to the various component parts, layers and drying times.
Today, while plaster of Paris continues to be a preferred and reliable method of obtaining a working model of the foot, other methods are also useful and widely used. Force plates that measure pressure transmitted through the feet and scanner technology are also popular and provide us with valuable diagnostic information from which to create orthotics. Compressible foam boxes are also a quick and clean method of obtaining foot impressions and are particularly useful for small children and patients with mobility issues for whom the wet plaster method is too cumbersome. Orthotic labs use precision machinery and high tech materials that can significantly influence how your foot functions for the better. These advanced methods and materials can yield tremendous change and improvement.
Patients often ask me if the “orthotics” that are available at the drug store or online are comparable to a custom made device. The price difference is after all quite considerable. However, when you factor in the materials, intensive manufacturing time and the fact that the custom made orthotic addresses your specific foot structure and function, as compared to the over the counter generic orthotic, the differences become immediately apparent.
At CanadaPhysio, trained and qualified Chiropodists assess your foot function and structure. Custom fitted orthotics are just one component of a comprehensive treatment plan that is intended to address your foot issues. Orthotics are available at any of our convenient locations to serve your needs across Ontario, in Toronto, Scarborough, Whitby, Mississauga and London. In addition to orthotics, a Chiropodist may suggest footwear modification, exercise and physical therapy to assist in restoring you to better foot function and health.