Steps in Manufacturing Orthotic Devices
In order to achieve the best initial change
with orthotic devices, several steps must occur. Following the
initial history and physical examination, the patient undergoes a
gait evaluation (walking and/or running), looking for pattern(s)
that may produce abnormal stress in the injured area (ie.
knock-knees irritate the medial side of the knee). There are over
20 anatomic variations which may impact an injured area. Your
doctor will be trying to make that correlation. If a correlation is
made, your doctor may want to evaluate the biomechanics of your
body with greater depth by range-of-motion testing and/or muscle
testing. The purpose of the biomechanical range-of-motion exam is
to measure and quantify the motion of all functional lower
extremity joints, identify abnormalities such as excessive laxity
or limitation, and determine the weightbearing and
non-weightbearing functional positions of those joints. The muscle
testing portion of the examination is performed in order to
determine muscle groups which may be excessively weak or tight and
to determine their part in the overall cause of the injury,
symptoms, or biomechanical problem. X-ray evaluation of joints may
also be indicated in selected cases. Due to the individual expense
of each of these procedures, examinations are recommended only if
your doctor feels the information provided by a procedure is needed
for a proper diagnosis.
Along with the gait evaluation correlating
gait to injury, an impression cast of each foot is taken. Most
casts are done to capture a non-weightbearing, neutral-position
impression of the foot. Neutral position is where the foot is in
correct alignment with the ankle and lower leg. This serves as a
Reference Point to all modifications. It is the Gold Standard - -
your foot before it steps on the ground which allows body weight to
alter its position from neutral. However, at times, other casting
methods are utilized for specific purposes, ie. in-shoe casting,
weightbearing casting, etc.
When making an appointment to be evaluated and
casted for orthotic devices, please inform the receptionist that
you are coming in for a casting appointment so that sufficient time
will be allowed. The negative casts are then sent to the orthotic
laboratory accompanied by a prescription written by your podiatrist
indicating not only the specifications for the correction of the
positive casts, but also the materials to be used, the dimensions,
and the individualized additions to be used in the manufacture of
your foot orthoses.
The manufacturer of functional orthotics is
thus a multi-step process involving detailed and intricate cast
correction, orthotic fabrication, and application of many other
additional items prescribed by your podiatrist for the treatment of
your specific condition. Finally, posts may be applied to the
bottom of the orthotic in order further prevent excessive and
abnormal motion predisposing to injury. The specific dimensions and
degree of motion control designed into these posts is described in
the orthotic prescription.
Important Notice:
We cannot give medical advice about how to treat a specific injury.
While we may discuss general exercises to prevent sports injuries
and also may recommend methods that can be effective in treating
sports injuries, not all exercises are designed for all individuals
or problems. A physician should be consulted before starting any
exercise program. If you are experiencing any severe pain or
discomfort, it is particularly important to seek the advice of a
knowledgeable physician and get a specific diagnosis and management
plan for your problem. The remedies outlined here are general
recommendations and are not intended as a substitute for
professional medical advice.
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