As we discussed in a previous blog post, Why ezWalker® by WalkEZ: The Facts about Over-the-Counter Arch Supports, the orthotic industry is a multi-billion dollar business, which explains why there are so many different arch supports to choose from. But an over-the-counter (OTC) arch support is not a custom-made foot orthotic.
OTC arch supports are mass produced, so the left and right arch supports are mirror-images of each other, and neither one are made for either of your feet. No two feet are exactly the same, so your arch support shouldn’t be the same either. True custom orthotics are specially fabricated for your individual feet, using casting, molding, or digital methods that make custom impressions of your feet. These impressions are designed to create orthotics that do a specific job, like reducing pressure on your heels or the balls of your feet, accommodating for deformities, or enhancing the way your foot functions. However, even custom orthotic businesses don’t always produce quality devices.
Should I Visit my Doctor to Get Custom Foot Orthotics?
Most people think they must see a doctor in order to be prescribed a custom orthotic. This is not true. The orthotic companies market to physicians and chiropractors since they routinely see patients with foot conditions or pain. However, most healthcare professionals have never been taught proper pedorthic techniques. They only know how to make an impression of a patient’s foot based upon what the orthotic manufacturer has taught them to do. A prescription is only necessary if insurance is going to be used for the purchase, and the insurance company requires it.
A certified pedorthist (C Ped) is a medical professional who has studied foot anatomy and pathology, biomechanics, and the design, construction, modification, and fitting of footwear and foot orthotics. Therefore, a pedorthist is specialized in making custom orthotics to address your specific footwear needs.
How Are Custom Orthotics Made?
A custom orthotic is only as good as the molding process used to make it. Several casting methods (such as plaster casting, impression foam, or 3D digital foot scans) are used to create an impression of the foot that is used to make the custom orthotic. All methods can be successful if they are done properly. But, not all healthcare professionals perform them correctly or use the methods that have been shown to be the most effective.
This method uses casting gauze similar to that used to set broken bones. It captures the foot in a subtalar joint neutral position, which means the subtalar joint (a joint located in the rear foot) is neither pronated (rolling inward) or supinated (rolling outward). It also captures the plantar contour (sole) of the foot, as well as the forefoot-to-rearfoot relationship. Plaster casting is good for creating functional support orthotics. This method does require skill and training to do correctly.
The cast is created when the patient is in a non-weight-bearing position – either lying face up or face down on the examining table. The patient may also be seated with the leg raised and the foot flexed.
The medical professional wets the casting gauze and places it on the foot in a specific way to capture the contours and shape of the foot. The medical professional will hold the toes and gently push the foot back with their thumb placed on the 4th and 5th metatarsal heads in order to make sure the foot is in the
neutral position during the drying phase. Once the cast is dry and hardened, it is gently removed from the foot.
Slipper casting is similar to plaster casting, except it’s not as messy or time consuming. Again, the patient is either sitting or lying on the table, so the foot is in a subtalar neutral position. A plastic bag is placed over the patient’s foot first. Then the medical professional wets a slipper made of casting gauze and places it on the foot, contouring the gauze to the foot similar to the plaster casting method.
This method uses a foam box to capture the foot impression. It is quick process with minimal to no mess. As a semi-weight-bearing technique, this method is used when the patient is unable to lie down for a plaster cast due to a medical condition or injury, or if the patient doesn’t have forefoot-to-rearfoot misalignment. Foam box impressions are often used for creating accommodative inserts for patients with severe arthritis or diabetes.
During this technique, the patient should be in a seated position during the whole process. Again, the foot should be in a subtalar neutral position. The foot is gently placed on the foam surface in the middle of the foam block. Keeping the patient’s lower leg straight up and down, the medical professional should gently and slowly guide the foot, pressing it into the foam with equal pressure on the heel and the ball of the foot. The patient will press their foot into about two inches of the foam, without grasping the foam with their toes. Then the foot is removed, leaving an impression of the foot in the foam.
Some practitioners use a foam box impression with a weight-bearing technique where the patient is standing during the process. In general, most medical professionals don’t advocate this technique since it can flatten the medial, lateral, and/or transverse arches of the foot, creating an inaccurate impression.
Both the semi-weight-bearing and weight-bearing techniques require proper instruction to perform them correctly and successfully in order to create a proper orthotic.
This method digitally scans the foot, creating a full-color 3D digital cast or impression. It is a quick and easy process and eliminates the mess of plaster or foam box methods.
Since this is a weight-bearing process, the patient stands on the platform of the machine, placing one or both feet on the sensor plate. The operator clicks a button and a computerized image the foot is taken. Some digital machines use hydraulically driven or reverse action pins that fill in the gaps and contours of the plantar surface of the foot. In all cases of digital scanning procedures, the process is fully automatic. The data is then used to create the custom orthotic using computer technology.
Getting a Biomechanically Correct Orthotic
There is only one casting method for custom orthotics that delivers an orthotic designed to biomechanically enhance the way you walk. This method uses either an impression foam technique or a digital method employing the reverse action pin system. When crafting a biomechanical functioning orthotic, the foot must be placed strategically in the molding medium, so the rear of the arch is supported strategically at the STT (sustentaculum tali) joint and allows the big toe, or the first metatarsophalangeal joint, to move and function . If this joint is locked up in any way, the foot will not function in a biomechanically correct manner.
WalkEZStore.com Casting Process
The Walkezstore.com uses a bio-mechanical non-weight-bearing casting method that is unique to our store. Your foot is placed into impression foam in a strategic manner using our 7-step process, which will control the hind foot and allow proper function of the 1st metatarsal joint– creating a better step with each step you take.
After you place your order with The WalkEZstore.com you will be sent an impression kit complete with video instructions that will walk you step-by-step through the process on how to create a biomechanical impression of your feet. You send your impressions back to us and we can create a customized orthotic that will relieve your pain and allow improvement to your foot’s health. Better impressions make better orthotics, and we guarantee it.
Most casting methods found on the Internet instruct the customer to step into the impression foam slowly, yet completely, from a weight-bearing position as if you were simply taking a step. This method allows the foot to collapse and will only produce an orthotic that accommodates a collapsed foot. Some instruct you to use a seated position but still tell you to simply push your foot into the foam and remove it. This too will create a collapsed foot. Neither one of these methods will create a quality impression. Junk in is junk out. Ideally, the orthotic should redirect the foot and help it to walk better. A collapsed foot cannot be redirected. Therefore, this type of orthotic is simply a waste of your money. The best bang for your buck is the ezWalker® by WalkEZ. Read what people are saying about the ezWalker® Custom Performance Orthotics
The ezWalker® is biomechanically designed to help your feet walk more efficiently. It has been proven to improve foot health in as little as 6 months (the average is 1 year).
The ezWalker® is ultra thin, 3/4 length, and transfers easily from shoe to shoe. You’ll no longer need special shoes to wear your custom orthotic. Plus, the ezWalker® can be worn in almost any type of footwear. The ezWalker® fashion/dress insert designed for fashionable high heels can even be worn in flip-flops and sandals. Contact customer service for details.
The ezWalker® Performance Insole can be purchased via the Internet; therefore, anyone, from anywhere, can own one. We also offer one-on-one fittings at no extra charge for local customers and free consultations via the phone or Skype for non-local customers. Contact us to schedule an appointment.
ezWalker® Custom Orthotics – Because … when your feet feel good, you feel good.