Inside The Lab: Custom Orthotics Fabrication Process

An orthotic is only as good as the initial cast. In this case, the patient's foot is properly aligned with the subtalar joint neither pronated nor supinated (aka 'subtalar neutral'). This position is maintained with one hand while the other pushes the foot into the foam by pressing down on the knee. (Custom foot orthotics fabrication process, step 1.)

1.

An orthotic is only as good as the initial cast. In this case, the patient's foot is properly aligned with the subtalar joint neither pronated nor supinated (aka 'subtalar neutral'). This position is maintained with one hand while the other pushes the foot into the foam by pressing down on the knee. (See above.)

Plaster of Paris (or Gauging Plaster) is poured into an impression of the patient's foot. The result is a 3-dimensional mold or cast which is essential to creating custom foot orthotics. (custom orthotics fabrication process, step 2.)

2.

Plaster of Paris (or Gauging Plaster) is poured into an impression of the patient's foot. The result is a 3-dimensional mold or cast which is essential to creating custom foot orthotics. (See above.)

Once the plaster has hardened, the foam is removed and brushed. (Custom foot orthotics fabrication process, step 3.)

3.

Once the plaster has hardened, the foam is removed and brushed. (See above.)

Sanding screen/mesh is used to smooth unwanted bumps or ridges from the cast. The toes are not addressed because this portion of the cast is not used to create the orthotic device. (Custom orthotics fabrication process, step 4.)

4.

Sanding screen/mesh is used to smooth unwanted bumps or ridges from the cast. The toes are not addressed because this portion of the cast is not used to create the orthotic device. (See above.)

A tool is used to remove plaster from the forefoot which will create a metatarsal pad on the finished orthotic. (Metatarsal pads can treat pain at the ball of the foot, aka metatarsalgia). (Custom foot orthotic fabrication process, step 5.)

5.

A tool is used to remove plaster from the forefoot which will create a metatarsal pad on the finished orthotic. (Metatarsal pads can treat pain at the ball of the foot, aka metatarsalgia). (See above.)

The indentation is smoothed and shaped with screen/mesh. (Custom orthotics fabrication process, step 6.)

6.

The indentation is smoothed and shaped with screen/mesh. (See above.)

Plaster is added to the medial longitudinal arch. This partial 'filling in' permits a limited amount of pronation which is essential to comfortable orthotics. Plaster is also used to smooth the perimeter of the foot. (custom orthotics fabrication process step 7.)

7.

Plaster is added to the medial longitudinal arch. This partial "filling in" permits a limited amount of pronation which is essential to comfortable orthotics. Plaster is also used to smooth the perimeter of the foot. (See above.)

8.

The plastering is complete. (The toes have not been addressed because this potion of the cast is not used to fabricate custom foot orthoses.) (See below.)

The plastering is complete. (The toes have not been addressed because this potion of the cast is not used to fabricate custom foot orthoses.) (custom orthotics fabrication process, step 8.)

9.

Rectangular pieces of plastic are cut using a bandsaw and heated in a convection oven. The plastic is then draped over and pressed against the cast using a vacuum press where it remains until cooled. This plastic will be used to form the orthotic shells. (See below.)

Rectangular pieces of plastic are cut using a bandsaw and heated in a convection oven. The plastic is then draped over and pressed against the cast using a vacuum press where it remains until cooled. This plastic will be used to form the orthotic shells. (Custom foot orthotic fabrication process, step 9.)

10.

Excess material is cut from the orthotic shell using a bandsaw. (See below.)

Excess material is cut from the orthotic shell using a bandsaw. (Custom orthotics fabrication process, step 10.)

11.

Next the orthotic shell is thinned and shaped using a grinder. (See below.)

Next the orthotic shell is thinned and shaped using a grinder. (Custom foot orthotic fabrication process, step 11.)

12.

Thermoplastic material (cork and ethylene vinyl acetate composite) is cut and will be glued to the bottom of the orthotics. This provides extremely long-wearing and conforming bottom-cover. (See below.)

Material is cut and will be glued to the bottom of the orthotics. (Custom orthotics fabrication process, step 12.)

13.

Once glued, the bottom-cover of the orthotic is shaped with the grinder. (See below.)

Once glued, the bottom-cover is shaped with the grinder. (Custom foot orthotic fabrication process, step 13.)

14.

Blue cushiony material (poron) is cut out. (See below.)

Blue cushiony material (poron) is cut out. (Custom orthotics fabrication process, step 14.)
Glue is applied to both the orthotic and the poron. (Custom foot orthotic fabrication process, step 15.)

15.

Glue is applied to both the orthotic and the poron. (See above.)

Now they are glued together. (Custom orthotics fabrication process, step 16.)

16.

Now they are glued together. (See above.)

Excess material is trimmed. (Custom foot orthotic fabrication process, step 17.)

17.

Excess material is trimmed. (See above.)

Excess material is trimmed from the orthotics. (Custom orthotics fabrication process, step 18.)

18.

Edges of the orthotic shell are cleaned with the grinder. (See above.)

Soft, pink material (P-Cell) is cut and glued to the poron layer of the orthotic device. (Custom foot orthotic fabrication process, step 19.)

19.

Soft, pink material (P-Cell) is cut and glued to the poron layer of the orthotic device. (See above.)

This forms the top layer (top cover) of the orthotic device. (Custom orthotics fabrication process, step 20.)

20.

This forms the top layer (top-cover) of the orthotic device. (See above.)

The excess material is trimmed away and edges are finished with the grinder. And voila! A finished orthotic! (Custom foot orthotic fabrication process, step 22.)

21.

The excess material is trimmed away and edges are finished with the grinder. (See above.)

Voila! A finished product. (Custom orthotics fabrication process, step 22.)

22.

Voila! A finished product. (See above.)