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Orthotic Casting Article

Posted by Donna SL on 4/03/01 at 03:37 (043403)

HI All,

I found a site that describes the proper way to do neutral non weight bearing casting for functional orthotics. I think this is basically the way my pod takes them. He also drew a line down the back of my heel. First page shows casting technique, second page mentions errors that can occur if not done properly. It appears to me that there is more than just putting the foot in neutral. It seems like foot, and leg positioning is very important. That's why my pod said he doesn't use foam boxes. He said it's very difficult to see the foot in a foam box, and position it properly. I think there may be some sophisticated scanners out there somewhere that can take a cast, but the practioner still has to know how to position the foot.

http://www.palhealthsystems.com/castingorthotics.htm

http://www.palhealthsystems.com/CastNegative.htm

Non weight bearing casting is usually for functional orthotics. Semi weight bearing cast in foam boxes are usually done for accomadative orthotics.

Donna

Re: Orthotic Casting Article

JudyS on 4/03/01 at 11:42 (043433)

Donna, last year or so, I had a pair of custom orthotics that were made from a 'scan'. The scan occured when I walked across a pad that was on the floor and hooked to a computer.
I have tried, valiently, to use the orthotics but they just hurt my high archs too much.
Given the technology, I would think they would be very effective, but in retrospect, I realized that I simply could not walk 'normally' at that time and who knows what kind of image my horrible stride produced!

Re: Orthotic Casting Article

Barbara TX on 4/03/01 at 12:32 (043440)

Judy - I agree... why do they even make customs when the feet that they cast or scan or whatever are so inflamed and the gait so screwed up? It would seem that OTC inserts generally fitted to the foot's problems would be first, and then if there is some improvment from being in the chronic stage, customs. B.

Re: Orthotic Casting Article

Donna SL on 4/03/01 at 13:21 (043444)

Hi Judy,

I always wondered about orthotics made off wallking across a platform. I don't know much about them, but I wonder how the foot could be held in the proper position for casting especially if it is totally weight bearing, and moving. That's probably one of the reasons your orthotics are not right. The fancy scanners I've read about have the person sitting, or in a prone postion, with the foot in the proper position. and their foot is put on, or just pressed lightly on the scanner plate, but they are not moving. I've seen some people casted on systems where they are standing, but they are holding on to some type of rail, and the foot is only lightly touching the plate. Only one foot can be done at a time.

I've read one of the biggest reason for orthotic failure is from poor casting techniques. There are other reasons, like not doing proper gait analysis, exam, considering ROM, proper material selection, etc., because some problems don't show up on the cast, and the practioner needs to note this for whom ever is correcting the cast. Even under the best circumstances it may be tough to tolerate the best made orthotic. I know in my case even with the best techniques in casting, etc., my pod is having a tough time giving me the full support I need, because I have limited range motion in my ankles, high arches, excessive supination, forefoot problems, complications of PF, etc, and we are going through a trial and error period with different materials, and levels of support.

Donna

Re: Orthotic Casting Article

Beth D. on 4/03/01 at 15:26 (043459)

I agree with Barbara TX. If your feet are inflamed and you get a cast done for orthotics then it seems like the orthotics would be too big. I tried my castmade custom orthotics for 4 months with no improvement. I switched to Birks and felt better. I use Birk sport inserts in my sneakers and Birks to walk in-exclusively. I feel like I get good support, but am not having my foot manipulated in some way. Keep trying....

Beth

Re: Orthotic Casting Article

Julie on 4/03/01 at 17:07 (043472)

Judy, this doesn't make sense to me. I can't see how any full weight-bearing casting could give an accurate picture even of a pair of problem-free feet walking normally. Sounds like too much technology.

Re: Orthotic Casting Article

JudyS on 4/03/01 at 11:42 (043433)

Donna, last year or so, I had a pair of custom orthotics that were made from a 'scan'. The scan occured when I walked across a pad that was on the floor and hooked to a computer.
I have tried, valiently, to use the orthotics but they just hurt my high archs too much.
Given the technology, I would think they would be very effective, but in retrospect, I realized that I simply could not walk 'normally' at that time and who knows what kind of image my horrible stride produced!

Re: Orthotic Casting Article

Barbara TX on 4/03/01 at 12:32 (043440)

Judy - I agree... why do they even make customs when the feet that they cast or scan or whatever are so inflamed and the gait so screwed up? It would seem that OTC inserts generally fitted to the foot's problems would be first, and then if there is some improvment from being in the chronic stage, customs. B.

Re: Orthotic Casting Article

Donna SL on 4/03/01 at 13:21 (043444)

Hi Judy,

I always wondered about orthotics made off wallking across a platform. I don't know much about them, but I wonder how the foot could be held in the proper position for casting especially if it is totally weight bearing, and moving. That's probably one of the reasons your orthotics are not right. The fancy scanners I've read about have the person sitting, or in a prone postion, with the foot in the proper position. and their foot is put on, or just pressed lightly on the scanner plate, but they are not moving. I've seen some people casted on systems where they are standing, but they are holding on to some type of rail, and the foot is only lightly touching the plate. Only one foot can be done at a time.

I've read one of the biggest reason for orthotic failure is from poor casting techniques. There are other reasons, like not doing proper gait analysis, exam, considering ROM, proper material selection, etc., because some problems don't show up on the cast, and the practioner needs to note this for whom ever is correcting the cast. Even under the best circumstances it may be tough to tolerate the best made orthotic. I know in my case even with the best techniques in casting, etc., my pod is having a tough time giving me the full support I need, because I have limited range motion in my ankles, high arches, excessive supination, forefoot problems, complications of PF, etc, and we are going through a trial and error period with different materials, and levels of support.

Donna

Re: Orthotic Casting Article

Beth D. on 4/03/01 at 15:26 (043459)

I agree with Barbara TX. If your feet are inflamed and you get a cast done for orthotics then it seems like the orthotics would be too big. I tried my castmade custom orthotics for 4 months with no improvement. I switched to Birks and felt better. I use Birk sport inserts in my sneakers and Birks to walk in-exclusively. I feel like I get good support, but am not having my foot manipulated in some way. Keep trying....

Beth

Re: Orthotic Casting Article

Julie on 4/03/01 at 17:07 (043472)

Judy, this doesn't make sense to me. I can't see how any full weight-bearing casting could give an accurate picture even of a pair of problem-free feet walking normally. Sounds like too much technology.