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Hi, Which is better; casting or computer scanning...

Posted by Brian M. on 5/16/01 at hrmin (047953)

Hi I need to get replacement orthotics. I've only had one pair, so far. They were made by the Doc having me walk across a computerized plate which scanned my ambulation pattern.

I have started playing tennis again (for the first time in 21 yerars!) and I would like to get a pair of orthotics for work and for exercise/ casual wear. What type of impression makes for the best orthotic? If an actual impression of my foot is taken, will there be a foot impression on the orthotic? Will this provide better 'grip' inside the shoe? Currently, my foot seems to slide on the smooth surface of my orthotics.

My pain is fairly tolerable with this new activity. I have lost 25 lbs, and I hope to lose another 98! I am hoping my PF will go away after that.

Also, any recommendations on sneakers? I am a 318 lb. Nurse who stands for 14 hours a day 3 days a week.

Thanks for any help on this!
B.

Re: Hi, Which is better; casting or computer scanning...

bg cped on 5/16/01 at 21:12 (048012)

I am not a fan of the system that 'scans' the foot while walking over a mat. Say for instance you pronate (flat feet) good luck on the wt loss but you are a big guy, so walking your foot would distort a fair amount. Taking a impression of a mobile, moving, misaligned foot is kind of like shooting a moving target. The leather top cover may be part of the cause of slip, have a shoe repair recover it with hard foam.

The person that makes the orthotic and casts for it is critical. On the shoe issue if you do pronate at your size try a new balance 1220 or a Brooks Beast, a good running shoe store will have them. If you have a high arch foot dont buy those 2 models but look for a more neutral shoe

Re: Hi, Which is better; casting or computer scanning...

Richard, C.Ped on 5/17/01 at 07:52 (048054)

I personally like foam boxes and plaster strips to make a cast of the foot. They both give great detail of the foot. I don't care to much for the computer systems. Others really like them. I know that there are some here that like the computer milling method, so guys, don't kill me. I like to go with a more personal touch. To me, there is nothing like making the orthotic from scratch myself. I think people like that as well.

I don't want to sound like sour grapes, but there is a new orthopedic footwear chain that moved within 3 miles of our office that use the computer system. They are not C.Peds. They are just people that have had a couple of hours of training, then went out and bought a franchise. I have spoken with them myself, and they are clueless about biomechanics of the foot.

Sorry for the rant. Those are the methods I like and trust. You have to relize that it all comes down to who makes the orthosis, and what materials they use.

Good luck. If you have any other questions, please let us know.
Richard

Re: Hi, Which is better; casting or computer scanning...

bg cped on 5/17/01 at 18:29 (048125)

I cast with plaster splint for skate and dress orthotic because i use graphite for those. I have also used foam but having somebody that pronates stand up in the box in my opinion makes for a cast with sloppy tolerance
There are several computerized methods out there. And some are very flawed. Does the chain store use Amfit or one of the mat systems you just stand or walk over? There was a store in a mall near me that was I believe called the walking store. They used a similar method and got poor results. The person making them and casting makes a big difference.

Re: Hi, Which is better; casting or computer scanning...

Richard, C.Ped on 5/18/01 at 07:45 (048178)

Brian,
I am not sure what system they use. What sucks is that they have no idea what they are doing, treatment wise.
Richard

Re: Hi, Which is better; casting or computer scanning...

Sean, C.Ped on 5/18/01 at 09:18 (048186)

Brian,
You don't have to have the patient stand up in the foam to take an impression. The school I went to showed having the patient sit in an adjustable height chair so that you get their leg at a 90o angle to the floor and push on the knee while holding the foot in subtalor nuetral. The past president of PFA Roger Marzano (sp?) showed this method. If you practice at it, it can make for a great impression. If you don't you can push down on the for foot incorrectly and add alot of arch height. As you and others have said many times, it takes a qualified, dedicated, and practiced tech. to cast and make a good functional orthotic.

Re: Hi, Which is better; casting or computer scanning...

bg cped on 5/18/01 at 11:39 (048202)

I was not implying that yu cant make a good cast with biofoam. I was saying that having a pt stand up while casting is bad idea. I use biofoam on occasion. Also the cheap orthotics that send a bio-foam box thru the mail is a real bad idea

Re: Hi, Which is better; casting or computer scanning...

Sean, C.Ped. on 5/19/01 at 14:25 (048291)

Brian,
Sorry, I hadn't read your post on one of the earlier strings. I also agree with you about the business's that send biofoam boxes to patients houses for impressions is a bad idea.
Sorry for the goof.
Sean

Re: Hi, Which is better; casting or computer scanning...

bg cped on 5/16/01 at 21:12 (048012)

I am not a fan of the system that 'scans' the foot while walking over a mat. Say for instance you pronate (flat feet) good luck on the wt loss but you are a big guy, so walking your foot would distort a fair amount. Taking a impression of a mobile, moving, misaligned foot is kind of like shooting a moving target. The leather top cover may be part of the cause of slip, have a shoe repair recover it with hard foam.

The person that makes the orthotic and casts for it is critical. On the shoe issue if you do pronate at your size try a new balance 1220 or a Brooks Beast, a good running shoe store will have them. If you have a high arch foot dont buy those 2 models but look for a more neutral shoe

Re: Hi, Which is better; casting or computer scanning...

Richard, C.Ped on 5/17/01 at 07:52 (048054)

I personally like foam boxes and plaster strips to make a cast of the foot. They both give great detail of the foot. I don't care to much for the computer systems. Others really like them. I know that there are some here that like the computer milling method, so guys, don't kill me. I like to go with a more personal touch. To me, there is nothing like making the orthotic from scratch myself. I think people like that as well.

I don't want to sound like sour grapes, but there is a new orthopedic footwear chain that moved within 3 miles of our office that use the computer system. They are not C.Peds. They are just people that have had a couple of hours of training, then went out and bought a franchise. I have spoken with them myself, and they are clueless about biomechanics of the foot.

Sorry for the rant. Those are the methods I like and trust. You have to relize that it all comes down to who makes the orthosis, and what materials they use.

Good luck. If you have any other questions, please let us know.
Richard

Re: Hi, Which is better; casting or computer scanning...

bg cped on 5/17/01 at 18:29 (048125)

I cast with plaster splint for skate and dress orthotic because i use graphite for those. I have also used foam but having somebody that pronates stand up in the box in my opinion makes for a cast with sloppy tolerance
There are several computerized methods out there. And some are very flawed. Does the chain store use Amfit or one of the mat systems you just stand or walk over? There was a store in a mall near me that was I believe called the walking store. They used a similar method and got poor results. The person making them and casting makes a big difference.

Re: Hi, Which is better; casting or computer scanning...

Richard, C.Ped on 5/18/01 at 07:45 (048178)

Brian,
I am not sure what system they use. What sucks is that they have no idea what they are doing, treatment wise.
Richard

Re: Hi, Which is better; casting or computer scanning...

Sean, C.Ped on 5/18/01 at 09:18 (048186)

Brian,
You don't have to have the patient stand up in the foam to take an impression. The school I went to showed having the patient sit in an adjustable height chair so that you get their leg at a 90o angle to the floor and push on the knee while holding the foot in subtalor nuetral. The past president of PFA Roger Marzano (sp?) showed this method. If you practice at it, it can make for a great impression. If you don't you can push down on the for foot incorrectly and add alot of arch height. As you and others have said many times, it takes a qualified, dedicated, and practiced tech. to cast and make a good functional orthotic.

Re: Hi, Which is better; casting or computer scanning...

bg cped on 5/18/01 at 11:39 (048202)

I was not implying that yu cant make a good cast with biofoam. I was saying that having a pt stand up while casting is bad idea. I use biofoam on occasion. Also the cheap orthotics that send a bio-foam box thru the mail is a real bad idea

Re: Hi, Which is better; casting or computer scanning...

Sean, C.Ped. on 5/19/01 at 14:25 (048291)

Brian,
Sorry, I hadn't read your post on one of the earlier strings. I also agree with you about the business's that send biofoam boxes to patients houses for impressions is a bad idea.
Sorry for the goof.
Sean