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Position of standing, sitting, or lying to have orthotics cast?

Posted by Des L. on 7/11/03 at 23:06 (124180)

I recently heard that the best position for having custom orthotics cast is standing up. Mine were made when I was sitting down. Some also say they are made while the person is lying down.

Can anyone report on this?

My prescription for the orthotics was for PF, but I also have tarsal tunnel. The orthotics have been a great help to me, but I still have a moderate amount of pain most of the time. However, to try and walk without them is actually excruciating pain and almost impossible to walk at all more than a few steps. So I'm wondering if they would be more helpful to me and less painful if I had them cast while standing up.

Any input or information on this would be greatly appreciated.

Thanks,
Des L.

Re: Position of standing, sitting, or lying to have orthotics cast?

BGCPed on 7/11/03 at 23:20 (124183)

Standing up or wt bearing casts are flawed in my opinion. If you have poor foot alignment when standing then why take a cast of a poorly aligned foot?

The fols that cast wt bearing will claim that is best cause thats how your fot works are wrong. Material choices are also important

good luck

Re: Position of standing, sitting, or lying to have orthotics cast?

Ed Davis, DPM on 7/12/03 at 11:48 (124218)

Des:

BC is right on again on this one. If one has problematic biomechanics, the weight bearing cast captures that and 'locks it in.' Weight bearing cast is best for making molded shoes and/or accomodative orthotics, that is, trying to accomodate a deformity as opposed to effecting a correction.

Ed

Re: Position of standing, sitting, or lying to have orthotics cast?

Dr. Z on 7/12/03 at 14:37 (124235)

Hi
I agree also. A non-weight bearing cast will allow the practioner to capture the proper alignment of the foot and ankle in what is called a subtalar neurtal position. This is very important for corection any abnormal biomechanical problems that contribute to plantar fasciitis and other lower extremity functional and postional deformities. So sounds like you got the right type of casting. Go back and see if more prescription is needed for your foot problem

Re: I appreciate your replies

Des L. on 7/12/03 at 22:42 (124280)

Thanks to each of you for your consideration and explaining. I understand now and that certainly makes sense. And I will go back to see if I need a change in the prescription or some other type of adjustment done.
Very grateful for your time,
Des

Re: Position of standing, sitting, or lying to have orthotics cast?

Richard, C.Ped on 7/14/03 at 07:54 (124368)

There is a local company that has been doing braces and orthotics around here for well over thirty years or so. They take impressions standing. I usually get scripts from doctors to add arch fill to their product. hee hee.

Example: If you have flat feet, what is going to happen when you stand in the impresson box???? You get a flat foot impression. I do my impressions in a semi-weight bearing seated position. Casting is key. Do it wrong...the outcome will be wrong.

Tip: when being casted this way...do not push your foot down as if you were trying to 'help' the person casting. This leads to those do-it-yourself kits that you can get in the mail. When you push your own foot down, you flex muscles that should be relaxed when impression taking. A self impression can never come out correctly.
Richard

Re: Position of standing, sitting, or lying to have orthotics cast?

Des L. on 7/16/03 at 00:04 (124525)

Hi Richard,

Thanks for adding to this post. I appreciate all the information. Regarding the casting, I think I may have 'helped' a bit when the casting was done as it seemed that's what I should do. I was not instructed otherwise. I wonder if that is a reason for some of my pain and numbness most of the time. I will check into this.

Thanks again for your time and information.

Des L.

Re: Position of standing, sitting, or lying to have orthotics cast?

Richard, C.Ped on 7/16/03 at 08:00 (124528)

You are welcome Des. Please let me know if you have any other questions.
Richard