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Podiatrists mold custom orthotics to address patients' foot malformations. There are multiple means developed to create the basis for the molds, including plaster casts, foam box impressions, and three-dimensional computer imaging. The molds are used to create custom inserts that tend to be firm, flexible, and relatively soft.
Over the years podiatrists have developed numerous means to create the basis for their molds, plaster casts, foam box impressions, or three-dimensional computer imaging. None is very accurate: all produce proper fit under 80% of the time. [1] [2]
Traditionally, they were created from plaster casts made from the patient's foot. These casts were made by wrapping dipped plaster or fiberglass strips around the foot to capture the form, then letting it dry and harden. Once the cast was hardened, the doctor would carefully remove it from the patient's foot and ship the cast, along with a prescription, to an orthotics lab which would use the negative of the cast to create an orthopedic insert. Research studies demonstrate that inter-practitioner variability is a major factor in orthotic intervention in treating a single patient and for a specific pathology [3]
Recently, several companies have developed digital foot scanners that use specialized software to scan a patient's foot and create a "virtual" cast. These scans are made by having the patient place the foot onto a specialized flat image scanner that uses light and software to capture and create a 3D model. This 3D model is then electronically submitted (along with a prescription) to an orthotics lab, where it is used to program a CNC machine that will ultimately produce the orthopedic insert.
Manufacturers of these products choose various materials.
The firm or flexible models might require a period of adjustment. Depending on the severity of the arch collapse and the body's previous conditioning in response to that collapse, sudden readjustment can seem painful. Many attribute the feeling to walking on a walnut. It is recommended new users build up to wearing firm arch supports, starting with only a couple of hours the first day and adding an hour each successive day until the foot is adjusted to full-time usage. To mitigate this adjustment period, many manufacturers sell covering pads or have different gradations to build up to solid support. Some manufacturers cover their products in leather, which somewhat moderates the intensity of the correction while also adding to the stylistic look.
A shoe is an item of footwear intended to protect and comfort the human foot. Though the human foot can adapt to varied terrains and climate conditions, it is vulnerable, and shoes provide protection. Form was originally tied to function, but over time, shoes also became fashion items. Some shoes are worn as safety equipment, such as steel-toe boots, which are required footwear at industrial worksites.
A bunion, also known as hallux valgus, is a deformity of the MTP joint connecting the big toe to the foot. The big toe often bends towards the other toes and the joint becomes red and painful. The onset of bunions is typically gradual. Complications may include bursitis or arthritis.
A pointe shoe, also referred to as a ballet shoe, is a type of shoe worn by ballet dancers when performing pointe work. Pointe shoes were conceived in response to the desire for dancers to appear weightless and sylph-like and have evolved to enable dancers to dance en pointe for extended periods of time. They are manufactured in a variety of colors, most commonly in shades of light pink.
Pes cavus, also known as high arch, is a human foot type in which the sole of the foot is distinctly hollow when bearing weight. That is, there is a fixed plantar flexion of the foot. A high arch is the opposite of a flat foot and is somewhat less common.
An orthopedic cast, or simply cast, is a shell, frequently made from plaster or fiberglass, that encases a limb to stabilize and hold anatomical structures—most often a broken bone, in place until healing is confirmed. It is similar in function to a splint.
Flat feet, also called pes planus or fallen arches, is a postural deformity in which the arches of the foot collapse, with the entire sole of the foot coming into complete or near-complete contact with the ground. Sometimes children are born with flat feet (congenital). There is a functional relationship between the structure of the arch of the foot and the biomechanics of the lower leg. The arch provides an elastic, springy connection between the forefoot and the hind foot so that a majority of the forces incurred during weight bearing on the foot can be dissipated before the force reaches the long bones of the leg and thigh.
Ethylene-vinyl acetate (EVA), also known as poly(ethylene-vinyl acetate) (PEVA), is a copolymer of ethylene and vinyl acetate. The weight percent of vinyl acetate usually varies from 10 to 50%, with the remainder being ethylene. There are three different types of EVA copolymer, which differ in the vinyl acetate (VA) content and the way the materials are used.
Birkenstock Holding plc is a German shoe manufacturer known for its sandals and other shoes notable for contoured cork footbeds (soles), made with layers of suede and jute, which conform to the shape of their wearers' feet. Founded in 1774 by Johann Adam Birkenstock and headquartered in Neustadt (Wied), Rhineland-Palatinate, Germany, the company's original purpose was to create shoes that support and contour the foot, compared to the flat soles of many shoes during that time. In 1896 the Fussbett (footbed) was designed, and by 1925, Birkenstocks were sold all over Europe.
Cycling shoes are shoes purpose-built for cycling. There are a variety of designs depending on the type and intensity of the cycling for which they are intended. Key features include rigidity, for more-efficient transfer of power from the cyclist to the pedals, weight, a method of attaching the shoe firmly to the pedal and adaptability for use on and off the bicycle. Most high-performance cycling shoes can be adjusted while in use, via a quick-adjusting system that has largely replaced laces.
A removable shoe insert, otherwise known as a foot orthosis, insole or inner sole, accomplishes many purposes, including daily wear comfort, height enhancement, plantar fasciitis treatment, arch support, foot and joint pain relief from arthritis, overuse, injuries, leg length discrepancy, and other causes such as orthopedic correction and athletic performance.
An orthotist is a healthcare professional who specializes in the provision of orthoses. An orthotist has an overall responsibly of orthotics treatment, who can supervise and mentor the practice of other personnel. They are clinicians trained to assess the needs of the user, prescribe treatment, determine the precise technical specifications of orthotic devices, take measurements and image of body segments, prepare model of the evaluation, fit devices and evaluate treatment outcome. In the United States, orthotists work by prescription from a licensed healthcare provider. Physical therapists are not legally authorized to prescribe orthoses in the U.S. In the U.K., orthotists will often accept open referrals for orthotic assessment without a specific prescription from doctors or other healthcare professionals.
Foot and ankle surgery is a sub-specialty of orthopedics and podiatry that deals with the treatment, diagnosis and prevention of disorders of the foot and ankle. Orthopaedic surgeons are medically qualified, having been through four years of college, followed by 4 years of medical school or osteopathic medical school to obtain an M.D. or D.O. followed by specialist training as a resident in orthopaedics, and only then do they sub-specialise in foot and ankle surgery. Training for a podiatric foot and ankle surgeon consists of four years of college, four years of podiatric medical school (D.P.M.), 3–4 years of a surgical residency and an optional 1 year fellowship.
The Ponseti method is a manipulative technique that corrects congenital clubfoot without invasive surgery. It was developed by Ignacio V. Ponseti of the University of Iowa Hospitals and Clinics, US, in the 1950s, and was repopularized in 2000 by John Herzenberg in the US and Europe and in Africa by NHS surgeon Steve Mannion. It is a standard treatment for clubfoot.
Diabetic shoes are specially designed shoes, or shoe inserts, intended to reduce the risk of skin breakdown in diabetics with existing foot disease and relieve pressure to prevent diabetic foot ulcers.
Pronation is a natural movement of the foot that occurs during foot landing while running or walking. Composed of three cardinal plane components: subtalar eversion, ankle dorsiflexion, and forefoot abduction, these three distinct motions of the foot occur simultaneously during the pronation phase. Pronation is a normal, desirable, and necessary component of the gait cycle. Pronation is the first half of the stance phase, whereas supination starts the propulsive phase as the heel begins to lift off the ground.
Pet orthotics refers to the use of orthotics for pets. Orthotics is an allied health care field concerned with the design, development, fitting, and manufacture of orthoses. Orthoses, sometimes called braces or splints, are devices that support or correct musculoskeletal deformities and/or abnormalities of the body.
Eneslow is a chain of shoe stores in New York City founded by the Low family in 1909. They are America’s largest pedorthic retailer. In addition to its retail stores, Eneslow also manages the Eneslow Pedorthic Institute, a pedorthic education and training program.
Orthotics is a medical specialty that focuses on the design and application of orthoses, sometimes known as braces or calipers. An orthosis is "an externally applied device used to influence the structural and functional characteristics of the neuromuscular and skeletal systems." Orthotists are professionals who specialize in designing these braces.
UFP Technologies, Inc., founded in 1963 and based in Newburyport, Massachusetts, is a designer and custom manufacturer of medical devices, sterile packaging, and other products.
Foot Levelers is a foot care, footwear, and whole body health company based in Roanoke, Virginia, and owned by Kent S. Greenawalt.
