Custom Orthotics

Most of the time, patients do not know that they need custom orthotics. During the physical examination, your physical therapist is able to pick up on certain ailments that warrant attention. Some of the most common findings are severe flatness of the feet (also called overpronation), excessively high feet arch (called oversupination), knees deformities, bunions, degenerated big toe (hallux valgus and/or rigidus), flattening of the fat underneath the heel due to excessive pressure, plantar fasciitis, diabetic ulcer and so forth. Your practitioner may also measure your leg length and check for the discrepancy. He may also observe your walking behaviour to find aberrant patterns. Sometimes, these findings are discovered by accident. You may be coming to the clinic to resolve knee pain only to discover that it has been made worse due to severe flat feet following many months of poor training on the tracks, for example. That’s when custom orthotics can do wonders!

There are 2 ways that we design custom orthotics at Kent Chiro-Med Wellness Clinic: digital (2D) and foam impression (3D). Almost 90% of all of our patients prefer the digital method because it is reliable, provides accurate data collection, is fast to record, and provides reproducible results.

Our fitting appointment is complimentary and lasts approximately 15 minutes. This appointment is important as it is required to gather data collection from your feet or create a foot impression. A report of finding and opportunity for Q/A is provided for the patient afterwards.

Digital (2D) impression: The digital 2D impression has two parts. The first part is recording static pressure feedback from your feet while standing while the second part registers dynamic feedback from your feet while you are walking. It’s important to remember that in order to take accurate results, patients are encouraged to stand and walk as normally as possible. That’s why our practitioners can repeat the test as many time needed for patients to ensure that their movements are not too calculated, but rather smooth and as natural as possible. The test is very simple. There is a recording plate on the floor that is connected to the laptop via a USB plug. First, the patient is instructed to put both of his feet inside a white rectangle on the plate while maintaining a normal stand. Second, the patient is instructed to walk toward the plate. The goal is to walk as normally as possible and get one of the feet to land in the center of the plate. It is repeated twice to measure pressure points from the left and right food, individually. At this point, the data is recorded and saved on the laptop, ready for analysis.

Foam (3D) impression: Foam 3D impression is an older method of designing custom orthotics. It involves assessing the foot, correcting its arch and ankle position manually, then creating an impression of the corrected foot on a foam box. Foam 3D impression is recorded while the patient is sitting. Although the test is fairly quick to do, it provides certain disadvantages such as lack of input for dynamic foot behaviour and of lack of consistent reproducible results (ie. two practitioners may give you two different results). Patients often ask us to do foam 3D impression because of health care insurance reimbursement reasons. Certain insurance companies may only require patients to choose this method as part of their policy.