I am curious if there are any knowledgeable people on here in this field…I have spoken to 2 different people, and received 2 different answers. One says they should be made by stepping on a foam block which takes a mould of your foot, and another says a plaster cast should be made from your foot in in a non-weight bearing position…and of course, most chiropractors claim walking on a computerized mat is just as good…who is right.
I vote for the plaster cast. From what I have heard it is the most accurate, and I have used plaster cast molded orthotics for almost 20 years now (wow I must be getting old…)
rroof is the expert, if he responds his opinion is the one I would listen to. However, I have had three different sets made over the last ten years and the podiatrist always has done a cast. I am sure if you go to a registered foot Doctor they will cast your foot. If you think about it, the cast is the way to go because they will cast your foot in the proper position. In contrast, stepping on a mold could imprint a collapsed or not ideal position. I just had a new podiatrist cast a new set for me and it is well worth the investment.
John
As usual, the answer is it depends. If the orthotic is too offload pressure areas, then walking across a pressure mat works pretty well! If it for “general” arch/foot pain (and this is where an OTC device is often just as good, but won’t last as long), then the foam crush box works just fine.
But, the best way is a plaster slipper cast with the subtalar joint in neutral and the midtarsal joint locked. The more the pathology being treated, the more this method matters.
Then, there is the issue of WHY you are getting them. Were X-rays obtained? Rearfoot pain from a tarsal coalition that one is born with for example can’t very well be treated with an in-shoe orthotic. Are you going to run in them? Ladies dress shoes? Etc.
The Hanson’s running team use this guy http://www.performancezone1.com/ as do a number of elite athletes - perhaps this helps. I had mine made by Brian and they are very good. I also had some made with the cast method, prior to these, but the orthotic that is produced is not appropriate for running, too hard and not much forgiveness.
Any suggestions as to how I would locate a good podiatrist in my area? I live near Philadelphia so there are lots of docs around but I don’t know how to differentiate between those who treat the Big Mac crowd and those that specialize in the psychotic runner. I’d prefer to be the later so I don’t resemble the former.
Sorry to jump in here. I had orthotics made a year and a half ago for achilles tendonitis. I have high arches and they made the foam orthotics for me. With a lot of stretching and the orthotics the achilles is fine.
rroof, how long should these last me before I should get them redone?
Thanks.
Philly has a ton of excellent docs of all specialties. Best is to ask at your local running store and be sure to ask if he/she is a runner as well as they will likely have several recs in your area.
Sorry to jump in here. I had orthotics made a year and a half ago for achilles tendonitis. I have high arches and they made the foam orthotics for me. With a lot of stretching and the orthotics the achilles is fine.
rroof, how long should these last me before I should get them redone?
Thanks.
It really depends on what they are made of and how they are used. Should last at least 1 year - even high school football players with a soft device. A more rigid device, like the new ones out of carbon fiber, the shell lasts many years. The old polydor/ruhador ones would last 20 years. The topcover does wear out though (if you have one) and that only can be refurbished for minimal cost if the device and intended use is still the same. If you are in a soft, semi-custom running type orthotic, I’d plan on having them inspected after 12-18 months or if anything starts to hurt obviously.
i think this is the foam block type you’re talking about. i’ve had orthotics made both ways, and gotten good orthotics both ways. frankly, the way i describe in the article is a method few podiatrists and chiropractors could afford. but if you have access to it, i think it’s a pretty sound method.
Talk to the boys over at D2 Shoes an investment you will be happy you made.
Cheers,
rroof,
What is your opinion about these:
I have been using them for a year now with decent results.
This is nothing new - a laser scans the foot, and a 3D digital image is recreated. Most of these companies at least use a CNC machine (as do most large labs) to make a pretty exacting device and do a decent job.
The problem here is the same as the foam crush boxes though - if the foot is unweighted, are you in STJ neutral and midtarsal locked? If weighted, same issue. Many labs use a laser to scan the crush box impression (a negative), then transfer. The nice thing about the plaster slipper cast (yes it is a pain and messy) is that a real, physical positive mold is made and a good device can be made right onto it. But, this is much more labor intensive on both ends.
As with any of the above mentioned methods, the prescription after a good exam is still the most important aspect. If someone’s orthotics are all coming back the same (i.e. intrinsic external and forefoot post, same cover, et.) then look elsewhere.
Seems like shoeguy’s URL might have changed.
Update?
-Jot
perhaps, i do not know. but if you want him, you’ll find him.
Yes, Master Po. 
-Jot
Perhaps, Master Slo, it is FootDepotUsa.
Since I’m in San Diego about once a year, maybe I’ll try to get over there.
-Jot
On that note, anyone recommend some in the Netherlands (the Hague) who makes good orthotics? I have been looking all over (calling running shoes shops, google searches, etc) and found nothing. Is there any way to get fit for orthotics long distance?
Did you ever find an orthotist in the Hague?? I am looking for someone ASAP. Thanks!
Found nothing - did not get anything good until I got back to the states.sorry
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