a guide to

Orthotic Casting Methods

In order to make custom foot orthotics it is necessary to make positive foot models of the foot to vacuum press the raw material over. This ensures the contours of the orthotics match the patient’s foot. Effectiveness of an orthotic can often be directly associate with the accuracy of casting. Walking across or standing on a pressure mat will indicate areas of high pressure but not obtain the contours of your foot. Proper custom orthotics are always created from a 3-dimensional model of your foot. There are two manual methods of obtaining a 3-dimensional cast of the feet.

 Plaster Bandage

This method has been used for decades to take impressions of the feet with the patient lying either prone or supine. While casting the foot, the practitioner is able to position the foot in a subtalar neutral position and lock to midtarsal joint against the hindfoot. This is the position the foot should be in during the stance phase of gait. Taking an impression while a patient is non-weight bearing also captures the foot without any compensation. This method is most beneficial for patients who require a supportive device.

 Foam Box Impression 

There are two methods of casting using a foam box impression, weight bearing and semi-weight bearing. During the weight bearing method, the patient steps into a box of foam and the impression is obtained. During the semi-weight bearing process, the patient places their foot onto the foam and it is pressed down by the practitioner. This method is most beneficial for patients who require an accommodative orthotic to off-load a deformity or wound.

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