Several years ago A Step Ahead Foot and Ankle care decided that to have more control of our patients outcomes we needed to make our own orthoses in house. Patients and often their referring doctors often don’t realise that many podiatrists in fact do not make their own custom made orthoses. While they can prepare a script they have trouble really making a device that is perfectly matched to the foot.
In our last article we described how orthoses should be prescribed. As you will see the process is fairly complex and requires a number of measurements using some specialised equipment and a great deal of clinical expertise. The junior podiatrists at A Step Ahead Foot and Ankle care who have already completed a university degree and 1000 clinical hours still are observed and work with one of our senior podiatrists for the first two years after graduation to make sure they have a strong knowledge base behind them when designing an orthoses for a patient.
Once a 3 dimensional scan and measurements are taken of both your feet, it’s time for our Podiatrist to design the orthotics. Designing each orthoses is done using Cad-Cam software and specific to each person, each person’s individual design takes approximately 15 minutes ensuring a complete match to your foot.
From here the design is sent to A Step Ahead Foot and Ankle care’s CNC mill for cutting on average this takes about 20minutes for each of the orthoses shell. As mentioned before, each orthotic is individual and subsequently there can be as little as 1 mm differences in measurements in the orthoses so ensuring we get the milling right is very important.
After the mill has finished its very precise job, the orthoses edges need grinding so they fit comfortably into a shoe. At this time we will add covers to enhance the comfort of the device and small additions which will tweak the way you walk, such as metatarsal domes and rocker bars and possibly even more cushioning! We will also look at any further adjustments needed to change the postural position of your feet and legs. This can all add up and takes about an hour’s worth of time per pair to finish.
As you can see making a custom made orthoses can really take some time they are very complex devices with a real “handmade” component to each of them. Each device is designed to meet each patient’s specific health needs. So when people rightly ask “How come your orthotics cost …….” You can tell them because my orthoses are handmade just for me!