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The Problem with “Computer Generated” Orthotics
If you (or your insurance company) is going to spend money on custom
orthotics, make sure you are getting what you are paying for.
Unfortunately, there are a number of items being marketed as custom
orthotics that really are not. These are often the product of a
computerized system where the patient is asked to walk across a force
plate which then shows pressure distribution on a computer display.
Typically, the orthotic is made by adding extra components to a
pre-manufactured insole. Sadly, patients are often told that these are
custom – and charged a custom orthotic price.
Several studies have shown definitively that it is not possible to make
an effective custom orthotic from pressure measurements. This
“computerized orthotic” scheme has been around for a number of years. It
looks very high tech, but the orthotic you get is no better, and many
times worse, than a $35 prefabricated arch support.
You can see our
favorite OTC supports here. These computerized gait analysis and
orthotic systems are usually sold to practitioners with little training
in foot orthotic therapy.
So how can you tell the difference between these semi-custom orthotics
and authentic custom foot orthotics? If you are receiving authentic
custom orthotic devices,
a
three-dimensional mold of your foot must be made. Your foot must
be held non-weightbearing and your doctor can take this cast in three
ways:
• Plaster
• Fiberglass
• Laser Scan
Walking or standing on a force plate can be used to evaluate some
aspects of foot function, but a force plate cannot capture the
3-dimensional impressions of your feet that are necessary for best
outcomes when prescribing orthotics. Remember, a non-weightbearing cast
or scan of your foot must be taken in order to manufacture a functional
custom orthotic. If a practitioner suggests these “computerized
orthotics” to you, go somewhere else or buy an
inexpensive
high-quality prefabricated orthotic instead.
References
1 Forefoot to Rearfoot Angle – A Comparison of Orthotic Casting
Techniques. McPoil, TG; Schmit, D. Phys Ther. 1989 Jun;69(6):448-52
2 Position of the First ray and Motion of the First MTP. Roukis, et. al
1996 JAPMA. Vol. 86:11
3 A comparison of four methods of obtaining a negative impression of the
foot. McClay-Davis I, Laughton C, Williams, DS. J Am Podiatr Med Assoc.
2002 May;92(5):261-8
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All pages on this website © 2005-2010
Douglas Hale, DPM & Lawrence Huppin, DPM
Foot and Ankle Center of Washington, Seattle
The material provided on this web site is for informative purposes only.
If you need specific medical advice, please contact the office for an appointment.
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