While considering the key differences between custom and non custom orthotics, it is important to keep the patient’s needs in mind.
Besides, being relatively inexpensive to stock, off-the-shell orthotics are easily available and replaceable. However, these do not account for anatomical differences, with limited potential for individual modification.
This creates problems when considering the level of specific correction that is required for a patient’s condition.
To correct certain symptomatic conditions and biomechanical imbalances, patients might require heel wedges or metatarsal support, which cannot be achieved from generic shoe inserts.
These orthotics also prove inefficient for patients with left/right asymmetry or with feet which are not of a classical form or size.
A custom-made orthotic is obtained from an image or impression of the individual patient’s foot with specific added corrections, taking into account the patient’s foot function, deformity, body weight and activity level.
These orthotic devices are customised to fit in specific shoes such as dress shoes, loafers, and even sport-specific shoes such as ice skates and ski boots.
This type of an orthotic is manufactured based on a mould of the patient obtained through either a casting procedure or a digital impression, which is able to capture the three-dimensional properties of the foot.
The biggest advantage of using custom-made orthotics is the individualised approach to correcting biomechanical faults, along with the excellent, personalised fit.
This leads to rapid adaptation and longer-term symptomatic relief from underlying musculoskeletal problems affecting the pelvis, spine and lower limbs.
These orthotics are able to provide for specific corrections, asymmetrical posting and lifting, and support for any unusual and anomalous anatomical problems.
The casting technique for custom-fitted orthotics could include either a foam impression box or plaster casting.
Plaster casts rely heavily on technical expertise to obtain the corrected foot position and have been proven to possess poor clinical reliability.
A full weightbearing plaster cast fails to obtain a useful three-dimensional representation of the patient’s foot and theoretically, only captures the deformed foot position.
With the Integrated Multi-Axial Theory™ serving as the underlying guideline for MASS4D®’s casting and manufacturing techniques, our aim is to produce a functional orthotic which allows for maximum flexibility of all articulations of the foot and ankle while limiting hypermobility.
This type of functionality can be achieved only with a greater knowledge of the structure of the body and how the dynamic link present between the ankle and the foot, affects the musculoskeletal system.
For this purpose, it is important to examine the patient’s anatomy and to capture the foot in its corrected closed chain posture. This is obtained by mimicking the patient’s healthy stance-phase gait in a specialised foam box to create a semi-weight bearing impression.
An advantage of using a semi-weight bearing cast lies in its ability to highlight any fibrous tissue mass or bony developments, often showing its exact location.
Such a cast also helps in attaining a more definitive plantar contour, which is ultimately reflected in the final orthotic that provides for the gravitational soft tissue displacement.
MASS4D® orthotics attempt to support the motion of the foot before any pathological movement occurs, in order to prevent the onset of excessive structural collapse.
The mechanical ‘leaf spring’ effect of this full-contact orthotic under the arch of the foot, applies the greatest corrective force to the plantar surface, facilitating healthy supination balanced with functional pronation. This enhances an even distribution of soft tissues, boosting proprioception capabilities and optimising joint alignment.
This is the reason for the success of MASS4D® orthotic in active rehabilitation programmes and for treating lower extremity biomechanical faults.
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