There are two basic types of orthotics: accommodative and functional. Accommodative orthotics are used to distribute the patient's body weight away from a painful area and/or provide needed support to decrease pain.  The materials are softer than a functional orthotics and can be a combination of multiple types of materials, such as Plastizote, Poron, EVA, Multi-cork, Neoprene, Viscoelastic gel,  to name a few.

Accommodative style orthotics normally will require a shoe with a removable insole, so that the orthotics will properly fit inside the shoe.  Accommodative orthotics are generally thicker than functional orthotics based on the materials that are used.

An example of the accommodative orthotic casting and fabrication process is included below:

This is an example of a Charcot mid-foot collapse a condition normally associated with neurological issues when a patient does not have adequate sensation in the foot.

Taking a foam cast of a patient’s foot.  This is a semi-weight bearing cast.  The person is seated with back and hips at 90 degrees, hip and knee at 90 degrees, foot and ankle at 90 degrees.  The foot is held in a subtalor neutral position if achievable during the casting.

Negative foam cast impression

Harris Mat dynamic ink imprint of a persons foot.  This device provides information such as arch height and abnormal pressures on the plantar aspect of the foot.

 Ink imprint that the Harris Mat provided from photo above.

Pouring plaster into a negative foam impression to create a positive mold

 Pair of plaster casts (positive molds)

positive molds on the vacuum former machine- the top cover has already been formed and the cork (posting material) has been heated and will be formed to the top cover

The vacuum former machine with a latex bladder that sucks out all air and forms the posting material to the positive molds.

a positive cast of a right foot and accommodative orthotic material to the right that have been heated and formed to the plaster cast.

same as above – side view

insuring that the accommodative orthotic conforms to the patient’s foot.  This particular orthotic has a cut out at the fifth metatarsal head to decrease pressure at that area.

 Finished Product: Accommodative-style orthotic with topcover.  Ready to fit into an appropriate athletic shoe.