Author: Luke Wyatt

Custom Foot Orthotics for Skiing and Skating

Skiing is a sport with no swing phase of gait i.e., the foot is in contact with the supporting surface at all times.

Skating, however, has a “swing phase” where the basic foot function is one of “position” and not of motion (not pronation followed by supination). In skating there is no change in foot position during the “swing’ to “stance”.

Both sports rely on the position of the foot to the supporting surface.

Little or no motion occurs within the foot; motion within the foot is not a consideration. Posting is not indicated because motion is not paramount within the foot (posting positions the rearfoot at heel contact only and there is no heel contact with these sports).

The rigid forefoot extension (it flexes to the transverse plane on weight bearing) keeps a constant pressure on the plantar surface of the toes creating a bio-feed back through the proprioceptors in the skin on the plantar surface of the toes. This feedback causes the posterior leg muscles to contact. (Stand up, then lean forward and notice that the posterior muscles of the leg contract to prevent you from falling on your nose. Now, stand up, then lift your toes off the floor and then lean forward and you will fall on your face).

This feedback enhances skiing and skating.

Good alignment of the rearfoot and midfoot enable greater plantarflexion of the first metatarsal into the supporting surface for increased inside edge control for skiing and more powerful propulsion for skating.

 

Northwest Podiatric Laboratory is an industry leader in custom foot orthotic and related technologies. Dennis Brown, a retired British soldier, elite athlete and natural-born inventor founded the company in 1964 and was joined by a biomechanics pioneer, Dr. Chris Smith, in 1974. With an exclusive blend of science, craftsmanship and innovation, the partners have built a company that utilizes proprietary production techniques and technology to produce orthotics with a unique shape and unparalleled performance. Northwest Podiatric Laboratory has helped over a million people suffering from foot pain to lead better, pain-free lives. Learn more at www.nwpodiatric.com.

The Biomechanics of Heel Posting

When it was introduced in the early 1960’s, the rearfoot post was intended to invert the rearfoot of the orthotic (and the foot) a specific number of degrees enabling the subtalar joint to function around its neutral position. A rearfoot varus of nine degrees was given a varus post of nine degrees. (See Fig. 1). In theory, at heel contact the calcaneus would be inverted to the floor by nine degrees – so long as the lateral platform of the post was bearing the majority of body weight. (See Fig. 2). The subtalar joint would subsequently pronate as the weight shifted from the lateral platform to the medial platform. (See Fig. 3). The medial platform of the post was angled four to six degrees relative to the lateral post to facilitate physiologic pronation of the subtalar joint. When the medial platform was fully engaged with the supporting surface it acted as a terminal brake and subtalar joint rotation would cease. After this initial physiologic pronation ended the foot would subsequently resupinate to neutral and beyond producing a stable foot in preparation for propulsion.

This paradigm is erroneous. In the example above, when the medial platform is fully engaged in weight bearing, the distal medial aspect of the orthotic plate is five degrees inverted to the floor, a mechanical impossibility. (See Fig. 3).

With time, the high degrees of rearfoot posting steadily reduced to the customary four degrees (and sometimes 6 degrees) because of the potential for inversion sprains with the higher postings. Today, most rearfoot posts have a four degree varus lateral platform with a four degree medial grind off (See Fig. 4) to allow four degrees of rearfoot eversion at heel contact. (See Fig. 5). This means that resupination starts at the heel vertical position and is not dependent upon weight bearing of the medial platform. This change in perception requires some explanation.

In order to understand why resupination is not dependent on the medial platform of the post but rather the vertical position of the heel, consider the foot during the first 25% of stance as the foot contacts the floor. The foot contacts the supporting surface in the following sequence: lateral heel, then lateral forefoot, then medial forefoot and finally medial heel. (See Fig. 6). Medial forefoot contact and medial heel contact are almost simultaneous. Notice that the is everted on the rearfoot (locking the midtarsal joint) by the reactive force of gravity pushing upwards through the lateral forefoot. The same sequence occurs with the functional device: lateral platform of the heel, followed by the lateral forefoot and finally, the medial platform of the post. Thus, the eversion of  the forefoot on the rearfoot ultimately shifts the weight to the medial platform of the posts. The end-point of the eversion of the rearfoot is determined by the contact of the distal-medial aspect of the orthotic plate with the transverse plane and not by the medial platform engaging the supporting surface. In reality, the heel vertical position is the termination point of heel contact pronation no matter what degree of post is applied to an orthotic plate.

Increasing the value of the rearfoot post may be counterproductive. With higher degrees of posting a more inverted position is possible at the initial portions of heel contact but the subtalar joint must pronate further to reach the vertical end point. Remember the end point is determined by the distal medial aspect of the orthotic plate rather than the medial platform of the post. In other words, increasing the value of the rearfoot post increased the amount of pronation of the rearfoot at heel contact.

As stated before, most rearfoot posts will theoretically invert the rearfoot by four degrees and this is quickly followed by pronation to the vertical. Such a post theoretically mandates four degrees of motion that terminates with a vertical heel at the end of the first 25% of stance. An unposted device has no such mandate for motion and may not undergo the desired four to six degrees of motion at heel contact.

Rearfoot posts should be utilized with most function orthotics to assure physiologic pronation as well as shock absorption. This is especially true for any foot this is aximally pronated at the moment of heel contact such as heel spur syndrome and sinus tarsi syndrome. In the latter case, a higher degree of motion may be desirable because the symptomatology is dependent on the impact of body weight onto an immobilized subtalar joint. Controlled motion is the best long-term therapy for this syndrome.

 

Written by Chris Smith, DPM, Former Vice President and Medical Director of Northwest Podiatric Laboratory and Professor Emeritus of Biomechanics at the California School of Podiatric Medicine (CSPM) at Samuel Merritt University.

COVID-19 Update

NWPL closed on Friday, March 20 in response to the COVID-19 pandemic

 

As a manufacturer of medical devices, NWPL is classified as an “essential business.”  However, for the last 1.5 months, we’ve chosen to drastically limit time employees spend at our facility to maximize safety.

 

ON TUESDAY, MAY 5, NWPL IS OFFICIALLY REOPENING IN A LIMITED CAPACITY.

 

Production/Turnaround time

Smaller-than-normal crews will operate four days a week to process and fabricate orthotic orders.  Due to restricted manufacturing capacity and safety-related changes to workflow, in-lab turnaround time will temporarily be 10 business days instead of NWPL’s standard four or five business days.   

Shipping and Receiving

All orders sent to NWPL – SmartCast orders, casts or impression foam – can be received Monday through Friday.  Completed orders will ship most days, Monday through Thursday.

Customer Care

Customer Care will be available 7:00 a.m. to 11:00 a.m. (PST), Monday through Thursday (Tuesday through Friday the week of May 4).  Contact Customer Care at 800-443-7260 (leave a message, if needed) or email customercare@nwpodiatric.com.

Accounting/Billing

Our Accounting Team will continue to primarily work remotely.  Most days (Monday through Thursday), a member of our team will be available via phone to process payments or answer billing questions.  Call 800-675-1766 (leave a message, if needed) or email ar@nwpodiatric.com for additional assistance.

All other inquiries

Call 800-675-1766 (leave a message, if needed) or email info@nwpodiatric.com.

 

We’ve spent many hours developing safeguards and implementing policies that ensure our employees are working in a safe environment.

We’re delighted to take small steps forward that allow us to protect our employees, keep NWPL moving ahead and provide healthcare professionals and their patients with amazing custom foot orthotics!

Thank you for your continued patience during this challenging time.

Stay well!

 

The NWPL Team

NWPL reaches out with social media

Northwest Podiatric Laboratory is the secret weapon for healthcare professionals and patients seeking to lessen or eliminate foot pain.

Since 1964, podiatrists, physical therapists, pedorthists and more have trusted NWPL’s experience and craftsmanship to help their patients live pain-free lives.

Using social media allows us to share the heart of our company and people. Yes, we craft amazing custom foot orthotics, but taking care of each other, our community, the environment, healthcare professionals AND the people who will wear what be make is our core mission.

Stay in the loop by following and liking NWPL on your favorite social media platforms!

Facebook

Instagram

Twitter

“It’s important that healthcare professionals and patients see that NWPL is more than just another orthotic manufacturer,” says Luke Wyatt, NWPL’s Director of Marketing. “Hundreds of individuals and companies mold plastic and glue foam, but there’s only one company in North America weaving together heritage, craftsmanship, innovation and a heart for people – and that’s Northwest Podiatric Laboratory.”

Our team of talented technicians craft custom foot orthotics to treat many types of foot pain.

  • Plantar fasciitis
  • Bunions
  • Hammer toes
  • Heel spurs
  • Metatarsalgia
  • Morton’s neuroma
  • Posterior tibial tendon dysfunction (PTTD)
  • Adult acquired flatfoot (AAF)
  • Sesamoiditis/hallux limitus
  • Lateral ankle instability/peroneal tendonitis
  • More

We’re continually innovating and can’t wait to share what’s next!  Follow NWPL today!

 

 

Northwest Podiatric Laboratory is an industry leader in custom foot orthotics and related technologies. Dennis Brown, a retired British soldier, elite athlete and natural-born inventor founded the company in 1964 and was joined by a biomechanics pioneer, Dr. Chris Smith, in 1974. With an exclusive blend of science, craftsmanship and innovation, the partners have built a company that utilizes proprietary production techniques and technology to produce orthotics with a unique shape and unparalleled performance. Northwest Podiatric Laboratory has helped over a million people suffering foot pain to lead better, pain-free lives. Learn more at www.nwpodiatric.com.

Staying safe at NWPL

The health, safety and well-being of our team is a responsibility we take very seriously.

From being far ahead of the curve by offering great health insurance, paid sick leave and 401(K) matching to investing in an employee-led Wellness Committee, NWPL invests in its employees.

During the COVID-19 pandemic, we’ve doubled down on our health and wellness focus.

Kudos to Tam, NWPL’s Accounts Receivable Specialist (and the newest member of our team), for sewing awesome masks to help keep our team safe!

Small contributions can go a long way.  Thank you, Tam!

Stay well!

A Blast from the Past: NWPL in the 1980’s

Northwest Podiatric Laboratory is synonymous with out-of-the-box thinking, the relentless pursuit of revolutionary ideas, materials and technology, and exceptional customer care.

We merge the quality of traditional hands-on techniques with the convenience and performance of cutting edge technology. The result? Amazing solutions for foot pain! This isn’t a newly created marketing initiative to drum up sales…it’s baked into our DNA. Our laser-focus is evident in the millions of people we’ve helped over 50+ years. The spirit of Northwest Podiatric Laboratory is beautifully captured in the introduction to our 1989 company catalog. Back then, the technology was different and the hair was bigger, but our core remains unchanged.

Northwest Podiatric Laboratory company catalog, 1989:

Our laminate orthoses are fabricated from high performance materials used in the aerospace industry. Our unique processing of these materials, such as multiple layering of fiberglass and carbon fiber graphite cross layers within epoxy resin matrices, has resulted in state-of-the-art orthotic materials.

The new materials allow our orthoses to be inherently stronger and significantly thinner than all conventional orthoses, including rohadur, polypropylene, TL-61 and subortholen. In addition, our technological advances, such as “Triplane Tailoring” have enabled us to create orthoses that can be made flexible or rigid independent of thickness. Thus we are able to specifically design the internal structure of orthoses to control and transfer force factors according to the demands of the individual foot, specific activity and your Rx.

Northwest Podiatric Laboratory, Inc’s. ongoing research and development of orthotic applications using aerospace materials and technology has resulted in a close working relationship with the aerospace industry. Because of the sophisticated requirements of orthotic applications, our innovations in processes and materials have directly resulted in advances in aerospace technical development and international patents for Northwest Podiatric Laboratory, Inc’s. unique line of orthotics.

Christopher E. Smith, DPM., is presently a Professor of Podiatric Biomechanics at the California College of Podiatric Medicine and has over twenty years of professional teaching experience in his primary field of clinical and theoretical biomechanics. He is widely acknowledged by both his students and colleagues for his critical evaluation, attention to detail, specific insights and nuances and his preoccupation with the stability of the midtarsal joint.

His insights and experience have been major factors in the success of numerous world class athletes, including several United States Olympic Gold Medalists. Along with Dennis Brown, President of Northwest Podiatric Labs., he is engaged in ongoing research and development (as pictured above) of high performance composite materials and their application to functional foot orthoses.

Dr. Smith’s expertise, direction and knowledge have been instrumental in our development of our uniquely effective line of rigid orthoses that restore proper function while providing utmost patient comfort.

Dennis Brown is the main organizing and creative force in our team of experts. His experience in the design and fabrication of orthotics spans more than two decades. Holder of numerous worldwide patents, his ability to grasp theoretical principles and extend them beyond the ordinary continually results in breakthroughs in orthotic materials and fabrication processes.

 

 

Northwest Podiatric Laboratory is an industry leader in custom foot orthotic and related technologies. Dennis Brown, a retired British soldier, elite athlete and natural-born inventor founded the company in 1964 and was joined by a biomechanics pioneer, Dr. Chris Smith, in 1974. With an excluisve blend of science, craftsmanship and innovation, the partners have built a company that utilizes proprietary production techniques and technology to produce orthotics with a unique shape and unparalleled performance. Northwest Podiatric Laboratory has helped over a million people suffering from foot pain to lead better, pain-free lives. Learn more at www.nwpodiatric.com.

Ask NWPL – Info on Rx form

Question: Why does NWPL require so much patient information on the Rx form?

 

Answer: At first glance, age, weight, height, sex, activities and shoe type may appear superfluous. This information, however, is vital. It’s significance is apparent once we understand some concepts of composite orthotics (like NWPL’s Superglass). Let us begin by taking a step into the past. With thermoplastics, increased thickness is necessary to increase rigidity. Thicker is stronger and thinner is more flexible. Unlike thermoplastic materials, our Superglass orthotics have a true graduated flex range that is independent of the thickness of the device.

Shoe size, width and heel height are important considerations because these factors determine the final shape and dimension of the device. If we know the shoe size, we will check the cast/scan against standard lab sizes. Heel height is especially important when the device is for higher heeled shoes. Remember, for any shoe over 1.5″, the casts must be modified so the device will not rock on the shank of the shoe. Implicit in this modification is the lack of biomechanical control.

Shoe type is very important. While the length and width of the foot are readily determined from the anatomic markings on the casts/scan, we must consider the footwear when determining the precise dimensions of the device. A low dress shoe fits the foot much more snugly than the same size athletic shoe. Consequently, the devices must be fabricated to lesser dimensions.

We can make orthotics for nearly any shoe type, however, we recommend a lace-up shoe with a half inch heel. By giving us complete information, we can specifically engineer your prescription.

New Medical Director and Customer Care Supervisor

At Northwest Podiatric Laboratory, we’re passionate about helping people!

We’re known for out-of-the-box thinking, the relentless pursuit of revolutionary ideas and innovative technology, but the basis for our success is truly found in our Purpose and Vision Statement: We continuously strive to best serve each other, our community, our partners and those suffering foot pain, ultimately enhancing their quality of life.

We’re excited to announce the addition of not one, but two, amazing colleagues to our team – colleagues who will play a central role in serving you for years to come.

 

Timothy Messmer, DPM, Medical Director

Dr. Timothy Messmer joins Northwest Podiatric Laboratory as Medical Director and will work closely with Dr. Chris Smith, our current Medical Director and Vice President, for the remainder of 2018. Upon Dr. Smith’s retirement at the end of the year, Dr. Messmer will increase his hours and responsibilities at Northwest Podiatric Laboratory while also remaining in private practice.

As Medical Director, Dr. Messmer will work in collaboration with Ruben Valle, our General Manager, to insure sound biomechanical principles are followed in the design and fabrication of all products and technologies, act as an ambassador in the marketplace, be involved in education and consultation and more.

Dr. Messmer is a board-certified podiatrist who has been in private practice in Northwest Washington for 24 years and currently is working at Skagit Northwest Orthopedics, a multi-disciplinary clinic with offices in Mount Vernon and Anacortes, WA. He is board-certified by the American Board of Foot and Ankle Surgery, a fellow of the American College of Foot & Ankle Surgeons, member of the American Podiatric Medical Association, and member and past president of the Washington State Podiatric Medical Association.

“I’m delighted to be part of an industry-leader like Northwest Podiatric Laboratory. The values they hold mirror my own and I look forward to contributing to the success of healthcare professionals and patients who rely on us.”

In his free time, Dr. Messmer enjoys reading, studying and spending time with his wife. He has three grown children. Dr. Messmer resides in Anacortes, WA.

 

Ted Clevenger, Customer Care Supervisor

Ted Clevenger joins the Northwest Podiatric Laboratory team in the vital role of Customer Care Supervisor. In many ways, our Customer Care Department is the heart and soul (and voice) of the company – they’re likely the members of our team you speak to most. Ted will support, coach and motivate his team to ensure they have the tools for success while removing obstacles that stand in their way.

Ted’s background is primarily in supervision for community service organizations, most recently at Rebound of Whatcom County, a non-profit working with families who are trying to recover and rebuild after experiencing the devastating effects of trauma (www.reboundfamilies.org). Social service work has sharpened his abilities to build partnerships, develop people and provide hands-on leadership to diverse groups of people.

Ted also has sales experience in the real estate and education industries, making him a creative problem solver who can think quickly on his feet.

In both his community-focused and sales roles he’s had the opportunity to lead teams, handle crucial conversations and build internal leadership and ownership. Under the tutelage of Dr. Smith, Dr. Messmer and Ruben Valle, Ted’s knowledge and understanding of custom orthotics and biomechanics is expanding daily.

“Serving others and helping them grow is my passion! Providing our partners with amazing customer service, while helping my team soar to new heights is my continual challenge and goal.”

In his spare time, Ted enjoys long distance trail running and social partner dancing.

 

 

Northwest Podiatric Laboratory is an industry leader in custom foot orthotics and related technologies. Dennis Brown, a retired British soldier, elite athlete and natural-born inventor founded the company in 1964 and was joined by a biomechanics pioneer, Dr. Chris Smith, in 1974. With an exclusive blend of science, craftsmanship and innovation, the partners have built a company that utilizes proprietary production techniques and technology to produce orthotics with a unique shape and unparalleled performance. Northwest Podiatric Laboratory has helped over a million people suffering foot pain to lead better, pain-free lives. Learn more at www.nwpodiatric.com.