Author: Luke Wyatt

What do you want to know about custom orthotics? (FAQs)

Posted on July 31, 2023 by Luke Wyatt - Currents

EVERYTHING YOU WANTED TO KNOW ABOUT CUSTOM ORTHOTICS (BUT WERE AFRAID TO ASK)

At Northwest Podiatric Laboratory we often receive questions about our company, orthotics, and how we can help people with foot pain.

While some questions are quite unique (e.g. Can I wear my orthotics for water aerobics?), many of the questions we receive are asked quite frequently. We’ve learned a lot since 1964 and are excited to share a bit of the insight we’ve gained in our quest to help healthcare professionals provide their patients with world-class foot pain solutions.

Although extensive, our FAQs page isn’t designed to be comprehensive and should be used for informational purposes only. Patients should consult with a licensed healthcare professional, while healthcare professionals should contact NWPL directly for more help and insight.

Our FAQs page is split into two sections: Patients and Healthcare Professionals. There’s some overlap between the questions but each section is tailored to provide answers to the pressing questions we’re most often asked.

Click here to visit our Frequently Asked Questions page to learn more!

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 pioneer in the biomechanics of the foot, Dr. Chris Smith, in 1974. With an exclusive blend of science, craftsmanship and innovation, the partners 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.

NWPL crafts your orthotics FASTER

Posted on February 21, 2023 by Luke Wyatt - Currents

Foot pain relief from an orthotic lab that values your time

How long are you waiting for custom foot orthotics? Six weeks? Eight weeks? Ten weeks? Longer?

The truth of the matter is that it shouldn’t take ten, eight, six or even four weeks to make a pair of custom orthotics.

At Northwest Podiatric Laboratory, our standard in-lab turnaround time is only five business days. Outside of extraordinary circumstances (e.g. peak COVID in spring 2020), we’ve been receiving, crafting and shipping orders for custom foot orthotics in five business days FOR DECADES. (NOTE: Standard in-lab turnaround time for polypropylene custom orthotics is 10 business days. Standard in-lab turnaround time for Superglass®, NCV® and Prescription Comfort® is five business days).

As one of North America’s most respected custom orthotic labs for nearly 60 years, NWPL doesn’t resort to utilizing inferior techniques/materials, passing off generic insoles as custom, outsourcing important processes or putting profits before people to save time (or cost). Further, for the duration of the COVID-19 pandemic (and into the present), we kept every employee on the payroll at full wages. Our longtime employees are still here, leveraging hundreds of years of combined experience to painstakingly craft industry-leading custom foot orthotics.

In the world of custom orthotics, faster doesn’t mean worse and slower doesn’t mean better. Faster AND better is possible when you partner with the right orthotic lab.

Are you a patient? Tell your healthcare professional that waiting months for foot pain relief simply isn’t acceptable.

Find a healthcare professional in your area who partners with Northwest Podiatric Laboratory.

Are you a healthcare professional? If you’re ready to move beyond the excuses, delays, wasted time in your office and frustrated patients, we’re ready to partner with you.

Stop waiting and get started with Northwest Podiatric Laboratory!

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 pioneer in the biomechanics of the foot, 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.

NEW! iPad Pro & iPhone scanning for custom orthotics

Posted on July 25, 2022 by Luke Wyatt - News

Northwest Podiatric Laboratory makes prescribing life-changing orthotics easier than ever with a recent update to its SmartCast® app that introduces the ability to scan patients using iPad Pro and iPhone models with Face ID.

With 58 years of orthotic industry experience and 10+ years crafting custom orthotics from digital scans, healthcare professionals rely on Northwest Podiatric Laboratory to minimize cost and complexity while maximizing positive patient outcomes.

Upgrading from plaster, fiberglass socks, impression foam, and dated scanners to a modern scanning system is a game-changer for practices of all sizes and only requires three software/hardware components:

SmartCast Foot Positioning System® to align and hold patient’s foot for scanning.
SmartCast® app to scan patients and submit orders.
Apple iPad Pro or iPhone model with Face ID. (Scans captured with the Structure Sensor are also accepted.)

Healthcare professionals with compatible iPad Pro and iPhone models can download and try the updated SmartCast app for free – simply search NWPL in the App Store.

The SmartCast app was recently added to the VA App Store, making custom orthotics from Northwest Podiatric Laboratory available to healthcare professionals at VA locations across the United States.

To learn more about how scanning with the SmartCast app and prescribing custom orthotics from Northwest Podiatric Laboratory can elevate your practice, visit www.nwpodiatric.com or call 800-443-7260.

Northwest Podiatric Laboratory is the leader in the design and manufacture of premium custom foot orthotics. Located off the beaten path in the far northwest corner of Washington State, we’ve always been a little outside the mainstream with obsessively high standards and outside-the-box thinking. Dennis Brown, a retired British soldier, elite athlete, and natural-born inventor founded the company in 1964 and was joined by a pioneer in the biomechanics of the foot, Dr. Chris Smith, in 1974. With an exclusive blend of science, craftsmanship and innovation, we 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

Passing of Founder & President Dennis Brown

Posted on January 14, 2022 by Luke Wyatt - News

It is with profound sadness that Northwest Podiatric Laboratory announces the passing of beloved Founder and President Dennis Brown.

“Dennis has been the heart and soul of Northwest Podiatric Laboratory since 1964,” said Ruben Valle, CEO. “He lived and worked by a strict set of core values: responsibility, respect, honesty, integrity and fairness; all of us at Northwest Podiatric Laboratory are beneficiaries of Dennis’ vision and entrepreneurial spirit.”

Born in 1925, Brown lived a full and impactful life. He escaped desperate circumstances in war-torn London by joining the British Army in 1941 at the age of sixteen. A two-decade career in the British, and then Canadian Army ensued. Along the way, Brown’s athletic abilities afforded a scholarship offer for track and field and a spot on England’s Olympic Boxing Team (unfortunately, the army would not release him to pursue either opportunity).

Following his military career, Brown landed in Vancouver, Canada where his gift for solving problems and a chance meeting with a podiatrist would spark a passion that became his life’s work for the next 60 years. Beginning with the purchase of Northwest Podiatric Laboratory in 1964 and bolstered by the addition of renowned podiatrist, Dr. Chris Smith, in the 1970’s, Brown developed proprietary production techniques and technology for crafting biomechanically superior custom foot orthotics using advanced materials like carbon fiber. Identifying the need for more affordable foot pain solutions, Brown and Smith then established Superfeet to provide insoles to the public. In the decades that followed, Northwest Podiatric Laboratory and Superfeet established themselves as two of the most respected companies in their field.

Brown was responsible for more than 60 product patents and, staying true to his mantra of “Improve one-eighth of one percent every week,” he could be found in his research and development lab well into his 80’s. His curious mind and passion for invention never wavered.

Inspired by his own fight for survival in wartime London as a young man, Brown and his wife, Audrey, established numerous scholarship programs for deserving students. A man of legendary generosity, Brown touched an incalculable number of people – extending his reach far beyond the tens of millions of people who wear insoles and orthotics he developed or inspired.

Brown is survived by his wife, friends from around the globe and, hundreds of Northwest Podiatric Laboratory employees past and present.

Orthotics designed for kids with foot pain

Posted on January 12, 2022 by Luke Wyatt - Currents

Healthy feet. Active children. Happy parents.

Children’s OTC Orthotics are over-the-counter insoles that align and support children’s feet to promote improved posture, balance, and stability.

Since 1964, Northwest Podiatric Laboratory we’ve crafted world class custom foot orthotics for well over a million children and adults. This experience is the foundation of our Children’s OTC Orthotics.

To create an OTC orthotic able to serve even the most active children, we began with our highly regarded custom children’s orthotic and distilled it down to its essential elements:

Many children experience improved function and reduced pain with a well-designed OTC orthotic, although custom orthotics made from a plaster mold, foam impression or 3D scan may be preferred in some cases.

At Northwest Podiatric Laboratory, we’re proud to do our part to keep children health, active, and happy.

Key features

— A deep heel cup and heel post for stability.

— Kid-friendly colors.

— A sleek design for great shoe fit.

— Seven sizes that grow with kids (ages 18 months to approximately 8 years).

— Rigid construction for kid-proof durability.

— Made in USA.

Sizing

— A (Size 6)

— B (Size 7/8)

— C (Size 9/10)

— D (Size 11/12)

— E (Size 13/1)

— F (Size 2)

— G (Size 3)

For the next Northwest OTC option beyond Size G, select Premium or Elite Size 4/5.

(Note: Shoe sizes vary widely by manufacturer and the shape/size of every foot is different. Therefore, a child’s shoe size can only offer a rough approximation of which Children’s OTC Orthotic will provide the proper fit. Practitioners should always use a sizing Set to determine best size before ordering/dispensing.)

How to fit

Examine the child’s foot. Have the child sit on a chair or exam table and straighten one leg. Examine the child’s foot, roughly gauging the size and shape.
Locate the metatarsal heads. Locate the 1^st and 5^th metatarsal heads, marking them if necessary. You’ll use this information in Step #5.
Determine the approximate orthotic size. Based on your quick visual examination, select two or three orthotics from the sizing set most likely to fit the child.
Confirm the orthotic-to-heel relationship. Hold one of the orthotics to the child’s foot, being sure the foot and sample are matched (i.e. left foot with left orthotic sample). Ensure the children’s heel fits snugly into the orthotic, as it will when the child is wearing the orthotic in his/her shoe.
Confirm the orthotic-to-forefoot relationship. The distal (forefoot) end of the orthotic should be about 1cm proximal to the 1^st metatarsal head and about .5 cm proximal to the 5^th metatarsal head. Try different sizes, if necessary, until this relationship is achieved. When choosing between two sizes, it’s generally preferable to select the large size to allow for growth.
Dispense the orthotics. Many healthcare professionals find it advantageous to carry an inventory of Children’s OTC Orthotics to provide their patients with immediate foot pain relief. Other healthcare professionals prefer to order as need to eliminate the need to carry inventory.

Insight from Chris Smith, DPM, NWPL’s former Medical Director

Learn more about what makes Northwest Podiatric Laboratory’s Children’s OTC Orthotics unique and effective from NWPL’s former Medical Director, Chris Smith, DPM.

This orthotic is a generic foot device fabricated from an idealized stable foot.
This device is not correctional. It only improves the position of the foot to the floor while underfoot. The device will not create an arch. Like eyeglasses, the device only works when it is used.
For a given foot, a larger shoe may be necessary, but this is generally not the case. The device is surprisingly comfortable with high patient tolerance (efficacy).
The Midtarsal Joint is placed in its functional locked position, making the foot function as a rigid lever (as opposed to a flexible flat foot).
The deep heel cup and high flanges control (hold) the foot in a more upright, stable position as opposed to flexible flat foot position.
Stability in stance, walking and running are improved, sometimes dramatically. Less tripping and falling are to be expected.
The length of stride increases meaning that the user walks faster.
This device is intended primarily for the flat foot. If the foot is coincidentally symptomatic, most or all pain will resolve but the foot should be monitored by a healthcare professional.
The devices are color coded for size and each size will be appropriate for approximately one year.

Ready to step up to Children’s OTC Orthotics?

Contact our knowledgeable Customer Care Team at [email protected] or 800-443-7260.

Northwest Podiatric Laboratory is only able to work under the direction of a licensed healthcare professional and is unable to work directly with patients. Specific questions or concerns should be directed to a healthcare professional.

Scanned with SmartCast. Crafted by hand.

Posted on November 10, 2021 by Luke Wyatt - Currents

Easy-to-use technology, amazing orthotics and great patient outcomes from an orthotic lab you can trust

Northwest Podiatric Laboratory has invested heavily in proprietary manufacturing technologies to enhance the capabilities of its experienced craftspeople. Over the last decade, we’ve developed new 3D imaging innovations like the In-Office Foot Digitizer foot scanner and SmartCast® to help more healthcare professionals provide world-class orthotics.

SmartCast – a foot scanner using an iPad, 3D sensor and custom app – is truly a leap forward for podiatrists, foot and ankle surgeons, physical therapists and pedorthists seeking handmade quality and the ease of digital. From a practice management perspective, SmartCast is a win-win: speed and efficiency meet quality and unrivaled patient outcomes.

SmartCast and Northwest Podiatric Laboratory elevate custom foot orthoses

We get better data. Patients get better orthotics.
The patented SmartCast Foot Positioning System® helps healthcare professionals achieve perfect foot positioning every time. Great positioning and accurate 3D scanning ensure custom orthotics are crafted with unrivaled accuracy and function.

A superior experience.
SmartCast is quicker, more comfortable and less messy than traditional plaster casts or foam impressions. Best of all, the ease, convenience and speed don’t come at the expense of quality. With SmartCast, we’re crafting the best custom orthotics in our history.

Orthotics…faster!
Orders for orthotics are submitted digitally and received immediately at Northwest Podiatric Laboratory – there’s no extra processing, handling or shipping time. NWPL far surpasses the industry norm by crafting and ships custom orthotics in days and not months.

Handmade in the United States by people who truly care.
Our orthotics are crafted in Blaine, WA by skilled technicians with hundreds of years of combined experience. NWPL has earned its history and experience the hard way: through decades of work and dedication. With the same ownership since 1964, NWPL doesn’t need to create or fabricate a history; nearly 60 years of authenticity is built into every pair of orthotics that hundreds of thousands of patients benefit from every day.

Go from foot pain to happy feet in four simple steps:

Position and align the foot using the patented SmartCast Foot Positioning System®
A 3D scan of the foot is captured and reviewed for accuracy and completeness.
Scans and prescription information are securely submitted to NWPL and our technicians craft orthotics for each patients’ unique foot and foot pain – plantar fasciitis, bunions, heel spurs, hammer toe, Morton’s neuroma, sesamoiditis and more.
Finished orthotics are dispensed to patients who are now ready to do what they love with one-of-a-kind custom orthotics supporting them every step of the way.

Learn more about what industry professionals are saying about scanning for custom orthotics

Podiatry Today

Is Scanning More Effective Than Casting For Custom Orthoses?

Is 3D scanning Eclipsing Traditional Casting For Orthotics?

American Podiatric Medical Association

3-D Scan or Cast for Orthotics? That is the Question.

Ready to step up to SmartCast?

Contact our knowledgeable Customer Care Team at [email protected] or 800-443-7260.

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 pioneer in the biomechanics of the foot, 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.

NEW! The Richie Brace® is at NWPL

Posted on November 8, 2021 by Luke Wyatt - News

Proven custom braces designed for today’s foot and ankle specialists

Richie Braces and NWPL – a perfect match

Richie Braces is the “Northwest Podiatric Laboratory of custom braces.” Since the mid-1990’s, Richie Braces has perfected a range of custom braces renowned for their quality, biomechanical soundness and great patient outcomes.

NWPL’s PTTD/AAF custom orthotic is special because it can provide support and stability in a form factor that’s more “shoe-friendly” than most other foot orthoses. However, many patients simply require a higher level of support and stability than a custom foot orthotic can provide. The addition of Richie Braces to our product line up provides a “next level” solution for patients who need it most.

Finally (and most crucially), Richie Braces shares our values. Dr. Douglas Richie shares our passion for helping people by applying tried and true biomechanical principles to foot pain. In fact, Dr. Richie was a student of our longtime Vice President and Medical Director, Christopher Smith, DPM. The relationship between Dr. Richie and Dr. Smith extended far beyond podiatry school; Dr. Richie became a friend and trusted colleague of Dr. Smith’s for over 40 years.

Although we don’t craft Richie Braces ourselves, we can offer an elevated overall experience – the same consistency, innovation, and service you expect from NWPL.

Our purpose is to “best serve each other, our community, our partners and those suffering from foot pain, ultimately enhancing their quality of life” and Richie Braces are simply one more tool to help us fulfill this purpose.

Types of Richie Braces and clinical indications

— Richie Brace Standard – PTTD (mild-to-moderate), Lateral Ankle Instability, Peroneal tendinopathy and Cavo-varus deformity

— Richie Brace Dynamic Assist – Dropfoot, Peroneal Nerve Injury and Post-CVA

— Richie Brace with Arch Suspender – PTTD (mild-to-moderate) and Lateral Ankle Instability

— Richie Brace Restricted Hinge – PTTD (moderate to severe w/ subluxed TN Joint), Dropfoot (equinus Severe varus/valgus; weak calf), DJD (ankle or rearfoot w/ dropfoot & spasticity), Peroneal Tendinopathy (order with lateral arch suspender), Lateral Ankle Instability (severe; order with lateral arch suspender) and Peroneal Never Injury (fixed varus in hindfoot/ankle; order with lateral arch suspender)

— Richie Brace California AFO – PTTD (severe; stage IV), DJD (severe), Charcot Arthopathy, Ankle Deformity

— Riche Brace Gauntlet – PTTD (stages III and IV), DJD (severe), Hindfoot Deformity and Charcot Arthopathy

— Richie Brace Solid AFO – Dropfoot (fixed equinus; knee instability; spasticity; weak calf)

— Richie AeroSpring Bracing System – Achilles Offloading System (Tendinopathy of the Achilles tendon and Post-surgical and non-surgical management of the Achilles tendon rupture), Plantar Fascia Offloading System (Severe recalcitrant plantar heel pain syndrome), Midfoot Offloading System (treatment of sprain of the tarsometatarsal (TMT) joints and Treatment of degenerative arthritis of the midfoot joints), Dropfoot Stability System (neurologic conditions resulting in foot drop or loss of posterior leg muscle strength)

Get started today

Whether you’re brand new to custom braces or have order Richie Braces for years, we make the process easy!

Cast patient (fiberglass socks), complete print Rx (enclosed) and ship to NWPL

Scan with the new SmartCast® app (using brace/AFO scanning mode) and submit to NWPL.

Click here to learn more about casting and scanning for the Richie Brace

Click here to download and/or print our Richie Brace Rx Form

Please contact our amazing Customer Care Team with questions at [email protected] or 800-443-7260.

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 pioneer in the biomechanics of the foot, 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.

New! Polypropylene custom orthotics at NWPL

Posted on November 3, 2021 by Luke Wyatt - News

Legendary experience, quality and shape in proven polypropylene

Why does an innovator like NWPL craft orthotics using a material as ubiquitous as polypropylene?

One of the keys to our longevity and success centers on our willingness to listen to the needs of healthcare professionals and people suffering foot pain. Our new polypropylene custom orthotics are thoughtfully designed to maintain the core values thousands of healthcare professionals have trusted since 1964.

— Value – The industry-leading NWPL experience is now more accessible than ever.
— Shape – The one-of-a-kind shape of our orthotics is simply superior and transcends a specific material.
— Experience – We spent 1000’s of hours on new systems and processes to raise the bar for NWPL poly orthotics.
— Innovation – Polypropylene allows for new options including integrated posts crafted into the orthotic shell.

Features

— Trusted Northwest Podiatric Laboratory shape.
— Standard heel grind (flat area on bottom of shell in the heel) on non-posted orthotic to minimize bulk and improve shoe fit.
— Sleek and strong integrated heel posts and forefoot posts (featuring the classic NWPL shape).
— Maximum strength with minimal bulk.
— Unmatched NWPL look and feel. Polypropylene orthotics you can truly be proud of.

Benefits of polypropylene custom orthotics from NWPL

Orthotics designed and finished by NWPL. Shell made by a trusted partner to our specs.
Northwest Podiatric Laboratory’s best value in decades.
As easy to prescribe as they are to fit in nearly any type of shoe – from soccer cleats and running shoes to hiking boots and casual shoes.
A great option for healthcare professionals seeking new tools for their treatment toolbox.
Unbeatable support, reliability and patient outcomes.

When to order poly

Polypropylene is a versatile and reliable foundation when functional foot orthoses are required. Activities and pathologies where healthcare professionals most often choose polypropylene include:

— Patients seeking maximum bang for the buck
— Applications where maximum durability is a must
— As a replacement for existing custom orthotics

How to order

Healthcare professionals (podiatrists, physical therapists, etc.) can ship casts/impressions and print Rx form to NWPL OR scan and submit order via the new SmartCast® app.

Questions?

We’re here to help! Contact Customer Care at [email protected] or 800-443-7260.

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 pioneer in the biomechanics of the foot, 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.

NEW! Online account access

Posted on September 14, 2021 by Luke Wyatt - News

Streamline your workflow by accessing your Northwest Podiatric Laboratory account online!

Log in from your desktop, laptop, tablet or phone for key information and insight about your NWPL custom and OTC orthotics!

Your online account provides instant access to the information you NEED.

Check order status (received and shipped)
Review order specs/details
Track UPS shipments
View, download and print invoices
Export order history to Excel
Access photos and scans submitted via SmartCast

In the coming months and years, we’ll add exciting new tools and features to your online account!

Order supplies and Northwest OTC Orthotics
Manage account preferences
Pay bills online
Dig into exclusive NWPL content and insight

SIGNING UP IS EASY!

Contact Customer Care at 800-443-7260 or [email protected].
Provide Customer Care with your preferred email and receive an invitation to set your NWPL account password.
Log into your account at account.nwpodiatric.com or by clicking Account Login in the upper-right of our homepage (nwpodiatric.com).
Manage your account and orders more easily than ever.

Here’s a sneak peak of what your Online Account access will look like.

CONTACT US TODAY TO GET ONLINE ACCESS TO ALL YOUR NWPL ORDER INFORMATION

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.

Imaging for the equinus patient

Posted on July 12, 2021 by Luke Wyatt - Currents

Written by Northwest Podiatric Laboratory’s Medical Director, Timothy Messmer, DPM, and originally appearing in the Fall 2021 newsletter for AAWP (American Association for Women Podiatrists). Click here to learn more about AAWP and its mission to develop female podiatric physicians.

As podiatrists and their staff work through the daily flow of the office schedule, certain cases or situations might cause some pause. For those of you in the typical podiatric practice, you know that the ‘orthotics’ patient can often be challenging.

Not only are no two patients’ feet exactly the same, but different pathologies often present with varying degrees of challenges. Obtaining quality negative casts or digital scans in the patient with a significant equinus deformity can bring many difficulties.

We know from the anatomy as well as the clinical presentation, that patients with a tight Achilles tendon (whether it is isolated gastrocnemius or gastroc-soleus) present with the foot/ankle in a relatively plantarflexed position, and/or their deformity produces an excessive plantarflexory force when they are placed into proper position to cast or image the foot.

A few positioning tips (specific to supine casting technique) should help to ease the frustration that often is experienced in trying to obtain good quality plaster casts or digital images from these patients.

Patients need to be reminded that relaxing is key to this working well!
The knee should be flexed slightly with a bump/pillow under the knee or a step/raise (such as https://www.amazon.com/Step-Aerobic-Platform-Black-Risers/dp/B000BO8AAC ) under the calf being utilized. (Both of these techniques will help to relax the proximal tightness by negating the pull of the gastroc muscle as it originates off the distal femur.)
Hip position – asking the patient to lie flatter (fully supine with hip neutral) rather than sitting up in the treatment chair (with hip flexed) will help to reduce the tightness in the hamstrings, which is often seen coinciding with a tight Achilles tendon.
You will also want to avoid asking the patient to ‘fight off’ the equinus by actively dorsiflexing their ankle, because this will invariably lead to firing of their tibialis anterior tendon and result in dorsiflexing the 1^st metatarsal, leading to inversion of the forefoot and a ‘false FF varus.’

If you keep the above suggestions in mind when positioning your equinus patient for casting/scanning, you will make it much easier for both you and your patient to comfortably and reliably obtain high-quality images for the making of the best custom foot orthoses.

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.