The science of fabricating and dispensing custom foot orthotics requires practitioners to make a series of clinical decisions to deliver an optimal device for each patient. In addition to following the physician’s prescription or contacting them for a discussion to develop the best solution, there are often competing objectives to be considered, such as rigidity, cushioning, and bulk. The goal is to provide the therapeutic benefits the patient needs in a device he or she will tolerate and wear. Other considerations may include longevity of the orthotic, speed of delivery, and cost. Against this background of demands there is quite an array of materials and manufacturing methods available to produce foot orthotics, which can sometimes be confusing.
First Steps
The primary consideration in the design of any foot orthotic is the physician’s prescription and diagnosis. The second factor of importance are the findings from a thorough biomechanical examination. Thirdly, criteria such as the patient’s footwear, lifestyle, and activity level also guide the design and material choices. The top section of most orthotic lab order forms requests patient information that directly influences and informs this decision-making. Among the important details are the patient’s weight, shoe size, and shoe type that allow the technician to select the best materials for the orthotic. 
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