Orthotics Advisory

"Neutral Position" cast of a non weight-bearing foot. The reason a non weight-bearing cast is so important in the fabrication of orthotics is because you get the foot in its most corrected position with a good arch before it collapses with standing.

Secondly, as this picture shows, the forefoot to rearfoot relationships can be evaluated here. The instrument in the picture demonstrates "forefoot varus", where the forefoot is inverted in relationship to a vertical heel. Normally, this would cause the foot to compensate and pronate. The orthotic can be designed to allow for precise control of a tilted forefoot (See next picture for further clarification).

"Forefoot varus and compensation".
The bones at the ball of the foot ("metatarsal heads") are tilted at an angle, and so the foot has to get down to the ground and does so by pronating. The same holds true within the ski boot (See skiing section). An orthotic with forefoot varus posting corrects this problem (See next photo)

Orthotic with posting. This orthotic demonstrates forefoot varus posting and rearfoot posting as well. By "bringing the ground up" to meet the foot, the orthotic accurately prevents pronation.

Note that the orthotic device is not a "crutch". It allows for normal foot motion (e.g. absorbing shock at heel strike) but prevents the excessive or abnormal motion.