Orthotic Technology. Why we prefer Total Contact Orthotics.

There are really only two general categories of functional orthotic technologies.

First, there is the Root type or traditional functional orthotic which is manufactured based on the traditional "Root and Weed" theories. We orthotic castings are sent to a typical lab, the molds that are created then get "cast corrected" or "normalized".

Cast correction is a process where some plaster is added to the medial arch or instep. This lowers it to allow the various segments of the foot to function based on theories of this type of biomechanical teaching or school of thought. In other words, the resultant orthotic is much flatter or lower than your anatomical medial arch when you rest your foot in a corrected position. This means if you look at the cast corrected Root type orthotics, as they have much less intimate contact and fit with the arch of the foot, they allow more room or range for the bones of the foot to move and subsequently allows them to drop, collapse or pronate more extensively. A patient then has a greater tendency to continue to pathologically pronate through and over a traditional Root type device with corresponding results that can be far less impressive than you could have otherwise achieved with a more efficient device.

Then there is a type of orthotic collectively known as the "total or full contact" orthotic. These are the orthotics that we offer at Austin Foot and Ankle Specialists. They are manufactured utilizing different principles and algorithms. These most importantly neither include nor require any cast correction or manipulation.

The total contact concept, although getting some press in recent years, is not exactly a brand new concept. It has taken advantage of the relatively new plastics at hand today. These were not available fifty or so years ago when the more traditional and classic orthotics came on the scene.

The difference between the orthotics produced from these two very different technologies lies in the word "control". We now have the ability to control and manipulate our patient's gait much more efficiently and effectively with total contact orthotics when compared to what was able to be achieved using standard Root type devices.

The main reason for this is the component of cast correction and manipulation that occurs during the fabrication process of the traditional root type orthotic as previously stated.

The total contact orthotics do not employ any cast corrections or manipulations. As a result, you get a much more intimate fit up into the arch and along the entire plantar surface of the foot. This then provides a much greater degree of mechanical control.

Mechanical control is important to manipulate the bones of the foot into a much more optimal and stable position -- so that they can do what they were naturally designed to do. This is the basic idea behind total contact orthotics. Foot orthotics are not meant to replace the function of the foot, they are only meant to augment and enhance the foot's ability to function in a more anatomical alignment. The total contact orthotics, because of their intimate "total contact" fit secondary to having no cast corrections or arch fill added, passively maintains the bones of the foot at or near their optimal or maximally congruous positions. This then allows the bones of the foot to lock and do what they were naturally intended to do; lock together to act as a stable base and to allow an even and non-pathologic transfer of weight along the entire foot during stance phase of gait without any significant support required from the orthotics.