From: Keith L. Gurnick, DPM
I would like to commend Dr. Kristina Janson for making orthotics "in-house", and I suspect from her passion that she has obtained the skills and training necessary to properly and safely work with the necessary materials to fabricate orthotics for her patients. And yes, the process of making custom prescription foot orthotics can be labor intensive which is why so many local and national custom foot orthotic laboratories exist, going back to the increased awareness and prescribing of foot orthotics by podiatrists beginning with the boom of the distance running craze back in the late 1960s and early 1970s.
I do have some minor disagreements to her post that I would like to address.
1) There are more than a few podiatrists in the USA that make their own orthotics that have the same passion she has, and desire to make a great patient-specific oriented product and also have the training, experience, and expertise to do so. Sadly, this type of training has been neglected in the education of our podiatry students at our colleges.
2) A majority of podiatrists (that means at least 50%) have switched to 3D printed orthotics. I don't think so.
3) Plaster casting, "a unique approach" it is often considered a lost art form. False. Plaster casting is neither unique, nor a lost art form. 1000s and 1000s of plaster casts are still sent to labs every day to make custom orthotics.
4) Are plaster casts, foam casts, or imaging better to make a custom foot orthotic? It depends mostly on the clinician and the lab, but certainly, I believe that imaging technology is advanced enough to capture "foot nuances".
Keith L. Gurnick, DPM, Los Angeles, CA
