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Simplifying orthotics: Non-weight bearing vs weight bearing casting techniques

by Raymond Li. C ped (c), CK, PTS

An issue in the world of custom-made orthotics is non-weight bearing versus weight bearing casting techniques. Which is superior? What are the benefits of each? Why are there two methods? Let’s break it down in layman’s terms!

A casting technique is what a foot professional uses to make a mold or negative impression of your foot. From this measurement, a positive model can be made that should resemble the original foot as much as possible. The more accurate the positive model, the better the fit of the custom made orthotic that one can generate to accommodate the original foot.

So which is the better method: non-weight bearing or weight bearing casting? The answer is simple! If you are weight bearing while you are taking a measurement of your foot, your weight and way that you stand to distribute your weight will affect the shape of your foot’s natural arch. The positive model that you make from a weight bearing measurement will NOT resemble your original foot and therefore your custom made orthotic will NOT be made to cater to your foot.

Given this information, it would make sense that there is a Gold standard in which all foot professionals use non-weight bearing casting methods, right? Wrong! Even though every pedorthist, podiatrist, chiropodist is trained and tested using only non-weight bearing casting techniques, there are many unqualified individuals that use the easier less accurate weight bearing methods.

In conclusion, any patient interested in achieving the best custom-made orthotic should be doing their measurements in a non-weight bearing sub-talar neutral position. The construction of the orthotic should include the patient’s weight, activity levels and pathology as well but then we are starting to complicate an article that is trying to simplify things!”