Orthotic Fabrication

Our In-House Orthotic Laboratory

Most podiatric practices send their orthotic prescriptions to outside laboratories — a process that takes weeks and removes the physician from the fabrication process. At Arnold Ross DPM & Associates, we fabricate our custom orthotics in our own lab, on-site.

This gives Dr. Ross direct control over every step of the process — from the precision of the cast to the selection of materials to the final geometry of the device. It also allows rapid adjustments and ensures that the finished orthotic matches the prescription exactly.

The Fabrication Process

Creating a truly effective custom orthotic involves far more than simply inserting a foot into a foam box. Our process follows a precise sequence of clinical and technical steps:

1. Biomechanical examination — Dr. Ross assesses joint range of motion, lower limb alignment, muscle flexibility, and gait pattern
2. Neutral position casting — the foot is held in its subtalar neutral position while a plaster or fiberglass cast is taken; this neutral position capture is what separates a true custom orthotic from a generic insert
3. Cast preparation — the negative cast is filled to create a positive model of the foot
4. Prescription writing — Dr. Ross specifies all corrections, intrinsic and extrinsic posts, material specifications, and top cover selections
5. Shell fabrication — the orthotic shell is vacuum-formed or molded over the positive model using the prescribed material (carbon fiber, polypropylene, or softer accommodative materials)
6. Grinding and shaping — the shell is trimmed and refined to the exact prescription dimensions
7. Posting — forefoot and/or rearfoot posts are applied at precise angles to correct biomechanical faults identified in the examination
8. Top cover application — a top cover material is applied for comfort and to address any specific pressure needs
9. Quality inspection — the finished device is checked against the prescription
10. Fitting and gait evaluation — the patient walks in the orthotics while Dr. Ross observes gait correction; adjustments are made at this visit if needed

Materials We Use

• Rigid shell materials — polypropylene (most common), carbon fiber (ultra-thin, for dress shoes and sport applications)
• Semi-rigid materials — subortholen, Rohadur, and composite laminates
• Soft/accommodative materials — plastazote, PPT, Poron, Pelite (for diabetic and geriatric orthotics)
• Top covers — leather, suede, neoprene, and specialized cushioning materials depending on activity and foot type