The manufacturing of custom orthotics has been around for many years. What you may not know is that there are different types of orthotic labs, and they manufacture orthotics using different methods.
Understanding what type of orthotic lab you are using can help you better prescribe orthotics, and may affect your overall patient satisfaction.
How do you find out what type of lab you are using?? Read on to learn more about the different types of labs, how they manufacture orthotics, and the advantages/disadvantages of each.
Library Orthotic Labs
A library lab is one that you will see often. This type of lab uses a “library” system of pre-made positive casts and shells to manufacture orthotics. The cost of an orthotic from a library lab is a lot cheaper, up to 30%-40% less than their competitors.
Library labs manufacture their orthotics by taking the closest matching positive cast from their library to shape their shells, or they find the closest matching prefab blank using software that measures the arch height, heel width, and forefoot width.
According to Dr. Craig Payne in his analysis of custom orthotic fabrication,
Library devices are mass produced, prefabricated orthotic shells that labs either match to the negative model when it arrives at the laboratory or to the positive model after the design process. This skips several steps in the manufacturing process to produce a more economical device.
Although economical and money-saving, doctors are getting orthotics that are closer to prefabricated devices. Please note that because library orthotics are not pressed over a true positive cast of the patient's foot they are not actual custom orthotics and should not be sold or billed as such. According to Queensland Orthotic Lab,
There have been circumstances where podiatrists have unknowingly received library devices from their lab, thinking they were receiving custom devices.
3D Print Orthotic Labs
3D printing labs are one of the newest orthotic technologies to enter the industry. These labs use materials like Nylon and polyamide 11&12 to print orthotic shells directly into the desired shape and size. A digital record makes 3D orthotic designs easier to modify and reproduce.
One of the biggest advantages of this method is that it can create orthotics very accurately. A machine can create the shell in the correct shape with no human labor involved. 3D printing can also produce custom shapes and geometries not possible through traditional fabrication techniques.
Durability and time are the main disadvantages of 3D printing. The materials used in 3D printing are weak to heat and humidity and don’t hold up well against the gait forces generated over time. Some labs can take 5-6 hours to print a single insole. Others require up to 8-12 hours to make a pair of orthotics.
3D print labs are the most expensive type of lab because of the materials and time factor. An LER Study from 2017 found the cost to fabricate orthoses with 3D printing technology costs about $300 to $400 per pair compared with $60 to $80 for traditional orthoses. Though costs have gone down significantly since then, you should expect to pay more.
In short, 3D printing orthotic labs are still somewhat in the developmental stages. Faster speed and more experimentation with materials are still needed for 3D printing orthotics to reach its potential. This method of manufacturing orthotics will become more viable as costs decrease and larger/faster printers are invented.
Fully Custom Orthotic Labs
This is the most recognized type of orthotic lab. A fully custom lab creates orthotics working off a negative model of the foot and a prescription provided by the physician. They handle each order individually and often make cast corrections to the foot using software or plaster. Each orthotic is completely custom designed and manufactured.
There are a lot of steps in the orthotic manufacturing process, but generally fully custom labs can be categorized into 2 methods of manufacturing:
Traditional - The shape of the foot is milled from wood or poured from plaster. The lab makes corrections using plaster or computer software to create the positive cast. Next, the lab heats the shell material and forms it around the shape of the foot using a vacuum press. An advantage to this molding method is thinner shells result in a thinner device. The biggest disadvantage is more manual labor is required to grind or add posting to the shell after shaping.
Direct Mill - A block of material is put into the mill to cut out the orthotic shape from the plastic using “subtractive manufacturing." The machine mills the plastic shell into the shape of the foot and creates the final device. The advantage of this method is that it is very accurate and production is not labor intensive. A disadvantage is the device is often much thicker and has an unfinished look.
Knowing what type of lab you are using is important to the quality and fit of the orthotics you prescribe. As you prescribe custom orthotics to your patients, be sure to consider the following:
Although library labs may have the cheapest prices, keep in mind that there is a higher risk of error and the device not fitting the patient’s foot. 3D labs are the latest innovation in the orthotic industry, but there is room for improvement when it comes to long-lasting materials and manufacturing speed.
The most tried and tested lab type is a fully custom orthotics lab. Although not as fast as a library lab or fancy as a 3D lab, you can rest assured that their traditional methods work! Whether hand-made or direct-milled, fully custom labs are proven to make orthotic devices that are accurate to the patients foot and provide the most consistent and trustworthy results.
If you want to try a true fully custom lab, look no further! At Forward Motion, we correct every order individually and make each pair traditionally. Our lab uses the highest grade materials available, and our exceptional customer service, crew of pedorthists, and innovative technology make the process of casting and ordering custom orthotics easy and stress-free. Give us a try, schedule a call with one of our account representatives today and we will make you a free pair.