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Over the past 15 years, the use of custom-prescribed foot orthoses has undergone a meteoric rise in popularity. Because of their ability to improve the functional alignment between the foot, knee, hip, and pelvis, many practitioners have realized that they can effectively treat a wide variety of disorders with custom foot orthoses. Until now there has been a limited amount of published information explaining the details of orthotic design and fabrication. As a result, the interested clinician has been forced to rely on the conflicting and often misleading information supplied by competing orthotic laboratories. The purpose of this text is to clarify the role of the orthotic by relating the science of pedal biomechanics to the objective involved in orthotic design. The early chapters review the cardinal planes of motions, locations of the individual articular axes, the interactions of opposing forces acting upon the foot and the mechanical efficiency of the different muscles as determined by their spatial relationships with these axes. This is followed with a detailed review of both ideal and faulty foot function as related to a myriad of structural and functional anomalies. The final chapters review essentials of the biomechanical examination, casting techniques, orthotic fabrication and a flowchart for clinical problem-solving.
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