OrthotiCare Clinics – Custom Foot Orthotics

What is a foot orthotic (orthosis)?

A foot orthotic is an orthotic device that can be inserted into the footbed of footwear. It may provide improvements in support, alignment and biomechanics. It may also be used to provide accommodation for a foot deformity. Proactively, a foot orthotic can be used to prevent an injury or to protect an existing injury during the healing process.

While there are off-the-shelf and generic foot orthotics available at retail stores, they often address simple, common requirements such as shock absorption or minor support. These types of off-the-shelf foot orthotics are not usually appropriate for orthotic correction, function and support that is specific to an individual’s needs.

Only custom-made foot orthotics, when made by a qualified orthotic provider such as a Certified Orthotist, will address an individual’s specific needs and will provide an individual with appropriate orthotic treatment, given their specific medical diagnosis and/or prescription.

What are true custom-made foot orthotics (orthoses)?

True custom-made foot orthotics are made by a qualified orthotic professional, such as a Canadian Board Certified Orthotist. A superior custom foot orthosis is made from a plaster cast of the patient’s foot, held in the correct position during casting. During the patient’s plaster slipper-casting, and during subsequent mould-making processes, corrections and modifications are made by the Certified Orthotist to address the patient’s specific diagnosis, orthotic prescription and treatment goals.

At OrthotiCare Clinics, Our Custom Foot Orthotics are Made Using a 7 Step Process that Maximizes Your Function, Fit & Comfort:

At this appointment, the Certified Orthotist performs a full clinical assessment of the patient to confirm the diagnosis and the recommended orthotic treatment plan. This appointment includes an evaluation of range of motion, and static and dynamic foot/ankle positioning. An analysis of how the patient walks and uses their feet (i.e. gait analysis) is performed. Any other factors impacting the orthotic treatment will be noted. As needed, our Certified Orthotist consults with the prescribing physician or other care team members.
We make our custom foot orthoses using a precise plaster slipper-casting method. When performed by an experienced Certified Orthotist, this is a superior method for the design of custom foot orthoses. During plaster casting, the Certified Orthotist marks the adjustments needed to achieve the biomechanically correct position of each foot. Elements to incorporate for cushioning, accommodation and support are all planned for during this stage.
Plaster is poured into the plaster slipper-casts of the patient’s feet. Once dry, the slipper-casts are removed leaving 3-D plaster impressions of the patient’s feet – with all of the necessary markings on them for any modifications or additions needed. The Certified Orthotist modifies these plaster moulds to the custom measurements and specifications set out in the clinical assessment and custom plaster slipper-casting appointment.
At our on-site fabrication lab in Nanaimo, our highly skilled Orthotic Technician uses the modified plaster moulds, and the raw materials appropriate for the planned orthotic treatment, to laminate, vacuum-form, and manufacture the custom foot orthoses for each patient. Raw materials are selected based on the specific orthotic treatment results required for each patient. The custom foot orthoses are trimmed and then smoothed on a grinder to achieve a high-quality finish.
At the fitting and adjustments appointment, the Certified Orthotist may further trim and grind the custom foot orthoses in order to fit the foot orthoses smoothly into the patient’s footwear. Quality, supportive footwear (such as athletic, walking or orthopaedic shoes) is recommended to provide a base for the custom foot orthoses to sit on. The Certified Orthotist performs another clinical evaluation to ensure that all orthotic treatment goals have been met and that the best function, fit and comfort are achieved. Initial patient feedback is critical to make any fine adjustments needed to fully finish the custom foot orthoses.
Some patients will feel comfortable wearing their custom foot orthoses right away and other patients may require a longer adjustment period. Patients should begin by wearing their custom foot orthoses for as long as is comfortable. If they become uncomfortable, the custom foot orthoses should be removed from the footwear for a couple of hours and then re-tried. Initially, minor aches or tired feet are normal, but this should lessen over time. After one week of wearing the foot orthoses, if there is any discomfort then the patient should contact OrthotiCare Clinics to book a follow-up appointment for an adjustment.
If a patient requires further minor adjustments to their custom foot orthoses, a period of follow-up care is included, following the date the custom foot orthoses are dispensed. If a patient’s feet are not comfortable at any time, we want to know. Please contact our Nanaimo Main Clinic.

What are some of the many Foot Orthotic Treatments that we provide?

  • Custom, Prescription Foot Orthoses for adults and children
  • Custom Sports Foot Orthoses (for running, walking, soccer, skiing, tennis, hockey, golf and more)
  • Custom designed and made ballet PointeParts for pointe shoes
  • Carbon Plate Foot Orthoses
  • Custom Heel Orthoses, Heel Cups and Heel Lifts
  • Hallux Valgus, Bunion splints
  • Metatarsal Pads
  • Inter-digital toe inserts
  • Silicone Toe Sleeves
  • Custom-made, prescription Orthopaedic Shoes and Boots


What are some of the conditions that our custom foot orthotics can help to treat?

Achilles Tendonitis
Arthritis of the foot
Hallux Limitus Rigidus
Hammer Toes
Heel Spurs

Morton’s Neuroma
Pes Cavus
Plantar Fasciitis
Prominent Metatarsal Heads
Over Pronation
Shin Splints