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In shoe casting

Discussion in 'Biomechanics, Sports and Foot orthoses' started by fabio.alberzoni, May 21, 2012.

  1. fabio.alberzoni

    fabio.alberzoni Active Member

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    Hello everybody and thank for the attemption.
    My trouble is about find articles and books explaining the "in shoe casting" technique.
    I found something on Donatelli's book but not enough to begin to try it.
    If someone is able to explain me something more about this technique or give me an advice about where I can find articles or titles of books I'll appreciate a lot.

    pre-Thank you for your attention, Fabio
  2. As I recall, its covered in Valmassy. A better question might be: why? In nearly 25 years, I've never needed to.
  3. fabio.alberzoni

    fabio.alberzoni Active Member

    I read Valmassy too.I'd like to read somemore or know something about the personal experience .

    My interest is historical more than practical.I think I have to know very well the past to understand why is better the present.

    My summary of Valmassy:"push on V metatarsal head on the sole of the shoe and in the meanwhile keep the STJ in neutral position"
    ...it doesn't seems me enough.

    I heard of sportive application.It'll be interesting for me to know who made this,in which situation and with what result...

    I understand that this doesn't sound so interesting for you and I really appreciate your attention.

  4. efuller

    efuller MVP

    What you describe is pretty much it. When I was taught this technique, we always took the shoe and sent it to the lab with the cast to be sure that the orthoic would fit in the women's dress shoe. Casting in the shoe gave the shape of the foot when it was "pressed" on the shape of that shoe. This often gave a higher arch contour than a regular cast. This cast and sending the shoe to the lab really made sure that the orthotic would fit into the shoe. The orthotic may not fit into the patient's other shoes, but it would fit in the one that was used during casting.

    Also, a plastic bag is wrapped around foot and plaster before the shoe is put on. I was tought to use a vacuum pump to help the plaster dry faster in the bag. You don't necessarily have to use the pump.

    The method that I was taught also had the patient dangling their leg vertically off of the edge of the chair. This made it easier to push upward on the lateral forefoot and keep the STJ in neutral. Only one of my instructors regularly used this technique, Chris Smith. He admitted that it wasn't the same as casting, but he claimed that it better than no orthotic in the shoe.

    I can't say that I've used it enough to be absolutely confident that it is better than nothing in the shoe.

  5. fabio.alberzoni

    fabio.alberzoni Active Member

    I had a female friend that is a lawyer and for work has to wear high-heeld shoes(9mm).She's young,32 years old, and already got a bilateral hallux limitus. Is madness think to try with her with this tecnique?May be in a 6mm heeled shoe?
    I tried to convince her about changing shoes but no way!
  6. G.V. Zanetti

    G.V. Zanetti Member

    My advice about this technique is to contact some Podologist in Milano for update your knowledg on biomechanics and casting for orthotics.
    Giulio V. Zanetti:drinks
  7. A 6mm heel height on a shoe is not particularly high. Why wouldn't you just use a non-weightbearing cast and pitch the device to match the heel height differential. Why make it more complicated than it needs to be? To be honest with a 6mm differential (I suspect you don't mean 6mm though since you talked about "high-heeled shoes"), you'd probably get away without pitching it at all. You just need to slim down the shell width which is really easy.

    I've made orthoses for shoes with a 3 inch heel, just as a learning piece. I casted the foot non-weightbearing, with the forefoot plantarflexed on the rearfoot, put the forefoot balance on with the positive cast pitched to the shoes heel height and then ground through the heel-cup on a pitched grinder. It can be done, the question of whether or not you'd really want to do this for a patient with bilateral hallux limitus is something else again.
  8. fabio.alberzoni

    fabio.alberzoni Active Member

    Thank you very much!when I spoke about high-heeled-shoes I was speaking about 9 mm of height differential.But I think it's really to much this and also that with a shoe like that even the best orthotic can do nothing with an hallux limitus.
    ok about slimming but won't change the foot's morphology inside a 6 mm differential shoe?

    I also think to try to modify an old shoe grinding the sole(if sufficently thick) beneath the first toe to reduce the ROM request....is it madness?any other proposal?
  9. Maybe there is a language barrier here. 9mm (millimeters) is a small heel height differential. To put it in perspective most running shoes have a greater heel height differential than this. Making foot orthoses for shoes with a 9mm heel height differential should not require in-shoe casting, IMHO.
  10. efuller

    efuller MVP

    9 mm or 9 cm? 9mm is about the height differential of a running shoe.
  11. Boots n all

    Boots n all Well-Known Member

    The Heel "pitch" that you talk about doing an orthosis for, maybe best served by using an EVA type material for the orthosis and cast for the orthosis in your normal manner.

    The EVA material will flex, depending on the thickness, to marry the the heel pitch of the shoe and still support the arch and hold a met dome where you need it.
  12. fabio.alberzoni

    fabio.alberzoni Active Member

    Sorry!I equivocated a lot....I always said 6-9 mm but I wanted to say cm(centimeters).

    Now I understand why your answers seem to me so strange...sorry again!
  13. Petcu Daniel

    Petcu Daniel Active Member

    Hope this helps :
    Palamarchuk HJ, Fry J In-shoe casting technique for specialized sports shoes. J Am Podiatr Med Assoc. 1989 Sep;79(9):462-5

  14. G.V. Zanetti

    G.V. Zanetti Member

    The in shoe casting is a difficult and not efficient way to make a functional Orthotic.
    The best is the suspension technique or in charge ,
    Giulio v. Zanetti (Milano-Italy)

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