The Process of Making Custom Made Foot Orthoses – Casting to Fitting


The podiatrist goes through the medical history of the patient, discussing any conditions or injuries the patient previously encountered that may be contributing factors to any current conditions. The podiatrist begins the lower extremity biomechanical assessment. This includes orthopaedic assessment and clinical gait analysis. This is followed by a review of footwear with recommendations advanced based on lifestyle and activities. Finally, a 3 dimensional impression of the patient’s foot is captured or what is known as a ‘Anatomical Volumetric Foot Model’ [AVFM]. This is a physical or digital model that captures a person’s three dimensional plantar foot anatomy when the foot is non weight-bearing, semi weight-bearing and fully weight-bearing.

Foot Modelling

A digital AVFM must use actual 3 dimensional data points taken directly from the foot to duplicate plantar foot anatomy. The most common examples include laser 3D scanners, stereo-digital 3D imaging systems and pin array systems. A physical AVFM captures the foot anatomy through direct contact to duplicate plantar foot anatomy. The most common examples see plaster of paris casts used or foam impressions taken directly from the foot. Any material or method that uses direct capture of the entire plantar foot anatomy creates an AVFM.

plaster of paris cast

Plaster of paris foot casting

Manufacturing the Orthotic

Firefly Orthoses only accepts ‘Anatomical Volumetric Foot Models’ and all our prescription orthoses conform to this classification ahead of the manufacturing process.

Firefly will receive a prescription document from the Podiatrist, detailing all relevant information about the patient [weight, activity level, medical condition and footwear] along with either a physical or digital AVFM ahead of manufacturing the anatomical custom foot orthotic [ACFO]. The shell of the device is the foundation around which the device is created. The device’s shell is made from thermoplastics such as Polypropylene or Copolymer, Nylon reinforced thermoplastic, Carboplastic or Carbon Fibre. Each of these materials have unique characteristics that will benefit the patient depending on their needs.

There are two primary methods of orthotic shell manufacturing:

  1. direct milled devices milled from polypropylene plastic,
  2. vacuum press, where the shell is moulded using a vacuum press from carbon fibre or carbon plastics including: polypropylene, copolymer, carbon graphite or laminate resin with EVA.

The direct milled process sees the orthotic device fashioned from a block of the chosen shell material usually a Thermoplastic such as Polypropylene. From here the device is machine sculpted and shaped to meet the patient’s needs. This method is suitable for durable, long-lasting devices that accommodate all modifications.

The vacuum press method sees the heated shell material placed over the positive cast model, and moulded around the model using a vacuum press. This method allows for a variety of shell materials such as copolymer, XT Sprint or TL2100. Devices manufactured via this process are generally lightweight, offering greater flexibility and suitable for dress wear and sports wear such as football boots. Depending on the style of orthoses, there are limitations to the modifications that can be made to the vacuum pressed device.

The process of finishing the orthoses is a combination of computer aided design and manufacturing, coupled with craftsmanship. Firefly Orthoses’ highly skilled technicians finish the orthotic devices to exceptional standards.

Our technicians not only shape the orthoses to meet the contours of the foot, but further modify using postings, padding and additions to ensure the foot is balanced through the gait cycle. The finished device must meet the design requirements as specified by the prescribing physician, taking into consideration appropriate medial and /or lateral arch fill, lateral column expansions, heel expansion, and intrinsic forefoot and or rear-foot corrections.



Cast, positive mold and orthotic.

The image above shows a plaster of paris cast of the patient’s foot, followed by a positive mould of the cast and finally the finished custom made Firefly Orthotic Device.

The combination of materials, additions and modifications available to meet the patient’s needs can be viewed on our products page, and are combined alongside a suitable top cover material of either EVA, expanded vinyl, neoprene, open and closed cell polyurethane, cork and leather.

Firefly Orthoses Fit

The custom-made orthoses designed and manufactured by Firefly ensure enough flex for functional pronation and comfort and enough stiffness to maintain arch height for normal function.

Firefly Custom Made Orthoses

Finished Orthotic

Firefly Orthoses Website: An Education and Research Portal

At Firefly Orthoses we are all about crafting custom-made orthoses, but the world of foot orthoses never stands still (sorry for the pun). Research is continually published, building and progressing the field and our website acts as a portal to access a plethora of valuable and relevant information relating to orthotic therapy for the Podiatric professional. Indeed, Firefly has been directly involved in some important research projects including the A-Footprint project. This initiative led by Glasgow Caledonian University to develop cost-effective foot/ankle and foot orthoses to treat common disabling conditions, personalised for form and function. The A-Footprint research project explored the production of foot orthoses using 3D laser sintering techniques, techniques which today are used by companies such as SOLS in their 3D printed orthoses.

Firefly Website: A Research Resource

Firefly’s website is home to an ever-growing list of research articles. This is an excellent resource for both Podiatry students and professionals who are interested in achieving a deeper understanding of custom made ankle and foot orthoses. The research articles cover a broad range of relevant topics such as gait and posture, the use of technology in prescribing orthoses, to additive manufacturing. Many of the articles listed are linked to the publisher’s website. In some instances, the research article is linked to a full PDF version of the text.

Podiatric Biomechanic Symposia

In recent years, Firefly Orthoses has led the way in the dissemination of Podiatric knowledge. In 2008, 2011 and 2014 we hosted the Podiatric Biomechanic Symposium. These events brought the brightest and most progressive minds together to explore and discuss their work and developments in the field of Podiatric Biomechanic Therapy. Keynote speakers at the events included Trevor Prior, Douglas Richie and Tim E. Kilmartin. Our website functions as a portal, offering free access to the presentations from all three Symposia. We encourage you to access this valuable information and make the most of it.

How can we help?

If there is any aspect of prescribing foot orthoses you wish to find out more about, please don’t hesitate to contact us to request information. Firefly Orthoses can be contacted at [email protected], or alternatively you can make contact with us via Twitter @FireflyOrthoses. We will be delighted to provide you with the most up-to-date information available. At Firefly Orthoses we recognise the power in knowledge. We provide our customers with free technical support that ensures they achieve the best clinical outcomes. You can become a Firefly customer by visiting our New Customer page.

Georgie Hermitage breaks her own 400m World Record

Firefly Orthoses wearer, Georgie Hermitage bettered her T37 400-metre World Record at the IPC Grand Prix in London recently. 26 year-old Georgie beat her previous World Record set in Berlin on June 20th, crossing the line in London’s Olympic Stadium in a time of one minute 2.48 seconds. Her new time shaved .22 of a second of her previous record. Georgie competes in the T37 400m event. The International Paralympic Committee allocates the T37 classification for athletes with athetosis, ataxi and/or hypertonia. She is also a member of the women’s 4X100m GB squad.

Georgie has Cerebral Palsy, but the condition is only evident on close inspection. She is a patient of Katrina Waller, Clinical Lead and Podiatrist at Compleet Feet in Sussex. On her clinic blog, Katrina outlines that following a biomechanical assessment she could see how the condition was effecting Georgie’s running. Katrina outlines how Cerebral Palsy impacts Georgie’s movement; ‘… there being some muscle weakness and reduced muscle build on the left, but this does not slow her down or affect the quality of her life, far from it. She has found she can run better than many athletes’.

As her Podiatrist, Katrina identified a ‘tightness of her tendo-achilles and calf muscles meaning she has a functional shorter leg, with the foot tending to roll inwards. What we term over-pronation. Georgie is having to work the left lower limb hard to compensate, and the right side takes a lot of the strain. Not an ideal situation if you are trying to run super efficiently’. Georgie wears prescription Firefly orthoses in her running shoes. The orthoses are custom-designed to support Georgie’s foot to prevent over-pronatory stress. Katrina describes the benefit of Firefly Orthoses, ‘they allow Georgie run like an athlete, keep up with the high training demands placed upon her, helping her to secure her place to run in the 2016 Rio Paralympics’. You can read Katrina’s full blog post on Georgie here. Georgie intends to represent Great Britain at the IPC European Championships in Swansea in August as she builds towards her goal of competing for a medal at Rio 2016. All at Firefly Orthoses are wishing Georgie the best of luck and continued success!

2015 Podopaediatrics SIG Conference, Birmingham

Firefly’s Technical Manager Ines Labberte will be attending this year’s Podopaediatrics SIG Conference. The single-day conference is taking place on Friday July 3rd and will focus on the topic of Hypermobility, a relatively commonly issue encountered by the Podiatric profession when treating children. Hosted in Birmingham’s Holiday Inn city centre hotel, the conference will explore diagnosis, effects, and body wide impacts of hypermobility including Podiatric pain-management and strategies. Make sure to stop by Firefly’s stand at the conference and say hello to Ines. She’ll be happy to tell you how Podiatrists across the UK and Ireland choose Firefly Orthoses to treat flattened arches, frequently associated with hypermobility. See Firefly’s range of orthoses and contact us for further information about prescribing devices or placing orders.

3D Printed Orthoses – The Firefly & SOLS Partnership

Firefly have partnered with SOLS, the company whose 3D printed orthoses are challenging traditional approaches to the design and manufacture of orthotic devices. Operating out of New York, SOLS’ disruptive technology is seeking to positively influence how podiatrists interact with their patients by embracing enhancements in technology. news-3d-printed-sols Just three photos [arch, heel and ankle] captured using Apple’s iPhone or iPad is all that’s required to accurately map the key anatomical features of an individual’s unique foot and gait. Speed, efficiency and most importantly accuracy are at the heart of this process.

SOLS arch capture with iPad at Firefly

Firefly Podiatrist captures planter foot anatomy using SOLS iPad app

SOLS heel capture with iPad at Firefly

Firefly Podiatrist captures heel aspect using SOLS iPad app

SOLS ankle capture with iPad at Firefly

Firefly Podiatrist captures arch aspect using SOLS iPad app

In keeping with traditional expectations, patient specifications and requirements are then applied to the digital model. From here it is customised for shoe type, patient weight, activity and foot flexibility. The customised digital model is then closely inspected by biomechanical and 3D engineers. The next stage sees the model become reality.  Laser sintered from aerospace grade Nylon plastic, the device is 3D printed printed to an accuracy of 5 microns. As an industry leader Firefly is constantly seeking new opportunities and practices to support the Podiatric profession.  Firefly’s partnership with SOLS is another example of how we are progressing Podiatry.  By engaging accessible technologies such as Apple’s iPhone and iPad, combining these with 3D modeling and printing software, we are delivering the future of Podiatry today. Register your interest in SOLS, email [email protected] today.

The Physio Matters Podcast featuring Podiatrist Ian Griffiths

We’d like to draw your attention to the excellent Physio Matters Podcasts.  The most recent edition of this accessible and informative series focuses on Podiatry and is titled The Myth of Over-Pronation. Presented by Jack Chews of Chews Health, the series explores musculoskeletal and sports medicine for those working in physiotherapy, sports therapy, sports rehabilitation, medicine and features guests who specialise in a range of related fields. We’re delighted to announce Firefly Orthoses have sponsored the most recent edition of the podcast (session 18) which features an extensive interview with consultant sports podiatrist Ian Griffiths. Ian discusses, amongst other topics:

  • the challenges of defining over pronation and the associated models of assessment and treatment,
  • the parameters of normality/normalising foot posture,
  • the challenges of applying the Foot Posture Index,
  • The ‘Old 3 Step Model’ Vs the Tissue Stress Approach,
  • the role of orthoses in kinetics and load management,
  • how to appraoch the patient who believes pronation is a causative factor in their problem?
  • If not pronation then what should we use instead? Danny Dyer’s Chocolate Homunculus.

The podcast is available to listen to from the following sources. ITunes: Chews Health: YouTube: We hope you enjoy.

Firefly Orthoses is Going Social

We’re embracing social media here at Firefly and we’d encourage you to ‘follow’, ‘like’ and ‘share’ with us across our various platforms. We’ll be posting news regularly on our website about our products, events and related topics. You can interact with us, posting questions, queries and comments about Firefly and our services to our various social media accounts. We’re always eager to hear your opinions. We’ll endeavour to provide you with informative content, relevant to the Podiatric profession. We’re always exploring new technologies and techniques that will enhance your ability to meet the needs of your patients. See our recent news item where Firefly’s medical director Martin Mc Geough demonstrated Sharp Shape’s 3D scanning technology in a clinic environment. Follow the links below to view our social media accounts. Firefly Orthoses on Facebook Firefly Orthoses on LinkedIn Firefly on Twitter 

Podiatric 3D Scanning Demonstration

We’ve packaged two videos of Firefly’s medical director Martin Mc Geough demonstrating how accessible and hassle-free scanning equipment is to use in the podiatry clinic environment. Firefly supply and lease both vertical and horizontal 3D scanners to practitioners across the UK and Ireland. We provide full training in the use of the technology and in the processing of the resulting data. Register your interest in ordering your scanner with Firefly today by emailing [email protected] or by phone on 00353 71 914 94 94.