HOW TO DISPENSE ORTHOTICS

STEP 1. CHOOSE THE RIGHT ORTHOTIC
FOR YOUR PATIENT

DENSITY AND STYLE

First, determine the density required by your patient. VASYLI orthotics are available in three different densities—low (green), medium (blue) and high (red)—to provide various levels of biomechanical control. Generally, a blue orthotic suffices. Patients in need of more control will require a red and others a softer green orthotic.

Second, choose a style of orthotic that fits your patient's footwear. VASYLI orthotics come in a full-length style for athletic footwear and boots, ¾-length for regular footwear, Slimfit for high-heeled fashion shoes, and Easyfit for narrow-fitting shoes like loafers and cleats.

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*Patient weight guide only

PRODUCT SELECTION MATRIX

Use this matrix to help find the perfect orthotic based on condition, type of footwear, and activity.

QUICK GUIDE

  • Always replace a full-length existing insert with the same style.

  • The Slimfit works very well in ladies’ fashion or low-profile footwear.

  • The heel piece suits hard-to-fit dress footwear.

  • The Easyfit suits both narrow (particularly children’s) and also wider-fitting shoes due to the lateral cutaway.

STEP 2. FIT THE ORTHOTIC DEVICE

  1. First, check the shoes into which you will fit the orthotic. If the shoe is too badly worn, it must be replaced. If the shoe has some form of thick lining or arch cushion, remove it from the shoe.

  2. Now pick a size of device that closely fits the contours of the foot. You do this by size comparison to the shoe fit (shoe size is only a guide as the arch lengths can be different in the same size foot). For greater accuracy, simply place the orthotic on the foot and see how it compares to the natural contours, making sure the distal edge of the orthotic finishes 5-10 mm behind the bisection of the 1st MPJ as per the diagrams shown.

  3. Fit the device to the extreme back of the shoe and ask the patient to walk around the room for a few steps. If there is no irritation, then allow the patient to wear the orthotic home.

  4. If heat molding is required, see Step 3 (video).

  5. It may take a few days for the patient's feet to become accustomed to the orthotic. If any discomfort occurs, have the patient remove them for one or two hours, then replace them and continue to remove and replace them until comfortable.

  6. If the patient is still suffering from initial symptoms after a typical break-in period of 3 to 5 days, you may need to reassess the density of the orthotic and adjust your orthotic prescription. Excessive arch intolerance usually indicates a lack of rearfoot control and additional rearfoot posting may be required.

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STEP 3. HEAT MOLD THE VASYLI ORTHOTIC

  1. After determining the correct density, model, and size, check the patient's footwear and remove any existing innersoles that may interfere with fitting.

  2. Place the orthotic (base up) on a heat-resistant surface. Apply the heat in a waving motion between the 2 Sorbon inserts (Fig 1). Do not concentrate the heat in one spot or along the arch profile as this may damage the product. When the raised lettering of the thermal indicator and the STC disappear, this indicates a molding temperature has been reached (approx. 194F / 90C).

  3. With the patient sitting, place the heated orthotic into one shoe. For maximum comfort, ensure the patient is wearing a sock or stocking.

  4. Place the foot into the shoe. Palpate and hold the foot in the neutral position, using the talonavicular technique (Fig 2). Ask the patient to stand with weight evenly distributed on both feet while maintaining the neutral position.

  5. Palpate the shoe, molding up into the arch area and around the heel cup. Press down in the forefoot to mold to the last of the shoe.

  6. Ask the patient to sit, controlling the neutral position until fully seated. Remove the orthotic from the patient's shoe and allow it to cool for 5 minutes.

  7. Repeat the process for the other foot.

  8. Check for correct prescription and add VASYLI orthotic additions or wedges, if necessary.

Talonavicular Technique

To place the subtalar joint into neutral:

  1. Place your thumb and index finger on either side of the talonavicular joint and palpate.

  2. When the joint feels equal or congruent, this represents a neutral alignment at the STJ. (i.e., no pronation or supination).

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Fig. 1

Fig. 1

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Fig. 2

Fig. 2