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By: Steven Montes

“Custom Made Foot Orthotics”
By: Steven Montes, BME
I am the owner of Montes Orthopedic in Tucson, Arizona. I have been making custom made foot orthotics for over twenty years. I learned this science from a man who was German. He taught me how to make 8 different types of foot orthotics. But more importantly he taught me how to adjust the appliances for the many different conditions of the feet.
I have learned these trade secrets, that would have lost, this intense type of education is what has made me a leader and a scientist in this field of Bio-Mechanics.
It is important to note that the German people were the first to developed the Bio-mechanical science that we see around the world today for many foot disorders. For hundreds of years the German people had been using this technology for almost every foot disorder known to man.
During World War II, when the United States and allied forces took over Germany. The United States together with other countries seized all the developed technological treasures that Germany had developed over hundreds of years. Among the many treasures taken were the design of the jet engine, Atom Bomb, and many other technologies that we still claim as our own. Among these treasures was the science of Bio-mechanics and the use of foot products to eliminate almost every foot disorder of the feet.
It had been well established for hundreds of years that a properly made foot appliance, is an alternative to most foot surgeries. However the decline in success of a foot appliance working to alleviate discomfort from the feet is greatly compromised due to our dependancy of sub-quality shoes being imported from third world countries.
This single factor has been attributed to the large increase in foot problems seen today around the world, where sub-quality footwear is available in abundance in every large department store around the world.
Where we as a people, have traded quality for quantity, we have overlooked the fact that now we as a people will un-doughtily will have to pay more in health care costs due to the increase of foot surgeries being preformed because of the decrease of a functional foot appliance in a sub-quality shoe.
Currently everyone in the world makes custom made foot orthotics the same way, from a casting of the feet. From this casting adjustments are made into the positive of the cast so the adjustments will appear on the finished product made of plastic, rohadur, polypropylene, leather reinforced with fiberglass and neoprene rubber, stainless steel, thermal made materials like pealight & cork, felt and latex. I have even made foot orthotics out of thin laminated pieces of different type woods. All of which require a great deal of knowledge and equipment to manufacture.
Everyone still holds to the three different positions in casting the feet. The first being the Zero weight bearing position, where the feet are hanging over a chair or stool. The second being a Semi-weight bearing where the feet are placed into wet plaster or soft foam while the person is
sitting. The last position is done while the person is standing with their full weight into wet plaster or soft foam. After these molds are made, plaster is poured into the negatives to create a positive. After several days of hardening the negative is broken away from the positive. After several more days of the positive hardening. It ready to be treated or worked to include the necessary adjustments for the patients condition so that these adjustments will form into the plastic at the proper position of the problem.

Like everyone else around the world I made hard and semi-hard foot orthotics the same way. What my research in this area had concluded after being in my own business for several years, is that from prolonged use of the hard orthotics, I began to document the side affects from the use of hard orthotics and injury to people from being in these products for many years at a time. What I had discovered is that prolonged use of these products caused in some cases was a neuropathy and atrophying to the tendons and ligaments in the feet. I had also discovered that the natural fatty tissue pad in the feet had diminished form the use of hard orthotics over several years of use.
From this data of research I was able to develop the Insta-Mold Foot Orthotic System using different densities of orthopedic rubber shipped to the United States from Germany. I have been able to success and total eliminates the need for a casting of the feet. I have developed a custom made foot orthotic that forms to the feet while the feet are in motion. As the patient uses the product, they will develop a walking pattern onto the orthotic which is more accurate than a casting of the feet.
What makes this rubber so special is that the Germans have engineered the orthopedic rubber to activate at about 3 degrees below the body temperature and each layer has a different density. My under standing is that the rubber that they produced has a thermal activity that occurs and can change the density of the rubber to produce a material that works well with the body temperature. In other word as you wear this product the material will begin to active at about 3 degrees below the body temperature, which translates to the longer you are on your feet the more comfortable and softer the material becomes.
What causes this process to accrue is that the oil being used comes in different viscosities for example there is 10w to 40w oil, that we use in our cars or 10w to 30w oil. To explain about different viscosities oil and there affects on rubber, if you can recall as a child playing on the playground at school, on a cold day the ball you were playing with was hard, and on a hot day the ball would be soft. Well this is the affects of different viscosities of oil and how they play an important part in the use of rubber as a orthopedic material.
Also because of the flexibly of the orthotic I have been able to develop adjustments program that correct the way a person walks, and in some cases I have been able to throw the patient into over correction when warranted, by adding small adjustments to the rubber product over a period of time I am able to apply these adjustments much like a dentist that tightens teeth on braces. This process allows the patient to get used to each adjustment gradually over period of time, rather that the traditional products that tend to be over corrective or under correct making the appliance unbearable to use when first received.
In addition I have created and added the service part of this business back to this industry.
Where as to day if you have ever had a need for foot orthotics you will know that when you have picked up a pair of appliances most places give you the orthotic and thank you for your business whether you are satisfied or not.
It is true that most orthotics being made today fail due to the inability to achieve or establish forefoot control to the feet. Since all custom foot orthotics are only able to offer rear-foot control.
There has been no research done to offer fore-foot control back to the feet, except with the advancement in design in regards to the big athletic shoe companies and their foot ware. They are the only ones so far that have shown promise in the area of forefoot control .
Having realized that if I was going to be successful in creating advanced product that I would have to also achieve forefoot control. So early in the development of my products I established true forefoot control by placing a specially designed wedge material on the outside lateral aspects of the shoe, and because this wedged material is very successful in that it allows me to add more adjustments to the medial area of the orthotic while positioning the knees into a neutral position which in turn will re-balancing the shoes.
Since it is a medical fact that 90% of the population in the world has one leg shorter than the other, I use a heel lift to add to the success of my work. To me having one leg shorter than the other is responsible for a majority of the hip and knee transplants that occur in the US and are singularly responsible for most lower and upper back problems in the world.
With the multiple adjustments for correction I have been able to advise dentists on how important it is to use a custom made foot orthotic in relation to patients with TMJ problems. I have developed the product so that patients with TMJ can get a more effective response to the treatment being used with the mouth appliance. How this works is that every time I add an adjustment to the foot appliance, I have to calculate the amount of control that I have posted to the foot product. Example: if I post the patients feet products 2 or 3 degrees, using valgus or varus control I have to inform their doctor of these changes so the physician can re-adjust their mouth appliance to the periodical adjustments as I make them to their foot appliances. This process offers a higher success rate to the patient with TMJ problems. Also I have noticed that this area of control can speed up the healing process, using the mouth appliance and foot appliance together.
An overview of my business is that with the crude equipment that I have invented, I can manufacture up to 60 pairs of my pre-made foot orthotic that are self molding, by myself in one day. One size will fit all shoes and it only takes me 15-20 minuets to fit a person with a pair of my foot orthotics, adjustments take me 5-10 minuets to apply to the product or shoes. So with the step by step adjustments that I add periodically to the orthotics I can fine tune the product to the needs of the patient based on their comfort. In regards to children with Pres-Planis or flat feet, I have the ability to through their feet into over correction with the multiple adjustments I add periodically. After several years of use at this stage of correction, I have found that permeant development of the longitudinal arch occurs.
Also with the specially designed wedge that is placed on the outside lateral aspects of the shoes I have been able to established forefoot control.
Finally with the heel lift that I provide for the discrepancy in leg length, I can provide a truly successful service that makes the Insta-Mold Foot Orthotic System truly an advancement in the science of Bio-Mechanics.
This product makes all hard foot orthotics obsolete and non-effective, except for one medical condition which is to the case of fractures in bones or joints to the feet, and you don’t want the flexibility of the shoe to hamper the healing process. The patient should only be in the most ridged type of orthotic available, which is the rohadur plastic foot orthotic, and for only 2 years at the most. The time that it takes for most bone fractures to heal in the foot.

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