240 Richmond Street, London, Ontario | Phone: 519-850-4721 | Fax: (519) 850-1816

Lower Extremity

Custom Foot Orthosis

Custom foot orthoses (also called orthotics) are used in individuals to help support and align the foot-ankle complex, redistribute the forces appropriately across the entire foot and/or reduce pain.  Along with aligning the structures of the foot, foot orthotics reduce muscle fatigue and helps promote efficient muscle performance during gait. 

At Custom Orthotics of London Inc. an individual’s gait and biomechanical alignment is assessed to determine the orthotic design best suited for the individual’s needs. We fabricate inhouse ¾ length, full length, diabetic, extra soft, rigid and semi rigid foot orthotics.

This device may be suitable for individuals with:

  • Plantar fasciitis
  • Rheumatoid arthritis
  • Osteoarthritis
  • Heel pain
  • Metatarsalgia
  • Sever’s Disease
  • Diabetes
  • Overpronation
  • Hallux Rigidus
  • Bone Spurs

Supramalleolar Orthosis (SMO)

This orthosis provides hindfoot support by including the ankles.  These orthoses fit inside the shoe and help with medial lateral control of the ankle when walking.  These devices are preferred for individuals who severely pronate, have low tone (hypotonia) or need increased support to help stand and walk that a foot orthosis cannot provide.

We can provide custom inhouse fabricated SMOs or off the shelf versions that are sized according to shoe size and not custom fabricated, such as:

  • Leapfrogs
  • DAFOs – Kangaroos

Ankle Foot Orthosis (AFO)

Ankle-foot orthoses (AFOs) are designed to protect and support the foot and ankle in a functional position, enhance walking, improve balance or prevent muscle contractures. They are often used to help support or align the foot and ankle. These braces start below the knee, extending past the ankle and under the foot.  There are various types of AFOs and will be determined by the orthotist once a comprehensive evaluation has been completed.  Strength of the musculature of the lower extremity, range of motion, weight bearing abilities and patient goals are all taken into effect when choosing the type of AFO.

Some of the AFO designs we commonly fabricate include;

  • Rigid
  • Articulated
  • Energy Storage & Return
  • Nighttime Stretching
  • Charcot Restraint Orthotic Walker (CROW) & Bivalve/Clamshell
  • Patellar Tendon Bearing (PTB)
  • Supramalleolar Orthosis (SMO)

Knee Orthosis (KO)

Commonly referred to as knee braces. KOs provide increased joint stability, pain relief, and ultimately allow return-to-work or recreational activities. Types of KOs that we are able to provide include: custom knee braces, post-operative braces, osteoarthritic unloaders, ACL and MCL braces, neoprene sleeves, patella stabilizers, and knee immobilizers. 

This device may be prescribed to an individual with;

  • Osteoarthritis
  • Ligamentous Injury or Instability
  • Athletic Trauma
  • Post surgery

Knee Ankle Foot Othosis (KAFO)

A KAFO is a custom made device that encompasses the knee ankle and foot, that is used to control instabilities that an ankle foot orthoses (AFO) cannot control.  A KAFO can be fabricated out of thermoplastic or metal and leather.  

Thermoplastic KAFOs are molded directly to a a cast of the leg.  This option is lighter and more cosmetically appealing then the conventional KAFO.  Conventional KAFOs are fabricated from a cast or tracing of the leg. These devices are made with metal and leather and attach directly to the shoe. 

This device may be suitable for individuals with:

  • Poliomyelitis
  • Spinal cord injury
  • Peripheral nerve injury
  • Severe knee osteoarthritis
  • Multiple Sclerosis (MS)
  • Trauma

Hip Knee Ankle Foot Orthosis (HKAFO)
Reciprocating Gait Orthosis (RGO)

An HKAFO limits hip and knee movement. It is beneficial for individuals with stability issues, weakness and/or paralysis.  It also reduces or minimizes the risk of the hip dislocating or moving out of its proper position. 

An RGO is a type of orthosis which consists of bilateral KAFOs with a combination of locking knee joints, hip joints, and a custom-molded pelvic girdle and a thoracic extension.  When the RGO is engaged, the hip joints are coupled with cables to prevent bilateral hip flexion simultaneously. Hip extension on one side coupling hip flexion on the other side through the cables produces the characteristic reciprocal walking gait pattern. This type of orthosis requires physical therapy in order to optimizing the function and receive the most benefit. They must also have good head and trunk control in order to operate this device.

This device is beneficial for individuals with:

  • Spina bifida
  • Spinal cord injury
  • Other pathologies who requires the help of standing and walking


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