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Trouble with our feet can be trouble, indeed. Foot problems can make our whole bodies ache. In many cases, if left untreated, these problems can be disabling. James A. Ryan, a doctor of chiropody in Toronto, Ontario, has devoted his professional career to helping people overcome foot problems. Chiropody is the medical specialty devoted to foot care and is more commonly called podiatry in the United States.

CNC machining is now helping Dr. Ryan provide this care and healing with more efficiency. About six months ago, he installed a Haas TM1 toolroom mill to computerize the production of custom orthotics—the rigid inserts that slide into footwear to compensate for and correct defects in the natural structure of a patient’s foot and ankle. In the past, Dr. Ryan produced these inserts by hand, one by one, for each patient. Today, he uses Delcam’s PowerShape CAD software to design these inserts and PowerMill (also by Delcam) to create the CNC programs that run the toolroom mill. The inserts are milled from hard plastic or other materials and feature contours that match those of foot. In addition to orthotics, Dr. Ryan also uses the CAD/CAM software to produce CNC programs for machining shoe lasts, the solid form around which a shoe is molded. He needs these lasts to construct entire orthopedic shoes.

Dr. Ryan has been making custom orthotic inserts and customized orthopedic shoes for many years. He prides himself on being a very competent craftsman. More importantly, he is a skilled and conscientious diagnostician. In other words, he is very good at studying and discerning the reasons why his patients are having trouble with their feet. He uses a variety of diagnostic tools to gather data about the shapes of their feet, their ranges of motion and the ways they walk. These tools include laser scanners and digitizers.

When he is designing an orthotic appliance for his patients, he takes all of this data into account. Formerly, he relied on his skill and experience to do this design work effectively. Then he molded and finished each insert by hand—a time-consuming and meticulous process.

Now, by importing digital data into his CAD software, he gets a head start on the design phase. The software helps him apply his skill and experience, so he hasn’t relinquished any of the craftsmanship and artistry that made his orthotics particularly effective with his patients. Programming the mill with PowerMill lends itself equally well to Dr. Ryan’s efforts to create the exact geometry that will best correct defects in the shape and function of the foot.

Interestingly, Dr. Ryan sees his work with the CAD and CAM software as an extension of his treatment of each patient. “It’s part of the creative process that becomes part of the healing process,” he says. The automation provided by CAD/CAM and CNC machining has enabled him to provide orthotics much more responsively to his patients’ needs. This means that patients can get on the path to recovery sooner and find relief from pain more quickly.

Dr. Ryan uses the same CAD/CAM software to design and machine custom shoe lasts. These are milled on the TM1. A rotary table provides the fourth axis for milling the complete last in one setup. However, producing the last is only one step in the process of constructing a custom orthopedic shoe. The panels of leather and other pieces of material that are formed around the last to make the actual shoe have to be designed, cut out and assembled.

Dr. Ryan is taking steps (no pun intended) to relieve the burden of doing most of this work by hand. Ultimately, he has a vision for automating much of this process. His hope is to thereby reduce the time and cost associated with producing custom-made shoes. One day, he believes that it will be practical and affordable for almost everyone who needs such shoes to obtain them. He sees “prescription” footwear becoming as routine as prescription eyeglasses or dentures.

For now, Dr. Ryan uses certain modules of the Crispin software package for the footwear industry. (Delcam acquired this software 2 years ago. It complements the other design and manufacturing software in its portfolio.) He uses this software to lay out the shoe panels needed to build a shoe. These panels are the leather pieces that form the upper shell of the shoe, and they must fit without bunching or puckering when assembled. The Crispin software automatically generates the 2D patterns based on the 3D, digital model of the foot. These patterns are then plotted directly on the leather to be cut out.

“I still cut the leather by hand, but it’s a perfect application for a CNC waterjet cutter,” Dr. Ryan says. Acquiring this technology is his next step.

Attending the Technical Summit was an eye-opening experience for Dr. Ryan, he says. Because the event was hosted at Methods Machine Tools’ tech center and showroom in Sudbury, Massachusetts, he had the chance to see many types of CNC machine tools and automated manufacturing technology. These included new models of Matsuura machining centers and Nakamura multitasking centers, for example.

“It was inspiring,” he says. “I could see how a medical machining operation could serve not only the need for custom orthotics and footwear, but a whole range of critical, customized medical applications.”

What he has in mind is not the same as a job shop, however. Rather, he sees trained medical professionals such as himself being able to treat patients on a new level, but with the same personal attention and care that he strives for in his own practice. From his perspective, CAD/CAM and CNC machining are not merely manufacturing technologies but a new addition to the array of medical arts. “I want to see the patients I treat to be whole again. Using my creativity to do this is personally very rewarding,” he says. Enhancing that creativity with CAD/CAM and CNC machining is a great stride forward.