When you walk into the basement of Health Sciences Centre’s (HSC) Materials Handling Building on 59 Pearl Street, it might feel like you’ve taken a wrong turn.

You haven’t.

Behind those doors, you’ll find a space that looks more like a workshop or art studio than a hospital department. Plaster models of legs and feet fill shelves and workbenches. Hand tools and power tools sit alongside pieces of braces and other devices being shaped and adjusted. Plastic is heated and moulded, while 3D technology helps turn patient measurements into custom models.

This is where the HSC Rehabilitation Engineering team provides orthotics care, making custom braces and other devices designed to support, protect, and improve how a part of the body functions. The prosthetics they design replace missing body parts to help patients continue on their healing journey.

The third Annual National Orthotics and Prosthetics Day is on September 19 and is a great opportunity to highlight this service that is available right at the hospital – and the specialized expertise behind it.

HSC’s Orthotics team has grown significantly in recent years and now includes four certified orthotists and a resident, supported by four orthotic technicians and a shoe shop technician.

That growth has expanded the department’s outpatient capacity while strengthening its ability to respond to HSC inpatients, including complex and urgent cases. The department is also accepting new outpatient referrals.

What makes the service particularly valuable at HSC is what happens under one roof: patients can be assessed by clinicians, have custom devices made by the on-site technical team, and continue working with the orthotics team as their needs change throughout recovery.

The department provides both inpatient and outpatient orthotics care, working closely with physiotherapists, occupational therapists, physicians, surgeons, and other health professionals involved in a patient’s care.

For orthotists at HSC, regular access to other Allied Health professionals is invaluable.

“I am constantly reaching out to people and getting their perspective on how things are going,” said Ashleigh Milani, a certified orthotist at HSC.

For Patrick Smith, another certified orthotist at HSC, that can mean meeting a patient near the beginning of a difficult hospital stay and eventually seeing that same person walking in the Rehabilitation Hospital gym.

“I’ve had a couple of patients where you see them when they first come in, and they’ve had extended stays, and you see them when they’re over in the rehab centre, in the big gym, with physiotherapists, and you watch them progress,” Smith said. “And I think that’s one of the more rewarding parts of the job.”

The devices the team provides can range from relatively straightforward supports to highly customized orthoses for patients with complex needs.

HSC combines modern 3D scanning and carving technology with equipment that has been serving the department for decades. One example is the Plastivac, a machine dating back to the 1970s that helps technicians mould large pieces of heated plastic over a model.

“Combining this 50-plus-year-old machine with the modernness of 3D scanning and 3D carving of our positive models is quite a unique workflow across the country,” Milani said.

That combination of technology, equipment, and technical expertise has allowed HSC to build what Milani says is one of the department’s shining stars: its turnaround time for custom spinal braces.

For some patients with spinal fractures, the team can measure them for a custom thoracic lumbar sacral orthosis (TLSO) in the morning and have them fitted with the finished brace that same afternoon.

“I don’t really know any other facility or many other facilities in Canada that can measure a patient in the morning and have them fitted with that custom back brace later that afternoon,” Milani said.

When Milani shared HSC’s approach with orthotics and prosthetics professionals from across Canada at a recent national conference, the turnaround caught their attention.

“They were all very impressed by our turnaround times on some of these braces,” she said. “Some of them were quite shocked to hear that we were able to get it done in such a short amount of time.”

But the real value of that speed isn’t found in the workshop. It’s upstairs, with the patient waiting to move forward in their recovery.

“By cutting down the amount of time they have to wait to get this brace, that’s less time they’re spending waiting in a hospital bed,” Milani added. “Oftentimes, it’s reducing their stay by several nights.”

With their spine supported, patients can begin safely standing, walking, and working with their care teams sooner.

“To begin working towards some form of progress, whether that’s just working on standing with some stability or even walking again quite soon after a fracture like that, goes a long way throughout their whole rehab process,” she said.

Making something quickly, however, isn’t enough. A custom orthosis needs to provide the right support for an individual patient, and it needs to be something they can realistically use.

“The biggest thing with a custom one is that we’re trying to make it to the patient so that it fits them really well,” Smith said.

That fit becomes especially important when someone is relearning how to move following an injury or neurological event. Smith describes it as a matter of trust.

“You have to create something that, when they put it on, they trust that it’s going to do the job that you both want it to. If they don’t have that trust, you can lose the engagement of the patient faster,” he said. “They have two things they have to trust: they have to trust themselves, and they have to trust the device. If you can get them to trust the device, then they can learn to trust themselves.”

For many custom braces, patients can also choose colours and designs to make the device more personal. One patient gave Milani a list of flowers representing her grandchildren’s birth months, which became a bouquet incorporated into her brace.

For children and teenagers who may need to wear a brace for most of the day, those details matter.

“We try to incorporate elements into the braces so that when they see the braces, it just becomes a little bit more of them than it is this thing that they have to wear,” Milani said.

And while patients may wonder whether they are in the right place when they first arrive at the HSC Rehabilitation Engineering department, they soon learn that what happens in that space can have an impact far beyond it.

“I give them a device that almost always immediately helps reduce their pain and increases their mobility,” Milani added. “They know that they’re one step closer to the next goalpost.”

Smith also sees results when patients reach milestones that may have seemed far off when they first arrived at HSC.

“They weren’t walking before,” he said. “And now they’re walking.”

For a team whose work is about helping people move forward, that’s what all the technology, craftsmanship, and expertise ultimately comes down to.

– By Ligia Braidotti

Learn more from OPC

Orthotics Prosthetics Canada (OPC) is hosting a free virtual event:

• October 9, 2026, (11 a.m. Central): Virtual Panel discussion on “Improving Outcomes through Collaborative Decision Making”

OPC is also encouraging video submissions for stories from patients and Allied Health care providers on how their orthotic or prosthetic devices have impacted their lives.