The Founders of STS Company: Richard Stess, DPM and Peter Graf, DPM

They had been in both private Podiatric Medical practice in northern California and at the Veterans Administration Medical Center San Francisco for over 35 years but these are not the only ties that hold Dr. Peter Graf and Richard Stess together. Both their fathers were podiatrists, they had received an 8 year research grant from the Department of Rehabilitation Research and Development grant of the VA to develop a new diabetic shoe, they each held academic appointments at the University of California School of Medicine and they both were awarded 5 patents by the United States Patent office but they were looking for other challenges after deciding to retire from clinical practice. They both decided to retire. Sort of….

Being in private practice and at the Veterans Affairs Medical Center they became very proficient at casting for custom shoes as well as AFO's and understood that the effectiveness of these devices was largely determined on the accuracy of the negative cast. Plaster of Paris, although accurate, was becoming a liability because of the mess and time required to make an accurate model. It would take so long to take a good cast and then clean up after that they were forced to reduce the number of patients that they could manage during a day. This prompted their inquisitive nature. After many trials and failures, their efforts led to the development along with 3M Company of a synthetic tubular sock impregnated with water curable resins. It was their intention to develop a casting material for custom footwear that would not require the time nor mess of plaster and allow for removal without a cast saw. After being awarded their first patent, they established the STS Company in 1995.

After attending their first AAOP meeting in San Francisco the two learned that the casting sock was also ideal for obtaining accurate casts for AFO's as long as the casting sock could be molded to the knee. Having no experience in manufacturing they initiated the business by outsourcing all the production. The target customers were Pedorthists, Orthotists, Physical Therapists and Podiatrists whom collectively accounted for the majority of custom shoes and AFO's in the United States. Surprisingly however it was the German market that initially identified the usefulness of the casting products for custom footwear. The casting sock was embraced by German shoemakers and orthotists when it was presented at the Ortho Reha meeting in Berlin, Germany.

The American market however seemed to lag behind. "We were fighting the high cost of manufacturing vs. the benefits in the United States market. It was hard to overcome custom and habit" says Graf. Despite the preference of custom shoe makers for the STS sock, it seemed as if practitioners would not quickly shed the choice of fiberglass wrap despite it's inaccuracies for detail nor plaster with it's time consumption and mess. "This was a bit disappointing to us" said Stess but "we were not to be deterred as we have always been tenacious in something that we strongly believe in". Slowly the American custom shoe companies embraced the casting sock as it became more widely publicized by attending trade shows and advertising in professional journals. Some issues however involving the tubular fiberglass sock for custom shoes was a hard lesson for the two former practitioners. They soon learned that clinicians all too often were not using the product correctly nor reading the directions completely. As a result, some of what the two were learning after being in the market place for a few years, was that they had to refine and expand some of the casting products using some of the same techniques that they had been learning. This led to the development of a new polyester fitted casting socks of different lengths and widths impregnated with a similar type of a polyurethane water curable resin. The two developed various casting socks for specific lower extremity uses such as custom shoes, AFO's, supra malleolar AFO's, Knee braces. Along the way and by attending many trade shows they were learning new techniques for the application and removal of the casting socks from other practitioners. Practitioners embraced these new methods as the products became more widely distributed. Most of the O and P distributors gradually brought the STS casting socks into their product catalogues so that they were now more widely available.

One product that Graf and Stess had conceived of in 2001 was a casting sock for custom foot orthotic devices. The two "retired" podiatrist believed that in order to achieve a successful out come regarding functional control of the foot that a more accurate cast needed to be obtained. "We know that neither foot ink prints, foam boxes nor computerized foot plate systems could obtain the proper foot impression necessary to control the many planes of motion of the foot", said Dr. Stess. In order to develop a casting sock for custom foot orthotic devices they felt that they needed a water curable resin that was fast enough without creating excessive exothermic reaction impregnated onto a slipper sock. In their opinion plaster took too long to set and created too much of a mess in today's modern practices. The search proved more difficult and more time consuming then they had anticipated but were successful in finding the correct resin that appeared to have the ideal characteristics almost a year later. They developed a 2 minutes set resin and next they had to devise a method for impregnating the resin onto a newly designed slipper sock that would conform to the plantar surface of the foot. After more time, trials and failures they did in fact create a method that would coat the polyester socks consistently and evenly. The two doctors out sourced their manufacturing for a few years after receiving a new patent and then brought the slipper sock to the market in 2003. They recently opened their own manufacturing facility in 2007 in Sonoma California in order to insure high quality coating and to maintain costs as much as possible. Polyurethane resins have been increasing as petroleum costs have increased and in order to attempt to control the cost of the end product the STS Company has undertaken the majority of it's own manufacturing.

Because of it's new manufacturing capabilities the STS company hopes to be able to develop new products for the industry as well as other non medical uses. A few new products are already in the pipeline including a line of pediatric products. The new Slipper Clip that was designed to increase the molding of the plantar surface when using the slipper sock was recently released and has proven an amazing improvement of the contouring of the slipper socks.

The doctors personally attend most O and P, Pedorthic and Podiatry meetings in order to learn how their products are used by practitioners and to touch base with their customers. The STS Company regularly donates casting socks to most of the Podiatric Colleges and pedorthic courses so that students and practitioners get to use the castings socks the way that they were intended and as early in their education as possible. "There are many tricks and techniques we have learned the past few years that will assist the practitioner in using our casting socks more effectively" says Dr. Stess. It seems as though the STS Company is becoming an integral product for most practices. When asked if they miss private practice, the doctors seem to agree that their time doing in service casting courses and workshops fills the void by not seeing patients. Doesn't sound like they are really retired.