Bruce MacDonald had been in the business of making and selling shoes his entire adult life when something unexpected occurred to him.

“I realized I didn’t actually know anything about the foot,” he said. “The hand-sewn, hi-end product I had made for most of my life really isn’t a good shoe, orthopedically.”

That revelation came not long after MacDonald, 63, was forced to shut down his MacDonald Footwear factory in Showhegan after losing too many orders to cheap, overseas labor. Starting over from scratch, MacDonald took work for other companies, even selling tractors for a time, while learning everything he could about every muscle and all 26 bones in the foot. Chinese companies might be able to undersell him with mass-produced, generic shoes, MacDonald knew, but they could not hope to compete with American ingenuity and craftsmanship.

Finally, in 2006, four years after shuttering his 92-person plant, MacDonald founded Pine Tree Orthopedic Lab with four workers, operating out of a leased garage in Leeds. The company grew quickly and within a year MacDonald moved it to Livermore Falls, where he took over a former roller rink at 175 Park Street. That provided enough space for an 8,000-square-foot manufacturing facility and, later, a 2,000-square-foot retail showroom.

Although largely founded to fill doctor prescriptions for specific shoe and brace needs, including diabetic shoes and inserts, custom orthotics, braces and other durable medical supplies, walk-in customers now account for 43 percent of Pine Tree’s business — up from 10 percent when the storefront opened in 2008. For each and every retail customer, Pine Tree provides a free foot analysis.

According to industry statistics, the average American takes 8,000 steps a day, with one and a half times his or her body weight coming down on an area of the heel bone about the size of a nickel with each step, reverberating up through the knees, hips and lower back. And yet, only 17 percent of people with pain attributable to the feet ever see a doctor. Pine Tree will make a referral to a doctor when one is required, but fills every other foot need, including modification to any of the quality brands they have in stock.

“We came to Livermore Falls for manufacturing, because there were shoe workers living here who had the skills, who we felt we could train to work on orthopedic appliances,” said MacDonald. “But then we thought we’d try and serve people in the area as well. Economics 101 might tell you that Livermore Falls isn’t the best place for a shoe store, but today we draw people from all over, from Bangor to Boston.”

That drawing power, said MacDonald, is largely due to Pine Tree Orthopedic’s workforce, which now numbers 14.

“No one is exactly like us in Maine, because we put a lot of money into education,” said MacDonald, noting that in addition to himself and his son Todd MacDonald, who serves as Pine Tree’s operations manager, two other company employees also are certified pedorthists.

“No one else has four certified pedorthists on staff in one location in Maine,” he said. “And whatever someone needs, from prescribed orthopedics to simple shoe modifications, we can do it right here, we don’t have to send it out to someone who has no connection to the end user.”

In fact, Pine Tree Orthopedics boasts a turn-around time on braces of less than 48 hours, putting to shame the national average of four weeks.

“We’re one of only two or three labs in the country that have this technology,” said MacDonald, “but apart from that, what we provide here is not just your basic, white ortho. Whatever someone wants, for any lifestyle or activity, we’ve got a shoe that fits the bill, from high-end hiking boot to casual clogs and sandals.

“It’s true, we don’t sell a cheap $19 sneaker,” said MacDonald. “What we do provide is high-quality shoes and inserts, along with custom-made foot orthosis and shoe modifications designed to alleviate people’s pain, because we’re not walking on dirt anymore. We’re walking all day on hard surfaces the foot was not designed for.”

Among Pine Tree’s employees, all of whom are cross-trained on a host of manufacturing steps, with many also logging time working directly with customers in the retail store, is Joleen Mills, a Livermore Falls resident with more than 17 years of experience in the shoe industry.

“What I really like about my work here,” she said, “is knowing that every single item I work on is helping someone live a better life.”

And, while many Pine Tree workers, like Mills, and MacDonald himself, came from traditional shoe shops, others, like Mike Leary of Wilton, a former newspaper production supervisor, arrived following a recession-fueled career change.

“Every single thing I know about making custom shoes, I learned right here from three generations of MacDonalds” he said, while using a laser scanner to create a computer model for the creation of an individualized ankle brace.

The first generation Leary refers to is MacDonald’s father, Robert MacDonald, who started out sewing shoes by hand at the Norwalk factory in Showhegan, soon after arriving home from the Marines in 1946.

The elder MacDonald advanced through the years, preforming nearly every job the shoe industry had to offer, from production line to front office.

“I guess I was lucky, I took it one step at a time and always had bosses who thought I knew something,” he said, modestly, while cutting the pattern to a leather brace cover for an amputee victim.

At 88, Robert MacDonald, who eventually became vice president of operations at Stride Rite Shoe, even opening the company’s factory in Haiti, mostly works his own schedule. Of course, that sometimes means logging a full workday that starts at 3 a.m., if that’s when he happens to get up.

“I’ve always worked seven days a week,” he said. “There’s a lot of people out there who need special shoes and it feels good to do this.”

In truth, the old Yankee work ethic all three MacDonalds share has rubbed off on each of their employees, down to the youngest, Jacob Jackson of Carthage, hired right out of high school.

“He’s become one of the best shoe-modification guys I’ve ever seen. He’s got great hand skills,” said Bruce MacDonald, during a tour of the Pine Tree plant. “I’m all for on-the-job training, and this is intense, hands-on, training.

“Really, we have a great staff were,” said MacDonald. “They’re the reason we’re making thousands of braces per year, and why we’ve been quietly growing each year.”

For the MacDonalds and their staff, not to mention their legions of customers, shoe manufacturing in Maine is alive and well.

“You live and breath it and once it gets in your blood it’s all you want to do,” said MacDonald, with a hearty smile.