Shoe Modifications
Orthopaedic Footwear Modifications
Even after the ‘best fitting’ shoe is found, it still may not fit well enough for a successful pedorthic treatment plan. The footwear may need further modifications that can be simple or complex.
The following are types of pedorthic footwear modifications:
- Lift: Additional material is added either internally or externally to a shoe to add height to one side; this is usually applied when a structural leg length difference is determined.
- Stretching: Stretching the upper of a tight-fitting shoe to offer more room can reduce painful pressure to a hammer toe or bunion; the use of a professional shoe stretcher, a wooden shoe stretcher, or a ball-and-ring stretcher can be helpful.
- Resole: The original sole is removed and replaced to offer a level sole or different tread.
- Inner shoe supports (MLA, MTA): When support is needed inside the shoes, a medial longitudinal support (or arch cookie, scaphoid pad) or metatarsal arch support (to offload the ball of the foot) can be added.
- Buttress/ Flare: This is rubber material added to the outside of the shoe to bolster up the shoe support and offer a wider base of support.
- Rocker sole: Your Pedorthist can grind a smooth forward roll onto the shoe when your foot has limited or painful ROM at the forefoot
- Shuffle plate/Toe slider: This is an addition of a smooth, low friction material to the bottom of the front of the shoe to reduce shoe gripping which can lead to falls. This is often used for stroke patients with foot drop.
- Balloon patch: A ‘ballooned’ patch of material is fastened over an accommodated hole made in the upper of a shoe to take pressure off a painful hammer toe or bunion.
- Closure modification: This is a permanent external modification of the upper of the shoe to change its closure. Examples include the addition of hook-and-loop (Velcro) straps, buckles, or lacing changes such as lock lacing. Our on-site industrial sewing machine is used.
- Excavations: This is a hole which is drilled out of the midsole of the shoe from the inside to create a well or hollow for a soft tissue lesion, bony prominence, or sensitive area.
- Split sole: This is an aggressive patient-specific footwear modification used to widen one part of the sole of the shoe when a deformed foot requires a wider area to reduce pressure rubbing. A cut is made through the midsole and outsole of the shoe that is then spread with additional material inserted to broaden the base of support. This modification re-lasts or reshapes the entire shoe.