Discover our custom orthotic additions and modifications, tailored to specific pathologies and patient needs to enhance function, comfort, and clinical outcomes.
Metatarsal Pad
- Description: 6 mm thick domed Poron designed to lift and spread the metatarsals, recreating the transverse arch
- Uses: Effective for forefoot and transverse arch conditions including dropped metatarsals, metatarsalgia, hallux valgus, interdigital neuroma, interdigital bursitis, hammer toes, excessive callousing, and reduced transverse arch
- Contraindications: Rigid or immobile forefoot; tarsal coalitions
- Notes: Recommended for bilateral use; pad size determined by technicians. Typically placed centrally at the distal edge of the orthotic shell, with the option to position slightly more distal if needed
Full Heel Cushion
- Description: 3 mm foam pad covering the entire heel cup area
- Uses: Designed for patients with plantar fasciitis, non-centrally located heel spurs, fat pad loss, or those requiring additional rearfoot shock absorption
- Contraindications: Shallow heel counter in the shoe
- Notes: Must be used bilaterally to avoid limb length discrepancy. Only suitable for shoes that can accommodate extra rearfoot bulk. Should not be used in conjunction with a heel spur pad
Heel Spur Pad
- Description: Horseshoe-shaped 3 mm Poron pad placed around the periphery of the heel cup to lift the calcaneus and relieve pressure from a centrally located spur
- Uses: Specifically for treating patients with radiographically confirmed centrally located heel spurs
- Contraindications: Non-centrally located heel spurs; shallow heel counter in the shoe
- Notes: Must be used bilaterally to avoid limb length discrepancy. Should not be used in conjunction with a full heel cushion
Hole in Heel with Foam Disk
- Description: A 1¼″ hole cut through the orthotic shell beneath the calcaneus; optionally filled with a 3 mm foam disk
- Uses: Designed to accommodate heel spurs in dress shoes where a heel spur pad may cause fitting issues
- Contraindications: Non-centrally located heel spur; shallow heel counter when used with a full heel cushion, heel spur pad, or extrinsic rearfoot post
- Notes: Works optimally when combined with an extrinsic rearfoot post and either a full heel cushion or a heel spur pad
Morton’s Extension
- Description: 3 mm foam pad placed under the first metatarsal-phalangeal joint, extending from the distal end of the shell to the distal phalangeal joint, designed to raise and slightly immobilize the great toe
- Uses: For patients with a dorsiflexed first ray, turf toe, hallux rigidus, or a short first metatarsal (not to be confused with a long second metatarsal)
- Contraindications: Footwear with a narrow toe box
- Notes: Available only with a full-length orthotic. Typically used in conjunction with a metatarsal pad
Reverse Morton’s Extension
- Description: 3 mm foam pad placed under the 2nd–5th metatarsal-phalangeal joints to the sulcus, designed to offload the 1st metatarsophalangeal joint and slightly dorsiflex the first ray
- Uses: For patients with a plantarflexed first ray, hallux limitus, sesamoiditis, or severe forefoot valgus deformity
- Contraindications: Forefoot varus; footwear with a narrow toe box
- Notes: Available only with sulcus or full-length orthotics. Reverse Morton’s extension is typically used in conjunction with a metatarsal pad
1st Metatarsal Cut Out
- Description: Cut-out in the orthotic shell beneath the 1st metatarsal-phalangeal joint at the distal-medial aspect, designed to slightly plantarflex the first ray and pronate the forefoot
- Uses: Commonly used for functional hallux limitus and in supinators; allows the first metatarsal to drop into plantarflexion, promoting forefoot pronation for improved toe-off and heel strike
- Contraindications: Osteoarthritis of the first metatarsal; forefoot varus
- Notes: Should never be used in patients with pathological first toe conditions, as this modification may aggravate existing first toe pathology
Reinforced Arch
- Description: 3/8″ (10 mm) Poron arch fill laminated to the plantar surface of the orthotic, designed to increase rigidity
- Uses: Most commonly used for patients over 280 lbs who require greater biomechanical support than the most rigid 3.5 mm orthotic provides
- Contraindications: Narrow or tight-fitting footwear; cavus or rigid feet
- Notes: Must be used bilaterally and is not recommended for patients under 240 lbs. Should only be used in footwear that can accommodate increased bulk
Heel Raise
- Description: Extrinsic heel lift added to the underside of the orthotic, manufactured from extra-firm posting material
- Uses: Unilateral use for anatomical leg length discrepancies; bilateral use in small lifts to treat limited ankle dorsiflexion (equinus) or Achilles tendonitis
- Contraindications: Functional leg length discrepancy; older patients who have never worn a heel lift
- Notes: Specify which leg requires the lift for anatomical discrepancies. Maximum lift height is 10 mm, though most shoes cannot accommodate this height. Always extrinsically post the non-lifted orthotic unless space is limited. First-time users should not be corrected more than 50% of the total leg length discrepancy. When used bilaterally for equinus or Achilles tendonitis, a 3 mm lift is recommended
Rearfoot Extrinsic Post
- Description: Extra-firm posting material added to the plantar surface of the orthotic heel to increase stability and invert the foot
- Uses: For moderate to severe overpronators, unstable feet, and patients weighing more than 240 lbs
- Contraindications: Tight-fitting footwear
- Notes: Rearfoot extrinsic posts increase orthotic bulk and should only be used in shoes that can accommodate a thicker device. Neutral option adds stability, particularly for rigid or cavus feet; varus option is used to correct moderate to severe overpronation
Sandwich
- Description: 1 mm vinyl cover placed under the forefoot of sulcus or full-length orthotics
- Uses: Adds rigidity to sulcus or full-length topcovers
- Contraindications: Footwear with a narrow toe box
- Notes: Specifically intended for running or court shoes where additional reinforcement is required
Hard Medial Flange
- Description: Medial border of the orthotic extended upward to provide additional containment around the medial longitudinal arch
- Uses: For severely pronated, pes planus, or everted foot types and genu valgum; stabilizes the subtalar and midtarsal joints
- Contraindications: Dress or narrow-fitting shoes
- Notes: Recommended for use in wider footwear and in conjunction with an extrinsic rearfoot post
Hard Lateral Flange
- Description: Lateral border of the orthotic extended vertically upward to provide added containment around the lateral longitudinal arch
- Uses: For severely supinated, pes cavus, or inverted foot types, and genu varum; increases stability and helps prevent inversion sprains
- Contraindications: Dress or narrow-fitting shoes
- Notes: Recommended for use in wider footwear and in conjunction with an extrinsic rearfoot post
Medial Rearfoot Skive
- Description: Intrinsic grind at 15 degrees into the medial aspect of the positive cast to a depth of 2 mm, 4 mm, or 6 mm
- Uses: Used to intrinsically correct excessive overpronation
- Contraindications: Dress or narrow-fitting shoes
- Notes: Must be used in conjunction with an extrinsic rearfoot post and a deep heel cup
Lateral Rearfoot Skive
- Description: Intrinsic grind at 15 degrees into the lateral aspect of the positive cast to a depth of 2 mm, 4 mm, or 6 mm
- Uses: Used to intrinsically correct excessive oversupination
- Contraindications: Dress or narrow-fitting shoes
- Notes: Must be used in conjunction with an extrinsic rearfoot post and a deep heel cup
Extra Foam Padding under Top Cover
- Description: Additional foam layer added to the topcover, extending from the heel of the orthotic to the distal end of the topcover
- Uses: For patients who require extra shock absorption and/or cushioning
- Contraindications: Dress or narrow-fitting shoes with low heel counters
- Notes: For use with sulcus and full-length orthotics only. Available options include 2 mm (1/16″) black foam or 3 mm (1/8″) blue foam
Extrinsic Forefoot Post – 3/4 Length
- Description: Extra-firm posting material added to the distal portion of the plantar surface of the orthotic to further stabilize and invert or evert the forefoot
- Uses: For non-weight-bearing forefoot varus or valgus deformities and whole-foot pronators
- Contraindications: Tight-fitting shoes; ¾-length forefoot posts should only be used with ¾-length orthotics, as they are less effective than sulcus-length posts
- Notes: Extrinsic forefoot varus posting is strongly recommended for severe non-weight-bearing forefoot varus or valgus deformities. Where space allows, sulcus-length posting is highly recommended. Available options include varus or valgus
Extrinsic Forefoot Post – Sulcus Length
- Description: Extra-firm posting material added to the distal portion of the plantar surface of the orthotic to further stabilize and invert or evert the forefoot
- Uses: For non-weight-bearing forefoot varus or valgus deformities and whole-foot pronators
- Contraindications: Tight-fitting shoes; forefoot sulcus posts may only be ordered with sulcus or full-length orthotics
- Notes: Extrinsic forefoot varus posting is strongly recommended for severe non-weight-bearing forefoot varus or valgus deformities. Where space permits, sulcus-length posting is highly recommended. Available options include varus or valgus
Forefoot Pad to Sulcus
- Description: Soft 3 mm foam pad placed at the distal portion of the orthotic to the sulcus
- Uses: For patients requiring additional cushioning under the metatarsals, including those with loss of fat pad beneath the metatarsals
- Contraindications: Footwear with a narrow toe box
- Notes: Should be used in conjunction with a metatarsal pad
Sub-Metatarsal Accommodation
- Description: 3 mm foam pad placed at the distal portion of the orthotic extending to the sulcus, with cut-outs beneath specified metatarsal head(s) to offload pressure and balance the forefoot
- Uses: To accommodate plantar warts, corns, severe calluses, and dropped metatarsals
- Contraindications: Footwear with a tight-fitting toe box
- Notes: Best results are achieved when used in conjunction with metatarsal pads. For optimal placement, the affected area should be marked on the plaster, slipper sock, or foam cast using lipstick or ink. Must be ordered with a sulcus or full-length orthotic. Options include left or right metatarsals 1–5
Neuroma Pad
- Description: Teardrop-shaped pad placed in an interdigital space to spread the specified metatarsals
- Uses: Specifically used to alleviate symptoms of interdigital neuroma and intermetatarsal bursitis
- Contraindications: Cannot be used with a ¾-length orthotic
- Notes: Metatarsal pads are generally effective at relieving interdigital symptoms while also correcting the transverse arch. Neuroma pads are recommended only after metatarsal pads have been tried without success
Deep Heel Cup
- Description: 16 mm deep heel cup, doubling the depth of the standard 8 mm heel cup
- Uses: Provides increased stability for severe overpronators and helps gather fatty tissue beneath the calcaneus
- Contraindications: Shallow heel counters; tight-fitting shoes
- Notes: Automatically included with KidsFlex, UCBL, and medial and lateral rearfoot skives. In most cases, a standard deep heel cup is sufficient to help control calcaneal overpronation
Soft Medial Flange – Top Cover Style
- Description: Soft winged extension off the medial longitudinal arch of the orthotic
- Uses: Pads the sharp medial edge of the orthotic shell to reduce the risk of blisters and calluses
- Contraindications: None
- Notes: Strongly recommended for severe overpronators with flexible flat feet
Hole in Heel
- Description: 1¼″ hole cut through the orthotic shell beneath the calcaneus
- Uses: Designed to accommodate heel spurs in dress shoes where a heel spur pad may cause fitting issues
- Contraindications: Non-centrally located heel spur; shallow heel counter when used with a full heel cushion, heel spur pad, or extrinsic rearfoot post
- Notes: Works optimally in conjunction with an extrinsic rearfoot post and either a full heel cushion or a heel spur pad