10 Common Shoe Modifications in a Podiatry Practice

Photo above shows 1/8 inch or 3 degree varus wedge placed into the midsole of a running shoe for better pronation control. Placing the wedge (up to 3/8 inch commonly used) within the midsole or on the outersole is more powerful support than as a shoe insert.

The photo above shows 1/4 inch valgus wedge applied the lateral border of a dress shoe (pinky toe side) to control supination forces. Of course, shoe repair shops will use material that blends into the outersole for better cosmesis.

Here is a common version of power lacing where the lst and 3rd eyelets are used, in contrast to the 1st and 2nd. See if one modification feels more comfortable and/or more stable. Power lacing can add 10-20% more pronation or supination support to a shoe, and a must when you are using orthotic devices.

The photo above illustrates the point that shoe eyelets are meant to be skipped to alleviate pressure on the top or sides of the foot. It is good to experiment with skipping eyelets when you have bunions, instep pain, or even generalized foot pain to see if it is helpful.

In the photo above the shoe is being cut to increase flexibility. Many shoes are just too stiff in the ball of the foot. The cuts should not go all the way to either side or to the bottom of the shoe. Many problems of forefoot pain are helped with the simple modification. However, if it makes the problem worse, you will need some way of stiffening the area, or purchase a new shoe.

In the photo above tiny cuts are being made into the midsole to allow the shoe to compress more on one side. Here the cuts are being made on the medial side (big toe side) to allow the foot to pronate more in a supinator.

In the photo above, a small slit is placed under the first metatarsal in hallux limitus/rigidus to apply a stiff insert to limit big toe joint motion.

In the photo above, adhesive felt is used as a tongue pad to secure the foot better in the shoe, but also to off weight a sore area by the accommodation or cut out area.

In the photo above, a cut is being made in the heel counter padding to place into the shoe gel padding. This patient was getting irritation from the shoe in this area. A shoe repair store sowed the slit up after I tortured the shoe.

In the photo above, this illustrates that any spot of a shoe can be softened to be more friendly to a sore spot. Remember, shoe repair stores need to take your shoe over night to adequately stretch the appropriate area.