Shoe Wedging for Pronatory or Supinatory Problems

This post is a photo coverage of the common steps I use in shoe wedging for severe supination or pronation issues, that custom foot orthotics are not adequate enough.

This is a patient that had a complication in ankle fusion which left her right foot in varus foot (leaned to the outside) with terrible ramifications for her foot and the rest of her body.

First the midsole of the shoe is split with a 10 or 11 blade scalpel about 2 inches deep and within an inch of the toes.

Here the shoe is being stretched apart to make sure I got adequate cuts

I will then be using 1/4 inch Korex or grinding rubber that I purchase from JMS plastics in New Jersey to form my wedge.

The photo on the left shows the opening is separated as the glue dries. The photo on the right shoes both the shoe and wedge are glued and allowed 20 minutes to dry. The image below this is a closeup of the beveled wedge. 

There the wedge has been placed into the shoe and the excess removed

Superglue will used to seal any gaps 

Final product showed

Supinators: Help with Lateral Shoe Wedging

     There is really no great shoe for people whom overly supinate (roll their feet to the outside like spraining their ankles). One way that podiatrists, pedorthists, and shoe repair people handle this problem is with lateral (or valgus) shoe wedging. The wedging can be placed on the outersole or into the midsole as demonstrated by these photos. With excessive supination (aka lateral instability) accounting for 17 known symptoms, including ilio-tibial band strain, low back pain, ankle sprains or strains, cuboid syndrome, etc., this common wedging process can greatly diminish symptoms caused by this motion.

     The photo above demonstrates the initial cut with an eleven or ten blade half way up the midfoot and half way through the shoe from lateral to medial. The cut goes from the ball of the foot to the back of the heel.

Once the scalpel has made the cut, barge cement is applied to the inside of the shoe.

     Depending on the size of the wedge needed, grinding rubber (I purchase from JMS Plastics) is beveled and then both sides are glued and left standing to dry. Here 1/4" wedges are being made for multiple shoes. The front end of the wedge (placed into the front part of the shoe) is slightly rounded before skiving to ease in the shoe placement.

     Here is a closer view of the shoe wedge with the beveled part that will be placed into the shoe first (go in the deepest) and the rounded front part.

Here is the wedge being shoved (yes, shoved!!) not so gently into the shoe as deep as possible.

     Here is the shoe wedge from the side view after initial sanding to make presentable.

     Here is the finish product of a 1/4" valgus or lateral midsole wedge to fight excessive supination tendencies. Super Glue or one of its knockoffs is normally used here to seal any gaps. It takes time working with the Barge Cement to know how long to wait before applying the wedge. The patient should never feel that the shoe now overly pronates them. If so, there is too much wedge. Normally when this happens, this wedge is removed and a new one one half that thickness is then applied.