Metatarsal Pad

A 6mm thick dome shaped poron pad designed to lift and spread the metatarsals, recreating the transverse arch.

For Use: An excellent addition for treating forefoot/transverse arch problems,      such as: dropped metatarsals, metatarsalgia, hallux valgus, interdigital neuroma interdigital bursitis, excessive callousing and a reduced transverse arch.

Lab Recommendations: We recommend that the metatarsal pads be placed bilaterally. The size of the metatarsal pad is determined by our technicians. This addition is usually placed centrally at the distal edge of the orthotic shell, but can be placed slightly more distal.

Metatarsal Pad Options:
Distal Placement
Low Profile: 3mm thick

Contraindication(s): Rigid or immobile forefoot; tarsal coalitions

Full Heel Cushion

A 3mm foam pad covering the entire heel cup area.

For Use: Specifically designed for patients with plantar fasciitis, a non-centrally located heel spur, loss of fat pad or those who require additional rearfoot shock absorption.

Lab Recommendations: Should only be used bilaterally, to avoid creating a limb length difference. This modification should only be placed in shoes that will accommodate extra bulk in the rearfoot. The full heel cushion should not be used in conjunction with a heel spur pad.

Contraindication(s): Shallow heel counter in shoe

Heel Spur Pad

A horseshoe shaped 3mm poron pad, placed around the periphery of the heel cup area. Designed to lift the calcaneus off the orthotic and relieve pressure at the site of the centrally located spur. 

For Use: Specifically used for treating patients with centrally located heel spurs.

Lab Recommendations: A heel spur pad should only be used for radiographically confirmed centrally located heel spurs. The heel spur pad should always be used bilaterally to avoid creating a limb length difference. The heel spur pad should not be used in conjunction with a full heel cushion.

Contraindication(s): A non-centrally located heel spur; shallow heel counter in shoe

Hole in Heel

A 1" hole cut through the orthotic shell under the calcaneus.

For Use: Designed to accommodate heel spurs in dress shoes where a spur pad may cause fitting problems.

Lab Recommendation: Works optimally in conjunction with an extrinsic rearfoot post and either a full heel cushion or a heel spur pad.

Contraindication(s): A non-centrally located heel spur; shallow heel counter in shoe (when used with a full heel cushion or heel spur pad)

Hole in Heel Option:
Foam Disk: A 3mm foam thick disk placed in hole in heel

Hole in Heel (with foam)

A 1" hole cut through the orthotic shell under the calcaneus.

For Use: Designed to accommodate heel spurs in dress shoes where a spur pad may cause fitting problems.

Lab Recommendation: Works optimally in conjunction with an extrinsic rearfoot post and either a full heel cushion or a heel spur pad.

Contraindication(s): A non-centrally located heel spur; shallow heel counter in shoe (when used with a full heel cushion or heel spur pad)

Hole in Heel Option:
Foam Disk: A 3mm foam thick disk placed in hole in heel

Reverse Morton's Extension

A 3mm foam pad placed under 2-5 metatarsal-phalangeal joints to the sulcus. This is designed to take pressure off the 1st  metatarsal-phalangeal joint and slightly dorsi-flex the 1st.

For Use: Designed for patients with a plantar-flexed first ray, hallux limitis, sesamoiditis, and severe forefoot valgus deformity.

Lab Recommendations: Only available with a sulcus or full length orthotic. Reverse Morton’s extension should usually be used in conjunction with a metatarsal pad.

Contraindication(s): Forefoot Varus; footwear with a narrow toe box

Morton's Extension

A 3mm foam pad placed under the 1st  metatarsal-phalangeal joint, from the distal end of the shell to the distal phalangeal joint. Designed to raise and slightly immobilize the great toe.

For Use: Designed for patients with a dorsi-flexed first ray, turf toe, hallux rigidus or patients with a short 1st  metatarsal (short 1st metatarsals are very rare and are not to be confused with long 2nd metatarsals).

Lab Recommendation: Only available with a full length orthotic. Morton’s extension should usually be used in conjunction with a metatarsal pad.

Contraindication(s): Footwear with a narrow toe box

1st Metatarsal Cut Out

A 45° cut to the orthotic shell under the 1st metatarsal-phalangeal joint at the distal-medial aspect of the orthotic shell. This is designed to slightly plantar-flex the 1st ray and pronate the forefoot.

For Use: Most commonly used with functional hallux limitus and supinators. A 1st  metatarsal cut-out drops the first metatarsal down (into plantar-flexion) and forces the forefoot into pronation, achieving a better toe-off and conversely a better heel strike.

Lab Recommendations: Under no circumstances should a 1st  metatarsal cut out be used on a patient with a pathological 1st toe, as this modification will act to aggravate any 1st toe pathology.

Contraindication(s): Osteoarthritis in the first metatarsal, forefoot varus

Reinforced Arch

A 3/8” (10mm) poron arch fill laminated to the plantar surface of the orthotic. This is designed to add rigidity to the orthotic.

For Use:  Used most commonly when a patient is more than 280 lbs and needs more biomechanical support than our most rigid (3.5 mm) orthotic can offer.

Lab Recommendations: A reinforced arch should be done bilaterally, and should not be used for patients less than 240 lbs. Should only ever be used with shoes that can accommodate a bulkier device.

Contraindication(s): Narrow or tight fitting footwear; cavus/rigid feet

Heel Raise

An extrinsic heel lift added to the underside of the orthotic. The lift is manufactured using extra-firm posting material.

For Use: A unilateral lift is used for patients who have an anatomical leg length discrepancy. A small heel lift can also be used bilaterally to treat patients with limited ankle dorsi-flexion (ie.Equinis) or Achilles tendonitis.

Lab Recommendations: For an anatomical leg length discrepancy, please indicate which leg requires a lift. The maximum lift height is 10mm, although most shoes will not accommodate that high a measurement. Always extrinsically post the non-lifted orthotic unless space is an issue.  First time heel lift users should never be corrected more than 50% of their total leg length discrepancy.

When used bilaterally for limited ankle dorsi-flexion (ie. Equinis) or Achilles tendonitis a 3mm lift is recommended.

Contraindication(s): Functional leg length discrepancy; older patients who have never worn a heel lift

Rearfoot Extrinsic Posts

Extra-firm posting material added to the plantar surface of the orthotic heel to further stabilize and invert the foot. 

For Use: Used for moderate to severe over-pronators, unstable feet, and people who weigh more than 240lbs.

Lab Recommendations: Rearfoot extrinsic post add bulk to an orthotic and should always be used with shoes taht can accomodate a slightly bulkier device.

Options:
Neutral: To add stability particularly for patients with rigid/cavus feet.
Varus: Tor correct for moderate to severe over-pronators. 

Contraindication(s): Tight fitting shoes; supinators; varus or valgus rearfoot

Vinyl Sandwich

A 1mm vinyl cover placed under the forefoot of sulcus or full length orthotics.

For Use: To add rigidity to suclus or full length top covers.

Lab Recommendations: Specifically to be used for running or court shoes where reinforcement is required.

Contraindication(s): Footwear with a narrow toe box

Hard Medial Flange

Medial border of the orthotic is extended vertically upward to provide additional containment around the medial longitudinal arch (MLA).

For Use: For severely pronated, pes planus, everted foot types, genu valgum;  stabilizes the subtalar and midtarsal joints.

Lab Recommendations: Suggested to be used in conjunction with an extrinsic rearfoot post in wider fitting shoes.

Contraindication(s): Dress or narrow fitting shoes

Hard Lateral Flange

Lateral border of the orthotic is extended vertically upward to provide additional containment around the lateral longitudinal arch (LLA).

For Use: For severely supinated, pes cavus, inverted foot types, genu varum; to increase stability and help prevent inversion sprains.

Lab Recommendations: Suggested in conjunction with an extrinsic rearfoot post in wider fitting shoes.

Contraindication(s): Dress or narrow fitting shoes

Medial Rearfoot Skive

An intrinsic grind at 15° into the medial aspect of the positive cast to a depth of 2mm, 4mm or 6mm.

For Use: To intrinsically correct for excessive over-pronation.

Lab Recommendations: Must be used in conjunction with an extrinsic rearfoot post, and a deep heel cup.

Contraindication(s): Dress or narrow fitting shoes

Lateral Rearfoot Skive

An intrinsic grind at 15° into the lateral aspect of the positive cast to a depth of 2mm, 4mm or 6mm.

For Use: To intrinsically correct for excessive over-supination.

Lab Recommendations: Must be used in conjunction with an extrinsic rearfoot post, and a deep heel cup.

Contraindication(s): Dress or narrow fitting shoes

Extra Foam Padding under Topcover

An additional layer of foam added to the topcover. The foam layer runs the entire distance from the heel of the orthotic to the distal end of the topcover.

For Use: For patients who require additional shock absorption and/or cushioning.

Lab Recommendations: Should only be used for sulcus and full length orthotics.

Contraindication(s): Dress or narrow fitting shoes with low heel counters

Options:
1/16” Black foam
1/8” Blue foam

Extrinsic Forefoot Posts (Sulcus Length)

Extra-firm posting material added to distal portion of the plantar surface of the orthotic to further stabilize, invert or evert the forefoot. 

For Use: Non-weight bearing forefoot varus or valgus deformity; wholefoot pronators.

Lab Recommendations: An extrinsic forefoot varus post is strongly recommended for severe non-weight bearing forefoot varus or valgus deformity. Where space is permitted, sulcus length is highly recommended.

Options:
Valgus or Varus
Sulcus or ¾

Contraindication(s): Tight fitting shoes; forefoot sulcus post can only be ordered on a sulcus or full length orthotic

Extrinsic Forefoot Posts (3/4 Length)

Extra-firm posting material added to distal portion of the plantar surface of the orthotic to further stabilize, invert or evert the forefoot. 

For Use: Non-weight bearing forefoot varus or valgus deformity; wholefoot pronators.

Lab Recommendations: An extrinsic forefoot varus post is strongly recommended for severe  non-weight bearing forefoot varus or valgus deformity. Where space is permitted, sulcus length is highly recommended.

Options:
Valgus or Varus
Sulcus or ¾

Contraindication(s): Tight fitting shoes; forefoot sulcus post can only be ordered on a sulcus or full length orthotic

Forefoot Pad to Sulcus

A soft 3mm foam pad placed at the distal portion of orthotic to the sulcus.

For Use: Used for patients that require extra cushioning under the metatarsals; loss of fat pad under metatarsals.

Lab Recommendations: Should be used in conjunction with a metatarsal pad.

Contraindication(s): Footwear with a narrow toe box

Sub-Metatarsal Accommodation

A 3mm foam pad placed at the distal portion of orthotic which extends to the sulcus and is cut away under the specified metatarsal head(s).  This accommodation will offload the specified metatarsal(s) and balance the forefoot.

For Use: To accommodate plantar warts, corns, severe callouses and dropped metatarsals.

Lab Recommendations:  When used in conjunction with metatarsal pads optimum results are achieved. To optimally place a sub metatarsal accommodation, it is strongly advised to indicate where it is required on the plaster, slipper sock or foam cast with either lipstick or ink. The orthotic must be a sulcus or a full length orthotic.

Contraindication(s): Tight toe box

Options:
Left/1 2 3 4 5
Right/1 2 3 4 5

Neuroma Pad 1-2, 2-3, 3-4, 4-5

A teardrop shaped pad placed at an interdigital space to spread the specified metatarsals.

For Use: Specifically used to alleviate symptoms of interdigital neuroma, intermetatarsal bursitis.

Lab Recommendations:  Metatarsal pads generally do an excellent job of relieving interdigital symptoms while also correcting the transverse arch. Only after metatarsal pads have been tried without success, do we recommend the usage of neuroma pads.

Contraindication(s): Can only be used with sulcus or full length orthotic

Deep Heel Cup

A 16mm deep heel cup doubling the depth of our standard 8mm heel cup depth.

For Use: Offers greater stability for severe over-pronators. Assists in gathering fatty tissue under the calcaneus.

Lab Recommendations: The deep heel cup is automatically used on our KidsFlex, UCBL and medial and lateral rearfoot skives. General practice suggests that the standard deoth heel cup orthotic is sufficient in assisting to prevent over-pronation at the calcaneus.

Contraindications(s): Shallow heel counters, tight fitting shoes