Shoe Modifications can be performed to accommodate areas of abnormal pressure that may cause injury. Shoes can also be modified to help change the position and motion of the foot as it contacts the ground during walking.

Improperly fit shoes have the potential to injure the skin by creating a blister related to abnormal friction between the shoe and the skin. A professionally fit shoe that specifically accommodates all of the contours and bony prominences of the foot can help reduce the risk of developing a blister.

Occassionally the upper material portion of the shoe must be stretched to create additional room in the shoe for a specific deformity. A Ball and ring stretcher or other stretching presses can be used to stretch small portions of the shoe which will increase the room of the shoe. Not all shoe materials or shoes are suitable for stretching. Shoes with leather uppers are often times suitable for stretching.

For patients with documented leg length differences the internal portion of the shoe can be raised up to ½ inch to accommodate for the difference. Leg length differences greater than ½ inch must be made up by adding to the outsole portion of the shoe with light weight foam materials.

Additional modfications to the outsole of the shoe can be made that effectively change the pressure patterns on the bottom of the foot if the offloading from the accommodative orthotic alone is not sufficient. Additional metatarsal bars or rockerbottoms placed on the shoe outsole can be used to reduce abnormal pressure patterns as needed based on the specific problem being treated.

Shoe Modification: Examples

The goal of shoe modifications is to correct foot imbalance during weight bearing activities. In the flexible sensate foot, the corrections will be made to achieve proper weight distribution. The rigid, and/or abnormally structured foot, may not have sensation and is at high painful ambulation. Accommodation requires that the ground be brought up to the plantar surface of the foot with modifications and insoles.

Internal Modifications Internal modifications are changes made inside the shoe to relieve pressure or shear forces that cause pain, irritation or trauma to the foot. The orthotic added to the shoe may relieve some of the pressure, but many times the problem requires more relief. Tongue pads, scaphoid pads, metatarsal pads and stretching are commonly used as relief of irritation.

Inserted Modification Modifications made between the shoe and outsole. It includes SACH Heel, Inverter/Everter SACH Heel, Medial/Lateral Wedge, Forefoot Wedge, Beveled Heel.

External Modification Modification made to sole of shoe . General Rocker Sole and Elevation Procedure include several steps such as Remove sole and san shoe surface, Cut crepe for elevation and sand surface, Cover both surfaces with cement and let dry etc.

Upper Modification Modification made to the shoe's upper construction. It includes Bunion Modification, Retrocalcaneal Spur/Haglund's Deformity/ Pump Bump, Shrinking Heel of Shoe and Stretching or Reshaping Toe Box.

Systemic Modification Modifications that affect the entire shoe construction. It classifies to Spreading midfoot for chronic conditions, Spreading Forefoot Width for Accommodation and Stabilizers(Blsters) for Medial/Lateral Support And Heel Offset

Cosmetic Modification Modifications that affect the cosmetic appearance. Low boot(3 eyelet) with tongue. Hi-top lace extended upper. Adding a velcro instep flap. Adding a cross "X" strap. Adding a "T" strap Modification details courtesy of: bignwideshoes.com