Ball and ring stretching
Stretching the upper of the shoe using a standard shoe stretcher or a ball and ring stretcher.
A ball and ring stretcher can be used to stretch a small area over a bony prominence.
A standard shoe stretcher can increase the width, depth or volume of the upper - spot stretching also when used in conjunction with metal or wooden plugs.
Birkenstock Foot Bed
Removable foot bed
Add orthotics to any sandal with a removable foot bed/liner. To modify Birkenstocks, we peel off the top cover and work with the existing foot bed. Fill the spaces to customize the fit to the patient's foot contour and reapply the top cover.
Modify the foot bed with arch supports, kinetic wedges, varus/valgus posting, heel lifts for leg length difference or equinous to address the same issues as removable orthotics.
Buttress (Medial or Lateral)
Outrigger, counter support, external arch support, flange
Material (typically EVA) is fastened to the upper and sole on the inside or outside of the shoe creating a “wall” that supports the foot and widens the base of support to help control abnormal motion.
Useful with extreme hyper-mobility or deformity of the foot that cannot be controlled by an orthotic and shoe alone.
Combo of 3 modifications: split sole, excavation and rocker sole
Splitting and widening the sole of the shoe, possible excavations inside the shoe and the addition of a rocker sole.
Used to accommodate severe deformity and reduce pressure on the bottom of the foot.
Examples: Charcot foot, plantar bony prominences, plantar foot ulcers.
Rigid Rocker Sole
Rocker bottom (types: forefoot rocker, heel to toe rocker, midfoot rocker, severe angle rocker)
An addition or modification is made to the bottom of the shoe by increasing toe and heel angle and by adding rigid materials to reduce flexion.
Reduces pressure on the bottom of foot, energy consumption and stress on stiff or painful joints in the foot and ankle.
Used to reduce flexion of metatarsals and improve forward motion to address conditions such as foot drop and halux rigidus.
Shoe lift, external lift, leg length difference correction, short leg correction
Extra material added to the midsole or outsole of one shoe to make it thicker than
Accommodation for structural leg length difference and occasionally functional leg length difference, scoliosis or pelvic imbalance following injury or surgery.
A cut is made through the midsole and outsole of the shoe which is then spread – additional material is inserted to maintain the split.
Useful when the foot requires greater width in a localized area but not through the entire shoe accommodating deformity and widening the base of support.