Canadian Certified Pedorthists have many tools to improve patients’ mobility and comfort, including orthotics, supportive footwear and orthopaedic shoes. But for patients with certain foot types and conditions these tools may not be sufficient. These patients may require shoes that are modified or altered to exactly meet the shape and requirements of their feet and lower limbs.

A modified shoe may look like a normal dress or casual shoe but it’s actually chocked full of orthopaedic modifications. Pedorthists can make many modifications to footwear but some of the most common are:
Lifts – Lifts are used to increase the height of shoes for patients with different leg lengths, giving them a more level posture, improving their mobility and alleviating hip and back pain.  To add a Lift, we begin by splitting the sole off the existing shoe. Then we glue the Lift material to the shoe and grind it to meet the exact shape of the sole. Finally we replace the sole of the shoe so it closely matches its mate shoe and provides good wear and traction.
Buttress – a Buttress is a stiff wall, made of firm foam and often reinforced by a graphite sheet, that is inserted on one side of the shoe to improve stability and relieve ankle, knee, hip and back pain. Buttresses reduce the risk of falls and ankle sprains and help the patient from losing balance. To create a Buttress, we begin by marking the upper of the shoe where the material will be inserted. After we’ve prepared the side of the sole and the upper, we glue the Buttress in place and then cut and grind it to the shape of the shoe. We then add material to the outsole to make it level with the rest of the shoe.
Excavation – An Excavation is used to reduce pressure points and create a soft pocket to accommodate feet suffering from rheumatoid arthritis, complications from diabetes and anatomical bony prominences. To create an Excavation, we remove the sock liner and cut and grind away the midsole material from inside the shoe. Once the well has been ground out, we fill it with a cushioning material and then smooth out the top and replace the sock liner.
Balloon Patch – A Balloon Patch is designed to provide extra room in the shoe for bony prominences including severe bunions or hammertoes. To create a Balloon Patch, we first mark the desired location and size of the patch. Then we cut a hole in the upper of the shoe and stitch on a soft, leather patch with the necessary extra space. In addition to providing extra comfort, Balloon Patches also minimize pressure and friction on the foot which helps to prevent corns, callouses and blisters.
These are just a few examples of the types of modifications Canadian Certified Pedorthists can make to shoes. Many of our modifications don’t even have names because they’re custom designed for each patient’s specific needs. The magic of all modifications is they ease patients’ pain and discomfort and help put them back on the road to better mobility. For more information on how shoe modifications might benefit you, contact your local Canadian Certified Pedorthist.
By Ben Boyer, C. Ped Tech (C), C. Ped (C), Coquitlam, BC