Shoe modifications

1. What are some internal shoe modifications and their functions?
2. What are some external shoe modifications and their functions?
3. What is a rocker bar?
4. What are heel modifications and their functions?

Answers:
1. Heel cushion (soft pad for under heel - spurs), inner sole relief (pressure relief, usu for metatarsal heads), scaphoid pads (medial long arch support), metatarsal pads (transfers pressure from metatarsal heads to shafts), internal heel wedges (promotes foot inversion for pes planus), toe crest (toe pressure relief, for hammertoe).
2. Rocker bar, metatarsal bar (posterior to metatarsal heads, transfers load to shafts), sole wedge (can promote forefoot eversion or inversion), toe wedge (assist in intoing or outtoing), sole flare (widens base of support of shoe), shank filler (supports medial or lateral arch), steel shank (prevents motion of anterior sole, used with rocker bar).
3. Rocker bar is a convex strip placed across sole just posterior to metatarsal head (longer than metatarsal bar) thatis used to relieve metatarsal pain, assist rollover during stance, assist DF or push-off.
4. Heel wedge, heel flare, heel extension (to support arch), cushioned heel (stabilizes knee), heel lift (correct LLD of more than 1/4-1/2 inch).