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Betty McTague
Presents
The L.E.A.P. Program

DEFINITIONS

TYPES OF SHOE MODIFICATIONS

External shoe modification: any external change(s) to affect function of a shoe from the shoe’s original manufacturer’s specifications, including but not limited to the following:

Collar: an additional strip of material stitched around the topline of the shoe, sometimes padded. A collar may convert a low-top shoe into a high-top shoe or boot.

Counter stabilizer: an extension of the base of an existing heel medially (toward the body midline) and/or laterally (away from the body midline), encompassing the shoe counter. Its purposes are to stabilize the hindfoot and to provide a broader base of support.

Extended rigid shank: a firm, stiff, inflexible addition to the shoe between the insole and outsole extending heel-to-toe.

External wedges (posting): additions to the outsole and/or heel of the shoe that may be medial (toward body midline) or lateral (away from body midline). The function is to shift, transfer, or support weight upon standing or during ambulation. The purpose is to add support, stabilize, or equalize weight distribution.

Flared heel: an extension of the base of an existing heel medially (toward the body midline) and/or laterally (away from the body midline), which does not encompass the shoe counter. Its purpose is to stabilize the hind foot.

Heel elevations: additions to the heel of the shoe to accommodate limb length discrepancy. (Minimal elevations can be applied internally.)

Lateral Thomas heel: an anterior lateral extension longer than the standard heel to add hindfoot or midfoot support laterally.

Metatarsal bars: exterior bars with the apex placed proximal to (behind) the metatarsal heads, transferring pressure from the metatarsal heads. The bars are of various shapes, heights and materials.

Rigid rocker bottoms: exterior additions to the outsole that taper off to the distal tip of a shoe’s outsole, including extended rigid shank, and may taper off to the posterior edge of the heel, affecting biomechanical function.

Rocker bottoms: exterior additions to the outsole that taper off to the distal tip of the outsole and may taper off to the posterior edge of the heel, affecting biomechanical function.

Rocker sole

Mild rocker sole

Heel-to-toe rocker sole

Toe-only rocker sole

Severe-angle rocker sole

Negative-heel rocker sole

Double rocker sole

SACH heel (Solid Ankle Cushion Heel): a softer durometer material replacing a portion of the posterior heel base. SACH heels reduce shock at heel strike and compensate for the absence of ankle motion.

Sole elevations: additions to the outsole of the shoe to accommodate limb length discrepancy. (Minimal elevations can be applied internally.)

Thomas heel: an anterior medial extension longer than the standard heel to add hindfoot or midfoot support medially.

Velcro closure with D-rings: a shoe closure system of Velcro straps that fits through a rigid loop to assist individuals having difficulty tying laces.

Velcro closure without D-rings: a shoe closure system of Velcro straps without rigid loops to assist individuals having difficulty tying laces.

Internal shoe modification: functional or accommodative alteration(s) to the inside of a shoe that appropriately addresses the patient’s condition, including but not limited to the following:

Excavation: a depression created to the inlay or insole to relieve high pressure areas.

Heel spur modification: a device or modification in the posterior part of the insole or inlay designed to relieve pressure and absorb impact under the base of the heel/calcaneus.

Internal wedges (posting): additions to the interior of the shoe that may be medial (toward body midline) or lateral (away from body midline). The function is to shift, transfer, or stabilize, or equalize weight distribution.

Longitudinal arch pad: a device placed inside the shoe positioned medially between the calcaneus and first metatarsal head to provide support. Longitudinal arch pads are available in a variety of shapes, materials, and sizes.

Metatarsal pad: a device placed inside the shoe proximal to the metatarsal heads of an individual’s foot to relieve pressure and redistribute weight. Metatarsal pads are available in a variety of shapes, materials, and sizes.


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