Written by: Cherri Choate, DPM
6/30/2010

    Although often not considered as a seperate component, the bottom cover can be important in certain types of orthotics.  Many practitioners exclusively order devices with bottom covers, as the devices are fabricated with that component as a default addition  As an example, at Prolab, the Proaerobic device has both a top and bottom cover.  So when would this be important to consider?
    The bottom cover has the following common uses:
        1)  To protect any forefoot additions or extensions, such as metatarsal pads or metatarsal head punches/slots
                                      2)  To improve the integrity of the device-forefoot extension interface 
                                      3)  To add a "stiffness" to distal device and improve ease of transfer from shoe to shoe, if the topcover alone tends to
                                          be floppy and difficulty to manage
                                      4)  To add thickness to the forefoot area for shoe fit 
                                      5)  To decrease tendency for topcover to wrinkle or slip in toe box of shoe
                                The bottom cover also has some limitations that need to be noted:
                                    1)  It makes the device thicker, thereby taking up more room in the toebox of the shoe
                                    2)  It disallows modifications of any forefoot additions unless the layers are torn apart (which can be difficult)
                                   3)  It adds cost to the device               
 Just another option to keep in mind when ordering custom devices for your patients.

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