Written by: Cherri Choate, DPM
3/23/2011

It is common for practitioners to make adjustments to insoles or orthotics.  Once these in-office adjustments are made, the ideal would be to convert these to long term modifications on the orthotics themselves.  Translating what was done, to what the lab needs to do can be challenging, but here are a few suggestions:
In-office Modification                                         Lab order________________
 1)  Cobra Pad                                            Medial skive pad and/or Arch Pad
 2)  Aperture Pad                                       Aperture Pad (poron) under topcover
 3)  Metatarsal pad                                    Metatarsal pad or bar under topcover
 4)  Lower heel cup for heel callus           New topcover and reshaping of heel cup
 5)  Plantar fibroma pad                            Grind accommodation into shell
 6)  Added padding to top cover               Add layer of "X: under current topcover
 7)  Tilted orthotic shell up/down              Add valgus/varus wedge at distal edge of plate
 8)  Decreased post due to heel pain       Remove RF post OR change to RF post to soft EVA
 
Usually, the current topcover is going to be replaced when the orthotics are refurbished, so drawing on the cover for exact placement is helpful to the lab.  Any measurements are helpful as this allows more accurate adjustment of the orthotic.
                                                            
 

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