A patient presented to the office with a pair of functional foot orthotics in his hands asking for a second opinion. He reports pain on the rim of the heel to both feet since about a week of wearing them. He stopped wearing them while waiting to see me.
My immediate thought was that the devices were too narrow in the heel cup. He stood on them for me and, yes, they were indeed too narrow. What can you do with this pair of orthotics to adjust them to fit the patient?
Couple options: (Note: These options would certainly depend on whether or not the patient’s heel even fits in the heel cup! I make sure the heel fits in the heel cup non-weightbearing first.)
– raise the patient up out of the heel cup with a small heel lift underneath the top cover (Korex or poron works well)
– shallow out the depth of the heel cup (this requires a grinding wheel) this will effectively widen the orthotic

I also educate the patients and make sure they understand that if I can’t get the heel width increased enough to get the patient’s weightbearing heel width into the device that I would recommend a new pair of devices and I make sure to measure the weightbearing heel width and report that number to the lab on the Rx form.