Orthopaedic shoes

Off the Shelf Orthopaedic, Modified and Custom Shoes

Off the shelf orthopaedic, modified and custom shoes are three different names for shoes that provide different benefits. These kinds of shoes have features that can help with shoe fit as well as pain. You may notice these terms when reading though your insurance benefits, and they are all different.

Orthopaedic shoesOff the Shelf Orthopaedic Shoes

First, let’s talk about what off the shelf orthopaedic shoes are. They are a shoe you would find at a shoe store, but sold by a specialist like a Pedorthist. These shoes have a list of features that make it orthopaedic and more supportive and fitting for your feet. Some of these features include, but not limited to multiple width options, solid heel counter, removable footbed and an adjustable closure.

Off the shelf orthopaedic shoes are recommended when there is pain in the lower limb or there are issues with shoe fit. These shoes can typically benefit everyone because it would improve comfort for the feet.

Modified Orthopaedic Shoes

Modified orthopaedic shoes are an off the shelf orthopaedic shoe (see above), but a modification is added to the shoe. This kind of modification would be permanent to the shoe.

Modifications are recommended when there is something like a structural leg length difference, a wide foot or bunion causing additional pressure, a severely flat foot, ankle arthritis or an ankle fusion.

Shoe lift for a leg length differenceLeg Length Difference

A shoe lift is added when there is a structural leg length difference that is too large to fit inside the shoe. When the shoe lift is too large inside the shoe, the foot will slide out the back or the shoe will be too tight. A structural leg length difference is when one leg is actually short. This usually occurs due to a leg fracture as a child, from surgery or genetics. If it’s a functional leg length difference instead of structural, a shoe lift would not be the appropriate treatment. A functional different is when the legs appear short from something like a muscle imbalance or one foot collapses more than the other.

Wide Foot/Bunion

Typically, an off the shelf orthopaedic shoe will provide enough width for a wide foot or a bunion. When extra width is required, the sole of the shoe can be split to widen the base. This will provide support under the wide part of the foot. It also reduces pressure on the wide part of the foot.

Severe Flat Foot

A flat foot can be addressed with custom foot orthotics and off the shelf orthopaedic shoes, but a severe flat foot may need extra help.

Material can be added to the bottom of the sole to widen it, and provide a wider base for the flat foot. This reduces the pressure on the bottom of the foot, and it prevents extra collapse. If extra support is needed, material can be added to the entire side of the shoe. This holds the foot in place and prevents it from spilling out of the side of the shoe.

These modifications can also be used on the outside of the foot for a high arch or a foot that rolls outwards.

Ankle Arthritis/Ankle Fusion

When ankle arthritis or an ankle fusion is causing issues, a rocker sole is a great modification that can be added to a shoe. Some shoes will have a rocker sole already included, but a larger rocker can also be added. A rocker sole is a curved area to the shoe, either to the heel or at the toes. Both a heel and toe rocker can benefit for ankle issues. These rockers take pressure away from the ankle. They also allow the shoe to move instead of the ankle providing the work.

Another modification that can be done is to increase shock absorption during the initial heel contact. A soft material can be added to the back of the heel to absorb shock. This can reduce the strain at the ankle.

Custom Shoes

Custom shoes are typically recommended when the feet are not able to fit into any shoes even with added modifications. Some examples of these kinds of feet are extremely swollen feet, feet that are two or more sizes different from right and left and feet that are shaped in a way that will not allow an off the shelf shoe to fit.

With an off the shelf shoe, there is only a limited amount of material to work with. Modifications can change the fit of the shoe when there is a minor issue, but major issues would need a custom shoe made.


With these three types of shoes, there is a way to fit a shoe to every foot!

If you need shoes to help with pain or to improve your shoe fit, contact us to book an appointment!

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