Footwear Modifications and Repairs | Foot Balance Technology

✦

Precision Clinical modification

Built Around You Individual foot needs

FOOTWEAR MODIFICATION

Why Modifying Your Footwear Can Change How You Walk

Sometimes you simply cannot buy the shoe you need off the shelf. Whether you're managing a leg length discrepancy, recovering from surgery, living with Charcot foot or dealing with a diabetic plantar ulcer, standard footwear often falls short of what your feet really need.

At Foot Balance Technology, our in-house modification workshop operates under the clinical oversight of Dr Sayed Ahmed,, Australia's first PhD in Pedorthics and holder of the CPed CM AU credential - the qualification that permits the clinical fabrication of therapeutic footwear modifications.

Clinical Oversight In-House Workshop Therapeutic Modifications

CLINICAL PRECISION

FOOTWEAR CLINICALLY PRESCRIBED

MODIFICATION INDIVIDUAL

Pressure Management

Alignment Correction

Protection At-risk areas

PEDORTHIC CARE

The Need For Pedorthic Footwear Modification

A pedorthic footwear modification is a structural change to a shoe that's been specifically prescribed following a clinical assessment.

It might involve the sole, the upper or the way the shoe closes — whatever is needed to address your particular foot health issue, whether that's reducing pressure, correcting alignment or protecting an area that's at risk.

✓

NOT A COSMETIC ALTERATION

This is not the same as a cosmetic alteration or a standard shoemaker's repair. The prescription is based on assessment findings, and the modification is fabricated to clinical specifications.

External Shoe Modifications

External modifications change the shape, height or mechanics of a shoe's outer sole. They are applied to the outside of the footwear and are among the most commonly prescribed interventions at FBT. Each type addresses a different clinical need and is selected based on assessment findings rather than personal preference.

ROCKER

Rocker Soles

A rocker sole is a curved external modification that changes the way a shoe moves through each step. Instead of the foot bending at the forefoot as it normally would, the curved sole rolls the shoe forward, reducing load on joints and pressure points that bear the full force of push-off.

There are four subtypes, and choosing the wrong one defeats the purpose. A heel rocker softens the impact when your foot first hits the ground. A toe-only rocker takes pressure off the ball of the foot and toes. A mid-foot rocker shifts load away from the middle of the foot. A full rocker does both, and is used when the clinical picture is more complex.

Conditions that benefit include hallux rigidus, plantar fasciitis, Charcot foot, metatarsalgia, diabetic plantar ulcers and limited ankle mobility. The subtype prescribed depends on where pressure needs to be reduced and why. The material used is EVA - ethyl vinyl acetate - a lightweight, compressible foam shaped to precise clinical specifications.

20mm

Shoe Raises and
External Build-Ups

A shoe raise adds material to the heel and/or full sole to compensate for leg length discrepancy, or LLD. Even a difference of 5mm or more can affect gait and place uneven load on hips, knees and lower back over time.

For smaller discrepancies, a heel-only raise is usually sufficient. Where the difference exceeds 20mm, a full sole raise is required to avoid destabilising the foot. The outcomes of a well-prescribed raise include improved gait symmetry, reduced pelvic tilt and relief from knee and lower back pain. Materials used include EVA and crepe rubber.

WEDGE

Flares, Wedges, Buttresses
and the SACH Heel

These modifications adjust the base of the shoe to change how weight is distributed through the foot and ankle.

A medial flare widens the inner edge of the sole to reduce inward rolling, known as pronation. A lateral flare does the opposite, addressing feet that roll outward, or supinate. A heel wedge is a tapered piece of material that shifts alignment of the heel and subtalar joint, sitting just below the ankle. A buttress extends a flare upward along the upper, giving the midfoot additional structural support.

The SACH heel replaces the standard heel base with a compressible rubber insert that cushions each step. It's particularly useful when ankle movement is restricted - rather than the foot absorbing the impact of each step, the heel insert does the work instead.

CARBON FIBRE

External Metatarsal Bar
and Carbon Fibre Sole Plate

An external metatarsal bar is a strip of EVA applied across the ball of the foot on the outer sole. It shifts the shoe's flex point back behind the metatarsal heads, reducing forefoot pressure with each step - achieving a similar outcome to a rocker sole but without the full rolling motion.

A carbon fibre sole plate is a rigid plate laminated into the sole to prevent the foot bending during walking. It is used where any forefoot movement is harmful, including Charcot foot, hallux rigidus and diabetic plantar ulcer management.

Internal Shoe Modifications

Internal modifications are made inside the shoe to improve fit, reduce pressure on vulnerable areas and accommodate deformities that make standard footwear uncomfortable or unsafe.

A toe box excavation removes material from the insole beneath a prominent metatarsal head or pre-ulcerative lesion, creating a pressure-free zone over the area most at risk.

A metatarsal pad sits just behind the ball of the foot to spread load across a wider surface.

A tongue pad fills space at the front of the shoe to stop the foot sliding forward, a common cause of toe pressure and nail damage.

A heel cup cradles the heel to improve shock absorption.

An internal heel lift raises the heel within the shoe to address leg length differences or reduce strain on the Achilles tendon.

The primary material for internal modifications is Plastazote, a closed-cell foam that moulds to the foot with gentle heat.

Closure and Upper Modifications

For some patients, the challenge isn't the sole of the shoe but how it opens, closes and fits around the foot. People with limited hand dexterity, swollen feet or bony deformities often find standard lace-up footwear difficult to manage, and a poor closure system can create pressure points that cause real harm for patients with reduced sensation.

A Velcro conversion replaces laces with hook-and-loop straps that can be fastened with one hand and adjusted as swelling changes.

A strap extension lengthens an existing strap for wider or oedematous feet.

A D-ring addition creates a new anchor point where the original design lacks adjustment.

An elastic lace conversion allows the shoe to slip on without losing a secure fit.

A heel collar raises the back of the shoe to prevent the heel lifting during walking.

SHOE MODIFICATION

Shoe Stretching and Relasting

Shoe stretching uses mechanical pressure to widen the upper of an existing shoe, creating more room for bunions, hammertoes or oedematous feet. It is done gradually to avoid damaging the shoe's structure.

Relasting goes further, widening the entire sole base beyond the upper to increase ground contact and improve lateral stability. Both procedures extend the life of therapeutic footwear that might otherwise no longer fit safely.

Footwear Repairs: Extending the Life of Medical-Grade Shoes

Medical-grade footwear isn't something you can hand to just anyone for repairs. It was built to a clinical prescription, and whoever works on it needs to understand what that prescription was trying to achieve.

Taking therapeutic footwear to a general cobbler carries real risk. Replacing a worn rocker sole without understanding the original prescription can alter the modification's geometry entirely, undoing the clinical benefit and potentially creating new pressure problems.

FBT

At FBT, repairs are carried out in-house under clinical oversight. We handle outsole replacement, heel cap replacement, modification rebuild for worn rocker soles or raises, upper re-stitching, lining repair and sole re-bonding. Each repair is checked against the original prescription to ensure the therapeutic function is fully restored.

If your medical-grade footwear is wearing down, bring it in before the modification is compromised.

How the Modification Process Works at FBT

Every modification at FBT follows the same clinical pathway. Nothing is fabricated without a prescription, and every prescription is based on a thorough assessment.

It starts with a 45-minute assessment where we go through your medical history, your current footwear and how you actually move. We use 3D foot scanning and in-shoe pressure mapping to see exactly where your foot is under stress - not where we'd expect it to be, but where it actually is for you.

From that assessment comes a written prescription specifying the modification type, material and placement. The modification is then fabricated in our in-house workshop to those specifications, and you return for a fit and review appointment. Where needed, plantar pressure mapping is run again to confirm the modification is performing as intended.

For complex or progressive conditions, a follow-up review is scheduled to check for wear and update the prescription if required.

Funding Your Footwear Modifications

The cost of modifications isn't always something you have to cover out of your own pocket. NDIS participants may be able to access funding through Assistive Technology, and DVA covers modifications for eligible veterans. Enable NSW, icare NSW and CTP insurance are also worth exploring, and My Aged Care packages or private health extras may contribute depending on what you're covered for.

You don't need a referral to book at FBT, but bringing any existing GP letters or specialist reports will help us determine eligibility and get the process moving.

Frequently asked questions

What types of shoe modifications does a pedorthist do?

Pedorthic modifications include rocker soles, shoe raises, medial and lateral flares, heel wedges, SACH heels, carbon fibre sole plates, external metatarsal bars, toe box excavations, metatarsal pads, heel cups, Velcro conversions, strap extensions and elastic lace conversions. Each is clinically prescribed following a biomechanical assessment.

What is a rocker sole and who needs one?

A rocker sole is a curved external modification that rolls the shoe through each step, reducing pressure on joints and forefoot structures. It is commonly prescribed for hallux rigidus, plantar fasciitis, Charcot foot, metatarsalgia and diabetic plantar ulcers. There are four subtypes and the right one depends on where pressure needs to be reduced.

Can a pedorthist modify my existing shoes?

Sometimes, yes. It depends on the shoe's construction and materials. Some footwear simply can't accommodate a clinical modification without compromising the result. Your pedorthist will assess your shoes at your appointment and advise whether modification is feasible or whether medical-grade footwear is a better option.

What is a shoe raise and how does it help leg length discrepancy?

A shoe raise adds material to the sole to compensate for a difference in leg length. Even discrepancies of 5mm or more can affect gait and cause hip, knee and lower back pain. The type of raise prescribed depends on the size of the discrepancy and is determined by assessment.

How long do shoe modifications last before they need replacing or repairing?

It depends on the modification type, materials and how much walking you do. Rocker soles and raises made from EVA will compress and wear over time. Most modifications benefit from a review every 12 months, and FBT can assess wear and rebuild or replace what's needed.

Are shoe modifications covered by NDIS or private health insurance?

They may be. NDIS participants can access funding under Assistive Technology, and many private health funds cover pedorthic modifications under extras cover. DVA, icare NSW and Enable NSW are also possible pathways. Our team can help work out what applies to you

What is the difference between internal and external shoe modifications?

External modifications are applied to the outside of the sole and change the shoe's shape, height or mechanics. Internal modifications are made inside the shoe to improve fit, redistribute pressure or accommodate deformities. Many prescriptions combine both types.

Can shoe modifications help with Charcot foot or diabetic ulcers?

Yes. Rocker sole modifications and carbon fibre sole plates are used in the management of Charcot foot and diabetic plantar ulcers where reducing forefoot pressure is essential. These modifications work alongside custom insoles and medical-grade footwear as part of a broader clinical plan.

Find Us Easily

Westmead Clinic

To visit our Westmead clinic for an in-person appointment, we are located at Unit 19, 1A Ashley Lane, just 250 metres from Westmead Station, making it easy to access by train or local transport.

Room 19, 1A Ashley Lane Westmead NSW2145

info@footbalancetech.com.au

1300 246 328

Castle Hill Clinic

To visit our Castle Hill clinic for an in-person appointment, we are located at Unit 8, 15 Carrington Rd, just 650 metres from the Hills Showground Metro station, with on-site parking available.

Unit 8, 15 Carrington Rd Castle Hill NSW2154

info@footbalancetech.com

1300 246 328

Campbelltown Clinic

20 King St, Campbelltown NSW 2560 (Open on Thursday only)

info@footbalancetech.com.au

1300 246 328

Our Research Partners

Accepted Health Funds & Government Funding

Book a Footwear Modification Assessment at Foot Balance Technology

All modifications at FBT are prescription-based. That means the first step is always an assessment, not a walk-in fitting. Our team will take the time to understand your condition, your footwear history and your daily needs before anything is fabricated.
No referral is needed. We see patients at our Westmead, Castle Hill and Campbelltown clinics, and NDIS, DVA and major health funds are accepted.

Book Your Consultation

Footwear Modifications and Repairs: What a Pedorthist Can Do for Your Shoes

Why Modifying Your Footwear Can Change How You Walk

The Need For Pedorthic Footwear Modification