Internal Modifcations

Internal Modifications

Metatarsal Pad

  • placed just behind the problem met head

  • metatarsalgia or localized callosities on the ball of the foot.

  • Relieves pressure under metatarsals

  • great comfort for dress shoes

Metatarsal Bar

  • wider metatarsal pad

  • corns and calluses across the metatarsal arch

  • evenly distributes pressure across entire met arch

  • by reducing pressure corn and callus will reduce

  • hammer toes & plantar flexed mets

Scaphoid Pad/Long Arch Pad

  • placed from behind 1ST mpj to anterior of the heel

  • additional medial arch support

  • help pronation

  • plantar fasciitis

  • acts as a shock absorber

  • 1ST met & 1ST mpj disorders

Sesamoid Pad/Dancers Pad

  • place on top of met heads w/ big toe in the pocket

  • turf toe & sesamoiditis

  • irritations under the big toe

  • relieve calluses and blisters under the big toe

  • common use by dancers

Morton’s Extension

  • Added under first met head & extends to 1ST ipj, or end of hallux

  • 1/18– 3/16’’ thickness

  • Increase load under 1ST met head

  • Use in orthotics or shoe insert

  • Hallux limitus, use flexible material to help increase 1ST mpj range of motion

  • Hallux rigidus, use rigid material to limit joint motion

  • for rigid design use with met rocker

Neuroma Pad

  • pad placed between metatarsal shafts to relief nerve pain

  • more commonly between 3RD and 4TH met shafts

  • pad 1/8 to 1/4” high use with wider shoe to achieve relief

  • use in orthotics or shoe insert


insole excavation include filters with silicone gel, ppt, or poron top cover.

  • heel

  • midfoot

  • forefoot

    • heel spur excavations

    • reduces impact pressure in painful area

    • work great for bony prominences

    • filled with memory foam

    • concave (horseshoe, donut)

Internal Shoe Adjustments

  • heel grips

  • tongue pads

  • felt half insoles

  • halters

  • felt heel pads

  • horseshoe correction

Eneslow’s Dress Comfort Combination
PPTCut Out At The Ball; Forefoot Rocker; Arch Support With Leather Cover

  • excavation of the forefoot

  • filled with soft foam or liquid ppt

  • arch support covered with upper matched leather

  • optional metatarsal pad for pressure relief

  • optional heel wedge for more correction

  • inside of the shoe covered with leather insole

  • 1/4’’ forefoot rocker

This is Eneslow’s unique modification, making walking in high heel shoes unbelievably comfortable. You can stand and walk longer without foot pain.


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