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Simple Insoles

Types of simple inserts

There are two types of inserts these are accommodative and corrective. They can be used independently or in conjunction with each other to address various lower limb abnormalities.


These types of devices do not provide any correction; they only protect the area under investigation e.g. a redistributive pad.


These are devices that correct or modify the alignment of the lower limb.

Where correction is possible, even if it is only partial, the corrective element should always take precedence over the protective element.

Choice of material

The choice of material will determine the amount of correction that is required. Considerable forces are generated during gait even with simple deformities therefore the firmer the material the better the correction.

It is important that the practitioner develops a working knowledge of the available materials in order to provide an effective service to their patients.

Before fitting inserts you need to consider the following:

  1. Patient’s footwear – accommodation of insert
  2. Type of device - will it cause discomfort to patient
  3. Sweaty feet - choice of cover material
  4. Cold feet - choice of base or cover material

Type of simple inserts and their use

Valgus pad/D-fillers

These are used to provide support to the medial longitudinal arch. These should only be used in conjunction with other functional components such as a medial heel wedge. If only a valgus pad is applied to simple insoles to support the arch this eventually lead to weakening of the supporting muscles over time. In order to prevent this problem a valgus pad should extend more proximally under the heel to provide support and stability of both the rear foot and medial longitudinal arch.

Tarsal pad

This sits proximal to the met heads and just distal to the medial and lateral tuberocity of the calcaneum. Its main function is to increase the weight bearing area of the foot particularly in patients with high arched feet that are experiencing discomfort under the metatarsal heads. It also provides stability particularly for patient who experience reoccurring lateral ankle sprains.

Tarsal cradle

Tarsal cradles consist of a valgus pad on top of a tarsal pad. Tarsal cradles provide both medial and lateral stability of the foot.

Tarsal cradles are suitable for the following conditions:

  • Tarsal arthritis
  • Severe ankle sprains (reoccurring)


Hallux toe prop

A toe prop can be applied as a separate component or it may form an extension of a cobra/valgus pad. The hallux toe prop extends from the distal edge of the valgus/cobra pad to the mid point under the first metatarsophalangeal joint (mtp jt). The main function of a toe prop is to increase the amount of available hallux dorsiflexion during the propulsive phase of the gait cycle, which may be restricted by conditions such as hallux limitus (also see functional hallux limitus wedge in the orthotics section).

Plantar metatarsal pad (PMP)

This is a pad that is placed under the ball of the foot to provide cushioning.

Winged pad/redistributive pad (“U”PMP)

This is a PMP with one or more cut outs under peak pressure area e.g. first, second or fifth metatarsal heads. Its main function is to reduce pressure under the site of discomfort.

Suitable for the following conditions:

  • Sesamoiditis
  • Plantarflexed first ray (fixed)
  • Subluxed 2 nd, 3 rd or 4 th metatarsal heads

Metatarsal dome

This is a dome shaped pad about the size of a 50p, which is placed directly under the 2 nd/3 rd or 3 rd/4 th metatarsal heads to help lift and spread the metatarsophalangeal joints.

Suitable for the following conditions:

  • Metatarsalgia
  • Morton’s neuroma


Cuboid pad

The cuboid pad is used when a patient presents with a chronically subluxed cuboid. It is placed under the calcaneocuboid joint.

Horseshoe pad

When peak impact forces on heel strike needs to be redistributed a horseshoe pad provides an aperture to help alleviate impact forces.

Suitable for the following conditions:

  • General heel pain
  • Heel spur
  • Bruised fat pad of the heel

Corrective components

Cobra pad

Cobra pads consist of a valgus pad with a tail that extends proximally around the heel. It provides stability from foot strike through to mid-stance; it also helps to provide cushioning for the heel at heel strike.

Cobra pads are suitable for the following conditions:

  • Heel pain
  • Plantar fasciitis
  • Rearfoot varus
  • Forefoot varus (not severe)
  • Reduced ankle dorsiflexion

Reverse cobra/wale pad

This is a cobra pad, which is place around the lateral border of the insert. These are suitable for patients who heavily weight-bear on the lateral border of their feet.

Medial/lateral heel or forefoot wedges

These are corrections which are applied to the heel / forefoot in order to reduce the rate / amount of pronation/supination.

  • Rearfoot varus, forefoot varus, valgus
  • Tibial varum

Posting can range from 3º - 5º