The goal of shoe modifications is to correct foot imbalance during weight bearing activities. In the flexible sensate foot, the corrections will be made to achieve proper weight distribution. The rigid, and/or abnormally structured foot, may not have sensation and is at high painful ambulation. Accommodation requires that the ground be brought up to the plantar surface of the foot with modifications and insoles.

Internal Modifications
Internal modifications are changes made inside the shoe to relieve pressure or shear forces that cause pain, irritation or trauma to the foot. The orthotic added to the shoe may relieve some of the pressure, but many times the problem requires more relief. Tongue pads, scaphoid pads, metatarsal pads and stretching are commonly used as relief of irritation.

Inserted Modification
Modifications made between the shoe and outsole. It includes SACH Heel, Inverter/Everter SACH Heel, Medial/Lateral Wedge, Forefoot Wedge, Beveled Heel.

External Modification
Modification made to sole of shoe . General Rocker Sole and Elevation Procedure include several steps such as Remove sole and san shoe surface, Cut crepe for elevation and sand surface, Cover both surfaces with cement and let dry etc.

Upper Modification
Modification made to the shoe's upper construction. It includes Bunion Modification, Retrocalcaneal Spur/Haglund's Deformity/Pump Bump, Shrinking Heel of Shoe and Stretching or Reshaping Toe Box.

Systemic Modification
Modifications that affect the entire shoe construction. It classifies to Spreading midfoot for chronic conditions, Spreading Forefoot Width for Accommodation and Stabilizers(Blsters) for Medial/Lateral Support And Heel Offset

Cosmetic Modification
Modifications that affect the cosmetic appearance. Low boot(3 eyelet) with tongue. Hi-top lace extended upper. Adding a velcro instep flap. Adding a cross "X" strap. Adding a "T" strap