The right shoe can do a great deal.
But for some clients, even a well-fitted shoe in excellent condition cannot fully meet their clinical needs without modification. Custom shoe modifications allow your existing footwear — or new footwear selected at Align — to be adapted to your specific biomechanical findings, structural needs, or medical condition.
Modifications are prescribed by your Align Registered Chiropodist as part of your Body Align Assessment or check-up, then fabricated by a certified orthopaedic lab to clinical specification. The result is footwear that does something a standard shoe cannot: support your body the way your body actually needs it.
Our Body Align Assessment is the appointment we recommend if you are looking for custom shoe modifications.
Experience a comprehensive 55 minute assessment from our team of Registered Chiropodists. Your clinician will examine how your body moves as a connected system - including your posture, back, hips, knees, ankles, leg length differences, walking gait, and, of course, your feet and any specific symptoms. This whole-body biomechanical evaluation features advanced slow-motion video analysis at 240-fps, musculoskeletal testing and includes a shoe shopping tutorial.
During your appointment, Custom Align Orthotics™ may be prescribed as part of your treatment plan, if clinically recommended. Your clinician will take precise 3D laser scans of your feet to create fully customized orthotics designed specifically for your body, movement patterns, and lifestyle needs.
Your custom orthotics are typically ready within two weeks, at which time you’ll return for a personalized fitting appointment to ensure proper alignment, comfort, and function.
All services are claimable under most extended health insurance plans through Chiropody, Podiatry or Custom Orthotics coverage.
Custom shoe modifications are recommended when:
Many clients arrive having been told by another provider that they need a shoe modification. If that describes you, your Align clinician will evaluate your footwear, your biomechanics, and your clinical history to confirm the prescription before anything is sent to the lab.
Shoe lifts are the most common modification we prescribe, and they are among the most clinically impactful. When a leg length discrepancy (LLD) cannot be fully addressed by an internal lift within the orthotic or shoe, an external lift built into the sole of the footwear provides a more substantial and structurally stable correction. Your clinician determines the lift height through a structured evaluation of your posture, gait, and pelvic alignment — striking the balance between correcting the discrepancy and maintaining comfort and stability. Lifts can be applied to the heel only or distributed across the full sole depending on the clinical indication.
A bunion — or any prominent bony enlargement at the forefoot — creates a pressure point that standard footwear cannot accommodate without modification. Targeted shoe stretching expands the upper of the shoe at the precise location of the deformity, creating space that relieves pressure without compromising the structure or fit of the rest of the shoe. This is particularly valuable for clients who have found footwear that otherwise fits and supports them well, and do not want to replace it. Stretching can also be applied for hammer toes, tailor's bunions, or other forefoot prominences identified during assessment.
Where stretching addresses a localized prominence, widening modifies the overall width profile of the shoe — typically through the toe box or midfoot. This is indicated when a client's foot width consistently exceeds what standard sizing can accommodate, leading to compression, skin breakdown, or altered gait mechanics as the foot compensates within a restricted shoe. Widening preserves the shoe's structure while giving the foot the room it needs to function properly.
A rocker sole modifies the geometry of the shoe's outsole to roll the foot through the gait cycle with reduced demand on specific joints. This is particularly effective when ankle dorsiflexion is restricted, when 1st MTP joint mobility is limited or painful, or when conditions like arthritis, hallux rigidus, or diabetic foot complications make normal heel-to-toe roll difficult or harmful. The location and radius of the rocker are prescribed to the client's specific gait findings — a forefoot rocker has a different clinical application than a heel-to-toe rocker, and the prescription matters.
A flare widens the base of the shoe's outsole — medially or laterally — to improve stability and reduce the tipping moment on the foot and ankle. A medial flare supports a pronating foot and reduces the tendency of the ankle to roll inward under load. A lateral flare is indicated where supination or chronic ankle instability creates risk of lateral rollover. Flares are often used in conjunction with orthotics and are particularly relevant for clients with significant coronal plane instability or those managing chronic ankle conditions.
A buttress is a reinforcing structure added to the heel counter or specific regions of the shoe's upper to provide targeted support or control where the standard shoe construction is insufficient. This is most commonly indicated in conditions involving significant rearfoot instability, post-surgical presentations, or structural foot conditions such as club foot — where the foot's shape or mechanics require a degree of external guidance that cannot be achieved through orthotic design alone. Your clinician will specify the location, material, and function of the buttress based on your clinical presentation.
Your clinician evaluates three things before any modification is prescribed: your biomechanics, your current footwear, and your clinical history. Modifications are never applied to footwear that is structurally worn out, poorly fitted, or incompatible with the intended correction — in those cases, your clinician will recommend appropriate footwear first.
Once the prescription is confirmed, your footwear is sent to a certified orthopaedic lab where the modification is fabricated to your clinician's specification. Turnaround time varies by modification type and will be confirmed at the time of your appointment.
Modifications are most commonly recommended as part of a Body Align Assessment or BAA check-up. If you have been referred by another health care provider, or have had shoe modifications prescribed in the past, bring your existing footwear and any relevant documentation to your appointment.
Not always. The shoe must have sufficient structural integrity and be appropriate for the intended correction. Your clinician will evaluate your footwear as part of the consultation and advise whether modification is suitable or whether new footwear is the better starting point.
Turnaround depends on the modification type and lab scheduling. Your clinician will provide an estimated timeline at your appointment.
Lift height and sole geometry changes are coordinated with your orthotic design where both are in use. Your clinician accounts for this in the prescription so the two work together, not against each other.
Yes. Bringing footwear you already wear and trust is often the best outcome — modifications preserve what works while correcting what doesn't.
Your clinician will review the referral and your clinical history. In most cases a focused evaluation is sufficient, but a full Sports or Signature Body Align Assessment may be recommended if your biomechanics haven't been evaluated recently. Your clinician will advise at the time of booking.
Ready to check 'healthy feet' off your self-care list? Book your appointment today by using the link below. It's never too early or too late to start. We look forward to helping you find beauty and balance through better foot health. Improve the way you move.
For any additional inquiries, please utilize our contact form and we’ll get back to you as soon as possible.
