Orthotic Modifications and Additions: All Included at No Extra Cost
Orthotic modifications change how a custom orthotic is shaped or how it behaves. Additions are components added to the device. Adjustments are changes made after a patient has worn it. At Orthix, you can prescribe any modification your patient needs, and all modifications are included at no extra cost.
All modifications included at no extra cost
Posting, heel lifts, met pads and bars, cut-outs, extensions, top covers and more. Prescribe what your patient needs on the order. There are no add-on charges for modifications.
Applies to modifications you prescribe on an Orthix order. Changes after submission and remakes follow the Orthix Terms.
Modifications, additions and adjustments: what's the difference?
- Modification:a change to the device's design, made when it's built, such as its posting, flexibility, heel containment or length.
- Addition: a component added to the device on top of the base design, such as a metatarsal pad or a heel lift, specified with a side, position and size or amount.
- Adjustment: a change to a finished device after the patient has worn it, usually after a wear-in period and a follow-up visit.
Labs and clinicians don't always use these words the same way. What matters on any order is that the lab can see what you want, on which side, where, and how much.
Common orthotic modifications, explained
Every modification below is available on request on an Orthix order, at no extra cost. If you need something that isn't listed, write it in your clinical notes. The lab reviews each order before accepting it and will contact you if anything needs discussing.
| Modification | What it is | What to write on the order |
|---|---|---|
| Rearfoot posting | An angled wedge or post at the heel of the device, either built into the shell (intrinsic) or added underneath it (extrinsic), varus or valgus. | Side, varus or valgus, amount in degrees, and intrinsic or extrinsic. |
| Forefoot posting | An angled post under the forefoot area of the device, varus or valgus, intrinsic or extrinsic. | Side, varus or valgus, amount in degrees, and intrinsic or extrinsic. |
| Heel skive | A medial or lateral adjustment to the heel area of the device, commonly used to change how the heel seat sits under load. | Side, medial or lateral, and the amount. |
| Heel lift | Added height under the heel, on one or both sides. | Side and height. |
| Heel cup depth | How deep the heel seat is and how high its walls sit. | Side, the depth you want, and why. |
| Metatarsal pad | A raised pad placed just behind the metatarsal heads, commonly used to offload the forefoot. | Side, position (which metatarsals) and size. |
| Metatarsal bar | A raised bar across the device just behind the metatarsal heads. | Side and position. |
| Cut-outs and accommodations | A recess or relief area in the device under a spot you want to offload, such as a single metatarsal head or part of the heel. | Side, location and size. Say what the relief is for. |
| Extensions | Extending the device, or part of it, beyond its usual length, for example under the first toe (Morton's extension) or under toes 2 to 5 (reverse Morton's extension). | Side, type of extension and which toes. |
| Flanges | A raised edge along the medial or lateral side of the device. | Side, medial or lateral, and how far it should run. |
| Device length | Where the device ends: full length, sulcus length or 3/4 length. | The length, and the shoe it has to fit. |
| Shell flexibility | How much the device bends under load, from flexible to semi-rigid to rigid. | The flexibility you want, plus the patient's body weight and activity level. |
| Top covers | The layer the foot sits on. Covers vary in feel, thickness and length. | Cover length, any cushioning preference, and the shoe it has to fit. |
Rearfoot posting
An angled wedge or post at the heel of the device, either built into the shell (intrinsic) or added underneath it (extrinsic), varus or valgus.
What to write on the order: Side, varus or valgus, amount in degrees, and intrinsic or extrinsic.
Forefoot posting
An angled post under the forefoot area of the device, varus or valgus, intrinsic or extrinsic.
What to write on the order: Side, varus or valgus, amount in degrees, and intrinsic or extrinsic.
Heel skive
A medial or lateral adjustment to the heel area of the device, commonly used to change how the heel seat sits under load.
What to write on the order: Side, medial or lateral, and the amount.
Heel lift
Added height under the heel, on one or both sides.
What to write on the order: Side and height.
Heel cup depth
How deep the heel seat is and how high its walls sit.
What to write on the order: Side, the depth you want, and why.
Metatarsal pad
A raised pad placed just behind the metatarsal heads, commonly used to offload the forefoot.
What to write on the order: Side, position (which metatarsals) and size.
Metatarsal bar
A raised bar across the device just behind the metatarsal heads.
What to write on the order: Side and position.
Cut-outs and accommodations
A recess or relief area in the device under a spot you want to offload, such as a single metatarsal head or part of the heel.
What to write on the order: Side, location and size. Say what the relief is for.
Extensions
Extending the device, or part of it, beyond its usual length, for example under the first toe (Morton's extension) or under toes 2 to 5 (reverse Morton's extension).
What to write on the order: Side, type of extension and which toes.
Flanges
A raised edge along the medial or lateral side of the device.
What to write on the order: Side, medial or lateral, and how far it should run.
Device length
Where the device ends: full length, sulcus length or 3/4 length.
What to write on the order: The length, and the shoe it has to fit.
Shell flexibility
How much the device bends under load, from flexible to semi-rigid to rigid.
What to write on the order: The flexibility you want, plus the patient's body weight and activity level.
Top covers
The layer the foot sits on. Covers vary in feel, thickness and length.
What to write on the order: Cover length, any cushioning preference, and the shoe it has to fit.
Modifications go into the online assessment and clinical notes in the Orthix app, together with the device family and the 3D model the app generates from your phone or iPad capture. For a field-by-field checklist, see the orthotic order form and prescription guide.
Start with the device family
The device family is the base design. Modifications fine-tune it for the patient and the shoe.
| Device family | Design focus (from the Orthix product pages) | Typical footwear |
|---|---|---|
| Dress | Low-profile, reduced-volume design for space-limited footwear | Dress shoes, loafers, some low-volume casual shoes |
| Casual | Everyday support and cushioning; the all-rounder in the range | Sneakers and walking shoes |
| Sport | Performance-oriented support and cushioning for repeated athletic loading | Running and court shoes, ski and snowboard boots |
| Marathon | Endurance-focused cushioning and a stable fit for repeated forward motion | Running shoes |
| Super Flex | Flexible shell that bends more readily with the foot | Active shoes where a more flexible device is preferred |
| Super Soft | Maximum-cushion option with a gentle underfoot feel | Roomier everyday shoes |
| Diabetic | Comfort-focused cushioning and pressure-management support for sensitive feet, within a clinician-guided plan | Footwear with appropriate depth and width; sometimes extra-depth or custom footwear |
| Safety Medix | Workday-focused support, with fit planning for safety boots and industrial footwear | Safety boots and industrial shoes |
| UCBL | Clinician-prescribed pediatric design with deep heel containment and higher sidewalls for close foot control | Stable, adequately deep shoes with secure closures |
Device families are ordering categories, not diagnoses. Pick the family that fits the patient's footwear and activity, then add your modifications and clinical notes.
Why clinics switch to Orthix
A simpler way to order custom orthotics for your clinic.
No scanner needed
Capture both feet on a phone or iPad. The Orthix app generates the 3D model.
Your first pair is free
Clinics new to Orthix get their first pair free on their first order.
All modifications free
Prescribe the modifications you need. They're included at no extra cost.
Simple online ordering
Online assessment, 3D model and order submission in one app.
Clear shipping
$8 per parcel/per orthotic, free at 21+ orders a month.
Typical fabrication 5–10 days
Typical fabrication time after lab acceptance, shipped across Canada.
No account or setup fees
Register your clinic and start ordering with no account or setup fees.
6-month guarantee
Manufacturing defects are repaired, remade or credited for 6 months after shipping.
Lab reviewed
The lab reviews every order before accepting it.
How to write modification instructions the lab can follow
- Name the device family and the shoe it has to fit, including heel height.
- One modification per line, each with the side (left, right or both), the location on the device, and the size or amount.
- Say whyin a few words, such as the pressure area, the goal or what didn't work last time, so the lab can flag a conflict.
- Mark left and right differences clearly instead of assuming the lab will mirror one side.
- Reference the previous device if this is a reorder: what to keep and what to change.
- Check the capture or impression matches the patient and side before you submit.
This is general guidance for clinic teams. Prescription decisions stay with the practitioner.
Changing an order after you submit
Under the Orthix Terms, changes to an order after submission need Orthix's approval, and they may not be possible once production has started. An approved change can affect the price and the timeline. If you spot something after submitting, message the lab on the order straight away.
Orthotic adjustments after fitting
Some devices need a follow-up adjustment after a wear-in period. Tell patients early that this is a normal part of fitting, and separate it from a remake.
Under the Orthix Terms:
- If a device has a manufacturing defect attributable to Orthix, contact the lab promptly with the order details and pictures of the device. Orthix may repair, remake or credit it.
- Fit or comfort issuesthat come from the prescription, assessment data, changes in the patient's anatomy, or shoe choice aren't manufacturing defects. Remakes for those reasons may be charged as new work, including shipping.
To ask about an adjustment, contact the lab on the order in the app, or at +1 (604) 447-2880 or info@orthix.ca. Our guide to reducing custom orthotic remakes covers how to tell an adjustment from a remake.
Order from a Canadian custom orthotics lab
Orthix is a custom orthotics lab in Canada, based in Vancouver, BC. See our Vancouver orthotics lab page for Lower Mainland pickup or courier. Clinics order online in the Orthix app: complete the online assessment, capture both feet on any phone or iPad, and the app generates a 3D model. Orthix also accepts 3D scan files in a format the lab accepts, and foam compression impressions. The lab reviews each order before accepting it, and typical fabrication is 5–10 days after lab acceptance. Finished orthotics ship to clinics across Canada.
Using another lab today? Our guide on how to switch orthotics labs walks through the move step by step.
Related guides
- Choosing a functional or accommodative approach? Read functional vs accommodative orthotics.
- Matching assessment findings to device families: the custom orthotic prescription and device-selection guide.
Switching labs? Your first pair is free
Clinics that move to Orthix get their first pair of custom orthotics free. Register your clinic, place your first order in the Orthix app, and see the fit and finish for yourself.
For clinics new to Orthix. One free pair per clinic, applied to your first order.
FAQ
- Do orthotic modifications cost extra at Orthix?
- No. All orthotic modifications you prescribe on an Orthix order are included at no extra cost. There are no add-on charges for modifications.
- What orthotic modifications can we order from Orthix?
- Orthix supports all orthotic modifications. Common requests include rearfoot and forefoot posting, heel skives, heel lifts, heel cup depth, metatarsal pads and bars, cut-outs and accommodations, extensions, flanges, device length, shell flexibility and top covers. If you need something else, write it in your clinical notes.
- What's the difference between an orthotic modification and an addition?
- A modification changes the device's design when it's built, such as its posting, flexibility or length. An addition is a component added to the device, such as a metatarsal pad or heel lift, specified with a side, position and size or amount. An adjustment is a change to a finished device after the patient has worn it.
- How do we prescribe a modification on an Orthix order?
- Add it to the online assessment and clinical notes in the Orthix app, with the side, the location on the device and the size or amount, and a few words on why. The lab reviews every order before accepting it and will contact you if anything needs clarifying.
- Can we change an order after submitting it?
- Changes after submission need Orthix's approval and may not be possible once production has started. An approved change can affect the price and timeline. Message the lab on the order as soon as you spot the issue.
- Does Orthix make orthotic adjustments after fitting?
- Contact the lab on the order to discuss an adjustment. Under the Orthix Terms, manufacturing defects are repaired, remade or credited. Fit issues that come from the prescription, assessment data, anatomy changes or shoe choice aren't defects, and remakes for those reasons may be charged as new work.
- Who can order from Orthix?
- Clinics and practitioners across Canada, including physiotherapists, chiropractors, podiatrists, chiropodists and pedorthists. Orthix doesn't sell to patients.
- Is there an offer for clinics that switch to Orthix?
- Yes. Clinics new to Orthix get their first pair of custom orthotics free, applied to the first order placed in the Orthix app. One free pair per clinic.
Educational content for clinic teams. It doesn't diagnose, treat or prescribe, and it isn't a substitute for professional judgment.
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Orthix · 101A-8380 St. George St, Vancouver, BC V5X 3S7 · +1 (604) 447-2880 · info@orthix.ca