tongue pad

tongue pad

clinical padding added to inner aspect of tongue of shoe to improve shoe fit against dorsum of foot, minimize shoe trauma to toes by preventing the foot sliding forwards within shoe, and ensure that metatarsophalangeal joints (i.e. widest part of the foot) are oriented at widest part of shoe (see Table 1)
Table 1: Footwear modifications
Foot featureModification made to shoe
Excessive heel inversion/pronationButtressed heel; flared heel; floated heel: lateral/medial build out to heel to add lateral (for supinated rearfoot) or medial (for pronated rearfoot) support
Pes planovalgusThomas heel: anterior medial build out from medial distal margin of heel to give added support under waist of the shoe
Pes cavus
Talipes varus
Reverse Thomas heel: anterior lateral build out from lateral distal margin of heel to give added support under the lateral mid-third of the foot
Excessive calcaneal eversion and mobile whole-foot pronation or fixed whole-foot supinationMedial heel wedge added to the outer of the heel, or placed within the heel seat, in conjunction with a medial sole wedge, Thomas heel and medial heel flare
Excessive calcaneal inversion and mobile whole-foot supinationLateral heel wedge added to the outsole, or placed within the heel seat, in conjunction with reverse Thomas heel
Painful plantar heel; plantar heel spurExcavated heel seat, infilled with cushioning, shock absorber
Forefoot supinatus in childrenContralateral wedging: lateral sole wedge and medial heel wedge, to invert the hindfoot and evert the forefoot
Painful hallux limitus; fixed hallux rigidusRocker sole: additional outsole added to increased thickness at treadline, tapering distally and proximally to increase the toe spring and allow the foot to 'rock' rather than dorsiflex at the MTPJs
Steel stiffener: the addition of a metal plate between the outsole and the midsole to reduce movement, and therefore pain, in a foot with painful hallux limitus
Hammered toeStar-shaped split release: slits cut through the upper so that the point of intersection of the splits is centred over the prominent joint
Balloon patch (see below)
Bunion; HAVLongitudinal split release: splits cut through upper over the 1 MTJ, parallel to the medial edge of the sole, to increase the width of the upper and ease tension over the prominent joint
Balloon patch: a hole cut in the upper over the prominence of the joint, repaired with a stretch patch of leather dyed to match the shoe upper, to provide a wide pocket to accommodate digital deformity
Oedematous footFacings extended proximally with the addition of extra eyelets, to increase the internal dimensions of the vamp
Elastic laces
Velcro straps
Severe digital deformityVamp replacement: replacement of the vamp with one that incorporates extra depth and/or width
Digital and/or nail trauma; plantar heloma miliareTongue pad: clinical or orthotic padding added to the inner aspect of the tongue of a Derby or Oxford shoe, to retain the foot into the heel cup and prevent distal slip of the foot against the inner of the shoe

MTPJ, metatarsophalangeal joint; HAV, hallux abductovalgus; MTJ, midtarsal joint.

References in periodicals archive ?
Try a tongue pad glued onto the back of the shoe tongue (available at specialty shoe stores).
For this reason, sports stores often sell separate tongue pads that you can insert to keep your foot from sliding forward in the shoe.
Some of the best stores are experienced with placing metatarsal pads, arch pads and tongue pads (which give a firm grip on the mid foot to prevent pistoning of the foot back and forth) in the new shoe.