orthotic device 10 is specifically designed to compensate for foot deformity occasioned by the use of high - heeled shoes . orthotic 10 is dimensioned to conform to the interior platform of a high - heeled shoe . preliminarily , it should be noted that the drawings and description address an insert adapted for a right foot . clearly , the same principals apply to the left but as a mirror image . referring now to fig5 anterior surface 11 , underlying the toes , has a thickness of approximately 1 / 8 inch ( 0 . 3 cm ) and is adapted to fit into the toe portion of the shoe . line 12 represents the posterior boundary of surface 11 and defines the anterior border of middle wedge portion 14 and corresponds to the metatarsal parabola . orthotic 10 rises at an angle of 40 ° from line 12 to posterior heel section 16 . posterior portion 16 contains shallow , meniscus shaped heel cup 18 ( of lesser thickness than the surrounding structure ) adapted to accommodate the heel of the foot comfortably and stabilize the posterior portion of orthotic 10 within a shoe . turning to fig6 and referring specifically to middle wedge portion 14 , it extends rearwardly from line 12 the metatarsal parabola to the metatarsal - cuneiform articulation defined by line 19 ( anterior of heel cup 18 ). middle wedge portion 14 defines forefoot valgus wedge 20 ( exaggerated for purposes of illustration ). the lateral aspect of forefoot valgus wedge 20 has a thickness of 3 / 16 inch which gradually diminishes to 1 / 8 inch at the medial aspect underlying the second metatarsal head . the thickness of the orthotic remains constant at 1 / 8 inch from the second metatarsal head across the first metatarsal head and to the medial boundary . the substantially uniform slope of the wedge diminishing in thickness by 1 / 16th inch between fifth and second metatarsal head provides a slope of approximately 3 °, thereby establishing an artificial forefoot valgus which contributes to a cumulative lowering of the median arch and stretching of the plantar fascia . the longitudinal configuration of middle wedge portion 14 is described with reference to lines 22 and 24 . line 22 corresponds to and underlies the second metatarsal bone and is approximately 1 inch ( 2 . 2 cm ) in length . the thickness of portion 14 along line 22 gradually diminishes from 1 / 4 inch ( 0 . 55 cm ) at line 19 to 1 / 8 inch ( 0 . 27 cm ) at line 12 . line 24 , corresponding to and underlying the fifth metatarsal , has a thickness of 1 / 4 inch ( 0 . 55 cm ) at line 19 which gradually diminishes to 3 / 16 inch ( 41 cm ) at line 12 and ultimately to 1 / 8 inch in anterior portion 11 . in other words , this wedge structure establishes a forefoot valgus posterior of the metatarsal parabola and also provides additional cushioning for the plantar fascia . in order to provide the above - described structure and to achieve the intended cushioning as well as the desired springing ( rebounding ) action of the orthotic on the plantar fascia and metatarsal bones , selection of the material to be employed is critical . the present invention requires particular cushioning and resilience properties . also , the material must possess structural integrity so as to withstand the repeated forces generated during locomotion . one material found acceptable is a closed cell foamed plastic with thermosetting properties . it is &# 34 ; plastizote po78 &# 34 ;, available from united foam plastics of georgetown , mass . &# 34 ; plastizote po78 &# 34 ; has an original ( non - thermoset ) density of 4 . 4 lb / ft 3 ( 120 gm / cm 3 ). alternative to the &# 34 ; plastizote &# 34 ; is &# 34 ; trocellan jv500 &# 34 ; produced by rogers foam corp . of somerville , mass ., having an original density of 6 . 5 lb / ft 3 and a thermoset ( 50 %) density of 8 lb / ft 3 ( 220 gm / cm 3 ). considering the fact that these materials will be thermoset , their densities will increase . when &# 34 ; plastizote po78 &# 34 ; has been thermoset to 50 % of its original thickness , it possesses a density of 6 . 4 lb / ft 3 and compression load deflection of 19 - 27 lb / in 2 ( 1 . 3 - 1 . 9 kg / cm 2 ( astm - 3574 - 81 ). a typical technique for producing orthotic 10 from such materials includes placing a sheet of 1 / 2 inch thick &# 34 ; plastizote po78 &# 34 ; in a convection oven with both top and bottom heating elements which is preheated to a temperature of between 340 ° and 400 ° f . ( 170 °- 205 ° c .). once the desired thermosetting temperature is achieved , the sheet is removed from the oven and placed in a mold corresponding to the desired contours of the insert . the mold is closed and pressure ranging from 5 - 10 lb / in 2 ( 0 . 35 - 0 . 70 kg / cm 2 ), preferably 7 lb / in 2 ( 0 . 5 kg / cm 2 at a closing speed between 40 and 400 inches per minute is applied . the mold is kept closed and then the inserts are permitted to cool for between 2 and 6 minutes prior to removal . ( in the event a ventilated mold is used , the cooling time can be reduced .) an alternative method contemplates heat molding . in this case , the &# 34 ; plastizote &# 34 ; sheet is placed directly into the mold and heated to where upon a closing pressure of up to 40 lb / in 2 ( 2 . 8 kg / cm 2 ) is employed . once the molding has been completed the finished insert , as above , is removed and excess material is trimmed . fig7 and 8 are provided to illustrate the effect of the longitudinal wedge of the invention on force distribution relative to the foot . for purposes of simplification , transverse wedge 20 is not depicted . fig7 schematically represents longitudinal wedge 42 relative to the foot . line 30 represents the bottom of a foot . the anterior ( phalangeal ) portion is represented by line 32 , the middle portion ( plantar fascia ) by line 34 and the heel by line 36 . line 38 defines the metatarsal bone which corresponds to a portion of the plantar fascia ( line 34 ). the locus of resistive force 50 is located where the bisectors of the wedge sides intersect . vertical force vector component 52 and horizontal component 54 are designated by arrows 52 and 54 , respectively . fig8 schematically illustrates a foot with the invention and the resulting resistive forces . for purposes of clarity , wedge 42 is not illustrated . angle 40 represents the median arch . irrespective of the artificial height increase and catapulting effect of wedge 42 relative to the metatarsal bones ( line 38 ), elementary biomechanical and geometric force vector analysis clearly indicates the effect of the force redistribution provided by the invention . it is noteworthy to mention that wedge 20 ( the forefoot valgus ) is not described with particularity here because as a practical matter , the first and second metatarsals more greatly influence the median arch and plantar fascia than do the third through fifth metatarsals . given the greater contribution coupled with the fact that wedge 20 turns the foot medially from the lateral aspect as well as effectively lowering the median arch , the principal force distribution occurs along the first and second metatarsals . the redistribution of the force across the foot combined with the compressive resiliency of the orthotic and the transverse , pronatory wedge contribute to the biomechanically beneficial effect of the invention when used with high - heeled shoes . in summary , a standardized insert for use with high - heeled shoes is provided with features a wedge structure intended to induce pronation and mimic the effects of rearfoot deformity while also providing a longitudinal wedge which contributes to beneficial force redistribution . the insert may be modified to include conventional characteristics . for example , it may be coated or combined with a textile or fabric layer on its upper surface for comfort and cosmetic reasons . other such variations or known techniques and materials may be used to improve or modify the basic invention as should now be apparent from the foregoing . such variations and modifications now being evident to the skilled artisan , are contemplated to fall within the intent and scope of the invention now defined by the following claims .
an orthotic for use with high - heeled shoes including a transverse and longitudinal wedges for inducing pronation and mimicking the forefoot valgus .