09/10/2026
Why add an extension beneath the big toe of an orthotic? The answer starts with the purpose of the prescription.
In this video, we demonstrate a Morton’s extension modification on a Slimflex orthotic, from marking out the material to shaping, fitting and finishing the extension. For podiatry students and clinicians developing their orthotic modification skills, this is a useful example of how a prefabricated device can be adapted to a specific clinical goal.
What is a Morton’s extension?
It is an extension beneath the first ray and big toe. When made sufficiently rigid, it can help limit upward bending at the big toe joint. This may be considered when managing a painful, stiff joint, such as in hallux rigidus, following clinical assessment.
What should you watch for in this demonstration?
• How the extension is measured against the orthotic before shaping.
• How the material is trimmed and the edges finished.
• How the extension joins the existing device.
• How the finished profile fits beneath the big toe area.
The key learning point: material choice matters.
The video identifies EVA and polypropylene as material options, but they will not automatically produce the same stiffness. Material properties, thickness and the finished design influence how the modification behaves.
Before making an adaptation, ask:
“What do I want this orthotic to do for this particular foot?”
Then consider how the device will work inside the patient’s footwear. A modification needs to suit the clinical aim, available shoe space and the person wearing it.
Small workshop details deserve attention because they contribute to the finished device.
📌 Save this video as a reference for your orthotic learning.
For clinicians and students: what would you check first when assessing the finished extension? Its stiffness, position or footwear fit? Tell us your reasoning below.
