Carlton Saddle

A Carlton saddle asks the midfoot to share more of the load. Its cushion starts just beyond the main heel contact and runs forward over the arch. The heel remains relatively lower, and a short version can also provide support behind the metatarsal heads. It is useful when heel relief and comfortable midfoot contact belong in the same prescription.

The Myolite platform lies above the frame beneath the top cover. Its proximal end begins at the distal plantar calcaneal region rather than filling the main heel-contact area. It continues toward the proximal metatarsal heads, with sulcus and toe-length versions extending farther into the covered forefoot. Heights are 1.5, 3, 4.5 and 6 mm. The extension portion is enclosed between the top and bottom covers.

The frame establishes the arch contour while the saddle raises and cushions its contact area. The main heel sits relatively lower than the added midfoot platform, producing the customary negative-heel effect: a relative contact difference, not a promise of a lower heel-to-toe shoe drop. When the distal end stops behind the heads, it can act like a metatarsal bar. A longer version carries support into the forefoot and has a different distal effect.

Choose a saddle when more midfoot contact is comfortable and helps reduce heel or selected distal pressure symptoms. It can combine arch accommodation with a broad support transition. The goals are better load sharing, more comfortable standing and improved walking tolerance. In plantar heel pain, its role is one part of a prescription that can also include rehabilitation and suitable footwear.

A prominent fascial band, plantar fibroma or already painful arch may be irritated by added midfoot pressure. A high platform can also crowd the shoe or create a ridge at either end. If the heel continues to contact a hard underlying surface, the desired redistribution has not been achieved. A rigid foot needs a contour it can accommodate comfortably.

Length is as important as height. The short version emphasizes a midfoot platform and distal bar-like transition; sulcus and toe-length versions continue contact farther forward. The four heights create progressively larger unloaded platforms. The best choice is the smallest useful contact change with comfortable arch loading and adequate shoe depth, rather than the highest possible saddle.

A suitable frame arch contour provides the base. A fascia groove can create room for a prominent band within that support. A scaphoid pad, metatarsal bar or full layer may overlap the saddle and increase total height. Each added contour should contribute to the same goal without creating an excessive midfoot rise.

A heel cushion softens direct heel contact. A heel-spur pad creates focal heel relief. A scaphoid pad concentrates on the medial arch, and a metatarsal bar concentrates on the region behind the heads. A uniform layer suits diffuse sensitivity when a relative platform is unnecessary.

Check heel symptoms and arch tolerance separately. Assess contact at the proximal saddle edge, fascial band and distal transition during walking. At follow-up, look for useful heel relief without a new midfoot ridge or forefoot hot spot. Pressure assessment can show whether the intended sharing of load is occurring.

The saddle combines principles examined in heel-insert, forefoot-support and arch-contact research [E48, E04, E47]. Running and modeling studies show that changing arch contact does not produce one universal plantar-fascia strain response [E51, E52]. The clinical rationale is therefore comfortable load sharing; it is not an assumption that added arch material always reduces fascial tension.