Pads & Cushions

Met Balance Pad

A Myolite platform around a selected metatarsal-head relief region. Adds surrounding support so the painful head sits relatively lower beneath the continuous top cover.

Met Balance Pad, view 1
  • 1.5 mm
  • 3 mm
  • 4.5 mm

15 Shore A Myolite

A metatarsal balance pad creates room by building up the neighborhood around a painful head. The selected area stays relatively lower while the surrounding forefoot receives a Myolite platform. It is useful when the goal is focal accommodation with more supporting material around the target.

The pad sits over the forefoot extension, beneath the top cover and above the bottom cover. It begins at the distal frame edge and continues beyond the metatarsal heads. A curved proximal relief border follows the selected head, with straighter boundaries toward the adjacent interspaces. The outer pad edges blend into the extension; the internal relief edge retains a defined step. The standard platform is 3 mm thick.

The frame and extension provide the base. The added platform brings neighboring plantar tissue into earlier contact, leaving the selected head relatively recessed. Its internal step preserves that height difference under the continuous top cover. The receiving heads and soft tissue now carry more contact, so they need adequate cushioning and tolerance. If the entire forefoot is sensitive, a broader accommodative contour can be preferable to concentrating load around one small recess.

Choose a balance pad for a selected prominent or pressure-sensitive metatarsal head when the adjacent forefoot can accept additional support. Multiple selected heads can be accommodated within the same strategy. The goals are less focal pressure, better standing and walking tolerance, and protection of a recurrent pressure lesion within an appropriate care plan.

The internal edge must stay beyond the tender footprint. A defined edge under a lesion can create a painful ring or crescent of contact. Added forefoot bulk may crowd a shallow shoe, while soft surrounding tissue may compress enough to erase the recess. A neuropathic foot needs objective attention to both the target and the neighboring heads.

A 3 mm platform offers a moderate difference between the target and surrounding support. Placement and relief width control whether that difference is useful. A larger surrounding platform gives more unloaded space but also demands more shoe room and asks the receiving tissue to accept more contact. Preserve the complete lesion footprint rather than using pad height to compensate for an opening that is too small.

A broad cushioning layer can soften the receiving area. Proximal metatarsal support can move some loading away from the head line. A Morton or reverse Morton extension can change the same relative heights, so its contribution should reinforce the intended relief rather than raise the selected target again.

A punch creates a cavity by removing existing cushion and usually adds less forefoot bulk. A slot carries relief distally. A dome or broad bar redistributes pressure from behind the heads. A total-contact accommodative design is useful when several regions need more even support.

Check the selected head, internal relief border and adjacent heads in the intended shoe. Assess standing and propulsion, because the head can move relative to the opening during gait. At follow-up, look for lesion improvement and new margin or adjacent-head callus. If transfer pressure develops, widen or reposition the relief before relying on a thicker platform.

The balance pad belongs to the family of relief designs that use surrounding support to reduce focal loading. Plug-removal and individualized forefoot-design studies provide measured examples of that principle [E06, E09]. Metatarsal-pad studies show why relief must be balanced against the tissue receiving the load [E03, E05]. The defining clinical idea is shared support around a well-located target.

  1. Effect of metatarsal pad placement on plantar pressure in people with diabetes mellitus and peripheral neuropathy.

    Twenty adults with diabetes, neuropathy and prior forefoot ulcers. Placement 6.1–10.6 mm proximal to the metatarsal-head line reduced peak pressure by an average 32% ± 16%. More distal placement could increase pressure.

    The useful placement range belongs to this neuropathic-foot sample. Head location, lesion footprint and the assembled insole still guide individual fitting.

  2. Effects of metatarsal domes on plantar pressures in older people with a history of forefoot pain.

    Thirty-six older adults. Domes reduced distal forefoot pressure by approximately 45–60 kPa. Positioning 5 mm proximal to the heads gave the best balance of distal relief without increasing pressure where the pad sat.

    This study directly supports the dome contact strategy in older adults. Its pressure findings do not establish long-term pain improvement or one position for every population.

  3. The effect of removing plugs and adding arch support to foam based insoles on plantar pressures in people with diabetic peripheral neuropathy.

    Twenty-six adults with diabetic neuropathy. Removing foam-insole plugs at the highest-pressure forefoot region reduced mean peak pressure by 32.3%; adding arch support produced further offloading.

    Removing local material reduced pressure in a neuropathic population. The construct differs from a simple circular punch and does not alone establish active-ulcer healing.

  4. Evaluation of orthotic insoles for people with diabetes who are at-risk of first ulceration.

    Sixty adults with diabetes and neuropathy tried nine individualized insole designs. Metatarsal-bar position affected pressure relief, and generic design rules left more high-pressure sites than individualized selection.

    The study supports individualized forefoot location and cushioning. Its measured pressure changes explain the design strategy rather than proving every bar configuration is equivalent.

  5. The relationship of the position of the metatarsal heads and peak plantar pressure.

    CT and pressure measurements showed that first-, fourth- and fifth-metatarsal-head positions did not coincide precisely with local peak pressure.

    Anatomical location and the pressure-sensitive footprint are related but distinct. Accurate fitting can require both rather than a bony landmark alone.

  6. Foot orthoses for forefoot pressure reduction and the hypothesized role in calf muscle stretching: A systematic review highlighting an evidence gap.

    Twelve studies with 456 participants reported reduced forefoot peak pressure or pressure-time integral with tested orthoses. Metatarsal support and soft contoured designs showed useful pressure effects. No eligible study tested a design specifically intended to stretch the calf.

    The review used a narrative synthesis because designs and populations differed. Its included primary studies retain their original evidence identity and do not independently validate each Root modification.

  • Morton's Extension - Standard (with 1st)
  • MP-MYO-15A-1p5-1M 1.5mm Met Balance Pad 1st - 15 Shore A Myolite
  • MP-MYO-15A-1p5-2M 1.5mm Met Balance Pad 2nd - 15 Shore A Myolite
  • MP-MYO-15A-1p5-2M3M 1.5mm Met Balance Pad 2nd & 3rd - 15 Shore A Myolite
  • MP-MYO-15A-1p5-2M4M 1.5mm Met Balance Pad 2-4 - 15 Shore A Myolite
  • MP-MYO-15A-1p5-3M 1.5mm Met Balance Pad 3rd - 15 Shore A Myolite
  • MP-MYO-15A-1p5-4M 1.5mm Met Balance Pad 4th - 15 Shore A Myolite
  • MP-MYO-15A-1p5-5M 1.5mm Met Balance Pad 5th - 15 Shore A Myolite
  • MHB-MYO-15A-3p0-1M 3mm Met Balance Pad 1st - 15 Shore A Myolite
  • MHB-MYO-15A-3p0-2M 3mm Met Balance Pad 2nd - 15 Shore A Myolite
  • MHB-MYO-15A-3p0-3M 3mm Met Balance Pad 3rd - 15 Shore A Myolite
  • MHB-MYO-15A-3p0-4M 3mm Met Balance Pad 4th - 15 Shore A Myolite
  • MHB-MYO-15A-3p0-5M 3mm Met Balance Pad 5th - 15 Shore A Myolite
  • MHP-MYO-15A-4p5-1M 4.5mm Met Balance Pad 1st - 15 Shore A Myolite
  • MHP-MYO-15A-4p5-2M 4.5mm Met Balance Pad 2nd - 15 Shore A Myolite
  • MHP-MYO-15A-4p5-3M 4.5mm Met Balance Pad 3rd - 15 Shore A Myolite
  • MHP-MYO-15A-4p5-4M 4.5mm Met Balance Pad 4th - 15 Shore A Myolite
  • MHP-MYO-15A-4p5-5M 4.5mm Met Balance Pad 5th - 15 Shore A Myolite