Which modification is best to prevent the foot from sliding laterally off an orthotic?

The lateral flange is the most effective modification for preventing the foot from sliding laterally off an orthotic. This component acts as a structural barrier that provides support and stability to the outer side of the foot. By enacting a firm brace along the lateral aspect, it helps to maintain proper alignment and prevents excessive movement, which can occur during activities that involve lateral weight shifts.

Furthermore, the lateral flange is crucial for individuals who may be prone to overpronation or those who have a tendency to push outward while walking or running. By creating this additional support, the flange not only enhances comfort but also promotes better biomechanics by ensuring that the foot remains properly positioned within the orthotic device.

The other modifications like a higher heel or medial arch pad may improve overall foot function or comfort but do not specifically address the lateral sliding issue. The metatarsal pad, while beneficial for off-loading pressure on the forefoot, does not provide the structural support necessary to keep the foot from moving sideways off the orthotic. Thus, for lateral stability, the lateral flange is the most suitable choice.