Periodically I will see patients in the office who enjoy their orthotics in their higher volume athletic shoes, but report that their heels pop out of the shoes, or they sit too high and their heels rub the “wrong spot” on the heel counter, in lower volume shoes. What can you do to lower the heel position in the shoe? Using your grinding wheel, remove the rearfoot post and proceed to grind the shell of the orthotic as thin as possible without creating a hole. This drops the heel down in the shoe several millimeters to stop the patient from popping out. Note: you must keep the orthotic in a balanced position and not invert or evert the device during this process!