Which modification is designed to lessen the impact on the metatarsal heads?

The correct choice is metatarsal pads, which are specifically designed to distribute pressure more evenly across the forefoot and relieve stress on the metatarsal heads. By providing additional cushioning and support under the metatarsal region, these pads help to reduce discomfort and the risk of conditions such as metatarsalgia, which is exacerbated by excessive pressure on those areas.

Metatarsal pads effectively elevate the metatarsal heads, which decreases the load they experience during weight-bearing activities and can also improve overall foot biomechanics. This modification is particularly beneficial for individuals who experience pain under the forefoot due to conditions such as plantar fasciitis or arthritis.

In contrast, a lateral wedge influences the alignment of the subtalar joint and may be utilized for conditions involving supination or lateral instability, but does not specifically target pressures at the metatarsal heads. A Thomas heel is a type of shoe modification primarily used to control subtalar motion and disparity in limb length rather than addressing loads on the metatarsals. A heel cup, while beneficial for providing stability and comfort to the heel, does not directly alleviate the pressure on the metatarsal heads. Therefore, metatarsal pads are the most effective choice