FORS Insole: Proven Effective Offloading

FORS™, The Best Diabetic Offloading Insole Available.*


Diabetic Foot Ulcers Are Complicated. Offloading With FORS™ Is Simple.


  • Easy: For most people, getting effective offloading with FORS is as simple as wearing a post-op surgical shoe.
  • Comfortable: FORS can be worn comfortably all day, every day.
  • Stable: For people who have lost sensation in their feet, offloading boots and casts may increase risk of falling and injury. The FORS insole in a surgical shoe may be a safer option.
  • Durable: A single FORS Insole will typically last far longer than is necessary to heal most ulcers.
  • Affordable: The durability of the FORS often means saving time and money versus frequently replacing insoles.
  • Proven: FORS has been shown in multiple studies to provide clinically effective offloading.

Why Does Offloading Matter?


The presence of a diabetic foot ulcer is a huge health risk. These types of wounds are slow to heal and likely to become infected, and these infections can lead to devastating complications including amputations and even death. The longer a wound remains unhealed, the greater the risk of infection, and so it is absolutely critical to heal these wounds as quickly as possible. For people with diabetes and / or neuropathy, localized areas of high pressure on the bottom of the foot (plantar) increases the risk of developing plantar ulcers and disrupts healing because the ulcerated areas are repeatedly exposed to traumatic pressure while walking.


How Is FORS Superior To Other Offloading Insoles?

Courtesy Dr. S A Schumacher, Surrey BC Canada., and David Freeman, Onalaska, TX

FORS Insole after 5 months daily usage:

"The [FORS] innersoles are thicker than most, making offloading more effective. And they are quite well made. Adjacent plugs don't come loose and fall out, and these customizable insoles last a long time." Courtesy of Dr. S A Schumacher

Other brand after 1 month daily usage:

"Some of these innersoles flatten out rather quickly, and adjacent plugs become loose and fall out...expanding the size of the desired hole, diminishing the effectiveness...doing nothing to offload the ulcer." Courtesy of Dr. S A Schumacher

Other brand after 2 weeks daily usage:

"Not Made For Heavy People...It didn't take two weeks before it came apart...The FORS insole from Bonapeda is made of much sturdier stuff and has so far held out quite nicely." Courtesy of David Freeman, originally posted on

1).  Superior Pressure Mitigation

  • Successful offloading involves moving pressure away from high pressure areas without creating new high pressure areas. In fact, devices that shift high pressure away from the middle of ulcers but create increased pressure along the outer edges of ulcers can actually cause the ulcers to increase in size!
  • In a recent scientific study, the FORS insole was proven to reduce pressure on ulcerated areas by over 40%, without increasing pressure on the edges of the ulcerated areas.
  • In the same study, the leading competitor was shown to shift pressure from the center of ulcers directly to the edges of the ulcerated areas; and in fact, the highest pressure measurements in the entire study were observed along on the edges of the offloaded areas when that product was used.


2).  Lasts Up to 5x Longer

  • FORS plugs won't shift or fall out, yet can be removed easily at the time of fitting.
  • Made using a patented** design and superior materials, FORS Insoles hold up longer, are less likely to "bottom out", and provide effective offloading for heavier patients.




What Physicians Are Saying



"The FORS insole is easily modified to address patients, and is also very effective....It is made of rugged materials that will hold up and maintain offloading for a year...and it doesn't produce an 'edge effect'...It is a great insole, it just works...I really think it is the best of all the offloading insoles."

"...The FORS innersoles cost a bit more up front, but they offload better, so wounds close faster, meaning fewer overall visits and a lower complication rate, saving patients money in the long run. The FORS holds up as long or longer than 3 cheap innersoles, which are prone to flatten and break apart, putting more pressure back on the wound...The competition isn't even close."

"When used in conjunction with utilization of a "team approach" and use of modern wound care techniques, I have found FORS to be a highly cost-effective option for plantar pressure reduction. It has shown to dramatically reduce the severity of wounds, decrease healing times, and reduce amputation rates."

"My 'go-to' is the FORS, which I use 90% of the time...It's stable and easy to put on...I like it and the patients like it...The FORS offloading insole should be of prime consideration when TCC isn't possible or practical, as well as for step down after TCC."

"The FORS-15 system is easily customized for the patient, is not time consuming, is relatively inexpensive, and patient compliance is very high."



SELECTED CASE STUDIES (Courtesy of Payam Rafat, DPM.)  Click on images to see full study.

A 50 year old diabetic male presented to the wound care clinic with a chronic planter midfoot diabetic ulcer of right foot.A 59 year old diabetic female with ESRD on hemodialysis presents to wound care center referred by her primary care physician for a chronic heel ulceration. Patient has developed an Abscess of the right heel after stepping on a nail.A 60 year old diabetic male was admitted to the hospital through the emergency room due to an infected planter wound resulting from stepping on a nail. Surgical debridement was performed. The patient was discharged home from the hospital with antibiotics as per ID physicians recommendations.A 58 year old diabetic male with a prior history of partial left hallux amputation presented to the wound care center with a chronic ulceration of the planter medial aspect of the left hallux.A 45 year old diabetic male presented to the wound care center referred by a local hospital podiatry clinic for chronic diabetic foot ulcer with a prior history of underlying osteomyelitis.






Should I use the FORS Insole to offload my diabetic foot ulcer? (Is FORS appropriate for my personal situation?)

  • Please consult with your healthcare provider before using the FORS Insole to determine whether it is appropriate for you.
  • Please also consult with your healthcare provider to ensure that the FORS Insole is properly modified and fitted to your foot.


Can I use the FORS Insole in my regular shoes?

  • We do NOT recommend using the FORS Insole with standard shoes. FORS Insoles should only be used with shoes that are designed to accommodate extra thick insoles (15mm / 0.6 inch or greater).


Is FORS covered by my insurance?

  • In most cases, FORS is not covered by insurance. FORS is used to offload active ulcers or wounds. Medicare, Medicaid, and most private insurances do not cover offloading footwear.
  • While you may have coverage for "diabetic shoes" designed to help prevent ulcers; those shoes are not intended to offload active ulcers. In fact, if your ulcer developed while wearing diabetic shoes, you may want to consider replacing those shoes before you return to wearing permanent footwear.


Can I drive while wearing the FORS Insole?

  • For the foot used to drive (typically the right foot), we do not recommend wearing FORS footwear while operating a vehicle. We suggest wearing appropriate footwear while driving, and changing to FORS footwear when not operating a vehicle.


How long will a FORS Insole typically last?

  • In most cases, a single FORS Insoles will last longer than is required to heal a diabetic foot ulcer.
  • We recommend keeping the FORS Insole and shoe after ulcers have healed in the event it is needed again.


For How long will I need to wear the FORS Insole?

  • With proper treatment and offloading, most diabetic foot ulcers heal within 12 weeks, and often more quickly. Individual results will vary.
  • It is recommended to wear offloading footwear (such as the FORS Insole) as much as possible when walking or standing, including inside the home and even for short distances such as for bathroom visits.
  • A serious issue for many people is recurrence of ulcers after healing (e.g. ulcers come back). New skin following ulcer healing is typically fragile and vulnerable to re-ulceration for a number of weeks. It may be beneficial to wear the FORS Insole until appropriate permanent footwear is obtained that is designed to prevent re-ulceration (e.g. diabetic shoes with diabetic inserts).


How can I clean the FORS Insole?   Click here for cleaning instructions.


My foot is not making full contact with the FORS Insole, what can I do?

  • “Orthopedic wool felt” may be used to supplement the FORS Insole. Orthopedic wool felt is available from many online sellers.

Images above Courtesy Dr. S A Schumacher, Surrey BC Canada; (NOTE: This website may not display properly on mobile devices or tablets, using a computer is recommended.)



PHYSICIAN INTERVIEWS ABOUT FORS™ (see more on our youtube channel)




  1. Comparison offloading provided by FORS insole versus similar products, case studies, and more, Multiple article series, Journal of Wound Care / Wound Central, May 2021
  2. "Who Should Pay For Offloading Footwear To Treat DFUs?", M. Goldberg, Todays Wound Clinic, Jan 2018
  3. "Charcot  Versus Osteomyelitis""(FORS Used For Charcot), H. Penny et al, APWH poster, Oct 2019,
  4. "FORS-15 Clinical Evaluation - Multicenter" poster presentation, H. Penny, J. McGuire et al, A-DFS, Nov 2017,
  5. "FORS-15 Clinical Evaluation, Montefiore Mt. Vernon Hospital", P. Rafat et al, SAWC poster, Nov 2016
  6. "The DFU Dilemma: Is the Total Contact Cast a True “Gold Standard?", H. Penny, Lower Extremity Review (LER), September 2018,
  7. "Expert Opinion, Advances and alternatives in diabetic ulcer offloading", Lower Extremity Review, J McGuire et al, August 2018
  8. "Reexamining The Gold Standard For Offloading Of DFUs"; J. McGuire et al, Podiatry Today, March 2017
  9. "DFU offloading: we know what works, why don’t we do it?", H. Penny; Journal of Wound Care, North American Supplement, Vol 28, #5, May 2019
  10. A Guide To Offloading The Diabetic Foot, N. Martin et al, Podiatry Today (Continuing Education), Vol 18, #9, September 2005
  11. Use of Pressure Offloading Devices in Diabetic Foot Ulcers, Wu et al, Diabetes Care, VOL31, #11, Nov 2008
  12. Why is it so hard to do the right thing in wound care?, Fife C. et al, Wound Rep Reg (2010) 18 154–158






THIS WEBSITE DOES NOT PROVIDE MEDICAL ADVICE. The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.
Videos, presentations, and posters included on this website have been contributed by leading healthcare practitioners. The opinions expressed are solely their own, and Bonapeda Enterprises LLC has no financial relationship with any of the practitioners whose names, documents and comments are presented on this website (other than as a supplier).
*Statement from Dr. James McGuire, DPM, LPT, LPed, FAPWc, Professor Clinical Scholar, Temple University School of Podiatric Medicine, Recorded June, 2021. (
**The FORS Insole is covered by U.S. Patent 10,441,031


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