I talk a lot during the Clinical Biomechanics Boot Camps about many different design features that get used in foot orthotics such as the MOSI, the Kinetic Wedge and the Cluffy Wedge to name just a few. They are all useful features and have their places depending on what affect you are wanting.
For example, the Cluffy Wedge is deigned to hold the hallux in a slightly dorsiflexed position. This tenses up the windlass mechanism in the foot and brings on that windlass effect earlier. That is only going to be useful if you want to or need to bring it on earlier. If the windlass mechanism is functioning fine, then the Cluffy Wedge is probably not going to make any difference. That does not stop some clinicians using it as a ‘cure all’ and using it in in most orthotic prescriptions. The Cluffy wedge or a similar foot orthotic modification is indicated when it indicated and not indicated when its not indicated.