The incidence of amputations can be reduced in at-risk patients with this new custom off-loading shoe system. While appropriate antibiotics and surgical intervention are important in treatment, they are ineffective unless weight is off-loaded from the area of the foot being treated. This product incorporates a system of multidensity insoles that may be cut or otherwise altered by the orthotist to keep pressure away from the affected area. A semi-rigid rocker sole assists in ambulation while reducing friction and pressure from vulnerable areas of the foot. The soft upper leather can also be modified for protection of lesions or to allow for edema.