I recently had a flare up of gout and purchased these to see how much comfort they provide over a pair of Teva sandals I typically wear in the summer. The four additional shims for under the foot pad really helped because my feet are different - one side used a thicker shim than the other side, which makes this purchase exceptional. I have tried cutting my own before but the enclosed inserts are made to fit the shoe size when shipped. I wear a size 10 1/2 and the shims were the perfect size.