Footwear is always a hot topic in the podiatric world. Here are a few tips and tricks…

Footwear advice

Advise your patients to bring 2 or 3 pairs of their most commonly worn footwear to their first appointment. Here you can assess the practicality of their footwear and whether or not they will be compatible with an orthotic.

You may wish to discuss prescribing different orthoses for different shoes. For example, orthoses for everyday walking shoes and orthoses for football boots, dancing shoes, golf shoes, smart work footwear etc.  

You can always send the patients footwear to our lab, along with their foot impressions, and our technicians will ensure that the orthosis fits properly before it is returned.

Patient education on what is a good shoe is best practice, regardless of whether they wear it with an orthotic or not.

Here are some key features of a shoe that will not only aid in better foot health overall but should also take an orthotic.

  • Material - Avoid plastics/synthetics as they allow little ventilation, which leads to sweaty feet and increases the risk of fungal and bacterial infections. They also allow little room for expansion if an orthotic is to be worn in the shoe
  • Insole - Removable insoles that come with the shoe can be removed to allow more room for a prefabricated or custom insole.
  • Midsole - Should be moderately thick and firm to facilitate shock absorption. This will allow more stability when worn with an orthotic.
  • Outsole - Grooves and treads can help maintain traction and thus prevent slipping. To start with new orthotics can make your patients a little unsteady so more grip can help reduce this.
  • Heel counter - Enclosed, high, deep, firm and cushioned. Allows for more stability and room for an orthotic. Reduces the heel slippage that some patients complain of then wearing an orthotic as it makes them higher in the shoe.
  • Toe box - Deep, roomy and round toe box to accommodate the toes. Your shoes should conform to the shape of your foot, not the other way around.

This is essential when wearing a full length orthotic as it will give more room for your patient’s toes.

  • Fastening - Be it buckle, strap, elastic, velcro or laces, a fastening will support the foot on the orthotic and hold the shoe in place. It also reduces clawing of the toes.

 

Before the patient runs off to buy new shoes, ask them to stand on a piece of card and draw around their feet with no shoes on. When they find a shoe they like, they should try to fit the card into the shoe. If it ruffles at the edges, then the shoe will be too small.

 

Ideally, you want the patient to shoe shop after they have got their orthoses and to take their new orthoses with them when trying on shoes.

 

Get the Best Fit First Time – tips to share with your patients

  • Wear the same type of socks to the shop that you intend to wear with the shoes
  • Shop for shoes later in the day (this is when your feet are at their largest)
  • Get both feet measured. Measure your feet each time you buy shoes. Some shoes shops offer this as part of their service so be sure to ask
  • If one foot is larger than the other, try on a pair that fits your larger foot
  • You should be able to wiggle your toes and have at least half an inch between your longest toe (which may not be your big toe) and the end of the shoe
  • The width of the shoe should be snug but not tight. You shouldn’t see any bulging of the shoe material
  • Make sure your heel fits snug in each shoe and doesn't slip out as you walk
  • Feel the inside of the shoes for any tags or seams that might cause irritation. This is especially important for your diabetic patients.
  • Walk in the shoes before buying them. Please don’t fall into the myth of “I’ll wear them in”. They should feel comfortable right away!

 

by EMMA CHALMERS