what-when-how
In Depth Tutorials and Information
C h a p t e r
7
Chapter contents
Footwear options
Introduction 103
Retail footwear: 'What makes a
good shoe?' 103
Specialist therapeutic
footwear 104
Stock 104
Modular 105
Bespoke 105
Adaptations 107
Clinical decision making in
footwear choices 113
Who should be referred for
specialist footwear? 113
Footwear fitting 114
Length 114
Width 114
Heel seat 115
Heel counter 115
Instep 115
Entry to the footwear 115
Heel height 116
Controlling foot motion with
footwear 116
Footwear suitability
assessment tools 117
Evaluation of specialist
therapeutic footwear 118
Summary 119
Review questions 119
Reflection 119
Self-assessed questions 119
References 120
Introduction
There is a multitude of footwear options in rela-
tion to style, purpose and function. Patients
often need to be guided as to the suitability of
a range of footwear for different purposes. In
addition to the generic factors in footwear
design and it that make a good shoe, it has to
be acknowledged that there may be several
others that are unique to the individual patient.
In particular, when the foot's dimensions will
not it into retail footwear because of deformity
or excessively abnormal function, specialist
therapeutic footwear may be required. This
footwear may be off-the-shelf specialist foot-
wear that is often described as 'stock' foot-
wear. However, if the foot problem is greater
than can be accommodated in 'stock foot-
wear', or if the mechanical needs are complex,
then the footwear may have to be 'bespoke'
and made on a last manufactured for the indi-
vidual patient.
Retail footwear: 'What makes a
good shoe?'
There are now many manufacturers of retail
footwear who produce designs that are both
appropriate for the foot health of our patients
and affordable. Many foot problems benefit
from a change in footwear style or to a style
with different features. Some footwear can be
modified with rocker soles, which are helpful in
reducing forefoot pressures in the diabetic foot
and pain and pressure in the rheumatoid foot.
