what-when-how
In Depth Tutorials and Information
7
In fact there are features of retail footwear that make it ideal for the high-
risk foot but that are also useful for maintaining good foot health in any
individual. These features are:
•
stable heel: a heel that is broad enough for stability or elongated/
flared to increase this effect further
•
extended heel counter
•
padded topline to reduce irritation to the retro-calcaneal area and
the infra-malleolar areas
•
no prominent internal seams
•
winged toe puff
•
increased toe spring or rocker sole to reduce forefoot plantar
pressures
•
low laced for ease of access.
specialist therapeutic footwear
If patients have major foot problems or deformity, specialist therapeutic
footwear can be provided through hospital appliance departments or
orthotic services. Patients generally receive this footwear free of charge and
they are entitled to two pairs at any given time which are repaired or
replaced as appropriate when they wear out. Orthotists are the profession-
als who generally assess and provide this specialist footwear but increas-
ingly podiatrists are working alongside their orthotist colleagues or taking on
some of the orthotist's role, particularly in the provision of stock footwear.
Teamworking in this area has demonstrated improved clinical outcomes
and patient satisfaction compared with orthotists working in isolation
(Williams and Meacher 2001). It is important that podiatrists create good
working relationships with their orthotist colleagues in the assessment of
patients, shared information and the provision of specialist footwear.
Key
Concept
Specialist therapeutic footwear can be provided through hospital
appliance departments or orthotic services.
Stock
Stock footwear is specialist footwear which is available in a variety of
styles and fittings, for example extra deep and/or extra wide (
Figure 7.1
).
The manufacturers of this footwear provide size charts of optimal ranges
for length, joint width, joint circumference and instep circumference,
which are the measurements that are required to enable the practitioner
