what-when-how
In Depth Tutorials and Information
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5.
Width, length (heel to ball), depth and lack of symmetry outside the
range of available retail footwear.
6.
Any foot problem requiring substantial foot orthoses which cannot
be accommodated in retail footwear.
Referral for therapeutic footwear is not made on the basis of these
considerations alone, however, and further important issues should be
considered to increase the likelihood of a successful outcome.
As it is known that there are poor levels of use of specialist therapeutic
footwear, there are issues that need discussing with the patient before
referral for specialist therapeutic footwear so that they have realistic
expectations of the footwear they receive:
•
Information about the potential benefits: comfort, it and
improvements in foot, and general function.
•
Information about potential constraints such as limited styles and
colours, the number of pairs supplied and the poor suitability of
the footwear for hot weather.
•
The patient should see the footwear catalogues and, if available,
a pair of the shoes before being referred.
•
Above all, the patient should be allowed to raise any concerns.
Footwear fitting
Length
The overall length of the footwear can be checked by feeling the front of
the upper over the toe box. If the toe box is not too hard, the ends of the
toes can be located. There should be 1 cm space at the end of the longest
toe (and remember, it may be the second or third toe, not the first, that
is the longest). If the toes cannot be located through the upper then the
foot can be drawn around on a piece of paper and a strip 1 cm in width
can be cut from it, from the heel to the tip of the longest toe. This strip
is then inserted into the shoe and there should be a gap of 1 cm when
the strip is slid forwards to the toe area. At the same time the shape of
the toe box can be checked for suitability in relation to the toes.
The correct heel to ball length can be ascertained by checking that
the widest part of the foot is in line with the widest part of the shoe.
Width
Terms such as narrow, wide, regular and extra wide may be used by both
retail and specialist footwear manufacturers to indicate a size width. These
