Managing patient engagement in orthoses and footwear as a foot health intervention - Footwear and Foot Orthoses - page 137

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provides information on materials and testing of new products used in
the manufacture of footwear.
For general advice on footwear for arthritis sufferers, the Arthritis
Research Campaign ( http://www.arc.org.uk ) provides a patient leaflet
'Feet, Footwear and Arthritis' (available free; contains an excellent section
on suitable footwear for arthritis sufferers).
The Raynaud's and Scleroderma Association ( http://www.raynauds.
org.uk ) provides information on keeping feet warm and specifically what
types of footwear can be useful.
Finally, The Society of Chiropodists and Podiatrists ( http://www.
feetforlife.org ) provides information on foot problems and footwear.
general footwear advice
If patients do not have major structural problems with their feet, then the
majority will be able to purchase suitable footwear from retail outlets.
There is some general advice that can be given to patients whatever their
specific footwear needs.
They should be advised to shop at stores that provide service to their
customers and have knowledgeable salespeople. Getting properly fitted
footwear takes more than picking a shoe off the shelf and having the sales
associate ring up your sale. Their feet should be measured, particularly if
they have become wider over the years, or have changed shape because
of arthritis. Feet may change shape when standing, so it may be prefer-
able to have them measured while standing. If their feet tend to swell,
then it is better to shop for shoes later in the afternoon when they are at
their largest.
Size varies between shoe brands and style. Judge a shoe by how it
feels on the foot and not just by the size marked on the shoe. Ask the
patient to think about how the shoe its around the toes, under the soles,
and at the back of the heels.
Many people have one foot bigger than the other, therefore it is prefer-
able to buy shoes to it the larger foot (an insole can be used in the other
shoe). There should be at least 1 cm ( 3 8 in) of room at the front of the
longest toe.
Shoes should be tried on with the type of socks or other hosiery
normally worn and with any insoles or orthoses. Some insoles may
need extra depth, especially in the toe area. The right shoes will be
comfortable when you first try them on. Buying shoes to 'break in'
later is not a good idea. Ideally, the sole should be able to flex along an
imaginary line drawn from the base of the big toe to the base of the
little toe.