what-when-how
In Depth Tutorials and Information
Leather uppers are usually the most comfortable, and check that they
have leather inners (the inner lining). These are more breathable than
inners made of synthetic materials and will help avoid dampness and
fungal infections.
If the patient is worried about the appearance of their feet, dark colours
and a suede finish will help to disguise the problem.
Advise the patient to take time to fully lace and tie the shoes
properly and walk around in them before deciding if they are comfortable
or not.
Many people prefer to wear slippers in the house rather than shoes,
but slippers are not a good idea for those who have to wear special
insoles. Slippers also sometimes cause falls in the elderly. The uppers of
slippers are often soft and so are comfortable for hammer toes and
prominent joints, but the soles can lack adequate cushioning. Like outdoor
shoes, slippers should it properly and should not be too loose. Backless
slippers and slippers with a high heel should be avoided. The features of
the ideal slipper are generally the same as those of the ideal shoe.
If the patient needs to wear safety boots for work, they should pur-
chase them from a supplier displaying the British Kitemark sign. If existing
safety footwear is uncomfortable (maybe the soles are too hard or the
toes not roomy enough), patients may need to talk to their employer about
getting alternative shoes. Safety versions of extra-depth and cushioned
shoes are available.
If the patient has problems with circulation or cold feet, many slippers,
shoes and boots are available with linings such as sheepskin or synthetic
fur to help keep the feet warm. Wearing thicker socks or two pairs (as
long as they are not too tight) not only helps to keep the feet warm but
also provides extra cushioning under the soles of the feet. Keeping the
feet warm will also be easier if the rest of the body is kept warm.
summary
Providing patients with footwear advice is often both time consuming and
a challenge in respect of changing footwear habits. Having knowledge of
footwear construction, fitting and its effect on gait and foot function is
crucial for any practitioner involved in the management of the foot. This
knowledge is the basis on which we can provide information and advice
to our patients. As clinicians, we have to respect people's choice to either
engage in our advice or not as footwear plays an important role in our
self-perception and perception of how others see us. Focusing on the
person and their needs is the key to improving foot health through our
intervention of foot orthoses and appropriate footwear.
