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has become entrenched through the centuries, which has clear implica-
tions for our clinical practice.
Key Concept
The issue of appropriateness of footwear needs to embrace the
concept that it has to adapt to both the physical and the social
environment. This issue is unavoidable as it has been present in
society since footwear became more than protection in ancient
Egyptian and Greek societies.
origins and evolution of footwear design
The first footwear
Footwear is estimated to have started its long history of human use during
the Ice Age, with unkind weather conditions being said to have created
the necessity for footwear. Despite the fact that in Palaeolithic caves there
were footprints of unshod feet, when Ötzi 'the Iceman' was discovered
in the Tyrolean Alps in 1991, he was wearing footwear ( Figure 4.1 ).
There is evidence that shows that the history of footwear started at the
end of the Palaeolithic period, with paintings of this time in caves in Spain
and in the south of France showing footwear dating from 24 000 years ago.
That footwear was evident at this time is also supported by the work of
Erik Trinkaus (2005) who noted morphological changes in the pedal
phalanges resulting from either the presence or absence of footwear.
Among the utensils constructed of rock found in Palaeolithic caves, there
are several that were used to scrape the skins of animals, indicating that
the art of tanning is very old. Early footwear was made of wrappings, usually
made of leather or dried grasses. Later on, footwear developed to become
an oval piece of leather that was bound by strong leather thongs.
The earliest footwear in Britain must have resembled the pampootie
from the Aran Isles, Ireland. Very few early shoes have survived intact and
although fragments of Bronze Age footwear have been found in excava-
tions, there are not enough to determine styles. The purpose of footwear
at this time could be considered to be totally functional and there is no
evidence to suggest that it had a social role.
Roman footwear
“The reason the Romans built their great paved highways was because
they had such inconvenient footwear.”
Charles de Montesquieu, French philosopher (1689-1755)
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