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Shoe Battles with Patients

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Kevin Kirby, Dec 31, 2009.

  1. mamatootsies

    mamatootsies Member

    Re: Shoe Battles

    Dear Kevin,
    your article was very interesting, and makes a very valid point! I have learned very quickly we need to get into the minds of our pateints and try and understand the reasoning for non compliance especially with footwear. I am only half way through my degree and have seen supervising podiatrists eyes roll as the still hopefull student advises almost every patient they see on suitable footwear, to the point I've developed several means of attack on the subject!
    What helps me understand, (but also contradicts) is being female and having the genetic predisposition towards very 'BAD' shoes, I know the pleasure and pain a nice pair of high heeled boots gives! Dannenberg embraces this, with his Insolia insoles (I can hear the sharp intake of breath by those who know more...).
    I totally agree with the need to educate pateints, I also think more attractive 'GOOD' shoes need to be available, the mere mention of certain brands of footwear make patients toes curl, and we often get 'these were very good, expensive shoes'. How do we move forwards in our battle for footwear?:boxing:
    Last edited by a moderator: Jan 1, 2010
  2. spike123horse

    spike123horse Active Member

    Re: Shoe Battles

    I have been known to ask if they bought a Christian Dior dress in the wrong size/ fitting whether the cost would help it fit better? My heart sinks when patients come back from the orthotist with a pair of custom made shoes that 'they don't like the look of'! They never look at their feet & than the shoes & realize that the shoes are that shape because their feet are that shape aswell!!!! I try to get them to have 'going out 'shoes & those that are ok for wearing most of the rest of the time - it worked once, I think :pigs: Good luck!
  3. phil

    phil Active Member

    Re: Shoe Battles

    I find this is one of the issues i spend most time on with my clients. If they're not wearing shoes, or wearing terrible shoes, there's often not much left to do until they will change. And I find very often if you can sort out their footwear, the problem can resolve. Which doesn't make much money!

    My first employer told me not to give footwear advice until i'd made them custom orthotics. I got sick of that pretty quick. He said once, "what if you take a cast and they get new shoes and their foot is better by the time they come to pick up the orthoses?".

    One thing that is very important is to have a good knowledge of shoe styles and brands. I'm sure my wife get really worried when I walk into a shoe shop and pick up all the womens shoes, bending them and prodding them and trying to remove the foot bed. But at least I can give my patients exact advice on the shoes they need and where they can get them.
  4. W J Liggins

    W J Liggins Well-Known Member

    Let's not be shy here - we're speaking largely of females. Put the gun away ladies.....

    When you discuss lifestyle with a patient and analyse their activities, it is generally the case that they carry out the mundane day to day tasks when 'smart' shoes are not that important to them. However, when they 'go out' stylish footwear becomes of supreme importance. However, further analysis will reveal that they put their 'smart' shoes on, go to the car and then alight at their destination. They then (usually) sit down and eat and drink. They may then dance, sometimes removing their footwear (if young). Then they return home in a car and remove their shoes. Thus, throughout the evening, weight bearing has been limited and even when it takes place the foot is supinated in a high heeled shoe.

    It seems clear that the majority of weight bearing activity takes place during the day and the crucial thing is to persuade them that shoes appropriate to our treatment are also appropriate to them.

    Just as an anecdote, I once carried out surgical treatment on a fairly high powered and very smart (as in dressing, not clever - although she was) businesswoman. She was provided with the usual blue post-operative shoe and given limited weight bearing instructions. She managed to get hold of another post-op. shoe from a friend and wore a blue trouser suit. She was greatly amused when she was stopped and asked where she obtained those lovely blue sandals!

    Maybe we need to hire appropriate models and do a little more public relations.

    Bill Liggins
  5. Jeremy Long

    Jeremy Long Active Member

    I also read Kevin's article as it was published in the magazine. I'm also an advocate that many of the problems we treat are based on our patients' chronically poor purchasing decisions. Most retailing in this category is now self-service, and the consumer relies upon available advertising and suggestions from friends for their decisions. It can also be quite a challenge to persuade a patient to reconsider certain brands which previously enjoyed excellent product credibility.

    My most effective strategy is demonstrating how an individual patient's present shoes may work against treatment is to show how their foot works in relation to their shoes. Demonstrating present wear patterns can also help. Most of all, showing that the patient may not have to give up the look he/she desires in a shoe, while still achieving necessary build and fit qualities, makes their transition easier.

    If I can make a recommendation to anyone in our fields, it's to spend a few hours at a local shoe wholesale shoe market. Not only will you likely come away with a disappointed perspective on some brands that you may have fully trusted prior to such a visit, but you will discover at least a few brands that surprise or inspire .... as well as not "look orthopedic".
  6. Boots n all

    Boots n all Well-Known Member

    Firstly Happy new year all.

    Its a very good article Kevin.
    Sadly a daily occurrence for some of us, "No, the pointy toe shoes suit my foot shape" :bang:

    Comments about good style and brand knowledge for someone not handling shoes all the time is a hard one as manufactures change styles every 2-3 years and some change the manufacture process from time to time, as is the case with a major supplier to Australia currently, this change will be a great one to:cool:.

    l think the worst that you as a pod can do is recommend a brand,
    "Buy a pair of "X" brand they are good, look for a firm back that is deep and a broad toe box". the client comes in selects Brand "X", with a 3" heel that does have a firm back that is deep and a broad toe box, maybe suggest "Try brand "X" and a allow the trained staff to suggest the appropriate style for you:empathy:.
  7. MJJ

    MJJ Active Member

    One of the funnier cases I had was a 20ish girl that came in and said "My feet hurt when I wear crappy shoes."
  8. Moose

    Moose Active Member

    Evening All. There is a specific podiatrist about 40 minutes drive from me who makes the BIGGEST orthotics I have ever seen. They are hard to fit in bloke's runners let alone anything else. The physio who works on the same block has my copythotic poster in her window. I get probably 3 people a week make the journey (past 50 other pods probably) to supplement their 'army boot' orthotics with ones that will go into shoes you can wear with a ...wait for it .... skirt! It has been like that for about 10 years. I do wonder when he will notice that patient deposit molten piles of orthotic slag appear on his stairs every week. :cool: If anyone is interested, you can see the idea at http://www.copythotic.com.au. I think that they are very cool (unless you work near me, in which case they are cr*p, honest!)
  9. m.e. mcgowan

    m.e. mcgowan Member

    I was wondering if anyone has an opinion on the new rockerbottom shoes, such as Sketchers, MBT, etc...Some of my patients mentioned these and I was just inquiring if they help/work.

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