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The shoe is as important as the orthotic modifications

Discussion in 'Biomechanics, Sports and Foot orthoses' started by markjohconley, Oct 25, 2010.

  1. markjohconley

    markjohconley Well-Known Member

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    I notice how many of the students disregard the pt's footwear. I am not a footwear expert, but I try to always assess the footwear for fit (pt standing, looking forward and after i've got them to march up and down on the spot), sagittal plane 'break' (i was taught it should ONLY bend at the MPTJ's NOT midshoe), heel counter both medial and lateral and torsional (frontal plane).

    Please fill in any blanks.
  2. markjohconley

    markjohconley Well-Known Member

    Also, who owns those legs on the tready.....mmmmm......hard to concentrate....
  3. Boots n all

    Boots n all Well-Known Member

    expert = a drip under pressure

    We look for the above mentioned but we also need to note lateral and medial Malleolus, lateral being lower and set further back, can be a point of irritation, but most footwear dont represent that height difference these days.

    Heel cup depth, too low can be as bad as too high, width of met. heads, depth of toe box, the list goes on, but and then of course the all important colour, if its not red its just not going to work is it:D

    Sorry forgot to add.................and know the difference between a Derby and an Oxford
    Last edited: Oct 25, 2010
  4. Nilsen

    Nilsen Active Member

    Also look at the style of shoe. Sometimes the patient doesn't need footorthoses at all, simply to swap their high heeled court shoes for flat lace ups. Of course they would rather squeeze a bit of padding into their current shoes to relieve their "metatarsalgia" Can someone please tell my orthosurgeon this is impossible I have given up trying.
  5. Petcu Daniel

    Petcu Daniel Active Member

    I think important parameters of the shoes could be:

    - heel height,
    - toe spring,
    - longitudinal [sagital] profile of the bottom and heel angle,
    - the hardness of the bottom assemble [sole and midsole],
    - entrance width

  6. Apollus

    Apollus Member

    i'm a student at birmingham and for the last 3 years have worked fitting kids shoes in a shoe shop.
    like mentioned before there is a HUGE list of things to look for in a well fitting shoe, but for simplicity so long as there is adequate:
    -length to allow for growing room/room to flex
    -width for forefoot, 5th toe not pushing against lateral border
    -depth over instep, forefoot and toebox
    -security whilst walking
    -the heel is shaped to the malleoli

    once i am satisfied with these criteria i then watch them walking around the shop and generally palpate around the whole upper to give an idea of whther the style adheres to the shape of the foot.
    of course even with the kids you still have the problem of style, heel height, whether it comes with a toy inside the heel (darn clarks for inventing those yotoy things!) and all the other fashion criteria :/
  7. Boots n all

    Boots n all Well-Known Member

    Lets step away from heel height as a concern, its not.

    Its heel pitch that is of concern, that is the difference between the thickness of sole to heel, the angle of foot platarfextion in the shoe.

    You can have a 15cm /6 inch heel and if the sole is 5cm/2 inch then the heel pitch is 10cm/ 4inch not 6 inch.
  8. Apollus

    Apollus Member

    yes sorry should have been more specific with the heel height/pitch description, just so used to using the 'heel height' as a selling feature for the little girls!
    and just to clarify, I don't recommend that young girls wear shoes with a high heel pitch just talking them into getting the shoes because they have a 'cut out' heel if you understand :/

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