Prosthetic & Orthotic Information Resource

Orthopedic Shoes

Orthotic & Diabetic Shoes

There are three types of foot orthotics: flexible, semi-rigid, and rigid.

Why Orthopedic shoes?

Orthopedic shoes assist in shock absorption, provide limited arch support and protection.

orthopedic footwear

FOOT ORTHOTICS

Why Orthopedics?

The goal of orthotics is to help people achieve greater balance between stability and mobility. Bracing is used to enhance stability, and balance. Balance and mobility can be gained by practice while wearing the orthoses. The orthotic brace should be lightweight and durable, and it is very important to not over brace which could limit mobility.

The overall desire of foot orthotics is to decrease pain, and improve function. More specifically, orthotic intervention is applied to accommodate and or to correct deformities, provide shock absorption for the foot and improve the ability to walk or run. Foot orthotics are typically made from a mold after a podiatrist takes a plaster cast or other image showing the shape of the individual's foot.

There are soft, over-the-counter orthotics designed to assist in shock absorption and some also provide limited arch support. They are generally inexpensive and may be appropriate for patients with minimal biomechanical faults. Soft orthotics are typically made up of soft, cushy materials allowing for increased balance, and less pressure on uncomfortable, or sore spots. Soft orthoses also are worn against the sole of the foot, extending from the heel past the ball of the foot, including the toes.

For significant biomechanical issues, a custom orthotic is necessary which may be soft, semi-rigid, or rigid orthotic. If you have looked at shoe inserts in the pharmacy, you have probably looked at flexible or semi-rigid inserts. Over-the-counter, flexible inserts are the least costly, and they come in standard sizes and designs. The correction given is minimal, however, so use them only if you do not have too much misalignment and are primarily looking for additional shock absorption. If you have slight discomfort, you may try other insole modifications that are also less costly than custom orthotics. Inexpensive padding for the metatarsal (ball of the foot) or heel is available over the counter. Any modification should not cause pain, but help alleviate pain because of improved alignment. If the padding or insert increases existing pain or causes new pain, remove it immediately. Talk to your doctor before you try any drastic modifications. Custom soft orthotics are indicated to protect deformed or disvascular (inadequate blood circulation) feet and are made from soft, memory foam like materials. In some cases, a soft orthotic may not be enough to provide the amount of control required while a rigid orthotic may be too controlling. Semi-rigid orthotics are sometimes a good functional choice to provide adequate support and shock absorption. They are fabricated from multidurometer materials that provide graduated degrees of control. Multi-Durometer laminate materials (Composed of two or more materials, with sectional areas of differing shore hardness.) have a distinct advantage over single durometer materials to produce a better functioning foot orthoses.

Ortho Footwear
The shoe is the foundation for the orthotic device, and should provide good structural support. The orthotic shoe should have a firm heel counter to properly support the heel, with lacing or Velcro closure to assist in proper positioning around the foot.
There are several different orthopedic shoe options available. Options include a steel shank, shoe lift, rocker bottom, and double rocker bottom. The steel shank is used for patients with hallux rigidus to decrease pain by limiting foot motion while walking. Hallux Rigidus is a progressive condition involving a disorder of the joint located at the base of the big toe. The condition causes pain and stiffness in the big toe resulting in increasing difficulty to bend the toe. Hallux rigidus is actually a form of degenerative arthritis (a wearing / thinning of the cartilage within the joint that can occur in the foot as well as other parts of the body).
A lift is used to correct a leg length discrepancy; typically, 3/8 inch or less can be resolved by the shoe while a difference greater than 3/8 inch is usually corrected by an increased or taller shoe sole.
By decreasing mid-foot motion and metatarsal stress, a rocker bottom may alleviate foot and ankle pain in arthritic patients. A newer shoe design has a heel spring cushioned orthotic "double-rocker." which shows promise for improving shock absorption and decreasing pain.

Diabetic shoes are designed to enhance foot function, rather than being a shoe for fashion. One of the problems that diabetics have is they start to loose feeling and sensation in their feet. So if they tie their shoes too tightly or if they happen to have any type of discomfort with the fit of a diabetic shoe, a diabetic person may not feel the discomfort that someone who does not have diabetes would feel. The ill fitting shoe could create a sore, and a diabetic's skin does not heal very quickly. Therefore, diabetic shoes are made especially for a person with diabetes in order to both enhance foot function as well as protecting their feet.
The typical characteristics of almost all diabetic shoes are extra room in the toe box, extra depth, a stiffer sole and a heel counter for more stability and they generally have a removable insole. In short, diabetic shoes help by lessening the possibility of an infected or ulcerated foot. It is imperative that you consult your doctor to find out what type of diabetic shoes is best designed for you. And be sure not to make the mistake of wearing them only on occasion. Diabetic shoes serve an important purpose, to keep you from having foot related problems. For them to be effective they absolutely must be on whenever any weight is on your feet.
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