Footwear

Question 1

History of footwear

Answer 1

• provide protection from the environment
• conform to fashion
• assist function
• accommodate foot deformities
• treat musculoskeletal injuries

Question 2

Considerations for practice

Answer 2

• poor footwear choice has been linked to falls
• development of multiple conditions of the foot knee and lower back
• should be considered as first line of treatment

Question 3

Heel counter

Answer 3

• squeeze and push
• shouldn’t be able to collapse
• can break if shoes not unlaced properly
• if you can collapse it with your fingers imagine what your body weight can do to it
• heel counter stiffness is important : if rearfoot control required ; to improve balance

Question 4

Toe box

Answer 4

• depth: toes and joints can move freely
• width: grip over metatarsal heads
• length: a thumbs width from longest toe
• shapes: curves/straight last (can put pressure on 5th
• Seams: especially with diabetic patients

Question 5

Upper

Answer 5

• leather
• synthetics: avoid vinyl as no air exchange –> bacterial growth a problem if moisture accumulates
• mesh
• occupation/purpose
• hyperhidrosis (restricting footwear not ideal)
• lining on the inside: may be synthetic even if outer is leather; interaction with orthodox - can it be removed and plastic interface ‘squeak’

Question 6

Midsole

Answer 6

• cushioning : provides the shock absorption of the shoe. The force from the ground is absorbed by the shoe before it is sent up the leg and absorbed by the joint
• made from various and multiple material densities: air gel spring system, complex EVA

Question 7

assessing a shoe

Answer 7

• push and squeeze heel counter : should not collapse
• twist and bend shoe through midfoot: should not twist or bend
• weight: shouldn’t be too heavy
• should only bend at toes
• check that shoe is appropriate for individual and specific activities

Question 8

outline types of shoes

Answer 8

• thongs
• slipper
• loafer
• court
• mules
• oxford
• rocker bottom
• moccasins
• medical grade
• accommodation
• safety shoes
• specialised sports shoes

Question 9

considerations for rheumatoid arthritis

Answer 9

• extra depth
• extra width
• bony abnormalities
• fat pad atrophy

Question 10

poorly fitting shoes can be linked to:

Answer 10

• falls (appropriate adjustment, outer-sole material)
• pressure lesion
• neuromas
• callus & corns
• toe deformities

Question 11

adjustments

Answer 11

• stretch
• balloon patch
• external build up
• external heel raise
• additions
• rocker soles

Question 12

purchasing shoes

Answer 12

• purchase at the end of the day
• fit to both feet
• measure foot size whilst standing
• wear around the shop for 5 minutes
• thumb width
• take home and try around house for a couple of days make sure that you can exchange
• shoes do not “wear in”
• wear appropriate socks/hosiery