Padding and strapping

Question 1

Objectives/functions of padding

Answer 1

Redistribution, compensation, rest, stabilisation and containment

Question 2

Redistribution

Answer 2

Padding is used to reduce pressure by decreasing the applied force to an area and distributing the force over a larger surface area. E.g. Semi-compressed felt

Question 3

Compensation

Answer 3

Reduce the shock/velocity of the impact of force that’s causing an area to receive excessive stress. E.g. foams

Question 4

Rest

Answer 4

Help to reduce friction between the foot and shoe. Thin materials (e.g. Fleecy Web or Moleskin)

Question 5

Stabilisation

Answer 5

Padding is used to provide temporary realignment or turned in (osseous) structures (realignment is needed when weightbearing force is applied to a non-weightbearing area). E.g. Plantar Metatarsophalangeal Pad (PMP)

Question 6

Containment

Answer 6

Padding used to contain medicaments (like caustics and keratolytics) to a confined area

Question 7

What are the anatomical landmarks for padding?

Answer 7

1. Metatarsal heads
2. Styloid process of the 5h metatarsal
3. Navicular tuberosity
4. Anterior border of the heel

Question 8

What is the purpose of ‘bevelling’ or ‘skiving’?

Answer 8

To provide a smooth transition of the pad to the foot – w/o a bevelled edge, irritation can occur as there will be increased pressure near the sharp right-angled edge of the pad

Question 9

What are the 3 common techniques for adhering a pad to your patient’s foot?

Answer 9

Goal post taping, triangular taping and ‘complete cover; taping

Question 10

When do we use plantar metatarsal padding?

Answer 10

When there is pain and reduced foot/lower extremity function secondary to:

• Superficial lesions (e.g. HD, HK, VP)
• Musculoskeletal pathologies
• Soft tissue atrophy

Question 11

Most common types of plantar metatarsal padding

Answer 11

Plantar cover // Plantar metatarsophalangeal pad
// metatarsal bar // metatarsal dome

Question 12

How often should the patient replace felt padding?

Answer 12

2-3 days

Question 13

When should you review a patient with padding?

Answer 13

5-7 days

Question 14

When do we use digital padding?

Answer 14

Same for plantar metatarsal padding, but also includes ingrown toenails

Question 15

Most common types of plantar digital padding

Answer 15

Toe prop (alleviates dorsal/plantar forces)

Toe sleeve (cushions toes and reduces surface friction b/w 2)

Toe separators/wedges (separate toes and alleviate forces on joint surfaces)