Shoes and Therapeutic Footwear

Question 1

how can footwear maximize function

Answer 1

enhance shock absorption
reduce shear stress on the foot
accommodate/support the deformity
relieve pressure on sensitive areas

Question 2

what is the toe box

Answer 2

room available for the toe

Question 3

What should you consider first when enhancing function

Answer 3

consider footwear first before orthosis

Question 4

what is the quarter on a shoe

Answer 4

it is considered the high top part of a shoe

Question 5

where is the vamp of a shoe

Answer 5

located in the front part of the shoe

Question 6

what is the throat of a shoe

Answer 6

the front of the shoe where the tongue inserts

determines how wide the shoe can be opened

Question 7

how much room should one have in the tow box length when in standing

Answer 7

they should have 1/2 inch past the longest toe

Question 8

what type of person would need extra toe box height

Answer 8

someone with hammertoe, clawfoot, corns/calluses would need extra room in that area

Question 9

what is the shoe last

Answer 9

it is the ‘curve’ of a shoe; also the form or mold around which a shoe is constructed

Question 10

what type of shoe last would a pronater fit best in

Answer 10

a straight last

Question 11

what type of shoe last provides stability

Answer 11

a board lasted shoe last which is also hard and fibrous

Question 12

what type of shoe last is lighter and more flexible

Answer 12

a slip lasted shoe last which has no insole board

Question 13

what is the typical heel height

Answer 13

3/4 inch

Question 14

what happens if you have too much heel

Answer 14

decreased WB surface and puts the foot into PF while loading the forefoot
tilts the leg forward providing excessive stance phase and knee flexion

Question 15

what happens if the heel is too low

Answer 15

decreased PF

produces knee hyperextension

Question 16

What is the benefit of quarter height

Answer 16

provides more ankle stability and restricting ankle motion

Question 17

what type of throat has the lace come in at a narrow point which can restrict forefoot motion and makes it hard to get the foot in the shoe

Answer 17

BALMORAL throat

Question 18

why do we prefer the BLUCHER throat

Answer 18

it is open at the laces

better accommodates to orthtotics, swelling or deformities

Question 19

what to make sure a properly fitted shoe should have

Answer 19

ADEQUATE SPACING
shoe should be 1/2 inch longer than the longest toe
widest part should correspond with the widest part of the foot

Question 20

when should you get your foot sized and why

Answer 20

in the afternoon; this is because your feet are 1/2 size smaller in the morning

Question 21

what is a SACH

Answer 21

a solid ankle cushioned heel

it can reduce shock at heel strike and compensates for diminished ankle motion

Question 22

what type of heel flare would a supinator benefit from

Answer 22

a lateral outflare; since they invert and roll their ankles more often

Question 23

how does the thomas heel give more stability

Answer 23

it is externally applied on the bottom of the shoe to give more support in the heel

Question 24

how much correction would there have to be for a heel lift to be built up OUTSIDE of the shoe

Answer 24

if they need more than 1/2 inch they would need the heel lift done out of the shoe

Question 25

what is the difference between a fixed and flexible foot

Answer 25

a fixed foot can NOT be corrected and needs to be accomodated. We do this by bringing up the ground to the foot wherever side the gap is on with a wedge

a flexible foot can be corrected by adjusting the foot itself

Question 26

when would you use a medial heel wedge

Answer 26

for a fixed hindfoot varus

Question 27

when would you use a lateral heel wedge

Answer 27

for a fixed hindfoot valgus

Question 28

what would you do for a flexible rearfoot varus deformity

Answer 28

have the person wear a lateral heel wedge

Question 29

what would you do for someone with a fixed rearfoot valgus deformity

Answer 29

have them wear a lateral heel wedge

Question 30

what would you do for someone with a flexible rearfoot valgus deformity

Answer 30

have them wear a medial heel wedge

Question 31

what would you do for someone with a fixed rearfoot varus deformity

Answer 31

have them wear a medial heel wedge to prevent unwanted inversion injury

Question 32

what is a metatarsal bar used for

Answer 32

placed posterior to the met heads and used to relieve pressure on the met heads

Question 33

what is the purpose of a rocker bar

Answer 33

shifts the rollover point from the met heads to the shaft

Question 34

why are total contact casts the gold standard

Answer 34

they promote faster healing by having an off loading technique
there is greater weight distribution
good pressure relief for ulcers
provides stability for Charcot joints
immobilizes the wound
prevents edema

Question 35

what are the disadvantages of total contact casts

Answer 35

not suitable for patients with balance deficits or older population as they are unstable with it

the cast also requires weekly adjustments initially for the proper fit
must use assistive device with it

Question 36

what is a Charcot foot

Answer 36

progressive degeneration of the foot caused by neuropathic osetoarthopathy.
it is common in those with diabetes.
will see fracture/subluxation of the midfoot
it is more prone to ulceration due to loss of sensation

Question 37

what orthotic can someone with Charcot foot use

Answer 37

a CROW boot (charcot restraint orthotic walker)

it is a bivalved clamshell that encloses the foot and leg to decrease pressure and immobilize the foot