Shoes and Therapeutic Footwear Flashcards
how can footwear maximize function
enhance shock absorption
reduce shear stress on the foot
accommodate/support the deformity
relieve pressure on sensitive areas
what is the toe box
room available for the toe
What should you consider first when enhancing function
consider footwear first before orthosis
what is the quarter on a shoe
it is considered the high top part of a shoe
where is the vamp of a shoe
located in the front part of the shoe
what is the throat of a shoe
the front of the shoe where the tongue inserts
determines how wide the shoe can be opened
how much room should one have in the tow box length when in standing
they should have 1/2 inch past the longest toe
what type of person would need extra toe box height
someone with hammertoe, clawfoot, corns/calluses would need extra room in that area
what is the shoe last
it is the ‘curve’ of a shoe; also the form or mold around which a shoe is constructed
what type of shoe last would a pronater fit best in
a straight last
what type of shoe last provides stability
a board lasted shoe last which is also hard and fibrous
what type of shoe last is lighter and more flexible
a slip lasted shoe last which has no insole board
what is the typical heel height
3/4 inch
what happens if you have too much heel
decreased WB surface and puts the foot into PF while loading the forefoot
tilts the leg forward providing excessive stance phase and knee flexion
what happens if the heel is too low
decreased PF
produces knee hyperextension
What is the benefit of quarter height
provides more ankle stability and restricting ankle motion
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
BALMORAL throat
why do we prefer the BLUCHER throat
it is open at the laces
better accommodates to orthtotics, swelling or deformities
what to make sure a properly fitted shoe should have
ADEQUATE SPACING
shoe should be 1/2 inch longer than the longest toe
widest part should correspond with the widest part of the foot
when should you get your foot sized and why
in the afternoon; this is because your feet are 1/2 size smaller in the morning
what is a SACH
a solid ankle cushioned heel
it can reduce shock at heel strike and compensates for diminished ankle motion
what type of heel flare would a supinator benefit from
a lateral outflare; since they invert and roll their ankles more often
how does the thomas heel give more stability
it is externally applied on the bottom of the shoe to give more support in the heel
how much correction would there have to be for a heel lift to be built up OUTSIDE of the shoe
if they need more than 1/2 inch they would need the heel lift done out of the shoe
what is the difference between a fixed and flexible foot
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
when would you use a medial heel wedge
for a fixed hindfoot varus
when would you use a lateral heel wedge
for a fixed hindfoot valgus
what would you do for a flexible rearfoot varus deformity
have the person wear a lateral heel wedge
what would you do for someone with a fixed rearfoot valgus deformity
have them wear a lateral heel wedge
what would you do for someone with a flexible rearfoot valgus deformity
have them wear a medial heel wedge
what would you do for someone with a fixed rearfoot varus deformity
have them wear a medial heel wedge to prevent unwanted inversion injury
what is a metatarsal bar used for
placed posterior to the met heads and used to relieve pressure on the met heads
what is the purpose of a rocker bar
shifts the rollover point from the met heads to the shaft
why are total contact casts the gold standard
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
what are the disadvantages of total contact casts
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
what is a Charcot foot
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
what orthotic can someone with Charcot foot use
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
