Treatment of the Foot (2) Flashcards
talipes equino varus
foot points downward or inward
calcaneal deformity
DF deformity
splay foot
depressed TMT arch
morton toe
2nd toe is longer than the rest of the toes
pes planus
flat foot
supple pes planus
normal arch with WB
arch disappears w/ WBing
rigid pes planus
arch remains stiff and collapsed w/ and w/o WBing
how do we determine the proper fit of a shoe
check while in standing
measure
arch support
heel
foot orthotics/foot plate
what do we measure –> proper fit
3/8-5/8 “ longer than the longest toe
where should the shoe be the widest
at ball of foot
MT heads
what should the arch support match
MLA
high point = sustentaculum tali
heel counter –> proper fit
lower than malleoli
foot orthotics/foot plate –> proper fit
buy a shoe 1/2 size bigger
last of shoe
shape over which the shoe is built \
types of shape of shoe
regular
straight
in-flare
regular shape
L/R
straight shape
no L or R
initially either foot
pediatrics
pediatrics –> straight shape
shoes wear differently
Mark R and L
inflare shape
curved last
curved in / MT adductus
bunions –> more room
3 types of lasts
straight
semi-curved
curved
straight lasts
more stable
good for over pronators
semi-curved last
average arch
biomechanically normal foot
curved last
rigid foot
high arch
good for under pronators
construction last
rigidity of the shoe
board last
slip last
combination
board last –> construction last
rigid material b/w sole and upper
rigid shoe
mens dress shoe
slip last –> construction
no rigid material b/w sole and upper
flexible
ballet slipper
combination –> construction
rigid material b/w heel and upper
front flexible
back rigid
heel of the shoe
should be broad
2” in height
what does a wedge heel do
reduces stress on forefoot
where is the heal measured
at the breast of the heel
1/8” increments
what could a higher heel be used for
LOM in DF
upper shoe includes
everything above the sole
upper shoe should
not put pressure on top of foot
should be comfortable
upper parts of the shoe
vamp
toe box
quarter
heel counter
closure
throat
vamp
front of shoe/anterior to stitches
ends w/ toe box
toe box
high enough not to put pressure on dorsum of toes
toe deformities
hammer toes
claw toes –> diabetes, biomechanical imbalance in foot
quarter
medial and lateral sides of upper (behind stitching)
made more rigid medially to support MLA
heel counter
cardboard reinforcement of heel
height of counter
= type
low top
high top
3/4 top
low top –> counter
should be under malleoli
grasps the heel
too loose can cause blisters
3/4 top –> counter
first walker for babies
closure of shoe
laces
straps
velcro
what should we consider w/ shoe closure
consider pt’s eyesight and dexterity in the choice
throat of the shoe
bulcher throat
bal throat
bulcher throat
not stitched
bigger opening
good for braces
bal throat
stitched across
smaller opening
sole of the shoe
inner and outersole
outersole
provides traction
dress shoes
athletic shoes
dress shoes outersole
leather
hard rubber if balance is an issue
athletic shoes outsole
black rubber where needed
midsole of the shoe
sandwiched b/w inner and outer sole
fxns of midsole
shock absorption
foot control
what are midsoles built to do
guide
stabilize
support
energize the foot
what determines the stability of the shoe
last and fit
more stable shoe will have
straight last
for over pronators
medial posts for pronation control
dual density midsole
heavier and stiffer
neutral shoe will have
average foot (ideal)
semi-curved last
combination last
no medial post
dual density midsole
lighter and flexible
least stable shoe
semi-curved to curved last
for under pronators –> rigid foot
single density midsole
less stiff
slip last sometimes
light and flexible
