Proper Shoe Fitting and Analysis

get it right the first time!

 

Proper Shoe Fitting
The most important aspect of good foot health is properly fitted footwear. This fact is not fully appreciated by most patients, allied health professionals or shoe sales personnel. Being fitted with quality footwear that is biomechanically correct is of significant value to an individual's foot health. To enhance the viability of a prescription, a thorough understanding of how footwear functions in relationship to the problem is essential.

Because of this many medical professionals have recognized the importance of incorporating a board certified pedorthist into their "foot health team" A certified pedorthist is educated and professionally trained to select proper footwear and its application to specific foot conditions. A certified pedorthist should also ensure the prescription performs for the patient according to the doctors intentions.

Application of footwear to problem feet requires the basic understanding that the shape of the shoe must conform to the shape of the foot - not the reverse. The foot and shoe should work in tandem, thus reducing irritation to the foot and improving shoe function. certified pedorthists are uniquely qualified to ensure this happens.

 

 

Figure A

 
In figure A all four feet are the same length from heel to toe. Note that the two feet on the left have different lateral side and fifth metatarsal head measurements. The two feet on the right have different longitudinal arch and first metatarsal head measurements. Extreme care must be taken to choose a last that will accommodate each of these points.
 

Figure B

 
Figure B illustrates another problem related to poor shoe fit. as the foot moves forward, the longitudinal arch does not support the foot, causing undue pressure on the metatarsal heads. The results is that the shoe cannot function properly. A longer shoe is needed. In the diagram on the left, the shoe does not flex at the point of foot flexion. in the diagram on the right, the break point of the shoe cradles the foot allows proper flexion.

in summary: The shoe must fit the foot - don't force the foot to conform to the shoe.

 

Checking For Shear

This term refers to the Anterior/Posterior, Medial/Lateral and Even/Oblique parallel movement or sliding, gliding motion that produces stress or the tearing of tissue. This shearing and friction motion creates problems on the plantar surface of the foot.

If the shoe is properly fitted, the foot is more secure within the shoe, thus shear forces are reduced.

 

 

 

Shoe Analysis
 

 

 Shoes should wear in very predictable places and should not wear in other places. Inspection of a shoe may tell you much about a person's weigh tbearing and gait. heels should be worn just slightly to the lateral side of the center of the heel. this is the normal striking point of the average person's gait.

Heels are expected to wear. when the do, they need to be repaired or replaced. Keeping the heel balanced is part of good shoe maintenance. The amount of wear at this point depends upon a person's gait, weight, walking habits, and type of walking surface.

Check the shoe for weak counters by squeezing the heel area. the stiffer the upper at this point the better. a good heel counter will help control heel position for enhanced gait patterns.
 

 

 Badly worn heels not only throw the shoe off balance and/or cause damage to the shoe, but can also cause strain to the feet, legs and back.
 

 

 A line drawn lateral of center at the heel, bisecting the sole and slightly medial of center at the toe is the axis considered for normal gait and wear. Deviations can indicate gait problems.