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Aug 25

Written by: Cherri Choate, DPM
8/25/2010

   This weekend I was attending a class and a question was raised about the real importance of the shoe/orthotic relationship. The learners were questioning that most of the time they hear orthotic talks and shoe talks, but rarely, if ever shoe/orthotic talks. Why don't we describe this intimate relationship in detail more often? It is likely because each individual component has been developed by a different group. The shoe industry is primarily seen as a retail type of product, not as a "treatment" type of product. In contrast the orthotic industry has primarily been driven by medical professionals, and therefore is recognized more as a "treatment" and only more recently as a retail product. Despite the historical development of each, their value as a unit has been understated.  
   As a practitioner recognizes the need for mechanical intervention, the balance between the shoe and the orthotic should be considered. If a patient needs mild pronatory control, it is often deleterious to recommend a severe motion control shoe and fabricate an aggressive motion control orthotic.This situation often results in a higher level pain, such as in the knee, ankle or hip. In another instance, that same patient may be dispensed mildly motion controlling custom orthotics and without any shoe advice, they may start to wear them in 10-year-old cushioning shoes and the patient may see no improvement in their symptoms. 
   Unlike most other medical practioners, we do have an obligation to understand the shoe industry. Our patients will wear shoes and the shoes will impact their function. For many this may seem like an unnecessary burden, but from my perspective it is an extraordinary bonus. We have access to a "treatment" option that can influence the patient's biomechanics in a positive way. 
   Years ago, I attended a Footwear Show in Las Vegas and it was overwhelming. The volume of attendees, products and potential money exchanged, dwarfed any medical event I have ever attended. That weekend opened my eyes to the importance of embracing the footwear industry and incorporating it into my everyday practice.

Take a look: The research study in today's E-Journal article discovered some information regarding shoe use in diabetes patients with PAD. 
 

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1 comments so far...

Re: The Shoe/Orthotic Relationship

I really enjoy this part of our practice and I am hopeful that we will all become more educated on all types of shoes and shoe technology.

By CC1000 on   8/25/2010

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