Question:I have diabetes and some foot problems to go with it. Several of my friends in the local diabetes support group have special shoe inserts they swear by. What are these for?
Answer:Therapeutic footwear is an important tool in the treatment of the diabetic foot. Loss of protective sensation and foot deformities are the two most common uses for shoe modifications and/or foot orthoses in patients with diabetes.
A foot orthotic or orthosis (orthoses, plural) fits inside the shoe. It can be taken off-the-shelf and used as is or (more often) a custom-made insert is needed. Foot orthoses are designed to take the load or pressure off certain areas of the skin, especially over areas where the bones stick out. This idea is called off-loading.
Orthoses can be used to decrease shear forces, cushion tender spots, and support and control the foot. It's hard to believe but something as small and as simple as a shoe insert can improve your balance and the way you walk. It can protect your foot from injuries or pressure ulcers that can lead to loss of limb.
You may not need any kind of supportive footwear. But if you do, then a podiatrist, orthotist, or pedorthist can help you. The pedorthist is trained and certified in the selection and management of footwear for all kinds of patients.
Not all shoes are wide enough for an orthotic. This has to be taken into consideration when making or selecting the right device for you. Take your two most favorite shoes with you to your appointment. You may need a modified shoe as well as an orthotic. The pedorthist will help find what's best for you.Dennis J. Janisse, CPed, and Erick Jannise, CPed, CO. Shoe Modification and the Use of Orthoses in the Treatment of Foot and Ankle Pathology. In Journal of the American Academy of Orthopaedic Surgeons. March 2008. Vol. 16. No. 3. Pp. 152-158.
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