Your New Balance CATALOG source!
Footwear What Determines a Shoe's Therapeutic Abilities? Where Do People Get Therapeutic Shoes? Pedorthic Solutions Pedorthic Modalities Cost of Pedorthics Footwear Pedorthics is defined as the design, manufacture, modification, and fit of shoes and foot orthoses to alleviate foot problems caused by disease, overuse, or injury. Pedorthics, then, refers to footwear that is carefully and properly fitted to relieve or accommodate foot problems, whether temporary or chronic. The most important part of the pedorthic equation is shoes.
Shoes are the foundation on which pedorthic treatment is built. Any sort of foot orthoses (arch support) or brace is only as good as the shoe in which it is worn. Even the highest quality orthoses will not perform adequately if it is worn in an inferior shoe. Feet come in all different shapes and sizes...fortunately, so do shoes. Properly matching them is the challenge. Doctors often prescribe special shoes and/or foot orthoses for their patients with foot problems. Who better to help with these issues than a pedorthist!
Foot health is a topic most of us take for granted. The truth is, however, comfort, protection or safety, quality of life, and even stamina are largely dependent upon our feet and the footwear we select to serve them. Footwear not designed for the purpose for which it is being used, or footwear the wrong shape, size, and fit are likely to cause damage, injury, pain (at least discomfort), which can be avoided with the proper footwear selection.
How Can Shoes Help?
Pedorthic treatment is routinely prescribed to restore function, ease pain, prevent further pain or damage, and/or improve mobility. Shoes, because they encase the foot, are the key components in foot care and treatment.
Shoes serve two basic purposes: protection and performance. When shoes are used as part of a therapeutic plan, both purposes are essential. Working from a doctor's prescription, a pedorthist is the link between the patient and proper footwear to achieve the desired results of the prescription.
What Determines a Shoe's Therapeutic Abilities? Shoe shape is the most important factor. If a shoe is not the appropriate shape for a patient's foot, it can be more of a hindrance than a help. Shoes can have round, square, or pointed toes. They can be wide or narrow. The most important thing is that they match the shape of the foot as closely as possible.
Shoes are made of a vast array of materials, including leather, deerskin, canvas, and other fabric or man-made plastic materials. Selection of materials is important, depending upon the diagnosis.
The length and width of a shoe are equally important. Width is a three-dimensional measurement that incorporates girth and arch height. When a pedorthist is evaluating shoe length, having a thumb's width between the end of the longest toe and the front of the shoe is appropriate. It is important to remember that there is very little regulation in the shoe industry with regard to sizing. Sizes differ greatly from manufacturer to manufacturer and often between styles made by the same manufacturer. The activities in which a person participates, as well as the type of socks worn, are important considerations to shoe fitting. A pedorthist is specially qualified to help a patient determine which size of a particular shoe is best.
The manner in which a shoe is constructed also helps determine whether or not a shoe will work well for the individual. Some shoes are built with extra support and control. Construction techniques that make a shoe stiffer or more flexible, stronger or roomier are not apparent to the average person. The closure on the shoe also needs to be considered. A shoe that is suitable for therapeutic purposes generally requires additional depth and strength. Many pedorthic footwear prescriptions mandate the use of orthoses. Proper shoes must have the additional space available to accommodate the orthoses.
Back to Top
Where Do People Get Therapeutic Shoes? Many physicians refer their patients to accredited pedorthic facilities for their special footwear needs. With only 60 plus such facilities in the United States, our stores remain uniquely qualified to provide this specialized footwear assistance. For some people, shoes are simply a matter of comfort. For others, they are a medical necessity. Properly fitted footwear is essential.
Pedorthic Solutions The average person walks over 100,000 miles during a lifetime. That's the equivalent of four trips around the world! The average man walks seven miles a day, while the average woman walks ten, putting three times their bodyweight on each foot with every step. For a person weighing 150 pounds, that comes out to almost 5 million pounds of pressure on each foot every day! The human foot is made up of 26 bones, 19 muscles, 33 joints, 119 ligaments, about 20 tendons, three arteries, and five nerves. With all that walking and so many intricate components, it's easy to see why four out of every five Americans experience a foot problem at some point.
Those problems can be as simple as a callus or blister, or complicated enough to require surgery. Problems can be caused by overuse or by traumatic injury; or they can be caused by a systemic disease, such as diabetes or rheumatoid arthritis.
Pedorthics uses therapeutic footwear to help ease or eliminate these foot problems. Therapeutic footwear includes shoes (either custom or off-the-shelf), shoe modifications, socks, and foot orthoses. The pedorthist's main goal is to help a patient enjoy a pain-free, ambulatory lifestyle. Pedorthists work mainly from a prescription provided by a physician. While most of the work a pedorthist does is with prescription footwear and custom-made orthoses, there are many over-the-counter solutions for people who haven't had or don't need a medical evaluation.
Pedorthics is a Growing Field
Pedorthics is a growing field, both in terms of pedorthic technology and in the number of qualified and certified practitioners. Currently there are about 1400 certified pedorthists practicing in the United States and Canada alone ? and that number is rapidly increasing! The number of certified pedorthists continues to grow because more and more people understand the relationship between proper footwear and health -- not only foot health, but health of the body overall. A pedorthist earns professional credentials through a stringent and demanding educational process that includes both practice and patient management. Pre-certification studies cover a wide range of topics such as anatomy, physiology, biomechanics and gait analysis, and pathology (understanding the diseases and ailments that affect the foot and ankle). Pedorthists are well educated in shoe construction and fit, the principles and intricacies of foot orthosis design and fabrication, as well as material properties for foot orthoses and shoe modifications. They must understand how all of these things relate to and interact with one another. Before sitting for their board exam, most pedorthists spend time gaining practical experience by working side-by-side with a certified pedorthist in an accredited pedorthic facility. Many also spend time working with other allied health professionals, as hands-on experience is invaluable. Once potential pedorthists have completed all of the pre-certification requirements, they are tested by the Board for Certification in Pedorthics (BCP). Certified pedorthists must earn continuing education points every year in order to maintain their certification.
Pedorthic Modalities A recent study revealed that nine out of every ten women wear shoes that are too small for their feet, while eight out of every ten women say their shoes are painful. Nine out of ten foot deformities in women can be attributed to ill-fitting shoes. Obviously, having properly fit shoes can be effective for both solving and preventing foot problems. Many manufacturers make shoes specifically designed for pedorthic use. These shoes are called orthopedic shoes. They have factory insoles that are easily removed for replacement with foot orthoses. The toe area is roomy and can be readily modified. Nowadays, these shoes include many styles -- from a wing-tipdress shoe to a running shoe or a hiking boot. In cases of severe deformity, a pedorthist will actually custom- make a shoe from a model of the patient's foot. It is often necessary to modify a shoe with wedges, flares, lifts, rocker soles, or additional padding.
Foot orthoses can be fabricated to fit a wide variety of shoes. A custom-made orthoses is made from a model of the patient's foot -- either an actual model of the foot or a computer- generated model. There are literally hundreds of different materials used to fabricate foot orthoses, and a pedorthist is an expert at determining the correct combination of materials for each individual patient.
Cost of Pedorthics The cost of foot surgery and recovery is more than $3.5 billion every year in the U.S. Pedorthic care, initiated at the onset of a problem, can reduce pain and many times alleviate the need for surgery and/or hospitalization. Customarily, charges for pedorthics are based on what shoes, orthoses, or other services or products are required. The costs vary depending on factors like the choice of materials used or the complexity of the problem. Most pedorthists see patients by appointment, and there may or may not be a separate fee for an initial evaluation. During this evaluation, the pedorthist can offer an estimate of what is needed before the patient agrees to proceed with the work. Many health insurance providers recognize the preventative benefits of pedorthic care. Pedorthics, because it is conservative care, can be very cost effective.
Select Information and Diagrams Courtesy of Pedorthic Footwear Association and National Shoe Retailers Association