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Shoes & Shoegear
- 1. Shoes & Shoegear Tanvir Siddike Moin
- 2. Overview • 7 shoe styles • Shoe anatomy • Sizing • Shoe life • Evaluation • Minimalist • Diabetic shoe
- 3. The 7 basic styles
- 4. #1 Sandal • Oldest form • Basic open toe design • More robust for soldiers • New styles & variations • Poor support often leads to discomfort
- 5. #2 Moccasin • “Foot covering” • Popularized Native American, but has Ancient Mongol roots • Simple closed design
- 6. #3 Clog • Peasant shoes • Scandinavian countries • Wooden design • Resurgence in popularity
- 7. #4 Pump • Prominent in late 16th century United Kingdom • Thin constructed that acted as a “slip-on” • Heel lift added • Many variations
- 8. #5 Mule • Hybrid of a clog & pump • Closed toe, backless shoe • The original slipper • May have heel
- 9. #6 Oxford • First lace-up style shoes • Mid-17th century • Has been the mainstay of shoegear since • A “monk” is a variation with a buckle
- 10. #7 Boot • Closed-toe • Extends above ankle • Lace-up or slip-on
- 11. SHOE ANATOMY
- 14. Vamp
- 15. Quarter • Forms along the sides of the upper • Largest part of the upper quarter
- 16. Heel Counter • Maintains the shape of the shoe • Controls and stabilizes the heel http://www.google.com/url?sa=i&rct=j&q=heel+c Co5M&tbnid=dDiAmzUhOYb5BM:&ved=0CAUQjR oogle.com/imgres?q=heel+counter&um=1&safe=active&client=safari&s hl=en&biw=1130&bih=713&tbm=isch&tbnid=foNnxRo5EXUTCM:&imgre emiddlemiles.blogspot.com/2011/04/gear-review-nike- cid=YNtsktrWulxtwM&imgurl=http://4.bp.blogspot.com/-Sk- sxfEKitI/AAAAAAAAARg/PApPxs4-
- 17. Tongue • Prevents debris from entering • Protects against pressure of laces • Ensure it’s not too long to irritate leg
- 18. Padded collar • Cushion • Achilles notch
- 19. Lower (sole) anatomy • 3 components to the sole of a shoe • Inner sole • Middle sole • Outer sole
- 20. Outer sole • Portion of the sole that makes contact with the ground • Provides traction, resists wear, and absorbs shock • Treaded layer glued to midsole • Thinner than the midsole • Typically, either made from: • Blown rubber lighter, but less durable • Carbon rubber heavier, but more durable • Combination
- 22. Middle sole • Thickest layer • Provides the majority of cushioning and shock absorption • Modification layer • Typically made from EVA or PU • Ethylene vinyl acetate lighter, better cushioning, deteriorates quicker • Polyurethane denser, heavier, more durable
- 23. Modification layer • Mid sole cushioning devices • Medial post • Shank
- 24. Mid sole cushioning device • Majority comes from EVA • Manufactures also insert their proprietary cushioning systems (w/n midsole) • Most common cushioning systems use encapsulated air, gel or other materials
- 25. Medial post Within the midsole (firmer) EVA, thermoplastic urethane, carbon fiber or other materials In stability and motion control shoes Not in cushioned or neutral shoes Size ,shape, & density determine amount of stability provided
- 26. Shank Stiffens the shoe under the arch Makes the middle portion of the shoe more resistant to torsion and flexion In most running shoes except the lightest and most flexible Assists shoe in bending at toes Adds weight
- 27. Inner sole Not visible on constructed shoe Junction attachment of the sole to the upper shoe Not an insert
- 28. Sizing Use a similar weight sock and orthotics Leave at least ¼ inch (up to ½ inch) between longest toe and end of shoe Heel counter should be snug enough to prevent heel from sliding Fit shoe during the end of the day (swelling) Shoes should never need breaking in Always try on both shoes
- 29. Last
- 30. Shoe life Less dependant on age of shoe More dependant on amount of usage and signs of wear Athletes vs non-athletes Work vs casual Differences among body habitus Presence deformities
- 31. Shoe breakdown • Occurs most commonly at the outer sole • Has has outer sole worn through to the middle sole? • Is there a 4mm difference from the other side of the heel?
- 32. Shoe breakdown • Lack of middle sole shock absorption • Uneven on flat surfaces • Noticeable creases • General rule of thumb: Replace 300-500 miles
- 34. Guidelines for replacement Even without use shoes can wear out Depending on environment Best to replace athletic shoes that are over a year old Can be expensive in short term Will prevent injuries and keep patients active in long run
- 35. Picking shoes Right shoe for the right foot Shoe Best shoe for the job Shoe Comfort & Function > Appearance Comfort & Function Remove/Avoid if irritating Remove/ Avoid
- 36. Evaluating • Straight heel • Counter test • Stable sole bottom • Bend at the toes • Torsion test
- 37. Evaluating • Straight heel • Counter test • Stable sole bottom • Bend at the toes • Torsion test
- 38. Shoe recommendations • APMA • AAPSM • You don’t need to recommend a manufacturer, but give patients the knowledge to find their own shoes
- 39. Minimalist shoes
- 40. Minimalist shoes Became popular after an article in Time in 2007 Predominantly anecdotal Concept: • Feet were not meant to wear shoes, therefore, cannot function efficiently with use • Barefoot/minimalist shoes allow strengthening of the pedal musculature
- 41. Minimalist shoes Conflicting research Difficult to assess Assumes no deformity
- 42. Diabetic shoes • AKA extra-depth shoes • AKA therapeutic shoes • Prescribed
- 43. Diabetic shoes • Function • Protect residual foot • Maintain position inside the shoe & reduce shear • Contribute to restoring normal gait • Allow for accommodation of orthotic device • Allows for modification e.g. steel shank or rockerbottom
- 44. Diabetic shoes Supplied by orthotist or sale in private office Medicare supply new pair & 3 inserts each year Exam shoes during patient encounter
- 45. Conclusion Today’s shoes are variations of the 7 basic models Sole vs upper Find the correct shoe for the correct foot for the correct job Diabetic shoes can help prevent ulcer formation
- 46. References • Dr. Comfort. (n.d.). Basic shoe anatomy. • Janisse, D. J., & Janisse, E. J. (2006). Pedorthic and orthotic management of the diabetic foot. Foot Ankle Clinics of North America, 11(4), 717-734. doi: 10.1016/j.fcl.2006.06.005 • Mustafa, I. (2012). Shoes presentation. • Rossi, W. (1985) The seven basic shoe styles. Footwear and the Podiatrist 75(3), 169-171. • Vonhof, J. (2011). Fixing your feet: Injury prevention and treatments for athletes (5th ed.). Birmingham, AL: Wilderness press. • Yan, A. F., Sinclair, P. J., Hiller, C., Wegener, C., & Smith, R. M. (2012). Impact attenuation during weight bearing activities in barefoot vs. shod conditions: A systematic review. Gait & Posture (Advance Online). doi: 10.1016/j.gaitpost.2012.11.017
Notes de l'éditeur
- Essentially began as a slab of material held in position by linear shaped material Dates back to Egyptian times and prior & in Asia
- Algonquian AKA American Indian Usually made from a single piece of rawhide Like the other types contemporary styles exist
- Recent resurgence of clogs in Crocs and Dansko surgical shoes
- Does not refer to the reebok pump During the Elizabethan era
- Early use were sized smaller than appropriate Corn cutting become prominent during this time
- All the components that cover the foot are considered part of the upper Each have a separate name and perform a different function
- May extend proximally
- Will minimize excessive pronation or supination
- Different designs May be sewn into the quarters or may be an extension of the vamp May flip down to hid the laces
- Layer cake
- There isn't a reliable way to differentiate between carbon and blown rubber, so determine which you prefer and ask to see the specification sheets at the store
- Skate shoe traction mold for asphalt/cement Athletic shoe has better traction of terrain
- Research has not shown that any one manufacturer’s cushioning technology is superior to another Brooks DNA, non-Newtonian liquid, this midsole technology responds to the amount of force placed on the foot and disperses The pressure, providing just the right amount of resiliency. Simply put, you can expect soft comfort when you want it, firm support when you need it.
- Benefits: Decreases some of the inherent instability of cushioned midsole foam, Assists in controlling excessive pronation Consequences: Adds weight Misconception: Medial posts cause the foot to “roll out” Slows down or decreases pronation or “rolling in” but does not cause the foot to roll out or supinate
- The insole is glued, stapled or sewn into place in a shoe. The inlay goes on top of the insole and is removable. The inlay will be the portion which comes into contact with the foot. The inlay will be removed in a diabetic shoe and replaced with an insert. An insert can accommodate or assist with correcting during ambulation.
- Too short shoes cause bruising and blacken toenails. Too narrow shoes squeeze the ball of the foot can deform toes and lead to mortons neuroma Too wide blisters and increase risk for strains and sprain as foot slides inside the shoe Brannock device may be helpful to correctly length and width Variation amongst sizes between manufactures
- Shoes are built over a generic foot model called “last.” It will determines the shape and profile of the shoe. Curved are lighter and less supportive Straight are heavier and more supportive
- Adapted for Arnold Ross, DPM The shoes should remain even and not roll. If they roll when they are new, they will not stop the foot from rolling excessively when worn, and can cause injury.
- American Podiatric Medical Association American Academy of Podiatry Sports Medicine
- Traditionally an Oxford (or Monk) style of shoes with an additional 1/4 to 3/8 depth throughout the shoe
- TCC is considered the gold standard for DFU tx But diabetic shoes are a cornerstone of prevention To protect the foot To relieve areas of excess pressure To reduce shock To reduce shear To accommodate deformities Extra depth allow an orthotic to be added without a major change in height or stability
- Diabetic shoe sale in private practice