The Diabetic and High Risk Foot
Footwear for people with diabetes need to accommodate, support and stabilise deformities due to complication such as; neuropathic Charcot changes, reduced plantar fibro-fatty padding, amputation or hammer toes. Reducing the motion of the joints of the foot can relieve pain and improve function, resulting in a more stable, less risky platform.
Any areas of pressure within the shoe are at risk of skin breakdown and ulceration. Pressure areas must be avoided and the shoe modified as necessary to accommodate deformity and improve function.
Increased ground contact surface area, with medial and lateral midsole flare will enhance patient stability and reduce falls risk. Effective lacing or attachment systems ensure the foot is firmly secured within the shoe. Reducing shock and shearing forces of the foot within the shoe will also assist in protecting the diabetic foot.
Footwear considerations, like these, should be made for each and every patient, whether it is a child or an athlete; hallux rigidus or plantar fasciopathy .
Footwear is one essential piece of the biomechanical puzzle, and is the interface between the patient and the ground.