Footwear Lecture 4 PDF

FOOTWEAR PROTECTIVE EQUIPMENT AND BRACING ATHL 20082 WHY IS FOOTWEAR IMPORTANT TO AN ATHLETIC THERAPIST? Can predispose to injury (eg non-supportive shoe and PFPS) Can help increase shock absorption Provide support for ADL Our athletes wear them on their feet Can affect m...

FOOTWEAR PROTECTIVE EQUIPMENT AND BRACING ATHL 20082 WHY IS FOOTWEAR IMPORTANT TO AN ATHLETIC THERAPIST? Can predispose to injury (eg non-supportive shoe and PFPS) Can help increase shock absorption Provide support for ADL Our athletes wear them on their feet Can affect mechanics of movement WHICH SHOE COMPANY TO CHOSE?  FOOT TYPES Pes cavus – Supinator Normal arch - Neutral Pes planus - Pronator RELEVANCE TO ORTHOPEDIC INJURY How can footwear lead to an injury? Insole Supinators (pes cavus foot type) need a shock absorbing shoe to decrease injury Heel lift Greater than 1” will increase the load on the forefoot Minimalist Shoe Could lead to increase in stress # WHAT OUR SHOES CAN TELL US… Outsole - Weight bearing positioning - Differences between WHAT OUR SHOES CAN TELL US… Sock Liner Wear patterns Heel pressures Heel Counter excessive movement in the heel cup FOOT PROBLEMS CAN BE CAUSED BY: Narrow toe box bunions hallux valgus Flexible shoe weak heel counter weak medial support High heels Intro to Biomechanics video Plantar fasciitis Toe runner Achilles Tendonitis Short Length Claw toe, black toe  FOOT PROBLEMS HELPED Bunions Wider shoe, soft of seamless construction at widest part of foot Stiff rocker sole Toe Deformities Wide and deep fitting footwear, stretch fabric in toe box Stiff rocker sole Plantar Fasciitis If caused by poor intrinsic of foot – use minimalistic shoe Shoe with strong arch support “Shin Splints” Using stability – motion control shoe  COMPONENTS OF A SHOE Toe Box Houses the foot/toes Upper Material that the shoe is made of above the sole Should be breathable Made of either leather, canvas or synthetic Tongue Purpose to reduce friction between the laces and the extensor tendons  COMPONENTS OF A SHOE Ankle Collar Protects and cushions ankle in the shoe Heel Counter Important in controlling the calcaneus Assisting in limiting pronation during gait Achilles Notch Important in protecting the Achilles tendon as the foot goes into plantar flexion  COMPONENTS OF A SHOE Shank bridge btw the heel and ball of the shoe made of wood, steel, plastic Prevents distortion of the mid part of shoe Insole provides shock absorption Between the sole of shoe and persons foot Should inhibit growth of bacteria sock lining covers the top surface of the insole  COMPONENTS OF A SHOE Midsole Provides the bulk of the cushioning Provides control of foot found between the insole and the outsole primary materials used for midsole are: Ethyl Vinyl Acetate (EVA) Polyurethane (PU) May also contain other products to help with motion control or stability  COMPONENTS OF A SHOE Outsole Part of shoe that contacts the ground Purpose is for traction and shock absorption and are activity specific Heel Wedge Enhances shoes ability to absorb shock Can help to reduce the strain on the Achilles tendon Can help to control pronation Heel Flare A broader base of support a flared sole can reduce inversion and eversion SHOE X-SECTION  “LAST” Plastic or wooden foot form used to represent the foot during manufacturing process Every size and width has its own “last” Term “Last” is also used in with “Last Construction”  COMPONENTS OF A SHOE – “LAST” Board Last (Strobel) Full length rigid board under the insole of shoe Provides a firm foundation from heel to toe Found in motion control shoes Better for the severe pronator COMPONENTS OF A SHOE – “LAST” Slip Last Two ends of upper are stitched together and attached to the midsole Shoe has a seam down the middle of shoe Provides flexibly to shoe – great for supinators COMPONENTS OF A SHOE – “LAST” Combination Last Combines board and slip last Board last found ½ to 2/3 in the rear of shoe Promotes stability with flexibility  SHOE CATEGORIES Motion Control Shoes designed to provide maximum support to moderate to severe pes planus foot type Lots of aggressive medial posting in shoe (plastic) Straight last Stability Shoes designed for mild to moderate pes planus foot type Mild to moderate medial posting (denser material) Help to provide stability and cushioning Combination last  SHOE CATEGORIES Neutral No real posting in shoe Allows for better cushioning and flexibility of shoe Midsole is uniform throughout (EVA) For more neutral foot type Curved last  A GOOD SHOE FIT 1. Measure both feet 2. Make sure it conforms to shape of foot 3. Appropriate for activity level 4. ½” in back of shoe 5. Press heel to back of shoe and should get thumb space in front of toe 6. Fit the shoe for the longest toe  A GOOD SHOE FIT 7. Width of ball of foot fits 8. Should NOT NEED to break shoe in 9. Good heel fit 10. Should walk around in shoe - comfortable 11. Orthotics?  THE CORRECT SHOE Shoe and foot should move as one unit Midfoot should sit comfortably in the toe box Flexible part of the sole should be just behind the heads of the metatarsals Heel box should sit straight up and down in relation to the midsole There should be a solid heel counter  SHOES FOR PRONATORS 1. Combination or board lasted constructions 2. Dual density midsole - open to provide shock absorption and comfort - closed located along medial edge for control 3. Straight last - provides midfoot support and pronation control 4. Solid heel counter - helps to minimize rear foot motion 5. Heel flare - helps to control excessive rear foot movement  SHOES FOR SUPINATOR 1. Slip last - offers comfort and motion 2. Soft midsole - offers comfort and shock absorption 3. Curve lasted - conforms better to shape of foot 4. Solid heel counter - stabilizes the lateral aspect of the rear foot 5. Heel flare - can help control rear foot varus GAIT LINE  ORTHOTICS Functional Foot Orthotic Insole designed to help with foot and ankle biomechanics Prefabricated Foot Care Products Any mass produced prefabricated foot care item Sold over the counter and is readily available  CUSTOM FOOT ORTHOTICS Pes Cavus Foot Shock absorption Plantar fasciitis Pes Planus Foot Rigid Deep heel cup Midtarsal arch may drop If toes splay Longitudinal arch support Non-Contact injuries due to cleats? What are cleats, and who wears them? Cleats vs turf shoes Grass vs Turf Now design? New fit technology