Shoes & Shoegear Bryan Levay Monday, May 13, 2013

Overview 7 shoe styles Shoe anatomy Sizing Shoe life Evaluation Minimalist Diabetic shoe

The 7 basic styles

#1 Sandal Oldest form Basic open toe design More robust for soldiers New styles & variations Poor support often leads to discomfort 4no_MdXM&tbnid=c6Ou9hHtfzWyjM:&ved=&url=http%3A%2F%2Fwww.kshs.org%2Fp%2Fco ol-things-japanese- footwear%2F10365&ei=FdCPUeHGFIqiigek3YHAAw&bvm=bv ,d.aGc&psig=AFQjCNFt YeStNqcvAnCpbOxb-xz8r8zvPA&ust= ent=safari&sa=N&rls=en&hl=en&biw=1130&bih=713&tbm=isch&tbnid=ik g3ehXBR67uXM:&imgrefurl= Rhinestone-Heels-Sexy-Sandal-Comfy-Medium-Heel- / &docid=iQ3SOwXYivjVFM&imgurl= et.com/albums/z142/HOO121/Pics%252520VIII/P _01.jpg&w=10 24&h=768&ei=ndCPUdH4Oc2aiAf26oGIAQ&zoom=1&ved=1t:3588,r:1,s:0,i:86&iact=rc&dur=557&page=1&tbnh=181&tbnw=250&start=0&ndsp=1 8&tx=130&ty=52

#2 Moccasin “Foot covering” Popularized Native American, but has Ancient Mongol roots Simple closed design ri&rls=en&hl=en&biw=1130&bih=713&tbm=isch&tbnid=rJI48cJzaXU- ZM:&imgrefurl= htm&docid=_j1MNs05UIUutM&imgurl= etonka_moccasin_7.jpg&w=640&h=480&ei=89GPUa2tAtCaiAf6uoHgDw&zoo m=1&ved=1t:3588,r:50,s:0,i:238&iact=rc&dur=397&page=3&tbnh=179&tbnw =239&start=34&ndsp=20&tx=119&ty=72

#3 Clog Peasant shoes Scandinavian countries Wooden design Resurgence in popularity =&docid=sDtsm5nNf907sM&tbnid=b9cxa09njx6fxM:&ved=&url=http%3A%2F %2Fwww.shopping.com%2FDansko-Dansko-Professional-Cabrio-Clog-Women- s%2Fprices&ei=ZdSPUe70DaiViAfEsYBg&bvm=bv ,d.aGc&psig=AFQj CNEDbHvZdhr5NQYEOEyGNhLxhBbfLw&ust= fari&sa=N&hl=en&rls=en&biw=1130&bih=713&tbm=isch&tbnid=QUAlBeDf0O dVfM:&imgrefurl= sko-work-clog-professional- crocs.html&docid=S2YrFDXuN0Fj3M&imgurl= O5ifP_2IIe4/T78Yntry3PI/AAAAAAAAYBI/qK1kyJkISdU/s1600/DANSKO-CROC- CLOGS- 13.jpg&w=600&h=440&ei=h9aPUZ7VBoe4iQf7hIGoAw&zoom=1&ved=1t:3588,r:15,s:0,i:128&iact=rc&dur=284&page=2&tbnh=181&tbnw=247&start=13&nd sp=20&tx=54&ty=90

#4 Pump Prominent in late 16 th century United Kingdom Thin constructed that acted as a “slip-on” Heel lift added Many variations en&rls=en&biw=1130&bih=713&tbm=isch&tbnid=COlKH2tQnqm2DM:&imgrefurl= ndershoes.com/ARA/889,5,6,ARA-St-Tropez-blue-nubuck-opentoe- pump.html&docid=I9mJ6r65m5OOGM&imgurl= lg.jpg&w=500&h=375&ei=8dqPUeX5MPCPiAeVkoCABQ&zoom=1&ved=1t:3588,r:21,s:300,i:67&iact=rc &dur=261&page=14&tbnh=175&tbnw=223&ndsp=24&tx=84&ty=68 vqbBnrBHFMqbM&tbnid=K3WtgvAmBlJxgM:&ved=0CAUQjRw&url=http%3A%2F%2Fwww.e bay.com%2Fitm%2FNew-GRISHKO-Maya-Ballet-Pointe-Shoes-Size-7-XXXX-M- %2F &ei=KNyPUavLKKboiAeYroGYAQ&bvm=bv ,d.aGc&psig=AFQjC NGfd5Tw_IUrcYJwsNzj53yUNawdiw&ust=

#5 Mule Hybrid of a clog & pump Closed toe, backless shoe The original slipper May have heel =yZIrTm8S5tlqFM&tbnid=XBbqodRkHMh_GM:&ved=0CAUQjRw&url=http%3A%2F% 2Flovetosparkleandshine.blogspot.com%2F2012%2F04%2Fdefinition-of-beauty- shoe- styles.html&ei=6N6PUdysDYWtiAeipoGYBQ&bvm=bv ,d.aGc&psig=AFQjC NEJuJLWyzMduSUm4rCdGM2oVvX3JA&ust=

#6 Oxford First lace-up style shoes Mid-17 th century Has been the mainstay of shoegear since A “monk” is a variation with a buckle ve&client=safari&sa=N&rls=en&hl=en&biw=1130&bih=713&tbm=isch&tbnid= mNpXY8vISqZP1M:&imgrefurl= %3FtName%3Dlace-up-oxford-shoes.html&docid=hlPqHO- lExSR_M&imgurl= 1&w=1900&h=1900&ei=99- PUZS_Ls3PiAfl5oDYCQ&zoom=1&ved=1t:3588,r:71,s:100,i:217&iact=rc&dur=1 271&page=8&tbnh=191&tbnw=190&ndsp=24&tx=84&ty=61 rls=en&hl=en&biw=1130&bih=713&tbm=isch&tbnid=74MHj8ldIQwBXM:&imgrefurl = gents/&docid=DK7_sDGRZHin9M&imgurl= 1/harris-tan-double-monk-shoe-brown-product _full.jpg&w=1020&h=732&ei=a- GPUdCfNejyiAeplICgBw&zoom=1&ved=1t:3588,r:6,s:0,i:98&iact=rc&dur=568&page =1&tbnh=182&tbnw=254&start=0&ndsp=15&tx=58&ty=51

#7 Boot Closed-toe Extends above ankle Lace-up or slip-on n&biw=1130&bih=713&tbm=isch&tbnid=GYJqUG2eDEoTBM:&imgrefurl= com/boot-outline-1431-vector- clipart.html&docid=pUQvNSSDHBSz5M&imgurl= 7c-14/boot-outline-Download-Royalty-free-Vector-File-EPS jpg%253Fv3&w=1200&h=1200&ei=A-KPUc2dF- aSiQfDmoCwDA&zoom=1&ved=1t:3588,r:48,s:0,i:232&iact=rc&dur=385&page=3&tbnh= 183&tbnw=203&start=37&ndsp=20&tx=79&ty=115 s=en&hl=en&biw=1130&bih=713&tbm=isch&tbnid=wSILxymByYQr4M:&imgre furl= boot-assorted-colors/-/A &docid=LjIj8-Xv- nMTXM&imgurl= 97/ jpg&w=410&h=410&ei=A-KPUc2dF- aSiQfDmoCwDA&zoom=1&ved=1t:3588,r:39,s:0,i:205&iact=rc&dur=319&page =3&tbnh=185&tbnw=185&start=37&ndsp=20&tx=37&ty=108 t=safari&rls=en&hl=en&biw=1130&bih=713&tbm=isch&tbnid=pX5ObHsweero yM:&imgrefurl= tp://buildaboot.com/sites/default/files/temp/ png%253F &w=500&h=500&ei=beKPUavdOKm5iQfUloGoBg&zoom=1&ved=1t:3588,r: 95,s:200,i:289&iact=rc&dur=334&page=15&tbnh=184&tbnw=225&ndsp=20&t x=139&ty=119

SHOE ANATOMY

Upper Lower (sole)

Uppers vamp tongue padded collar eyelets counter quarter top line

Vamp Covers the top of the toe box May have a toe cap Different composition based on function =en&biw=1130&bih=713&tbm=isch&tbnid=xY5ypTq10o5eEM:&imgrefurl= free-5-0-v3/mens-nike-free-5-0-v3/nike-free-5-0-v3-mens-running-shoes-gray-green-1&docid=Sr- 5m57LYbgNVM&imgurl= V3/Mens%252520Nike%252520Free% % %252520V3/Nike%252520Free% % %252520V3%252520Mens%252520Running%252520Shoes%252520Gray%252520Green1- 1.jpg&w=500&h=500&ei=0PqPUfb6O-2SiAeq- oHYAQ&zoom=1&ved=1t:3588,r:52,s:100,i:160&iact=rc&dur=616&page=9&tbnh=181&tbnw=225&ndsp=1 6&tx=102&ty=109 i&rls=en&hl=en&biw=1130&bih=713&tbm=isch&tbnid=_LyQRmnbrg6qLM:&imgrefurl= /buy-work-shoes.web-mall.biz/product/1/257/Shoes-For-Crews-Statesman-Mens-Brown-No- Slip-Dress-Shoes.html&docid=q3iBs0ABSKUjbM&imgurl= mall.biz/img/1/249.jpg&w=350&h=350&ei=hvuPUd7AB6qOiAfJ94DIDg&zoom=1&ved=1t:358 8,r:60,s:400,i:184&iact=rc&dur=671&page=24&tbnh=188&tbnw=197&ndsp=20&tx=89&ty=6 1

Quarter Forms along the sides of the upper Largest part of the upper quarter

Heel Counter Maintains the shape of the shoe Controls and stabilizes the heel Co5M&tbnid=dDiAmzUhOYb5BM:&ved=0CAUQjRw&url=http%3A%2F%2Fwww.theshoesnobblog.c om%2F2012%2F07%2Fbreaking-in-shoes-your-first-30- days.html&ei=QgKQUZ_hHMmUiQeY0oDgAg&bvm=bv ,d.aGc&psig=AFQjCNHwJA4eV3x m1merBpnK7zc_xg9aeA&ust= a=N&rls=en&hl=en&biw=1130&bih=713&tbm=isch&tbnid=foNnxRo5EXUTCM:&imgre furl= free.html&docid=YNtsktrWulxtwM&imgurl= ToRr4T_4/TaxsxfEKitI/AAAAAAAAARg/PApPxs4- DoE/s1600/nike%252Bfree%252Bheel%252Bcounter.JPG&w=506&h=367&ei=gACQUc b2G4adiAfOxIHQBg&zoom=1&ved=1t:3588,r:71,s:0,i:305&iact=rc&dur=385&page=5& tbnh=191&tbnw=264&start=71&ndsp=21&tx=184&ty=134

Tongue Prevents debris from entering Protects against pressure of laces Ensure it’s not too long to irritate leg

Padded collar Cushion Achilles notch

Lower (sole) anatomy 3 components to the sole of a shoe – Inner sole – Middle sole – Outer sole ZYcpnM&tbnid=mcejDICpLGKXAM:&ved=0CAUQjRw&url=http%3A%2F%2Fhypebeast.com%2F2009 %2F11%2Fasics-gtii-tweed- collection%3F_locale%3Den&ei=FyORUfW9DIS0iQf7wYHYDQ&bvm=bv ,d.aGc&psig=AFQj CNEK5VoPanPLsFR_jt22pcfqHwf4KQ&ust=

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

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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

Modification layer Mid sole cushioning devices Medial post Shank

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

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

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

Inner sole Not visible on constructed shoe Junction attachment of the sole to the upper shoe Not an insert

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

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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

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?

Shoe breakdown Lack of middle sole shock absorption Uneven on flat surfaces Noticeable creases General rule of thumb: Replace miles

Shoe breakdown Heel counter deviation

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

Picking shoes Right shoe for the right foot Best shoe for the job Comfort & Function > Appearance Remove/Avoid if irritating

Evaluating Straight heel Counter test Stable sole bottom Bend at the toes Torsion test &cd=&docid=KfcuIwAVZZ5jXM&tbnid=opt2ihPlJqjgXM:&ved=0CAUQjRw&url= http%3A%2F%2Fwww.therunnershigh.com%2Farticles%2Fdefrunningasa2.ht ml&ei=uB2QUbODHq- ViQfX5YGIAg&bvm=bv ,d.aGc&psig=AFQjCNHb0cKBVixwjuyMOQr7H 3q6ATnLfQ&ust= &cd=&docid=SROGfnHg03Rs- M&tbnid=VLcW9nn0zKj2HM:&ved=&url=http%3A%2F%2Fwww.footankle.co m%2Fshoes.htm&ei=jB2QUfPZGIePiAe3joHoBw&bvm=bv ,d.aGc&ps ig=AFQjCNHb0cKBVixwjuyMOQr7H3q6ATnLfQ&ust= Adapted for Arnold Ross, DPM

Evaluating Straight heel Counter test Stable sole bottom Bend at the toes Torsion test &cd=&docid=xrJFpRKw9lVm8M&tbnid=obo6Um9XO3fOyM:&ved=0CAUQjRw &url=http%3A%2F%2Fkenva.wordpress.com%2F2008%2F04%2F15%2Fthe- shoe-test-by-mark-t-reeves%2F&ei=BR- QUYvyGMjIkQXm9oHYDw&bvm=bv ,d.aGc&psig=AFQjCNFspuHlJZXk eeYz95AhGWoJIKDvbw&ust=

Shoe recommendations APMA AAPSM You don’t need to recommend a manufacturer, but give patients the knowledge to find their own shoes

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

Minimalist shoes Conflicting research Difficult to assess Assumes no deformity

Diabetic shoes AKA extra-depth shoes AKA therapeutic shoes Prescribed k7M&tbnid=aC64w_qbQqhp3M:&ved=&url=http%3A%2F%2Fwww.wcbl.com%2Forthotics-2%2Fdiabetec- shoes%2F&ei=4ziQUfmGJqKbigfr84Eo&bvm=bv ,d.aGc&psig=AFQjCNFL-1QBiFX9KRnO7EKvDUiWbwc-mA&ust=

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

Diabetic shoes Supplied by orthotist or sale in private office Medicare supply new pair & 3 inserts each year Exam shoes during patient encounter NPM&tbnid=Y8ltNc5- 6F4p3M:&ved=0CAUQjRw&url=http%3A%2F%2Fwww.freemandrug.com%2Fid64.html&ei=cCSRUfiWH82ViAeV3YGgBA&bvm =bv ,d.aGc&psig=AFQjCNF_wkPftLE5ldCZiUBxAVm3rINALg&ust=

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

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), doi: /j.fcl Mustafa, I. (2012). Shoes presentation. Rossi, W. (1985) The seven basic shoe styles. Footwear and the Podiatrist 75(3), Vonhof, J. (2011). Fixing your feet: Injury prevention and treatments for athletes (5 th 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: /j.gaitpost

QUESTIONS? Thank you!