It is often said that the state of your feet shows in your face – and painful feet can certainly make a big difference to how you feel, and limit your mobility to a significant extent.
People with the most complex foot problems could benefit from having custom-made footwear: there are still a few shoemakers who have the expertise to make comfortable and stylish shoes that can accommodate foot problems associated with disabilities and long-term medical conditions.
Sometimes, the NHS may prescribe orthopaedic footwear, if one or both feet are of a very irregular shape, for example, or if there is a significant difference in size between them. People with diabetes or arthritis, or other conditions that make the foot or ankle weak or prone to injury, may also require custom made footwear. If you think that you may be eligible for NHS-prescribed footwear, you should ask your GP to refer you to a specialist related to your disability, in the first instance. They will then prescribe the footwear you need, and refer you on to the Orthotic or Surgical Appliance Department, who are responsible for the provision of the footwear. The person who measures you for footwear is an orthotist.
Less severe problems may be addressed with bespoke orthotic insoles – made to a cast of the feet, these can transform the way you walk, and often enable the wearer to continue to wear shop-bought shoes. The sort of conditions that can be helped by correct orthotic insoles include diabetes, plantar fasciitis, hallux valgus (bunions) and pronation (feet rolling inwards excessively). They can also help manage pain and difficulty in walking caused by long-term conditions such as polio, spina bifida, stroke and cerebral palsy. Short-term use of orthotics may be required following sports injuries. Here, a custom-made orthotic insole is being shaped to fit inside the shoe.
Shoes and Slippers
Even without conditions that require special custom-made orthotics, pressure on the soles of your feet can make walking uncomfortable. As we get older, the pads of natural cushioning on the soles of the feet get thinner and less effective at absorbing pressure. Gel insoles are a good way to help absorb impact and so ease the pressure.
Many people who lose the dexterity to tie shoelaces would still like to wear a smart pair of lace up shoes, rather than being limited to loafers or Velcro fastening. One solution is elastic laces, which turn lace-ups into slip-on shoes. Another possibility is spring clips, which hold the laces closed.
If you need extra room to accommodate bunions, swelling, problem toes, bandaging or very wide feet, there are ranges of shoes and slippers available which are wider and deeper than usual footwear, in styles to suit range of conditions, including stroke, arthritis, diabetes, or leg ulcer.
A shoe horn is a simple, low-cost aid that helps with putting on shoes, particularly if you have reduced dexterity or weakness in your hands. A long handled shoe horn, such as the ones shown here, avoids the need to bend down in order to get the shoes on.