Foot ulcers and foot orthotics
The feet are often subject to large pressures during weight-bearing dynamic activities such as running or walking. Pressure under the plantar surface during such activities varies due to a number of factors influencing rollover during gait phases. In addition to structural changes caused by diabetic vascular pathology and dryness of the skin which make the plantar more vulnerable to stresses and strains, diabetics often lose sensation in their feet, making them more prone to injury. Increased plantar pressure and the resulting planar ulceration is typically treated by off-loading of the plantar surface. Off-loading mechanisms include reductions in walking speed, correction of foot rollover during gait, and load transfer from affected pressure areas to other areas of the foot. If left untreated, plantar ulceration can result in further ulceration and amputation.
Various types of footwear and foot orthotics can be used to redistribute weight and alter the biomechanical function of the foot. Studies have shown that plantar peak pressures in the medial forefoot and hallux can be significantly reduced through the use of orthotic-friendly footwear.
