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Dress shoes often present the most challenges for both the practitioner and the patients. You can improve your success rate when using orthotic therapy with dress shoes by becoming knowledgeable about types and characteristics of shoes that complement orthotic therapy. This will allow you to assess the probability of successful orthotic treatment with the patient's current shoes.
Have patients bring in their dress shoes for assessment before ordering orthoses. Are they appropriate for orthotic therapy, or are they contributing to the problem? Do they have a removable liner, allowing the orthosis to fit into the shoe? If you have any doubts about their shoes, advise your patients that, although you can make orthoses fit inside their current dress shoes, there is no guarantee that their feet will fit in the shoes with the orthoses. Discuss alternative dress shoes that will allow them to continue their orthotic therapy, and provide a resource for orthotic-friendly dress shoes, such as ProLab's Shoe List. Tell your patients that we recommend that you send their shoes to the lab when ordering dress orthoses, to ensure proper fit. A clear understanding and reasonable expectations by your patients before ordering their dress orthoses generally results in satisfied patients.
How do you manage the orthotic patient with less than "optimal" footwear? Any tips?