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Does anyone have any experience of sandals that are designed to be used with orthoses? Are there any particular types of devices that work well? Or is it the case that you'll never get adequate rearfoot control in footwear that doesn't have a full heel?
I am not sure about "orthotic friendly sandal", but:
1. A number of orthotic labs (mostly USA) are offering sandals (mostly Birkenstock like) with a custom made foot bed (ie orthotic) from a cast or optical scan.
2. We have used the Nike running sandal in some of our 3d kinematic orthotic studies - the orthotic stays in place pretty well (and we have exposure of landmarks to attach markers for vicon capture).
__________________
Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia http://www.latrobe.edu.au/podiatry
__________________________________________________ ___________________________________ God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University This is where I am, where are you?
Are those BITE sandals available in the US? I have seen those from TEVA which aren't too bad either. I think a sandal with a removable foot bed can be replaced with a cork and leather device which should fit nicely might work. Any ideas for suggestions to patients? I do know that my diabetic insole and shoe supplier can make a sandal with plastizote as a custom type device, but it is not too stylish, and more for the elderly female customer.
Bite sandals are available in the US. a DPM here in Montana sent a pt over with a pair of sandals for me to put an elevation on. Her orthotics fit in the sandal very well.
I order BITE from a canadian supplier called RMP Athletic, based in Mississauga, Ontario (they happen to be the canadian distributor for Brooks running shoes, too).
But there is an orthotics lab that you can order the Bite sandals with the orthotics already in them. See http://www.parisorthotics.com/ - they're based in Vancouver, British Columbia.
Ed
__________________
Edward Yip
York Foot And And Ankle Clinic
15423 Yonge St
Aurora, ON, Canada
L4G 1P1
905-713-2546
I ordered several pairs for myself and my wife from Rocky Mountain Orthotics Lab and we are quite happy with the sandals. They use removable footbeds. http://www.rmolink.com/index.htm
As some of the other posters have already said, the US/Canadian labs offer the service of making sandals with bespoke orthoses in straight from a cast.
I've tried making insoles to fit into sandals bought by the patient (with removable footbeds (eg Ecco), but find that it really does have to be something more like a simple insole eg cobra, due to the base thickness demands of fitting it into the sandal.
I now use Firefly (UK postal address) as I get all my casted orthotic devices from them anyway. They offer a range of 'walking sandals' that the orthoses are made to fit into. Much less hassle and higher patient acceptability as they appreciate the bespoke aspect of the service!
Firefly are connected to a US/Candian lab and I've had practically 99% success using their devices!
Langer also offer a range of Birkenstock sandals for which bespoke orthoses can be designed from a cast, but I've not used them!
In the UK Paul Mountford (Pod and Pedorthist) scans casts for custom orthosis fabrication (the orthoses are made by Bergmann in the USA).
We talked a while ago about making a casted device which would become part of the sandal - not sure how much further Paul got with this, but I think the idea was to offer the device/sandal marriage in a wider choice than Birkenstocks or similar.
we had podiatrist send the sandles and neg cast, scanned cast and inlay as normal and took the dimensions of the inlay, transfered to lab, device came back a little bit oversized (as requested), simply reduced to fit sandle and bobs your uncle
My understanding, from talking to the pod concerned, was that the product cuurently available in the UK from L***** was not as good as their promotional literature would have us believe.
I have been using Bites for 2 years. They are wonderful!. Their tread is great (non slip and aggressive) so you can tell folks if they are wanting to hike, golf etc and do outdoor actvities without reservation.
Freeman Churchill, C. Ped (Canada)
Hi David
i believe there was a couple of issues involved, one being (if i'm correct in my understanding of what was said by the pod), they ordered the footwear from lab(never worn them) and sent a neg cast, my advice would be to get patient to purchase the sandles with a removable inlay, wear them for a few weeks, come back take cast etc send both cast and sandle to lab for orthotic construction, who's to say they ordered the right size shoe for their foot in the first place......
Hey Freeman how are you keeping, are you attending the PFA symposium in Indi next month
some other issues we kept in mind when manufacturing an orthoses for the sandle to replace the inlay
We used a corrected cast with a slightly lowered medial arch (more than normal) because of the fact that there is no space between orthotic and sandle in medial aspect, unlike normal process where we have a space between orthotic and shoe, (My understanding is that sometimes labs use an uncorrected cast then heat and mould original inlay over the uncorrected cast creating a high medial arch),
Also if an uncorrected cast used the arch becomes to high and causes possible lateral sliding of foot and it may be placed into a possible supinated position
We also felt if we did not lower the arch the patient may also incure discomfort and possible blistering of medial arch because of contact between the foot and orthotic
We also used a flexible material to allow some flexion of orthotic in medial arch to help eliminate the possibility of the discomfort/blistering
If we used same material as the inlay's made of, ie cork, this could possibly make the device to rigid in medial arch because of the density
as i said earlier these were the concerns we kept in mind when creating the orthotic
As a pedorthic clinic we stock a few models of Bite sandals and a few others which are orthotic friendly. Bites do not come in half sizes so sizing exactly is important. Guessing up or down could make a significant error. I prefer to err on the side of not overcorrecting the medial arch in terms of back fill. For most people, I use Hi density Black plastizote with a 5-55 durometer EVA post and midfoot fill. I will use Ortholite, a black fabric top cover and we have had great results.
Orthoactive out of Canada has a line of sandals with a bit of a heel which we use to encourage people with an equinus as a slipper around the house. I think where we live (Canada) people will use a slipper to break the cold barrier between the floor and their foot. If you can convince them to use a stable and corrected sandal instead of a slipper, it reduces the time their are not properly aligned. And their feet are less cold.
Freeman
some other issues we kept in mind when manufacturing an orthoses for the sandle to replace the inlay
We used a corrected cast with a slightly lowered medial arch (more than normal) because of the fact that there is no space between orthotic and sandle in medial aspect, unlike normal process where we have a space between orthotic and shoe, (My understanding is that sometimes labs use an uncorrected cast then heat and mould original inlay over the uncorrected cast creating a high medial arch),
Also if an uncorrected cast used the arch becomes to high and causes possible lateral sliding of foot and it may be placed into a possible supinated position
We also felt if we did not lower the arch the patient may also incure discomfort and possible blistering of medial arch because of contact between the foot and orthotic
We also used a flexible material to allow some flexion of orthotic in medial arch to help eliminate the possibility of the discomfort/blistering
If we used same material as the inlay's made of, ie cork, this could possibly make the device to rigid in medial arch because of the density
as i said earlier these were the concerns we kept in mind when creating the orthotic
l
It's great to see some home-grown (UK, that is) initiative taking place.
Having now seen some photographs of the sandals in question, I can vouch for their general finish, and the marriage between orthosis and sandal looks flawless.
Orthotic Friendly Sandals
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