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J Am Acad Orthop Surg, Vol 16, No 3, March 2008, 152-158.
© 2008 the American Academy of Orthopaedic Surgeons
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Shoe Modification and the Use of Orthoses in the Treatment of Foot and Ankle Pathology

Dennis J. Janisse, CPed and Erick Janisse, CPed, CO

Mr. Dennis Janisse is Certified Pedorthist and Clinical Assistant Professor, Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, WI. Mr. Erick Janisse is Certified Orthotist and Vice President, National Pedorthic Services, Inc, Milwaukee.

None of the following authors or a member of their immediate families has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Mr. D. Janisse and Mr. E. Janisse.

Reprint request: Dennis Janisse, Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, 7283 West Appleton Avenue, Milwaukee, WI 53216.

Shoe modification and foot orthoses can play an important role in the nonsurgical management of foot and ankle pathology. Therapeutic footwear may be used to treat patients with diabetes, arthritis, neurologic conditions, traumatic injuries, congenital deformities, and sports-related injuries. These modalities may improve patient gait and increase the level of ambulation. They also may be used to treat acute problems such as plantar fasciitis or metatarsalgia and as preventive tools in patients with diabetic neuropathy. Shoe selection is primarily based on the condition of the patient, the foot shape and type, and the patient’s daily activities. Modifications include flares, which provide stability; extended shanks to reduce bending stresses; rocker soles to rock the foot from heel strike to toe-off; and relasting, or reshaping, shoes to accommodate deformities. The four main types of custom orthoses are the accommodative, which cushions and protects the foot; the semi-rigid, which cushions and protects as well as provides support, control, and weight redistribution; the rigid, which offers arch support; and the partial foot prosthesis, which addresses partial amputations and helps protect the foot.






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Copyright © 2008 by the American Academy of Orthopaedic Surgeons.