Free Footwear Health Check

Distal Myopathy is a rare disease which is listed under the muscular dystrophy group of progressive genetic disorders. Distal Myopathy largely affects the muscles of the extremities – hands, feet, lower arms or lower legs.

 

I want to stay out of a wheel chair!

 

Recently at Happy Feet Pedorthics we assisted a person with distal myopathy. The woman was born with the condition but it did not manifest itself until later in her life. She came in with a pair of Drew extra width and depth strap court shoes. They looked great except that on the right foot they were too short and were putting pressure on the toes. This had been noticed by the physiotherapist as the client worked through the physiotherapy program.

 

The advantage of the strap court as a shoe design is that that foot with the AFO can get into the shoe and they are great party shoes! The disadvantage of the strap court is that the style is not as supportive as a closed in shoe be it velcro or lace closing for the physiotherapy program and more extended walking. So the option here for the strap courts as the party shoes were a split fit – the right bigger than the left!

 

For the more supportive shoes the client selected Drew lace ups with the pedorthic modification of making the right long opening – which is the way allow for foot entry with the AFO!

 

The person’s broad aim with her condition was to stay out of a wheelchair for as long as possible. Both legs are weak, the right more so, hence the AFO for this leg. Specifically at present the aim to work on going up steps and also inclines. To be able to do both more easily would enable her to continue living in her home without changes at this time.

 

The client went on her way from Happy Feet Pedorthics impressed and delighted that a shoe can be altered for individual needs! This is what pedorthics is about – it is not just the shoe it is what you can do with the shoe!

 

I want to stay out of a wheel chair!

 

Clare Nelson CP CM AU

Poliomyelitis is a preventable infectious disease. Years after recovery from polio, post-polio syndrome can occur. This is what has happened to a client who came to Happy Feet Pedorthics. He shared some of his story as we completed the assessment and fitting of new shoes and finalized the modifications. The man:

 

  • Contracted polio when he was 15 months of age
  • As a child the doctors told his mother to never expect him to be out of a wheel chair
  • As a child he spent 2 ½ years in hospital – sleeping in an A Frame at night, until one day his mother “kidnapped” him and took him home – he remembers his mother massaging his legs with some orange stuff 3 times a day
  • Had custom made shoes for about 10 to 15 years
  • After this he had shoes off the shelf which were modified by inserting a ferrule to use calipers – in the very old days called leg irons – on the outside of his shoes
  • At primary school he had a longer caliper on the right and a shorter one on the left leg
  • At high school he only had a caliper on the right
  • For most of his life he has walked with the aid of 2 sticks except when he “lost” them to the waves when he was in his later high school years
  • As he started work he walked without the aid of calipers or sticks
  • For the last 30 years and being 69 now, he has been using a KAFO – knee ankle foot orthoses – as the pain to the right knee had become too great and there is increasing muscle wasting and weakening.
  • Being an active and thorough renovator he is aware of time – time to have the strength to prepare his home for the future needs of his wife and daughter who are wheelchair bound due to a condition called CMT – Charcot Marie Tooth.

 

The Renovator’s need to Walk Independently
The Renovator’s need to Walk Independently

So now for the shoes and the modifications. At Happy Feet Pedorthics we fitted the man with a Drew Walker style extra width and depth shoe which accommodates his KAFO on the right and the slimmer foot on the left. A split fit was not required.

 

With the modifications a negative heel was required on the left shoe with thinning of the sole right through to the toes, and for the right a leg length difference build-up of 25 mm was required and upon review prior to bonding the sole, we established that a heel raise of 10 mm was also required on the right.

 

The current footwear was of limited help as to the modifications as they were so old that a shoe was worn on the right and a sandal on the left. So in reality estimations were made by using heel raises internally and then applied the same externally. The client’s goal was to be able to walk at home at times without his sticks, the left knee had to be able to lock back as he walked and the right knee had to be able to lock in with the KAFO. Having achieved this, the client was very happy with the service provided by Happy Feet Pedorthics.

 

 

The Renovator’s need to Walk Independently
The Renovator’s need to Walk Independently

Clare Nelson CP CM AU

At Happy Feet Pedorthics it could asked: what do we sell – the sausage or the sizzle, the shoes or the comfort. Actually we don’t think we sell anything! We assess and fit people for footwear and make a pedorthic recommendation, the shoes at times literally walk out the door and we receive payment for our work along the way for our quality service and product.

So when we look at these feet – they look pretty normal but why the walking stick?

The shoes the clinet came in with are the burgundy coloured ones with the material at the heel which does not tone in very well. This man has a condition called Essential Myoclonus. Myoclonus refers to a sudden, involuntary jerking of a muscle or group of muscles. A hiccup or a twitch – or in more severe cases a person’s ability to eat talk or walk can be affected. Essential Myoclonus is a form of Myoclonus.

Back to the sausage or the sizzle – the shoe or the comfort! For comfort – the difference was the SACH heel. Not a short angled cushioned heel – SACH heel like in the burgundy shoes, but an extended SACH heel like in the picture of the brown shoes. (The colours are in the pictures for explanation purposes only.)

Finally many people at Happy Feet Pedorthics say – Happy wife, happy life! And we know that there are many Happy Feet walking out the door of Happy Feet Pedorthics with modifications and repairs toning in with the original shoe!

Clare Nelson C Ped CM AU