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Same diagnosis – many presentations

At Happy Feet Pedorthics we see many people with the same diagnoses who present very differently – from the diagnoses of a bunion or callous to HAV to amputees to Spina Bifida.

Every day I am reminded of my privilege to walk with people who have an understanding of their condition and are getting on with life, using their abilities live a very full and rich life rather than seeing that they have a disability.

For me to express my privilege from a spiritual dimension – I find myself putting my worry of the moment in context and being thankful for my abilities and my life.

Spina Bifida is a condition which affects the spine and the spinal cord, occurring before birth in the first month of a baby’s development in the womb. The cause of Spina Bifida are not known, but are thought to relate to a complex combination of both genetic and environmental factors.

In Victoria, each year 30-35 babies are identified with Spina Bifida. Of these between 7 and 15 survive after birth. There are about 5,000 people living with Spina Bifida in Australia and about 2,000 of these live in Victoria.

People with Spina Bifida have varying degrees of permanent disability – including paralysis or weakness in the legs, incontinence, and learning difficulties.

As a pedorthist at Happy Feet Pedorthics one responds to the person with their individual needs.

Case 1:

  • Mobility – walking and use of a scooter
  • Associated condition of diabetes – requiring regular podiatry care, including the care of areas at risk of ulcerating
  • Pedorthic footwear – custom made shoes with particular attention to the heel counter so as to not rub on the foot but to give support, air holes to support air circulation as feet get very moist and accommodative orthoses
  • Wear and tear issues – shoes require regular repair on the outsoles and inside linings


Case 2:

  • Mobility – wheel chair
  • Associated condition of neuropathy – which means there is not sensation at the feet
  • Pedorthic footwear – smart looking! Prefabricated medical grade footwear – with particular attention required to the back height so as to not cause pressure at the back of the heel: and length so the shoes don’t bend up at the front causing damage to the toes, un be known.
  • The shoes will last a long time as the person is not walking


Case 3:

  • Mobility – electric wheel chair, can weight bear to transfer
  • Associated condition of no ankle bone in the left foot, and lymphoedema
  • Pedorthic footwear – no trouble for the right – but for the left – short of a foot covering decision is about a shoe for when sitting or a shoe for when weight bearing
  • Wear and tear issues – considerable wear and tear on the compression garments

Case 4:

  • Mobility – wheel chair and walking with 2 sticks
  • Pedorthic footwear – pretty looking shoes to accommodate the AFO’s – so extra width depth to fit the small 2 differently sized feet
  • Wear and tear issues – will be in the realms of “normal” given the gait cycle

Clare Nelson C Ped CM AU

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