Bottom of the Foot Soreness: Think Accommodation

Above is a Spenco insert which has the area of soreness cut out on the right foot. You can mark the sore area with a felt pen or old lipstick on your foot. Then put your foot into the shoe and walk a few feet to see where the mark comes out. Cut an area just bigger than the mark. 2 layers may be appropriate.

Here 1/8 th inch adhesive felt is being used to accommodate a sore big toe joint. Be creative with old shoe inserts that you are not using anymore.

ShearBan: Great to Reduce Friction at the Bottom of the Foot

When trying to eliminate friction from the bottom of the foot, especially in cases of ulcerations, scars, calluses, and sore points, ShearBan and Engo are 2 great products. Here I am using ShearBan, with 1/8th plastazote or memory foam, with an accommodative pad to reduce both the vertical load and the shearing load (friction) on a developing ulcer. This patient has already had toes amputated from PAD, or peripheral arterial disease, and any developing sore must be protected as well as possible. 

1/8th inch Memory foam (plastazote) from JMS Plastics to replace the shoe insert to reduce the vertical load on the sore area.

The developing sore, which has not yet ulcerated, is marked with Wet and Wild Lipstick

The shoe insert is placed into the shoe, and then the foot with the lipstick, is carefully placed. The patient is asked to walk a few feet. The first mark is always from the foot getting into the shoe, with the mark closest to the toes being where the sore is located.

A small piece of ShearBan is placed on this area on the top surface of the memory foam in direct contact with the sore area. You want to reduce the shearing force in as small area as possible since you do not want the foot sliding too much in the shoe. 

Here 1/16 inch neolon, also from JMS Plastics, is placed on the bottom surface of the pad to off weight the sore. 

Here the 2 glued sided are joined accomplishing the off weight bearing. So, with the above treatment, this shoe insert has reduced vertical load, reducing friction or the shearing force, and off weighted the sore area. One of these functions should help prevent pain and further loss of limb. 

When the bottom of your feet are sore, Consider Accommodations

 Here is a pair of insoles made of neolon, a knockoff of Spenco. Spenco is the best shock absorping material on the market that I have worked with over the last 30 years. It is shock absorbing and very durable. You can purchase at many retail stores or at www. spenco.com. I cover almost all my orthotics, other than dress and Hannaford, with spenco. It is neopreme, the foam rubber you find in wet suits.

http://www.spenco.com/

 Here I have made accommodations, or cut outs, for a patient with sore areas under both fifth metatarsals and both big toes. See how the inserts have changed from their original design. This can dramatically change the pressure distribution on the bottom of the feet.

Here I have added more accommodation to the bottom of the inserts by taking adhesive felt and placing it next to the cut out areas. The adhesive felt can be purchased as a roll from http://www.mooremedical.com/ . I use 1/8 inch felt. You can use many products to glue or tape onto the insert to accomplish the off weighting of the sore area. Many of my patients are quite artistic.