ORTHOPEDIC SHOE
● It comprises the largest class.
What is an orthosis?
● The term is derived from the Greek
“ortho”, to straighten.
● An orthosis is a mechanical device
that applies forces to the limbs or
other parts of the body.
● A device applied to a human limb to
control or enhance movement or to
prevent bone movement or
deformity, for example, a splint or an
arch support.
● An orthosis is a device that is
applied to a part of the body to
correct deformity, improve function,
or relieves symptoms of a disease.
● The word is derived from ortho,
meaning straight.
● An orthosis is an externally applied
device which supports or assists the
musculo-neuro-skeletal system.
What is a splint?
● This is a temporary device that may
serve as the same function.
What is the three-point pressure
principle?
● This forms the mechanical basis for
orthotic correction; a single force is
placed at the area of the deformity or
angulation; two additional counter
forces act in the opposing direction.
What are the four functional classes of
orthoses?
● Stabilization (supportive)
● Motorized (functional)
● Corrective (surgical)
● Protective
Stabilizing or Supportive
● These orthoses permit the patient to
control an otherwise uncontrollable
segment or an entire limb.
Motorized or Functional
● This is characterized by a motor
element designed to impart active
function to an otherwise paralytic
or paretic limb segment.
● The most frequently used is a coil
leaf spring.
● Its primary use is in flaccid paralysis.
Corrective Orthoses
● In order to realign or correct parts
of a limb, a relatively high force may
be required.
● They are most likely to be effective
when used during infancy.
● * the most common corrective
orthoses are the braces for scoliosis.
Protective Orthoses
● This protect or maintain the
alignment of a diseased or injured
limb.
● Weight relieving orthoses are also in
this category.
LOWER EXTREMITY ORTHOSIS
Principles of Lower Limb Orthosis
● Use only as indicated for as long as
necessary.
● Allow joint movement wherever
possible appropriate.
● Orthoses should be functional
throughout the phases of gait.
 ● An orthotic ankle joint should be
centered over the prominence of the
medial femoral condyle.
● An orthotic hip joint should be in a
position that allows the patient to sit
upright at 90 degrees.
● Patient compliance will be enhanced
if the orthosis is comfortable,
cosmetic, and functional.
What is a shoe?
● An external covering for the human
foot, usually of leather and
consisting of a more or less stiff or
heavy sole and a lighter upper part
ending a short distance above, at, or
below the ankle.
● The purpose of wearing a shoe is to
protect the foot.
● Shoes are the important foundation
of the lower limb orthosis.
● Shoes are used to protect and warm
the feet, transfer body weight while
walking, and reduce pressure or
pain through redistributing weight.
● Shoes should be comfortable and
properly fitted. The should be atleast
1 cm longer than the longest toe and
correspond to the shape of the feet.
* Common ortho shoe = leather
shoe and boots.
● The shoe can be divided into lower
and upper parts.
● The lower parts consist of the sole,
shank, ball, toe spring, and heel.
● The upper parts include the quarter,
heel counter, vamp, toe box, tongue,
and throat.
* Shank= Ball of the foot
* Tongue
* Throat= entrance
* Counter= mid cut, high cut,....
Major components of shoe
● 1) SOLE
● 2) HEEL
● 3) UPPER
● 4) LININGS & REINFORCEMENT
*Lining & reinforcement varies from different
brands and designs.
*Designs of linings and reinforcement varies
on different sports.
Sole
● Inner sole= contact with foot
● Outer sole= contacts with ground
● Ball (widest part)
● Toe spring= creates push off from
stance to swing phase

Terms to Remember
● Pronation has also been referred to
outrolling.
● Supination has also been referred to
inrolling.
● Orthosis are donned and doffed not
put on and taken off.
A) Outer sole
● Checkout means an examination of
B) Inner sole
the patient after the orthosis is fitted.
C) Ball
* insert arthrokinematics of supination,
D) Shank area
pronation
E) Shank Piece
F) Toe Spring
The sole is the bottom part of the shoe.
The widest part of the sole is at the metatarsal
heads and is called the ball.
The narrowest part of the sole, between the
heel and the ball, is called the shank.
*Shank piece shows as the “hole” below the
shoes
What is toe spring
The toe spring is attached to the outer
surface, between the outer sole and the floor.
The purpose of the toe spring in the design of
the shoe is to cause a rocker effect during
push-off and to reduce wrinkling of the upper.
*Toe spring’s function is to create a pre-
swing momentum
How is the height of the heel measured?
The height of the heel is measured in eighths
of an inch at the breast.
Shoes with lower heels, no heels, or negative
heels also exist.
A spring heel, which has a heel height of only
1/8 to 3/16 inch, is placed under the outer sole
and thus eliminates the heel breast. This type
of heel is common on shoes for infants and
children up to 3 years of age.
What part is the breast?
This is the anterior surface of the heel.
What part is the pitch?
This is the inclination of the posterior
surface of the heel from the vertical.
*depends on what type of shoes must be
used
What are the different heel heights?
* Spring 1/8
* Oxford 6/8 to 8/8
* Military heel 10/8
* Cuban 12/8
*Highest heel for orthopedic shoe - Cuban
aka Stilletos
· A spring heel is one-eighth inch
high.
· An Oxford heel is three quarters to
one inch high.
· A military heel is one and one
quarter inches high.
· A Cuban heel is one and a half
inches high.
What is the upper?
● The upper is that part of the shoe
that is above the sole.
● It is most commonly made of leather,
although any soft and durable
material may be used. Leather is
found to be the most comfortable
because it allows evaporation and
absorption of moisture and molds
well to the shape of the foot.
● * Leathers are the advised or
recommended for everyday shoes
● * Rubber shoes are the ones
advised for sports/athletes)
Vamp
- Anteriorly, the vamp has a
reinforced toe box or toe cap to maintain
appearance and to protect the toes
 against trauma. (*Vamp aka Toe Box
shoes)
Parts of the Upper
· The Upper
- Vamp
- Quarters
- Counter
- Throat
- Toe box
- Tongue
What is the VAMP?
● The vamp covers the dorsum of the
foot (includes the tongue piece) and
superior aspects over the toes.
● This section i.e. the toe puff is
reinforced which serves to give the
shoe its shape as well as protect the
toes.
● The vamp is often made of more
than one piece, creating a
decorative pattern. There are
various types of vamps suited to
different styles of shoes.
What is a QUARTER?
● The complete upper part of the shoe
behind the vamp line covering the
sides and backpart.
● Posterior section of shoe
● *It can be high, mid, or low cut
● *The quarter determines the shape
and cut of the shoes)
QUARTER HEIGHTS
● Basic designs are mainly determined
by the shape of the upper, especially
the design of the toe and the height
of the quarters.
● On low quarter shoes, or the Oxford,
the quarters extend approximately 1
inch below the malleoli and do not
restrict ankle or subtalar motions.
● In high-quarter shoes, the quarters
may cover the malleoli, either just
barely, as in the chukka shoe, or by
2 inches or more, as in boots.
● *Low cuts aka Oxford
● *High cuts aka chukka or boots
● *Mid cuts also known and seen in
rubber shoes
THROAT
● At the base of the tongue
● *The entrance of foot to the shoes
● *Basketball shoes are narrower
● *Common shoes varies
What are the type of throat styles?
● The most common throat style is the
blucher type, in which the lace stay
is not directly fastened to the vamp.
● the laces are tied to two pieces of
leather independently attached to
the vamp; also known as "open
lacing."
● In England, the Blucher is known as
the Derby shoe.
● This is more recommended for
patients requiring an orthosis.
 ● *Regular shoes= shape varies
● *Shoe last is the leather shoes

● A balmoral type is when the lace is

fastened to the vamp.
● The balmoral is a type of laced shoe
in which the vamp has a slit that is
closed by laces.
● It is named after the Scottish castle
where this style was first introduced.
● In England, the balmoral is called
the oxford.

Closure

● A lace-to-toe shoe is often referred
to as a surgical shoe/ surgical boot.
● The lace stays extend to the toe
● It may have high or low quarter
● *Lace-to-toe can be seen in
majorettes
● Adjustable closures
○ laces, elastic shoe laces,
Velcro flaps
● Nonadjustable closures
○ Zippers, require minimal
dexterity & leg agility
*Most closures are the laces
*Usually 1 piece vamps does not have laces
*Zippers mostly are for designs only but
some still have laces on the inside
*Eyelets= pasukan ng laces

SHOE LAST
Linings & Reinforcements
Shoe Lasts - refers to the shape of the
shoe ● They protect the foot & hose for
contact with the rougher surfaces of
● Regular lasts
the underlying leather & stitching
● Straight lasts
● Toe Box - protects the dorsum of
● Outflare and inflare lasts
toes against trauma
● Custom lasts
 ● Counter - a leather which preserves ● Mule
the shape of shoe in area of ○ A backless shoe or slipper with
anatomic heel or without a heel.
● Long medial counter - counter
extended distally on medial side
● Long lateral counter - less common

*Counters creates the shape of the shoes

*Counter itself holds the whole heel area
*Long medial counter= shape of shoe
● Monks
Shoe Style ○ Similar to Derby Shoes but with
a cross over section to fasten the
● Boot
quarters with a side buckle.
○ Any footwear extending above
the ankle. There are numerous
designs and types for a variety of
uses and made from a number
of materials

*High school shoes

● Pumps
○ Heeled shoes with low cut fronts
and usually no fastening.
○ The term "stiletto" refers to a
● Clog type of shoe heel that is pointy,
○ A thick soled wooden shoe thin and high. Also called "spike"
sometimes with leather upper. or "spiked" heels.

● Moccasin
○ The term moccasin originates
from the Algonquian language
for foot covering *Stilleto aka Spiked

*Most common basic leather shoes