Formulario de respuestas
Nombre:
Begoña Gonza
Email:
Categoría:
Foot Biomechanics
Pregunta:

Hi, good afternoon,

I have a diabetic patient who has cavus foot. They came to my practice because they suffered from painful feet at the end of the day working in the country. On examination, the tendons were noticeable, resembling taut guitar strings.

All that they wanted were insoles for rest.

I took a mould and made a PP insole, above all due to their weight (with no modification), but they came to my practice today saying that they felt like their feet were burning and that the material feels very stiff.

The thing is that I now have a couple of cases where the same thing happens; such a stiff material bothers them, and I think that it might be because I don’t get the lining quite right, that it’s not dense enough for the patient not to feel the stiffness of the PP.

So, I’m asking if you can give me some advice about this. And in this particular case, as it is a diabetic patient, whether to line the insole with Plastazote and Poron so it feels different and has more cushioning.

Thanks a lot, hugs.

Respuesta

Good afternoon,
In the case of this kind of patients with diabetes, the mechanical characteristics of their foot call for a functional insole with materials with greater mechanical strength (plastics). I recommend using a softer combination for the upper lining with more cushioning so that the first sensation for the patient is one of comfort. 

The materials that you can combine are 2 upper linings such as an intermediate layer of polyurethane (Poron) and an upper one of Plastazote. You must take the thickness into consideration; not so thick as to create rubbing or pressure at the front of the footwear. 

Don’t forget that another machined material exists, namely POLYURETHANE. You could use it lined with Plastazote for this kind of patients if corrective foot orthoses are not required. As you will be aware, it is recommended for this kind of patients due to its low resistance, which means that the whole insole has greater cushioning from impacts, and there is better dispersion of the plantar pressure. 

I hope my answer has helped you.