The term "orthopaedic shoes, orthotic shoes, custom made shoes, comfort shoes and diabetic shoes" are terms that are often used interchangeably and incorrectly by many people including patients, physicians, insurance company representatives and other health care professionals. I hope to explain the terms here to clarify the terminology for those people who are investigating the options.
Custom Made Orthopaedic Shoe
The first and most easy to define is the "custom made orthopaedic shoe". This type of shoe is made specifically for one person by using measurements and a cast impression of the persons foot. The cast and measurements are used to make a last or model of the foot around which the shoe is constructed from raw materials such as leather, foams and soling.
Advantages
- excellent fit for hard to fit or severely deformed feet
- choice of materials
Disadvantages
- price - usually very expensive ($800.00 - 2,500.00)
- hard to find a provider
- takes time to make and adjust
- styles are not usually current
Stock Orthopaedic Shoe
Stock orthopaedic shoes are ready made shoes that are usually purchased through a speciality shoe store. This type of shoe is made in different widths and with extra depth in the toe area to accommodate toe and toe deformities. They often have extended heel counters to give additional support and control to the heel area. Most stock orthopaedic shoes are made of soft pliable materials to prevent any excess pressure areas. They have removable insoles to allow for use of foot orthoses or brace (AFO). The sole of the stock orthopaedic shoes is often wider and more stable than regular shoes and may have a rockered sole (think the bottom of a rocking chair) to promote a stable heel to toe motion. May be available with hook and loop closure (Velcro®). Common stock orthopaedic shoes include P.W.Minor, Finn Comfort, Mephisto, Naot and Drew.
Advantages
- fit most hard to fit feet
- accommodate for foot orthoses and braces (AFO)
- less expensive than custom made shoes ($150.00 - $500.00)
- excellent control and stability
- protect sensitive feet
- they can be modified
Disadvantages
- more expensive than regular shoes
- not always in current style
Comfort Shoes
Comfort shoes are widely available in many speciality stores and commercial or chain shoe stores. They sometimes have different widths available and have more current styles than traditional stock orthopaedic shoes. Many comfort shoes are made of soft pliable materials and have a cushion type sole. Common comfort shoes include Ecco, Birkenstock, Dansko, Wolky and MBT.
Advantages
- less expensive
- fit most regular shaped feet
- commonly available
- stylish
Disadvantages
- may not accommodate foot orthoses or braces (AFO)
- may not provide adequate support
Diabetic Shoes
Diabetic shoes are are not usually classified on their own. They are often shoes that are either custom made orthopaedic shoes or stock orthopaedic shoes depending on the shape, size and condition of the individuals' feet. A person with Diabetes may have a condition known as Diabetic Neuropathy where there is loss of sensation to the feet which occurs very slowly and necessitates very special care for the feet. Since many people who have Diabetes do not realize that they have neuropathy, it is critical to fit appropriate shoes to protect the feet from trauma both within and without of the shoes. It is essential that the shoes fit properly (see Buying and Fitting Shoes).
Some insurance companies will provide coverage for shoes. The best way to ensure that you know what your coverage is prior to getting the shoes is to send a predetermination or estimate to the insurance company. You most likely will also require a prescription with a diagnosis and treatment (orthopaedic shoes) from your physician.
