Footwear-the forgotten treatment-clinical role of footwear

Footwear in general plays an important role in protecting the foot from the environment by reducing the risks associated with trauma and enables users to have pain-free locomotion over a range of walking surfaces (McPoil 1998). However, the prolonged use of unsuitable footwear can also result in detrimental changes to occur that alter the protective nature of the shoe into a barrier between the contact surface and the natural behavior of the foot. These changes can result in altered foot morphology, reduced or impaired postural stability, neurophysiological alterations, muscle imbalance, and the development of a sensitive foot (Menz and Lord 1999, Robbins and Waked 1997). Alterations in footwear design, structure, and manufacture have been attributed to these mechanical and physiological observations.