Tips for Diabetic Foot Care

The nerve and blood vessel damage caused by diabetes can become a problem for your feet if you develop neuropathy, which occurs in about 70 percent of people with diabetes. To ensure the best possible foot health, follow these easy tips to keeping your feet healthy longer.

  1. Inspect your feet daily for changes in color, sores, or cracked skin. A mirror on the floor can help with getting a better look.
  2. When stepping into hot water, such as a bath, hot tub, or shower, use your elbow to check the water temperature. Because people with diabetes tend to develop nerve damage in their feet, they may not realize if the water is too hot and could therefor scald themselves.
  3. Look for shoes with more depth in the toe box and good coverage on both top and bottom and without seams inside the shoe that can rub on your foot.
  4. Wear shoes at all times—even inside the house. With neuropathy, it’s difficult to feel small cuts, scrapes, or other hazards that might harm your feet. Worse, you might not notice the damage until a minor injury becomes infected.
  5. Avoid high-impact exercises that include bouncing, jumping, and leaping. Instead, consider walking or swimming to avoid putting too much pressure on your feet.
  6. Quit smoking! The dangers of smoking run from your head to your feet. The nicotine in a cigarette can decrease the circulation in your skin by 70 percent. If you smoke, you’re depriving your feet of the nutrient and oxygen-rich blood that keeps them healthy and fights infection.
  7. Consider investing in a pair of orthotics or extra depth shoes. A properly fitted pair of orthotics or extra depth shoes can prevent foot wounds by improving fit and reducing pressure, pain, and the chance of deformities.

When You Might Need a Foot Orthotic

1 Nov 2019 Orthopedics

If you suffer from foot pain or other types of discomfort, you might need foot orthotics.

The following conditions are telltale signs you may benefit from orthotics:

Pain in your foot that lasts longer than two weeks.
Pain lasting longer than two weeks could be an indication of an injury. It would be a good idea to talk to your doctor about any ongoing foot issues. Orthotics can help manage pain for a range of different conditions such as metatarsalgia and shin splints.

Heel Pain
Severe pain in the heel is not normal. If you’re experiencing pain, particularly in the morning, it could be the sign of a foot condition, like plantar fasciitis. Plantar fasciitis can be treated with orthotics, metatarsal pads, stretching, and lifestyle changes.

Over or Underpronation
Our feet naturally have a turn to them. But sometimes, this can be over or under what is normal. When this happens, the conditions are called over-pronated or under-pronated and can cause significant pain and exhaustion. You will need foot orthotics to help with either of these to correct your feet.

Not sure if you suffer from over or underpronation? Try the Wet Test. With wet feet, stand on a piece of newspaper or paper towel and then examine your footprint. A footprint without a c-curve in the arch could signify a pronator, and a prominent c-curve could suggest supination or underpronation.

Knee Pain
Foot orthotics can change the distribution of force through the foot and ankle, resulting in a change in the distribution of force through the knee.

They can act as cushions to reduce the force through the foot and ankle, which can result in a reduction of force through the knee.

Foot orthotics can also change the alignment of the foot and ankle, which can result in a change of alignment at the knee. For example, they can control overpronation (rolling in) of the foot, which can result in patellofemoral pain, iliotibial band syndrome, or increased pain from some types of osteoarthritis worse. As the foot overpronates, the lower leg and knee internally rotate. Orthotics can help control overpronation of the foot, which in turn, improves the alignment of the knee and thereby reduces knee pain.

Medicare Coverage for Therapeutic Shoes, Inserts, AFOs, and KAFOs

Health insurance is a complicated business, and Medicare is no exception. If you’re a Medicare recipient and in need of therapeutic shoes, inserts, an AFO, or a KAFO, follow the guidelines below to ensure you get the coverage you need.

Diabetic Shoes and Inserts

Medicare recipients are entitled to one pair of custom-molded shoes with inserts or one pair of extra-depth shoes each calendar year. Medicare also covers two additional pairs of inserts each calendar year for custom-molded shoes and three pairs of inserts each calendar year for extra-depth shoes.

However, to receive this coverage, a podiatrist or qualified doctor must prescribe these items. Patients must also have been seen by the doctor treating their diabetes no more than 90 days prior to receiving the shoes.

If you meet the above requirements and your provider accepts Medicare, you’ll pay 20% of the Medicare-approved amount with the Part B deductible applied.

Don’t let a missing document stop you from getting the diabetic shoes or inserts you need. Review this Medicare document checklist to make your order easy and painless.

AFOs and KAFOs

Medicare will also cover AFO and KAFO prescriptions, although additional documentation and notes are necessary to receive full benefits.

Documentation from the ordering physician, such as chart notes and medical records, is required for coverage. Other required details include the history of the injury, illness, or condition, description of limitations of a typical day, status of the current orthosis, and reason for replacement.

Don’t forget any of the paperwork required for your AFO or KAFO. Review this list of documentation required by Medicare.

Standards of the Orthotic and Prosthetic Profession

The term “professional” makes you think someone has a specialized education, demonstrated skills, and proven experience. This is especially true for orthotists and prosthetists. Like their counterparts in the allied health professions, O&P practitioners are evaluated against exacting stan­dards of education, clinical experience, professional knowledge, and demonstrated competence.

The following are three areas in which orthotists’ and prosthetists’ standards are measured:


Nine U.S. accredited programs offer formal O&P education with credentials ranging from bachelor’s degrees to master’s degrees. The instruction in these programs places particular emphasis on anatomy and physiol­ogy, patient management skills, clinical practices and professional­ism, fabrication, and fitting tech­niques.


Board certification of practitioners establishes and promotes the highest standards of organizational and clinical performance in O&P service. The American Board for Certification in Orthotics and Prosthetics serves as the comprehensive credentialing organization for establishing individual and organizational performance standards in orthotic and prosthetic care.

ABC certification is well-recognized and highly respected in the O&P field. To earn it, orthotists and prosthetists must meet well-defined educational and experience requirements and pass a rigorous written examination, written simulation, and two-day clinical exam.


Despite the existence of national O&P certification and accreditation programs, various underqualified providers continue to deliver substan­dard orthotic and prosthetic care, resulting in negative consequences. To combat this, 14 states now require licensure for orthotists and prosthetists.

Allen Orthopedic Labs is an ABC certified office with ABC certified practitioners.

Common Usages of Ankle Foot Orthoses

1 Sep 2019 Orthopedics

Ankle-foot orthoses (AFOs) are the most commonly used orthoses, making up about 26% of all orthoses provided in the United States.

AFOs are externally applied and intended to control position and motion of the ankle, compensate for weakness, or correct deformities. AFOs can be used to support weak limbs or to position a limb with contracted muscles into a more normal position. They are also used to immobilize the ankle and lower the leg in the presence of arthritis or fracture and to correct foot drop caused by a variety of neurological and musculoskeletal disorders.

In fact, AFOs are sometimes referred to as the foot drop brace. Foot drop or “drop foot” is a condition where a person has difficulty lifting the front part of the foot. If you have foot drop, you’ll tend to drag your toes across the ground while walking. You may compensate for this problem by lifting your knee higher. In mild cases of foot drop, you will hear and feel your foot “slap” the ground while walking.

Allen Orthopedic Labs can effectively treat foot drop with the right ankle-foot orthosis. Contact us to learn more.

A typical AFO creates an L-shaped frame around the foot and ankle, extending from just below the knee to the end of the foot. AFOs can be purchased off-the-shelf or custom molded to an individual wearer.

Allen Orthopedic Labs has the latest technology and can fit you with an off-the-shelf solution or custom fabricated design tailored to your exact condition. Contact us and begin healing today.

How to Find the Right Shoes for Your Child’s AFO

Lots of questions are sure to arise when having to buy shoes for your child’s AFO. From types of shoes to fitting techniques and everything else in between, Allen Orthopedic Labs has the answer for you.

Don’t dismay! Here are our tips for buying shoes that fit your child’s AFO:

  • Your child may not want to go shoe shopping, and that’s fine. Just be sure to have the brace with you to fit into potential shoes
  • Wider shoes work best with AFOs
  • Buy two different sizes if necessary – HINT – Nordstrom Department Store will sell a left and a right shoe in different sizes for the cost of one pair of shoes
  • Sneakers are the most compatible shoe with AFOs
  • Consider pulling the insole out for a better fit
  • Look for shoes with a wide toe box
  • Cut away the fabric attaching the shoe tongue to the shoe if applicable.
  • Pick shoes with laces instead of Velcro because they provide a more secure fit
  • For shoes with Velcro, consider getting strap extensions to ensure a better fit
  • Instead of shoving your child’s foot in, try rocking the shoe heel back and forth, which will help it slide on more easily

Contact Allen Orthopedic Labs and we’ll answer any additional questions you might have about buying the right shoes for your child’s AFO.

There are a lot of great shoes out there, but these companies offer those that work best with AFOs:

  • Hatchbacks and Surestep because they design with orthoses in mind
  • Nike FlyEase
  • Answer 2 Shoes for AFOs
  • New Balance and Saucony because they offer extra wide sizes