Shoes Treatment 

Orthotics and choosing footwear

Orthotics (or the singular ‘orthosis’) are designed to aid movement, correct deformity and relieve discomfort. An orthosis is a device used to support, align, prevent or correct deformities and improve movement in parts of the body. For those managing lymphoedema this may mean wearing an innersole in footwear to correct problems like a fallen arch or flat foot. By correcting the foot’s position, the way you walk can be altered which in turn may help pain and discomfort but also assists the way the lymph flows in your legs.

If you have been prescribed orthotics, make sure you take them with you when choosing footwear and place them in the footwear when trying any footwear on. Your innersoles help to maintain the position of your foot and will influence your choice of footwear. Sometimes shoes or boots with more depth are required to accommodate the innersole and still allow enough room for the foot to move. Inadequate space in the footwear may cause pinching or sores as the skin rubs on the shoe and innersole.

If you think that you may need to be prescribed innersoles, speak to your healthcare professional. They may be able to refer you to a Podiatrist, an Orthotist or the local Surgical Appliances Department for advice and assessment.

Footwear during the intensive phase of lymphoedema treatment (Decongestive Lymphatic Therapy – Phase one)

During the intensive phase of treatment, the compression products used can be bulky, such as multi-layer lymphoedema bandaging. It is important that you maximise the effects of this treatment by keeping active however, obtaining shoes that accommodate the bulky compression bandages can be difficult. Here are some key points to consider:

• Your healthcare professional or lymphoedema clinic will likely be able to advise you about suitable footwear and how long you will need to wear this for. They may even be able to provide you with some shoes/boots as part of their service
• Boots with hook-and-loop fasteners (most commonly supplied to people to wear over a cast following a fracture) are often provided. These come in a variety of sizes so make sure you order, or are provided with, the correct size that does not restrict your walking by being too tight or cause you to be unstable on your feet by being too big
• Some forms of compression products used in the intensive phase of lymphoedema treatment are less bulky than multi-layer lymphoedema bandaging possibly enabling you to wear your own footwear. For example, a wrap compression system with adjustable straps is less bulky and often shoes can fit more easily
• Some managing their lymphoedema report some success wearing plastic clog type shoes

For those with lower limb lymphoedema, whether in the long-term management phase or intensive phase of treatment, it is important to consider the footwear you wear inside your home, as well as your socks.

Slippers

Slippers, or whatever you wear around your home, need to be supportive and not just comfortable. In general, the material that slippers are made from is very forgiving and so may lose shape easily. The slipper will then not offer the support that your swollen foot or limb requires and may have an impact on your swelling. It may be better to have a second pair of good fitting shoes to wear indoors instead.

Socks

If the compression product used to maintain and/or improve your swelling does not contain a full foot covering, or you prefer to wear a sock anyway, it may be helpful to consider the following points:

• Make sure that your socks are not digging in and restricting your circulation as this may make your swelling worse
• Some companies make socks designed for swollen feet with extra wide heels, increased depth over the instep and soft, non-restrictive tops and possibly seam free too
• It is important to wear socks or some type of ‘hosiery’ with your footwear. Most footwear is designed to be worn with a covering on the foot because the skin builds-up bacteria and sweat which is transferred to the footwear, causing odour. Socks or hosiery act as a barrier to the skin from the shoe and may limit rubbing, blistering and skin hardening as well as protecting any cuts and scratches on the foot

Finally, it’ll be great to hear about your footwear stories during lymphoedema treatment. Please share experiences in the LymphConnect forum, you can be sure that others will benefit.

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