FOOTWEAR & ORTHOTICS
As CMT can lead to high-arched feet, an incorrect gait, weak ankles, and other mechanical issues, choosing the correct shoes can help improve a person's ability to walk, whether it is reducing tripping over, or improving ankle stability, making life with CMT less challenging. Orthotic devices are also available for people with CMT, ranging from bespoke insoles to orthotic braces to help strengthen ankles and even the fingers.
1. Olney B. Treatment of the cavus foot. Deformity in the paediatric patient with Charcot-Marie-Tooth. Foot Ankle Clin. 2000;5(2):305-315.
FOOTWEAR
WHAT TO LOOK FOR
Finding comfortable shoes that help with daily activities, such as walking, can be a challenge for people with CMT. Below are a few key aspects to look for when choosing a pair of shoes:
MODERATE & WIDE HEEL
The general consensus is that a shoe with a moderate heel can help with walking as it can reduce the stress on the calf muscles and Achilles tendon while also letting it be used and stretch. An appropriate height should be discussed with a doctor as it will vary according to a persons needs
WIDE/SOFT TOP
As many people with CMT can suffer from feet with a high arch, having shoes that can be adjusted across the top to account for this is important as it can reduce stress on the top of the foot. Shoes that either are open-topped or laced up can be used.
ANKLE SUPPORT
Due to atrophied muscles in the lower leg, some people with CMT are more likely to suffer from ankle injuries. Therefore, shows with ankle support can help reduce the chance of injury and add stability to an area that usually is impacted by muscle weakness.
ADJUSTABLE INSOLE
Due to high arched feet being a common symptom of CMT, custom insoles are usually prescribed to help evenly spread the pressure of the foot. Because of this, choosing footwear that have either no insole shape, or removal insoles will make them compatible with any insole you are given.
RECOMMENDATIONS
There are many shoes to choose from that are CMT-friendly and range from smart to casual, from sporty, to formal. Below are a selection of shoes that I have found personally comfortable or meet the above criteria:
ORTHOTICS
WHAT ARE ORTHOTICS & HOW DO I GET THEM?
Orthotics are externally applied devices used to modify the structural and functional characteristics of the neuromuscular and skeletal system. For people with CMT, orthotics tend to range from insoles to AFO's (Ankle Foot Orthotics), which are informally known as leg braces.
Not to be mistaken as off-the-shelf devices, proper orthotics should be prescribed by a doctor and custom-moulded to your feet/ankles. Insoles sold online and elsewhere may provide mild relief for people with mild CMT, but will not be suitable for people with more pronounced high arches or other mechanical issues involving the feet and/or weak muscles.
KEY ORTHOTIC POINTS
When being prescribed orthotics by an orthopedist, there can be a lack of knowledge regarding CMT and what is required or beneficial. Below are a few points worth raising with an orthopedist if being prescribed insoles:
MODERATE HEEL
As with shoes, having a slight heel added to an insole can help with a person's walking ability if they have tight Achilles tendons or calf muscles. The extent of the heel should be determined by the orthopedist and will be based on the existing mobility in your feet.
ARCH SUPPORT
As high-arched feet are common in people with CMT, insoles should account for this and be made to support a high arch, spreading the foot's load equally across the insole rather than at uneven points.
FOOT STABILITY
An insole, when designed correctly, can help minimise foot rolling and keep the foot from angling too much to one side. This should be taken into careful consideration by an orthopedist as compensating too much in one way may result in the foot rolling the opposite way.