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Fitting problems & solutions

A continuaciˇn se muestran las diferentes soluciones ante problemas de calce.

Difficulty Identified Visual Signs Possible Causes Solutions
Too narrow Flesh squeezed into heel counter, shows signs of creasing, or dragging of skin. Incorrect draft: heel outline may have been poorly drawn. No heel width shown on draft. Provide an accurate draft of the heel outline. Measure the heel width and send to the makers for alterations to be made.
Feels very tight. Heel may not be able to sit properly on the seat. Foot can not pass down into toe box. For stock items, choose a wider heel fitting; look for a maker who offers choice of heel widths.
Counter may bulge at the sides and become distorted by forcing the heel down into the counter. Counter may bulge at the sides and become distorted by forcing the heel down into the counter.
Offset by form of last As the shoe is eased onto the foot, the heel is positioned to the outside of the counter. The heel has to be forced into the shoe. The last may be straight lasted or the forepart wider on either the medial or the lateral side. If this does not match the foot shape then a conflict of pressure will result. Varus or valgus heel position, club foot or major rear foot deformity cause heel position to differ from standard last. Examine the shape of the foot and the shoe form, to see if they correspond. If stock footwear is indicated from foot measurements, check whether straight-lasted shoes are available for improved heel shape - test them for suitability. Bespoke may be necessary, where the foot shape appears unusual. Full accurate drafts and casts will need to be taken.
Difficulty Identified Visual Signs Possible Causes Solutions
Cutting into Achilles tendon Flesh bulges over the topline. Heel-to-ball ratio is too short, forcing the foot into the counter. Check the heel-to-ball length and overall length, to be sure these are correct. If heel-to-ball is short, then ask for a re-last to correct this, showing the ball position. For stock, change to another last where heel to ball fitting is longer.
Discomfort felt by wearer at the back of the shoe. Overall length is too short. If overall length is short, but heel-to-ball is correct, then add length to the toe end only - stating by how much in shoe sizes, e.g. half size.
Foot pushed forward by the counter top line, leaving a space in the counter below. Curve or profile of counter is too short around top line. For foot profile problems, take a Polaroid« or digital photo, draw the shape, or cast the foot and send to the maker for correction of the counter shape. Refit the shoe to check.
Sides of counter ?bellow? below malleoli and the top line of the back is pulled into the tendon. Heel seat width is too narrow, forcing top line to cut into Achilles. Measure heel width and look for, or request, more heel width as a modular alteration.
Depth at back of counter too deep. Request reduction in counter depth or look for a brand that is lower. For stock shoes, consider if the foot is really suitable for ?ready made? or needs modular instead to achieve the correct fit.
Too high Rubbing under either medial or lateral malleoli. Height of malleoli not measured and stated on the draft. Unusually low malleolar heights. Draw a line on the shoe counter with an effaceable leather pen, to show where it needs lowering. Give the measurement in mm, and request that the counter is lowered. This can be altered at fitting stage on bespoke or as an adaptation on stock items if there is no padded collar.
Ankle fracture causing changes to bony prominences. For bespoke, send in remeasured long and short heel lengths, and ask for remake of back quarters. Make sure that the long and short heel measurements are taken in the correct positions.
Catching the Achilles tendon. Presence of ?heel bumps? or bursae over Achilles tendon. Soften the counter with chemical softener, and use ring and ball stretcher to create a ?bump? in counter; encourage gradual ?wearing in? over a few days. Bespoke items can be ordered with a cavity in the counter stiffener to accommodate the bump.
Too low Does not grip the foot properly and foot comes out of the shoe too easily. Feels unsafe in wearing. Counter depth sits too low on the foot. On unfinished footwear, request counter depth to be increased and give measurements.
Inlays may be too thick under heel, and lifting foot out. Stock items: choose different maker.
Inside heel raise is too high for the counter. Reduce inside heel raise height, and add balance to external heel height, or change to external shoe raise only.
Excessive oedema affects how the heel sits down in the counter. Request modular or bespoke only. Straighten the back curve to accommodate oedema and increase width of heel seat.
Top line cuts in to foot. Top line cuts in to foot. Drawstring type of fastening around top line pinches flesh. Change style. This style should not be chosen for any vascular, oedematous or ulcerated cases.
Long heel measurement is incorrect (too short). For bespoke, send in remeasured long and short heel lengths, and ask for remake of back quarters. Make sure that the long and short heel measurements are taken in the correct positions.
Proportions of long and short heel measurement should be between 1.5 and 2.5cm difference, on average. If they are greater, or very close, then a bespoke last will be needed. For bespoke, send in remeasured long and short heel lengths, and ask for remake of back quarters. Make sure that the long and short heel measurements are taken in the correct positions.
Difficulty Identified Visual Signs Possible Causes Solutions
Too long Footwear causes pain/discomfort; foot gets ?tired?. Creases too far back. Check for wear marks on sole behind flexion point. Foot is flexing too far back in shoe, incorrect fitting. If stock is being used, find shorter heel-to-ball last fitting. If bespoke, re-last on a last with a shorter heel-to-ball.
Too short Heavily creased vamp below facings. Toe puff may be creased as well. Toes often sore.?Turned up? toe end. Heavy wear marks placed forward of flexion point. Foot is flexing too far forward in shoe, incorrect fitting. If stock is being used, find longer heel-to-ball last fitting. If bespoke, re-last on longer heel-to-ball fitting. (This problem is rarely found with bespoke footwear if drafts and measurements have been taken correctly.)
Difficulty Identified Visual Signs Possible Causes Solutions
Limited range of motion (ROM) Twisted or angled creases that seem unusual. Wear marks heavy to lateral side. Check first metatarso-phalangeal joint: ROM may be fixed or severely limited. Add rocker sole and compensating heel to aid toe-off.
Difficulty Identified Visual Signs Possible Causes Solutions
Too deep Facings overlap; excess leather around area. Creases along quarters. Incorrect instep measurement (if oedema present, this can be variable).Incorrect instep measurement (if oedema present, this can be variable). Check measurements for changes from original draft. If these have changed then supply new measurements to maker and request accordingly. Refit.
Foot slides down shoe causing gap at back of counter. Patient can sometimes feel toes at end and says shoes are too short. Deep creases appear at base of facings. Incorrect long and short heel measurements ? again, could be due to oedema. For stock, try changing inlays, or add valgus filler. If the shoe fit is satisfactory elsewhere, a tongue pad may solve problem.
For bespoke, request ?reduce instep circumference and set facings apart by x mm?.
Too shallow Facings appear too far apart; tightness over dorsum of foot. Pressure on dorsum from fastenings. Look for high-instep foot shape (e.g. pes cavus) or possible dorsal prominence. Check draft and add instep height measurement and ensure the instep line is drawn in. Request ?increase over instep? (and give measurement in millimetres). Close in facings by x mm?. Refit.
Velcro straps do not fasten over adequately. Lace facings have a wider space at top than the base. Bulky valgus inlays. Too many inlays: stock shoes may have up to three layers. Adjust inlays to try and correct the fit. Remake inlays if you consider the shoe to be satisfactory otherwise.
Layered bandages are very variable and may cause extra bulk. Variable oedema. Wait for dressings to be reduced or stockings to be supplied, and supply temporary healing shoe short term. Or ask for swelling cork to be added, which requires re-lasting with the addition.
Deep crease at base of facings at level of stay stitch. Instep measurements are incorrect. Also check position of tape measure. Was it too low? Check measurements. Request increase in instep circumference giving measurement in mm. Look at alternative supplier for better fit.
Instep strap styles can often be shallow. Change style for a better fit, if style is unsuitable for foot shape.
Too narrow Facings pulled apart at wrong angle. Very tight; may not get shoe onto foot. Poor quality drafts, no instep line or the measurements were not recorded correctly. Redraw draft and ask for re-last.
Quarters bulge on medial side. Excess pronation may cause poor foot position in shoe. Corrective inlays may help. Uppers will need re-lasting to accommodate these inlays. (A quick way to check before casting is to use prefabricated neutral orthotics within the existing fitting and observe any improvements to foot position and/or facings).
Incorrect style: does not suit foot shape or fasten properly. Wrong style? Oxford facings can be very difficult to fit well, especially if instep is high. Instep bar or key-hole style can be shallow or narrow across instep. Change style to Gibson or Derby instead. Reconsider style chosen, or redraft or cast to improve fitting.
Too wide Facings feel loose; excess leather, particularly along medial side of quarter. Fitting too wide. Entry probably too wide as well. Change to narrower fitting, check foot on inlay for heel seat and instep fitting. Measure heel width: if it is narrow, it could also affect the instep.
Facings butt or overlap. Foot not retained adequately into counter. Incorrect long heel measurement, or reduction in measurement due to oedema or change of dressings, etc. Check measurements. Reduce instep circumference and/or entry giving measurement in mm. Remove inlays and check fitting again. Trim back inlays if faulty, until they fit correctly. Adding a valgus filler or a moulded inlay may save replacing the shoe.
Inlays too thin. Increase inlays, but beware as this may compromise the fit elsewhere.
Insole board may be too wide at instep. Reduce width of insole board; draw line on underside of shoe to show where it should be reduced. Give measurements.
Difficulty Identified Visual Signs Possible Causes Solutions
Too narrow Foot can not pass down into toe box. Joint width not shown on draft. Incorrect girth measurement. Measure joint width, remeasure girth and request increase at entry giving measurement in mm.
May not get shoe on. Fitting incorrectly ordered or wrong fitting delivered. Check the order. This may not be what was ordered.
Pressure across toe joints. Incorrect width measurement. Reorder on wider fitting.
Feels too tight. Inlays too thick. Remove inlays. This will give some indication of extra space required. Feel the sides of the sole board, under the first and fifth joints; check it is positioned under the joints properly. Request an increase in entry width across first to fifth metatarsal heads on the insole board. Give the amount of increase required in mm.
Stretch creases visible across vamp at base of facings.Visible `tight spots? especially over hallux abducto valgus. Foot has changed since measured. Solution as above.
Too shallow May not get shoe on. Incorrect girth or joint measurement. Request increase in circumference giving measurements in mm.
Very restricted feel as foot enters shoe. Foot may have altered due to oedema or dressing type being changed. As above. Or issue temporary healing shoe, and wait for improvement.
Width may be correct, but shoe feels too tight. Inlays too thick. Try to reduce inlays. If padding required, request increased depth to accommodate this. Give measurements.
Deep creases formed at base of tongue. Indicates fitting depth is incorrect. Increase depth by removing inlays. Request increase in depth, and give measurements in mm.
Too deep Foot slides forward to touch end of toe box. Measurements may have changed. Check draft again, and remeasure. Send new measurements and draft, and request relast to reduce excess depth.
Incorrect inlays; may be too thin or not customized. Try different inlays or order custom inlay. If required, give depth of materials to be used. Fit in shoe again before altering depth or fitting.
Insole board maybe too wide. Check width of insole board and, if necessary, reduce width on the side of the extra width. Also request reduction in circumference by stating on the fitting note the number of mm required. To check the amount required, use 3 mm inlays until the fit seems better (note: one 3 mm inlay = 6 mm girth). Keep adding inlays until the fit is good. Remove them, add twice the depth of the insoles to the girth measurement and this will tell you how much to reduce girth.
Foot slides forward to touch end of toe box. Excess leather across joints. The last does not match the foot. Check draft for changes, and request re-last to reduce entry.
Deep creases on flexion. Deep creases at base of facings or bulge at base of facings. Facings may be too wide apart. Excess leather in vamp. Check position of facings to joint region, and check instep area.This is probably too wide as well. Reduce entry and instep and refit. If insole is correct width, and inlays are suitable, then reduce entry circumference. Check toe box depth as this may also need changing.
Difficulty Identified Visual Signs Possible Causes Solutions
Too wide Feels big. Change in measurement; reduction of oedema. Check draft: remeasure if necessary.
Excessive space around the toes. Change in oedema or in hosiery or dressings. If oedema is variable, then allowances are needed. Redraft and request ?add swelling corks? (removable 3 mm cork inlays that can be added or removed).
Insole board is too wide. Feel position of the forefoot in vamp. Draw with effaceable leather pen where the excess is situated. Request reduction of insole board in mm. Check depth as this may also need to be reduced.
Deep fold creases on flexion. Excess leather. This is possibly depth not width. Feel the position of the foot in the vamp: if width is correct under first to fifth joints, then reduce circumference.
Too deep Feels ?baggy?. Excess leather across dorsum. Deep creases on flexion. Change in measurement; reduction of oedema. Reduce whole forefoot area by ?lasting down? and refit. If joint width is correct, reduce distal to the joint circumference.
Base of facings bulge up from vamp. Instep/entry is also too deep.
Too narrow Feels tight. Toe box shape of shoe not compatible with foot shape. Compare foot shape with shoe; request change in toe box shape, if necessary, to rounded or square. Use inlay to check for width.
Forefoot squeezed. Swelling may have occurred. Refit once swelling has reduced, or monitor swelling until stabilized.
Stretch creases. Insole board too narrow. Check insole board against foot and request increase in width if too narrow. Mark shoe with effaceable leather pen where more width is needed.
Toe puff may press into toes. Toes bulge into upper on lateral border. Too narrow in toe box, or toe box wrong shape for foot. Request change of toe shape and re-last the upper. (Note: increasing the width will also increase the circumference.)
Too shallow May not get shoe on. Incorrect measurement. Check draft, remeasure and request increase in depth giving measurement in mm.
Very tight. Change in measurements. Request increase in depth, giving measurement.
Toes rub on vamp leather. No toe box depth measurement given on draft. Solution as above.
One high toe may be pushing up on the upper. Position of high toe not given on draft. Mark tight area with effaceable leather pen, circle the area to be increased and request `blocking up? of tight area, if rest of toe box depth is sufficient. Give measurement. Pol. El Rubial, calle 2, n║13      03400 VILLENA (ALICANTE)     SPAIN 96 534 35 78 96 580 82 59