C04: Footwear & Orthotic Prescription

Footwear is the foot's mechanical environment for almost all the time it spends outside the clinic. It only prevents recurrence when two conditions hold together: it demonstrably relieves peak plantar pressure, and it is actually worn. In one prospective study, an in-shoe peak pressure below 200 kPa combined with adherence above 80% was protective against recurrence, and the strongest single predictor of a recurrent ulcer was a minor pre-ulcerative lesion.

This is the prescribing module. It teaches matching provision to risk and foot shape, verifying offloading with in-shoe pressure measurement where available, reading a callus as a design brief rather than something to pare away, designing for adherence at home, and what to do when an ulcer recurs despite footwear that offloads and is worn, including referral for surgery. C07 goes deeper into the biomechanics beneath these decisions: why load concentrates, shear, gait assessment and the evidence for individual insole design features. C04 turns that into a prescription and its review.

Content is tiered at Foundation, Core and Advanced level, with two algorithms and three case vignettes. You receive the Teaching Document, the Evidence Base, the slide deck, a narrated video and an audio overview.