Shear and Friction Forces and Diabetic Foot Ulceration: Podiatry Today Article on Smart Orthotics, Inserts, and Therapeutic Footwear

Here’s yet another article addressing shearing forces as a neglected cause of diabetic foot ulcers: Can Smart Orthotics Have an Impact in Preventing Ulceration? The article observes that experts are increasingly recognizing the importance of shear in diabetic foot ulcer formation. This kind of attention to shear is so important.

A key issue raised by the article is whether shear forces can be mitigated without drastically reducing gait efficiency. As the article observes, friction and shear are necessary for efficient gait. Mitigating shear therefore reduces gait efficiency. If gait efficiency is reduced, according to the article, a walker would need to take “a greater number of steps to traverse a certain distance.”

What the article fails to recognize is that shear does not have to be reduced all over the foot. Shear can be offloaded just at the problem area – an area of callusing or blistering, for example. That is the beauty of products like ShearBan® and our consumer product ENGO®– they can be strategically placed just at the area of concern to offload shear. Use of ShearBan® or ENGO® will not reduce gait efficiency noticeably.

How can we make the claim that ShearBan® and ENGO® will offload shear without noticeably reducing gait efficiency? We have no studies. What we have is something better. ENGO® is used by ultra-marathoners, extreme athletes and over 30 professional sports teams. In fact, just today we received a repeat order for ENGO from a National Football League® team. (We even receive a holiday card from one NFL team because they like ENGO® so much!) Put simply – If ENGO® reduced gait efficiency, would NFL teams and extreme athletes of all kinds be using it?

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