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Therapeutic Foot Care Certificate Program
Part I: Online Home Study Program
Program Glossary
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a-: Prefix - without, not, lack of, e.g. ataxic muscular coordination
AADE: American Association of Diabetes Educators
ab-: Prefix - from, away from, e.g. abduction
Abduct: Motion of the distal segment away from the midline
Abduction: Movement of a body part away from the median plane of the
body
Abrasion: Irritation or injury of skin tissue that leads to a scraped area of
the skin
Acceleration: The swinging limb catches up to and passes the torso
Accommodative foot orthosis: An orthotic device designed to try to
control abnormal function of the foot. They are used to cushion, pad or
relieve pressure from a painful or injured area on the bottom of the foot,
and can be fabricated from a three-dimensional model of the foot by
taking a plaster mold of the foot, having the patient step into a box of
compressible foam, or using a mechanical or optical scanner to scan the
foot
ACE: American College of Endocrinology
Achilles tendinitis: Inflammation and degeneration of the achilles
tendon, the large tendon located in the back of the leg that inserts into
the heel, that may develop following sudden changes in activity level,
training on poor surfaces, or wearing inappropriate footwear, especially
when participating in activities that involve sudden stops and starts and
repetitive jumping (e.g., baseball, basketball, football, tennis, running,
dancing). In some cases even prolonged periods of standing can cause
symptoms
Achilles tendon: Largest tendon in the back of the leg, joining the heel
to the calf muscle
Active movement: Patient moves a part of the body
Active propulsion: The point of time in the gait cycle in which there is
heel off of the support limb that ends with heel contact of the swing limb
ad-: Prefix - to, toward, near, e.g. adduction
-ad: Suffix - to, toward, near, e.g. cephalad
1
• ADA: American Diabetes Association
• Adduct: Motion of the distal segment towards the midline
• Adduction: Movement of a body part toward the median part of the
body
• -algia: Suffix - refers to pain, e.g. metatarsalgia
• ambi-: Prefix - both, both sides, e.g. ambidextrous
• Ambulate, ambulation: Walking about
• amphi-: Prefix - on both sides, e.g. amphiarthrosis
• Amphiarthrosis: A form of articulation permitting little motion (e.g.: pubic
symphysis)
• Angle of gait: The angle the longitudinal axis of the foot makes with the
line of progression. The average gait angle is 7° toe out per side or 12° to
15° total
• Ankle foot orthosis (AFO): A mechanical device used to support and
align the ankle and foot, to suppress ankle and foot muscles when
overactive, to assist weak and non-functional muscles of the ankle and
foot, to prevent or correct ankle and foot deformities, and to improve the
functions of the ankle and foot
• Ankle gauntlet: Lace-up or velcro fastened ankle brace that helps resist
inversion and eversion ankle injuries
• Ankle joint: Also known as the talocrural joint (TCJ), this is the joint
which connects the proximal end of the talus to the malleoli of the tibia
and fibula, forming the “hinged” ankle joint
• ankyl/o-: Prefix - refers to a stiff joint, e.g. ankylosis
• Antagonist: A muscle whose action is the direct opposite of that of
another
• Antalgic gait: Walking with a limp to minimize pain on weightbearing
structures
• anter/o-: Prefix - before, in front of, e.g. anterolateral
• Anterior, ventral: The front part of the body
• Anterolateral: Away from midsagittal
• anti-: Prefix - against, e.g. antifungal
• Arch pain: Inflammation and/or burning sensation at the arch of the foot
that can be caused by a structural imbalance or an injury to the foot: the
most frequently cause is plantar fasciitis
• Arch strain: Inflammation and/or burning sensation at the arch of the
foot that can be caused by a structural imbalance or an injury to the foot:
the most frequently cause is plantar fasciitis
• Arch support: Off-the-shelf or custom made orthotics used to support
the transverse and longitudinal arches of the pronated foot
• Arteries: Blood vessels which transport blood away from the heart
2
• arthr/o-: Prefix - refers to a joint, e.g. diarthrosis
• Arthritis, rheumatoid: State characterized by inflammation of joint or
joints
• Articular cartilage: Cartilage found at the joints
• Asymmetric neuropathy: Nerve damage that affects only one side of
the body
• Autonomic neuropathy: A neuropathy of the autonomic nervous system
that affects internal organs such as the bladder muscles, the
cardiovascular system, the digestive tract, and the genital organs
B
• Back strap: A piece of fabric or leather that is located atop the shoe at
the upper back used to hold the shoe on the foot
• Balance: Equalization or opposing forces
• Ball: Width of the sole at the metatarsal heads
• Base of gait: The horizontal distance from one heel strike to the next
heel strike
• BCP: Board for Certification in Pedorthics
• Beta cell: The cell type found in the islets of Langerhans in the pancreas,
beta cells make insulin and release it into the blood stream
• bi-: Prefix - which refers to two, e.g. bilateral
• Bilateral: Pertaining to right and left sides
• Biomechanical strategies: Methods of addressing physical forces that
place wear and tear on the foot during the walking or running gait cycles
• Biomechanics: The study of motion in individuals as it relates to internal
and external forces that cause or influence movement, i.e. the study of
movement and physics of the physical form; the science of locomotion of
the human body
• Blood glucose: The main sugar that the body makes from food that is
ingested. The primary source of glucose is carbohydrates, however, fats
and proteins can provide some glucose as well. Glucose is the major
source of energy for living cells and is carried to each cell through the
bloodstream, and requires the presence insulin in order for the glucose to
be uptaken in cells
• Blucher: Front-laced shoe in which the quarters are not attached distally
to the vamp, giving more allowance at the throat and instep in fitting
• Boyd: Amputation at the heel of the foot
• Breathability: The ability to allow air exchange to the foot through the
material of the shoe
3
• Bubble or balloon patch: A permanent external modification made to
the upper of the shoe by adding material to accommodate a bony
prominence on the foot
• Bunion shield: A device that is placed on the foot and intended to
comfort, protect, and moisten painful bunions by molding to the foot,
realigning the big toe, and providing immediate relief
• Bunion: One of the most commonly occurring foot conditions. Also
known as hallux valgus, a bunion is an inflammatory swelling of the bursa
over the metatarsophalangeal joint of the great toe, characterized by an
abnormal prominence of the inner aspect of the 1st metatarsal head,
accompanied by bursal formation, and resulting in a lateral or valgus
displacement of the great toe, bunions are painful swollen areas that
occur at the hallux, or great toe
• Bunionette: Also known as a tailor’s bunion, this is a bunion that occurs
at the base of the fifth toe, and is much more common in women than in
men, primarily because of wearing high heels
• Buttress: A permanent external modification made to the midsole,
outsole, and upper of the shoe, intended to bolster the support available
through the midfoot
C
• Cadence: Also known as step rate, cadence refers to the steps per
minute as an individual walks. The average cadence is between 101 to
122 steps per minute, and is directly related to an individual’s height
• Calcaneal apophysitis: Also known as Sever’s Disease, this is an
inflammation of the cartilaginous gap in the calcaneus that occurs in
children between the ages of 8-12
• Calcaneal heel spur: Calcaneal exostosis formation secondary to a
break in the periosteum of the calcaneus due to tensile forces in the foot.
Tends to be associated with plantar fasciitis due to chronic irritation at the
calcaneal tuberosity
• Calcaneus: The largest of the tarsal bones; the calcaneus forms the
heel and articulates with the cuboid anteriorly and the talus
• Calluses: Thick areas of skin that form in response to repeated pressure
and friction that are intended to protect the skin and the structures
beneath it from injury
• Cancellous or Spongy Bone: Soft bone texture primarily present in the
heads of bone and near the marrow cavity
• Capillaries: Small vessel connections between arteries and veins which
provide nutrition to tissues and remove waste products
4
• Caudal: Situated beneath or on the underside or inferior side of the body;
toward the tail
• Cavus (Pes Cavus): Hollow foot, an exaggeration of the normal arch
• Cephalad: Toward the head or anterior section of the body
• Charcot foot: A foot complication associated with diabetic neuropathy
that results in destruction of joints and soft tissue. Also called "charcot's
joint" and "neuropathic arthropathy"
• Chopart: Amputation of the foot, with the calcaneus, talus, and other
parts of the tarsus being retained
• chrondr/o-: Prefix - refers to cartilage, e.g. chondromalacia
• Chukka: Three-quarter Blucher boot with two or three eyelets or velcro
closure
• circum-: Prefix - around, e.g. circumduct
• Clawtoe: A condition in which there is a high arched foot and toes
hyperextended at the metatarsophalangeal joint and flexed at the distal
joints
• Clogs: Shoes with no back (contour)
• Compact or dense bone: Highly vascularized bone tissue found in the
diaphysis of the bone
• Compartment syndrome: A condition that arises when there is
increased pressure within a small space, or compartment, that leads to a
decrease in circulation and function of all tissues which are within that
space
• Composition: Various materials, which are pulverized, compressed and
held with a binder to form a sheet material for insoles, midsoles and heel
bases, and other components
• Compression force: A force that pushes along both ends of a structure
and causes compression of the object
• Conform: Ability of a material to be molded to the shape of the foot
• Contralateral: Located on the opposite side of the body
• Contusion: More commonly known as a bruise, a contusion results from
an impact to the body that crushes underlying muscle fibers and
connective tissue with no breaks to the skin
• Cookie: Longitudinal arch pad
• Corn pad: Mechanical barrier product that limits friction between toes
and shoes. Pads are sometimes medicated to wear away excess skin
• Corns: Thickened areas of skin that form in response to excessive
pressure and friction, as the result of the body's attempt to protect the
skin and the structures beneath it
5
• Counter: A stiff piece of leather or heavy material, placed around the
heel of a shoe between the lining and the outside of the shoe, that is
intended to strengthen the back of the shoe and keep its shape
• Cranial: Toward the head
• Crossover toe: A condition in which there is joint instability of the second
toe leading to misalignment and drift
• Cuboid: On lateral side of foot, articulates proximally with calcaneus and
distally with bases of fourth and fifth metatarsal shafts
• Cuneiforms: Three wedge-shaped bones located between distal aspect
of navicular and bases of three medial metatarsal shafts
• Custom foot orthosis: An internal foot device manufactured through
the use of a 3-D foot image, intended to accommodate bony deformities,
and/or modify movement patterns of the foot and lower extremity
• Custom-molded shoe: Shoe molded from a full-dimensional cast of a
patient’s foot
• cutane/o: Prefix - refers to skin, e.g. subcutaneous
D
• -dactyl/o: Suffix - term that refers to a finger or toe digit, e.g. syndactyly
• Deceleration: Forward movement of the limb is slowed down to position
the foot for heel strike
• Deep: Located internal to the surface of the body, e.g. muscle, arteries
• derm/a: Prefix - refers to the skin, e.g. dermatology
• -desis: Suffix - to bind or stabilize, e.g. arthrodesis
• Diabetes mellitus: A metabolic disease that occurs when the body is not
able to use glucose for energy and growth. Insulin is either absent or not
well utilized in the body, which leads to the inability of cells to take in
glucose for use
• Diabetic retinopathy: Damage to the retina of the eye, caused by
damage to the retinal blood vessels resulting from diabetes. Retinopathy
is a leading cause of blindness
• Diaphysis: The elongated cylindrical portion (the shaft) of a long bone,
between the ends or extremities, which are usually articular and wider
than the shaft
• Diarthrosis: A movable joint (e.g.: synovial joints)
• Digital fracture: Contact fracture of the phalanges of the foot, most
commonly located at the fifth toe, but also found at the third and fourth
toes
• Dispersion pad: Pads that evenly redistribute weight in the foot
6
• Distal interphalangeal joint (DIP): Forefoot joint located between the
middle phalanx and the distal phalanx of each toe
• Distal neuropathy: Nerve damage that affects the hands and/or the feet
• Distal: Some part of the body that lies away from the central portion, or
trunk, of the body; further away from the point of insertion
• dors/o-: Prefix - term that refers to the back or top of the foot, e.g.
dorsolateral
• Dorsal: Top of the foot
• Dorsiflexion: Movement of the foot whereby the foot or toes move
upward toward the shin, e.g. Foot off of gas
• Dorsum: Top aspect of the foot
• Double support phase: Both limbs are in contact with the ground
simultaneously
• Double support: The phase of gait that encompasses the period of time
when both feet are on the ground, and occurs twice in the gait cycle.
Consists of initial double support and terminal double support
• Doubler: An interlining, cemented in place to the upper part of a shoe
and located between the toe lining and the vamp, is used to provide
additional padding to the forepart of the shoe, and to maintain the shape
of the shoe
• Drop foot: A condition that results in excessive ankle plantarflexion in
the terminal swing as a result of insufficient dorsiflexors
• dys-: Prefix - refers to a bad, painful, or difficult condition, e.g.
dysfunction
• Dysesthesia: impaired or painful touch sensation
E
• Edema: Accumulation of fluid in the tissues
• Elevation: Material added to the plantar aspect of the shoe for limblength discrepancies
• endo-: Prefix - refers to an inner location, within something, e.g.
endoscopy
• epi-: Prefix – refers to an area upon or surrounding, e.g. epidermis
• Epiphysis: The end of a long bone, usually wider than the shaft, and
either entirely cartilaginous or separated from the shaft by a cartilaginous
disk
• eryth-: Prefix – refers to something red in color, e.g. erythematous,
erythrocyte
• -esthesia: Suffix -term which denotes feeling or sensation, e.g.
anesthesia
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• Eversion: Turning away from the midline of the body
• Evert: Motion away from the midline
• Exostosis: Another name for a spur, an exostosis is a growth or
projection that arises off the surface of the bone due to chronic irritation
of the site
• Extension: Movement of a joint in the body so that the angle between
the bones of the limb and at the joint is increased
• Extensor digitorum longus: Runs along anterior surface of tibia along
dorsal aspect of foot and extends to four toes; function is to extend toes
and dorsiflex the ankle
• Extensor hallucis longus: Runs along anterior surface of fibula and
crosses anterior to the ankle joint into dorsal surface of distal phalanx of
hallux; function is to dorsiflex the hallux and ankle joint
• Extensor: Muscle that straightens a joint and moves a limb farther from
the body
• Extrinsic muscle: A muscle which originates outside of the part of the
body where it is found or upon which it acts
F
• Fascia: Tough fibrous membrane which covers muscles and other soft
structures of the body, and can serve to join bones or separate muscle
• Fibula: Located on lateral aspect of leg and is a more slender bone –
distal end is the lateral malleolus, part of the ankle joint
• Fixator: An accessory muscle that serves to steady a part
• Flange: A projected edge
• Flare: Widened heel or sole base; permanent external modification
made to the shoe, especially at the midsole and outsole, intended to
widen the base of support on the medial or lateral portions of the shoe
• Flexion: Bending a joint in the body so that the angle between the bones
of the limb and at the joint is decreased
• Flexor digitorum longus: Located at the middle of the posterior tibial
surface, leads to tendon that runs behind medial malleolus along plantar
surface of foot and inserts into distal phalange of lesser toes; function is
gripping of the lesser toes, and assist in plantarflexion of the ankle joint
• Flexor hallucis longus: Location begins at lower two-thirds of posterior
surface of fibula and runs along plantar of surface foot inserting into base
of hallux; function is to flex the hallux and assist in plantarflexion of the
ankle joint
• Flexor: A muscle that bends a joint and brings a limb closer to the body
8
• Foot care: Active participation in taking special steps to avoid foot
problems such as sores, cuts, bunions, and calluses, which can all lead
to amputation. Good care includes daily examination of the feet, toes,
and toenails and wearing properly fitted shoes and socks or stockings
• Foot flat: The moment in time during the stance phase when the foot is
flat on the ground
• Fracture: A split or a break of a bone, due to a contact or pressure in
excess of that which the bone can withstand
• Functional foot orthosis: An orthotic device used to correct abnormal
foot function as well as correct for abnormal lower extremity function.
There are various types and some may also attempt to accommodate
painful areas on the plantum of the foot. These are generally made of
flexible, semi-rigid, or rigid materials fabricated from a three-dimensional
model of the foot by taking a plaster mold of the foot, having the patient
step into a box of compressible foam, or using a mechanical or optical
scanner to scan the foot
• Functional shoe: Shoe designed to change the biomechanics of a
person’s gait
G
• Gait cycle: The activity that occurs between heel strike of one limb, the
reference limb, and the subsequent heel strike of that same limb
• Gait stride: The distance from initial contact of one foot to the following
initial contact of the same foot
• Gait: The rhythmic alternating movements of the two lower extremities,
which result in the forward movement of the body. Simply stated, it is the
manner in which we walk
• Gastrocnemius: Has two heads, medial, and lateral, and runs along
posterior surface of calf into the achilles tendon; function is to assist the
soleus in flexing the ankle joint
• Gastroparesis: A form of neuropathy that affects the gastrointestinal
tract, which keeps food from being digested properly and from moving
through the GI tract in a normal way, resulting in vomiting, nausea, or
bloating and interfering with diabetes management
• Genu valgum: Also known as ‘knock-knee’, genu valgum is a valgus
knee deformity in which the lower legs distal to the knees point away
from the midline, the knees are abnormally close together, and the space
between the ankles is increased
• Genu varum: Also known as ‘bow-leg’ genu varum is a varus knee
deformity in which the lower legs distal to the knees point toward the
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midline, the knees are abnormally separated, and limbs of the lower
extremity are bowed inward
Geriatric: Older people in the physiologic and pathologic aspects
Girth: Circumferential dimension measured around the last
Glucose tolerance test: A test given to an individual to measure his/her
ability to process glucose. The test is given in a lab or doctor's office in
the morning before the person has eaten. A first sample of blood is taken
from the person. Then the person drinks a liquid that has glucose in it.
After one hour, a second blood sample is drawn, and, after another hour,
a third sample is taken. The object is to see how well the body deals with
the glucose in the blood over time
Great (Big) toe interphalangeal joint: The joint between the two
phalanges of the big or great toe
Ground reaction force (GRF): The force generated when the foot
contacts the ground, and is equal but opposite to the force the foot
applies to the ground
H
• Haglund’s disease: A common condition in which there is an increase or
thickening of the lateral side of calcaneus, which causes it to become
more prominent; can result in abrasion, inflammation, and/or bursitis to
the area
• Hallux rigidus: The great toe, a condition in which walking is painful
• Hallux valgus: A deviation of the great toe toward the outer or lateral
side of the foot
• Hallux: Great or big toe
• Hammer toe shield: A mechanical barrier product that limits friction
between toes and shoes
• Hammer toe: A hammertoe is a toe hyperextended at the distal
interphalangeal and metatarso-phalangeal joints. The proximal
interphalangeal joint is flexed
• Heel cup: Cup-like device that is used to relieve pain and reduce stress
on the achilles tendon. The heel cushion and gel product absorbs heel
strikes and helps relieve pain
• Heel elevation: Material added to the heel only to accommodate
equines position or leg length discrepancy
• Heel pain: A common condition in which weight bearing on the heel
causes extreme discomfort caused generally by either over-use repetitive
stress or plantar fasciitis
10
• Heel spur: A bony growth on the plantar side of the foot where the
plantar fascia connects to the calcaneus; an abnormal growth or
protuberance of the heel bone formed by calcium deposits left when the
plantar fascia pulls away from the heel area
• Heel wedge: Wedge designed to help align the calcaneous during
ambulation to limit excessive pronation or supination
• Heel, Thomas: Heel with anteriorly extended medial border
• Heel-off: A point during the stance phase when the heel leaves the
ground
• Heloma durums: Also known as hard corns, these corns develop on the
tops and tips of the toes and along the sides of the feet
• Heloma molles: Also known as soft corns, these corns develop between
the toes and are sometimes referred to as "kissing corns"
• hem/o: Prefix - refers to blood, e.g. hemoglobin
• hemi-: Prefix - half or partial, e.g. hemidysesthesia
• hidr/o: Prefix - refers to sweat, e.g. hyperhidrosis
• Hindfoot: The tarsus region or back part of the foot
• homo-: Prefix - same, e.g. homolateral
• hydr/o: Prefix - refers to water, e.g. anhydrosis
• hyper-: Prefix - over, above, or excessive, e.g. hyperextend
• Hyperglycemia: Blood glucose levels higher than normal.
Hyperglycemia can result from a lack of insulin in the body, or when the
body cannot use the insulin it does have to turn glucose into energy.
• hypo-: Prefix - under, below, or beneath, e.g. hypoglycemic
• Hypoglycemia: Blood glucose levels lower than normal. In diabetic
patients this can occur when they have injected too much insulin, eaten
too little food, or have exercised without extra food. Symptoms of
hypoglycemia include feeling nervous, shaky, weak, or sweaty,
accompanied by a headache, blurred vision, and hunger
11
I
• Impaired glucose tolerance (IGT): Blood glucose levels higher than
normal but under the threshold for diagnosis of diabetes. People with IGT
may or may not develop diabetes
• Incidence: A statistical term that refers to the number of new cases of a
disease in a specified period of time
• Inferior: Lower section of the body; below
• Inflare: Last or shoe whose distal region provides more medial than
lateral surface area
• infra-: Prefix - below, beneath, inferior, e.g. infrapatellar
• Ingrown toenail: The edge of the toenail grows into the skin of the toe.
Most common in the great toe, ingrown toenails can occur in any toe, and
usually result from curved toenails, poorly fitting shoes, toenails that are
trimmed improperly, or a toe injury
• Initial contact: The stage of gait when the foot strikes the ground and
represents the beginning of the stance phase
• Initial swing: The stage of gait in which the thigh begins to advance; the
knee continues to flex and the foot clears the ground
• Inlay: Material or device inserted into the shoe
• Inner sole: Material conforming to the size and shape of the last bottom
upon which the foot rests; an insole
• Insensitive: Not appreciable by the senses; insensate
• Insertion: The end of the muscle that is attached to a bone or ligament
that moves upon muscle contraction
• Insole: Also known as the inner sole, this is the part of the shoe that is in
direct contact with the plantar surface of the foot. It lies between the
midsole or outsole and the sole of the foot, is generally removable,
allowing it to be replaced with orthotics
• Instep: Portion of the upper over the midfoot
• Insulin resistance: Inability of the body to use glucose in the presence
of insulin. This is common in individuals who are overweight, and in
individuals with high serum lipid levels and hypertension
• Insulin-dependent diabetes mellitus (IDDM): Also known as type I
diabetes, this is a chronic condition in which the pancreas makes little or
no insulin because the pancreatic beta cells have been destroyed. The
body cannot use glucose for energy: the use of insulin is required
• inter-: Prefix - located between, e.g. interosseous
• Internal: Inner part of a structure, e.g. the inside of a shoe
• intra-: Prefix - located in, within, e.g. intra-articular
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• Intractable Plantar Keratosis (IPK): Type of callus on the ball of the foot
having a deep core known as a nucleation. This particular type of callus
can be especially painful to pressure
• Inversion Ankle Sprain (See also Sprain): The most common foot
injury, an inversion ankle sprain is an injury to the ligaments located at
the lateral side of the foot at the ankle, characterized by pain, swelling,
and black and blue marks on the lateral side of the foot at the ankle. The
lateral ligament complex of the ankle consists of the following ligaments:
anterior talofibular ligament, posterior talofibular ligament and
calcaneofibular ligament, which work together to stabilize the ankle.
Inversion injuries constitute about 85% of all ankle sprains with
approximately 65% resulting in a tear of the anterior talofibular ligament,
and 20% in a tear of both the anterior talofibular ligament and
calcaneofibular ligament
o Grade I: mild swelling secondary to stretching the ligament
o Grade II: moderate swelling and an incomplete tear to the ligaments
o Grade III: severe swelling in the presence of a complete ligament
rupture
• Inversion: A motion in which the foot is rotated or turned inwardly
• Invert: Motion towards the midline
• Ipsilateral: Located on the same side of the body
• -itis: Suffix - refers to inflammation, e.g. sesamoiditis
J
• Joint capsule: A structure in which the diarthrostic or synovial joint is
encased. Composed of fibrous and synovial membranes, the joint
capsule attaches the ends of the articulations together
• Joint cavity: The enclosed, fluid-filled space inside the joint capsule that
allows the two bones of the joint to move against each other with little or
no friction, due to the presence of synovial fluid within the cavity
K
• kerat/o: Prefix - horn-like substance, e.g. keratosis
• kines/o - kinesis: Prefix/Suffix - refers to movement, e.g. kinesiology,
hyperkinesis
L
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• Lactic acidosis: The buildup of lactic acid in the body. Lactic acid is
produced by the use of glucose for energy. Lactic acidosis may be
associated with diabetic ketoacidosis or liver or kidney disease
• Last:
o In shoemaking, the last is the solid form (like a cast) that is used to
mold a shoe, and determines the fit of the shoe based on the design,
shape, and volume of the last; The solid form around which the shoe
is molded, approximating the shape and size of the foot, over which
a shoe is made; usually made of wood or plastic, or plaster
o The combination of the insole, midsole, and outsole components of
the sole of the shoe are also occasionally referred to as a last
• Lasting: Shaping or molding of the upper of the shoe to conform to the
contours of the last
• Lateral counter: extended to the fifth metatarsal region
• Lateral: Pertaining to the side or outside; away from the midline or
median of the body
• Levy mold: Full-length inlay that conforms to contour of the plantar foot
• Ligament: A band or sheet of tough, fibrous connective tissue which
attaches two or more bones, cartilages, or other structures as well as
providing support for fasciae or muscles
• Ligament: Fibrous tissue that connects bones to other bones and helps
stabilize joints
• Limb Length Discrepancy: A difference in length between the two limbs
in either the upper or lower extremity
• Linings: Shoe lining materials used today are leather, cotton, and
manufactured synthetics such as tricot and vinyl. Linings absorb foot
moisture and can be bacteriostatic
• Lis Franc: A division of the foot between the tarsus and metatarsus; an
amputation region
• Loading response: In gait, refers to the initial double support stance
period
• Long counter: Extended distally
• Long medial counter: A long medial counter provides support and
stability for high arched pes cavus foot
• Longitudinal arch: Arc of hindfoot and midfoot from mid-calcaneus
extending proximal to the first metatarsal head
• Longitudinal: Lengthwise; parallel to the long axis of the body or a part
of the body
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M
• Macro: Prefix - large, e.g. macromelia
• Macrovascular disease: Disease of the large blood vessels common in
individuals with diabetes of long duration, macrovascular disease
includes coronary artery disease, cerebrovascular disease, and
peripheral vascular disease
• mal-: Prefix - bad, or poor, e.g. misalignment
• Malleolus/i: Malleolus means hammer in Latin, and is used to describe
the bony projection found at the distal end of the fibula and the tibia, that
forms the ankle joint in combination with the talus
• medi-: Prefix - located in the middle of, e.g. medial
• Medial counter: extended to the first metatarsal region
• Medial post: A medial post provides stability and shores the midfoot
during the gait cycle
• Medial: Inside; toward the midline of the body; pertaining to the middle
• Medullary cavity : Pertaining to the marrow of the bone
• meta-: Prefix - located after, beyond, or behind, e.g. metatarsal
• Metatarsal bar (external): Permanent modification to the shoe wherein a
bar of some material is added to the midsole beneath the ball of the foot
intended to change the flex point of the shoe
• Metatarsal bar: Rubber, leather, or synthetic bar applied transversely to
the sole of the shoe with the apex immediately behind the metatarsal
heads
• Metatarsal cuneiform exostosis: Also known as a saddle bone
deformity, this refers to the formation of a spur on the dorsum of the foot
due to enlargement of the metatarsal cuneiform joint
• Metatarsal disarticulation: Amputation of the foot at the metatarsal and
phalangeal joint
• Metatarsal head: The end of the metatarsals which articulate with the
joints of the adjacent bones – generally used to describe the distal
metatarsal head
• Metatarsal pad: Permanent internal modification to the shoe via the
addition of material added to the area of the shoe proximal to the
metatarsal heads at the ball of the foot intended to support the transverse
arch of the foot to relieve pressure and redistribute weight
• Metatarsal phalangeal joint (MTP): Forefoot joint located between the
metatarsal and the proximal phalanx of the adjacent toe
• Metatarsal: Relating to the metatarsus or to one of the metatarsal bones
• Metatarsalgia: A general term used to describe a painful foot condition
that occurs in the metatarsal region of the foot
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• Microvascular disease: Disease of the smallest blood vessels;
common in individuals with diabetes of long duration. The walls of the
vessels become abnormally thick but weak, then bleed, leak protein, and
slow the flow of blood through the small vessels of the body, which leads
to a decrease in perfusion to some tissues, leading to damage
• Mid stance: Foot is flat on the ground and the weight of the body is
directly over the supporting limb
• Midsole: The midpart of the last of the sole of the shoe placed between
the outsole and insole. The midsole provides cushioning and stability to
the foot
• Midstance phase: The stage of gait in which the body progresses over
the foot in a controlled manner and the contralateral swing limb provides
the motion
• Mid-swing: The part of the swing stage of gait in which the thigh
continues to advance as the knee begins to extend and foot clearance is
maintained
• Midtarsal joint: A combination joint comprised of the calcaneocuboid
joint located on the lateral side of the foot, and the talonavicular joint
located on the medial side of the foot
• Mononeuropathy: Nerve damage that affects only one nerve
• Morton’s Neuroma (Morton, T.G. (1835-1903). Surgeon. Philadelphia,
PA): An inflammation or enlarging of the interdigital nerve trunk generally
between the third and fourth MP joint, which is characterized by
thickening or swelling of a nerve near the toes; typically more common in
women than men
• Morton’s Syndrome (Morton, Dudley J., Anatomist): This is
characterized by a short first metatarsal bone causing excessive weight
to be borne by the second metatarsal head. It is usually a hereditary
condition and will result in callus formation under the second and third
metatarsals.
• Morton’s toe: A common forefoot disorder in which the first metatarsal is
shorter than the others, leading to the appearance of a longer second toe
• Muscle (Skeletal): A tough, elastic tissue that is attached at either end to
a fixed location and moves or stabilizes a body part via contraction
• Muscle action: The movement of the body produced by the muscle
• my/o: Prefix - refers to muscle tissue, e.g. myofascitis
• myc/o: Prefix - refers to fungus or fungal, e.g. mycodermatitis
• myel/o: Prefix - refers to either the bone marrow or the spinal cord, e.g.
poliomyelitis, myeloma
• Myositis: Chronic, persistent muscle inflammation
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N
• Navicular: Boat shaped bone (Proximal portion is concave and distal
portion is convex) that articulates with head of talus proximally and
cuneiforms distally. Functions: Transmits forces hindfoot to forefoot
• Nephropathy: Disease of the kidneys caused by damage to the small
blood vessels or to the units in the kidneys that clean the blood. People
who have had diabetes for a long time may have kidney damage
• Nerve: Cordlike fibrous bundles of neurons that transmit sensory and
motor impulses between the central nervous system (CNS) and other
parts of the body
• neur/o: Prefix - refers to a nerve, e,g. neuron, neuralgia
• Neuropathy: A disease of the nervous system in which neurons of the
body are damaged. Neuropathy, especially peripheral neuropathy, is
common in individuals with diabetes. The three major forms of
neuropathy are: peripheral neuropathy, autonomic neuropathy, and
mononeuropathy
• Noninsulin-dependent diabetes mellitus (NIDDM): Also known as type
II diabetes mellitus, this is the most common form of diabetes mellitus.
Unlike type 1 diabetes, in which the pancreas makes no insulin, people
with type 2 diabetes produce some insulin, sometimes even large
amounts. However, either their bodies do not produce enough insulin or
their body cells are resistant to the action of insulin
O
• -o/genesis: Suffix - refers to a beginning or formation, e.g.
erythrogenesis
• onych/o: Prefix - a finger or toe nail, e.g. onychogryphosis curvature
• Origin: The initial point of attachment of a muscle; the origin does not
move when the muscle contracts
• orth/o: Prefix - straight, upright, or correction, e.g. orthograde walk
• Orthoses: Supportive device for the body
• oste/o: Prefix - bone, e.g. osteomyelitis
• Osteoarthritis: The most common type of arthritis, osteoarthritis is
characterized by the wearing away of cartilage around the joints. It is
also known as “wear and tear” arthritis, and is a non-inflammatory
degenerative joint disease that is accompanied by pain and stiffness in
the joints
• Outflare: Last or shoe whose distal region provides more lateral than
medial surface area
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• Outsole: The bottom part of the sole of a shoe that is exposed to
external wear, thus comprised of extremely durable materials to
withstand wear
• Oxford: Low-quarter, laced shoe
P
• -paresis: Suffix - a slight paralysis, or loss of sensation, e.g. hemiparesis
• Paresthesia: Burning, prickling, itching, or tingling sensation, with no
apparent physical cause
• Passive movement: Practitioner moves a part of the patient’s body
• Passive propulsion: The point of time in the gait cycle which begins with
heel contact of the swing limb and ends with toe-off of the support limb
• -pathy: Suffix - disease, e.g. neuropathy
• ped-, pod-: Prefix - refers to the foot, e.g. pedorthics, podiatric
• Pedal: Related to the foot, e.g. Pedal pulse, Ped, Pod, Pes
• Pedorthics: Allied foot health profession concerned with the design,
manufacture, fit, and modification of footwear and related appliances
• Periosteum: A specialized connective tissue covering all bones of the
body, and possessing bone-forming potentialities
• Periostitis: An inflammation of the periosteum, or covering of the bone
• Peripheral neuropathy: Damage to the peripheral nerves , which
usually affects the feet and legs leading to pain, numbness, or tingling.
Peripheral neuropathy is also known as "somatic neuropathy" and/or
"distal sensory polyneuropathy"
• Peripheral vascular disease (PVD): A type of macrovascular damage,
which affects the large blood vessels of the arms, legs, and feet, and is
common in individuals with long-standing diabetes. Results from lack of
blood flow to the limbs secondary to blockages in arms, legs, and feet.
The symptoms and signs of PVD include aching pains in the arms, legs,
and feet (especially when walking) as well as slowly healing sores.
Preventative measures include good foot care, cessation of smoking, and
controlling hypertension and blood glucose levels
• Peroneus brevis (PB): Muscle that begins at distal two-thirds of lateral
surface of fibula and leads into peroneus brevis tendon, which runs along
lateral surface of calcaneus and attaches to styloid process at base fifth
metatarsal shaft; function is evert the foot and assist the PL in ankle
plantarflexion
• Peroneus longus (PL): Muscle that begins at upper part of fibula,
continues downwards and behind lateral malleolus, runs diagonally
across plantar surface of foot and attaches to base of first metatarsal and
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medial cuneiform; function is to evert the foot and to plantarflex the ankle
joint
Pes cavus: Also known as ‘high arch’, is a condition that describes an
excessively elevated toe-to-heel arch of the foot
Pes planus: Also known as “flat foot,” this is a condition in which the
arch or instep of the foot collapses and comes in contact with the ground,
although in some individuals, this arch never develops
PFA: Pedorthic Footwear Association
phleb/o: Prefix - refers to a vein, e.g. phlebitis
Pirogoff: Amputation of the foot at the ankle, part of the calcaneus being
left in the lower end of the stump
Plantar aponeurosis: Also known as the plantar fascia, the aponeurosis
is the band of connective tissue that crosses the foot at the arch from the
calcaneus to the toes
Plantar fascia: The thick, ligament-like tissue that fans out over the sole
of the foot from its origin at the calcaneus to its insertion into the tendons
of the toes
Plantar fasciitis: Non-specific inflammatory change in the plantar fascia,
resulting in pain beneath the heel; Inflammation of the plantar fascia or
plantar aponeurosis, is especially prominent in the medial plantar side of
the heel. Often associated with heel spurs
Plantar warts: Painful epidermal tumors that occur on the plantar
surface of the foot, caused by human papilloma virus
Plantar: Bottom aspect of the foot
Plantarflexion: Movement of the foot whereby the foot or toes move
downward toward the sole, e.g. Foot on gas
Planus, pes planus: Refers to the presence of a flat foot
Platform: Elevated sole
-plegia: Suffix - complete paralysis, e.g. quadriplegia
Point of maximum tenderness (PMT): The time of greatest pain upon
physical examination and subsequent palpation of the foot
Polyneuropathy: Nerve damage that affects several nerves of the body
Posterior tibial tendinitis (PTT): Inflammation and swelling of the
posterior tibial tendon which runs from the inside of the ankle to the arch
of the foot
Posterior, dorsal: The back part of the body; the back portion of the
shoe or foot
Postprandial blood glucose: Blood level measured within 1-2 hours
after eating to see the amount of glucose. Normal is <140 mg/dL
Post-tibial tendon dysfunction: Tendinitis that results from a strain
placed on the posterior tibial tendon, leading to an inability of the tendon
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to hold up the arch resulting in flat feet, which can lead to heel pain, arch
pain, plantar fasciitis and/or heel spurs
pre-: Prefix - referring to something before or in front of, e.g. prematurity
Pre-swing: The stage of gait in which the foot remains on the floor while
the knee rapidly flexes and weight is shifted to the other limb
Prevalence: A statistical term that refers to the number of individuals in a
given group or population who are reported to have a disease
Prime mover: The muscle that acts directly to bring about the desired
movement
primi-: Prefix - first, e.g. primivarus
Pronation/Pronate: Tri-plane motion of the foot consisting of eversion,
dorsiflexion, and abduction
Proteinuria: The presence of protein in the urine
Proximal interphalangeal joint (PIP): Forefoot joint located between the
proximal phalanx and the middle phalanx of each toe
Proximal: Closer to the trunk of the body; Closer to the point of insertion
pseudo-: Prefix - false, e.g. pseudopodia
Pump bump: Also known as Haglund’s deformity, this condition is
characterized by a pronounced bony prominence located at the back of
the calcaneus. While it is often hereditary, this condition often arises as a
result of the constant friction associated with a tightly fitted shoe rubbing
against the heel of the foot
Push-off: In gait, this is the period of time in which there is advancement
of the limb into swing phase
-pyorrhea: Suffix - discharge of pus, e.g. dermopyorrhea
R
• Range of motion (ROM): The extent to which a particular joint can be
moved
• Ray: The metatarsals and phalanges combined form a ray, i.e., the first
ray is the first metatarsal and the hallux (big toe)
• retro-: Prefix - after or located behind, e.g. retrocalcaneal
• Retrocalcaneal bursitis: Inflammation of the bursa located in the
achilles tendon
• Rocker bar: Sole bar with the apex beneath the metatarsal shafts,
causing rocking instead of flexing action
• Rocker bottom: A modified sole apexed at various positions to assist
the gait cycle and relieve or transfer pressure from the designated areas
of the foot
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• Rocker sole: A permanent external modification of the shoe, applied to
the midsole and outsole. Material is added to the shoe, modifying the
shoe’s flex point in order to improve function or protection of the foot and
ankle; These shoe soles are used to control motion in the ankle joint, and
the metatarsalphalangeal joints. They also help reduce ground-reactive
forces to the metatarsal heads, the toes, and any area of the foot over
which the body propels
S
• semi-: Prefix - which refers to half or partial, e.g. semipermeable
• Sesamoiditis: Irritation and inflammation of the tissues surrounding the
sesamoid bones, under the first metatarsophalangeal joint, usually due to
repetitive, excessive pressure on the forefoot
• Shank: Firm, stiff, inflexible part of the shoe between the heel breast and
ball; the part of the sole of the shoe that is located between the heel and
the ball, and reinforced with rigid materials intended to support
• Shear force: A force that acts parallel to a plane; the planes remain
parallel, but the angles change
• Shin splint: A term that refers to pain in the tibial or shin area of the
lower leg. It can develop as a number of conditions, including periostitis,
myositis, stress fracture, or compartment syndrome
• Shoe heel: The solid back part of the shoe that covers the foot to the
sole of the shoe
• Short bones: Small bones that are generally cuboidal in structure, found
primarily in the hands and feet
• Short shoes: Improperly fitted shoes that provide inadequate space in
the toe box
• Single support: The point in the gait cycle which consists of mid-stance
and terminal stance phases, and begins with toe-off of the opposite limb
and ends with heel contact of the same limb
• Skin: The largest organ, the skin covers the entire body as a protective
membrane comprised of the dermis and epidermis, which also provides
touch sensation to the CNS
• Sole bar: A full-length bar made of steel or another rigid material that is
applied to the sole of the shoe in order to eliminate dorsiflexion of the foot
• Sole: The sole of the shoe is a combination region that is comprised of
the insole, midsole, and outsole
• Soleus: Located at posterior surface of fibula shaft and leads to achilles
tendon; function is to assist the gastrocnemius in flexing the ankle joint
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• Splay foot: Typically a flat foot causing toes to spread apart from each
other
• Sprain (Also see Inversion Ankle Sprain): Injury to a ligament; generally
divided into three grades:
o Grade I: mild swelling secondary to stretching the ligament
o Grade II: moderate swelling and an incomplete tear to the ligaments
o Grade III: severe swelling in the presence of a complete ligament
rupture
• Spur: Another name for an exostosis, a spur is a growth or projection
that arises off the surface of the bone due to chronic irritation of the site;
a dull spine or projection from a bone
• Stance phase: In gait, the period of time during which the foot is in
contact with the ground. This is the weightbearing phase of gait
• Step length: Measured from the heel contact of one limb to the heel
contact of the opposite limb. Each stride length will consist of two steps,
usually of equal length
• Stress fracture: A slight fracture of a bone in the foot that is related to
overuse and weakening or fatigue of the muscles, not due to impact
• Stride length: The distance between two consecutive contacts of the
same foot, measured from the heel contact to one limb to the next heel
contact of the same limb. The average stride length is 4.5 feet, and men
have a 14% longer stride length then women
• sub-: Prefix - referring to something under, beneath, or below, e.g.
subluxation
• Subtalar joint (STJ): The joint which joins the calcaneus to the talus,
and enables the foot to rotate at the ankle
• Sulcus: Long, narrow groove or furrow on the plantar surface of the foot
proximal to the phalanges
• Superficial: Located on or near the surface of the body, e.g. Skin, Vein
• Superior: Upper section of the body; above
• Supination/supinate: A tri-plane motion consisting of the simultaneous
movement of the calcaneus and the foot in the direction of adduction,
inversion, and plantarflexion
• supra-: Prefix - referring to something above, e.g. supraorbital ridge
• Sustentaculum tali: Projection on medial side of heel that helps support
the talus of calcaneus
• Swing phase: In gait, the period of time in which the foot is off the
ground and swinging forward; the unsupported phase that begins when
the foot is no longer in contact with the ground. The limb is free to move
• sym-: Prefix - meaning in union with, together, e.g. symphysis pubis
• Syme: Amputation of the foot at the ankle joint with removal of both
malleoli
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• Symmetric neuropathy: Nerve damage that affects both sides of the
body
• Synarthrosis: An immovable articulation in which the bony elements are
united by continuous intervening fibrous tissue (e.g.: joints between the
teeth and jaw bones)
• Syndrome X: Also known as metabolic syndrome, this relates to a
combination of health conditions that place a person at high risk for heart
disease: type 2 diabetes, high blood pressure, hyperinsulinemia, and
hyperlipidemia
• Synergist: A muscle that contributes to the action of the principle muscle
T
• Talipes equinovarus deformity: A complex deformity, actually a form
of clubfoot, involving many bones, articulations, and soft-tissue structures
in which the heel is elevated and turned outward from the midline of the
body
• Talocrural joint (TCJ): The joint which connects the proximal end of the
talus to the malleoli of the tibia and fibula, forming the “hinged” ankle joint
• Talus: Key bone of the foot in contact with tibia and fibula, calcaneus
and navicular. Movements of hindfoot and midfoot are tied to this bone
• Tarsus: The seven bones that form the hind portion of the foot
• Tendinitis: Inflammation of a tendon
• Tendon: A tough flexible connective tissue that attaches muscle to the
periosteum of the bones; fibrous tissue that connect muscles to bone
• Tensile force: A stretching force or tension that pulls at both ends of a
component or structure along its length
• Terminal stance: The stage of gait that takes place from the time the
heel rises until the other limb makes contact with the floor, and the body
progresses past the forefoot
• Terminal swing: During the swing stage of gait, the moment when the
leg reaches out to achieve step length
• Thermoplastic: Synthetic material that can be repeatedly softened by
heat and hardened by cooling
• Tibia: Located medially, is larger of two bones of the leg – distal end is
the medial malleolus, which forms parts of the ankle joint
• Tibialis anterior: Located at anterior of tibia, in front of ankle joint lateral
to medial malleolus and attaches to medial cuneiform and base of first
metatarsal bone; function is to dorsiflex ankle
• Tibialis posterior (TP): Location begins from top of fibula and tibia on
posterior surface, ending in posterior tibialis tendon that extends below
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medial malleolus and inserts into the navicular; function is to invert the
foot and assist in plantarflexion of the ankle joint
Toe box: The toe box of the shoe, intended to cover and protect the toes,
promoting the shoe’s durability by stiffening the shoe, is the semi-circular
area of the shoe that envelops the toes; Reinforcement used to retain the
original contour of the toe and guard the foot against trauma or abrasion
Toe cap: A device made of a thin flexible fabric that is used to protect the
toe from rubbing against the top of the shoe as well as comfort pain
caused by friction, blisters, corns, ingrown toenails, and calluses
Toe crest: An elastic or gel device worn between the ball of the foot and
the toes that is used to hold the toe(s) in a relaxed position, relieve
pressure, and help relieve pain caused by painful toe conditions including
hammer, claw, or mallet toes
Toe separator/comb: A soft cushioning device used to provide toe
separation to keep toes from overlapping, and to provide relief from corns
and friction
Toe sleeve: Aligns the big toe to reduce aggravation of bunions and
absorb pressure and friction to relieve toe irritations, including blisters,
corns, and calluses.
Toe spring: Elevation of the undersurface of the sole at the toe, works to
give a slight rocker effect to the shoe, is built into the last, and is
dependent on the shoe style, thickness, and heel height
Toe-off: Only the big toe of the forward / reference limb in contact with
the ground; when terminal contact is made with the toe
Transmetatarsal: Amputation of the foot at the metatarsal midline
Transverse arch: The arch formed by the metatarsal bones, 1-5
Transverse: Placed crosswise, situated at right angles to the long axis
of the body or of a part
Triglyceride: A type of lipid that is directly related to consumed fats.
The body needs insulin to remove this type of fat from the blood,
therefore, an individual’s diabetes is under control and a person's weight
is what it should be, the triglyceride level should be <150 mg/dL
U
• Ulcer, trophic: A lesion on the surface of the skin or a mucous surface
caused by superficial disintegration and loss of wound with superficial
loss of tissue from trauma; is not primarily an ulcer, but may turn into one
if healing stops or infection occurs
• Ulcer: A break in the skin; a deep sore. Diabetes patients often form
ulcers from minor scrapes on the feet or legs, from cuts that heal slowly,
or from the ill-fitting shoes; A local sore most commonly found on the
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surface of a toe or foot area, produced by the sloughing of inflammatory
necrotic tissue
• uni-: Prefix - referring to one, e.g. unilateral
• University of California Biomechanics Laboratory at Berkley
(UCBL): A foot orthosis used to stabilize a flexible foot deformity, usually
a flexible flat foot. This product differs from other foot orthoses because it
encompasses the heel with a molded heel cup which in turn holds the
heel, in a neutral, vertical position, and controls the inside arch of the foot
and the outside border of the forefoot
• Upper: All of the parts that comprise the upper parts of the shoe,
including the outside, counter, toe box, tongue and laces, and lining, that
will be put together with the last and the bottom of the shoe
V
• Valgus: Angular deformity in which the limb distal to the deformity is
angulated away from the midline; eversion away from the midline
• Vamp: Forepart of the shoe upper over the metatarsal shafts; the upper
part of a boot or shoe covering the instep and sometimes extending over
the toe; i.e., the complete front part of the upper of a shoe, including the
area where the shoe laces are located
• Varus: Angular deformity in which the limb distal to the deformity is
moved closer to the midline of the body; inversion towards the midline
• Veins: Blood vessels which transport blood toward the heart
• ven/o: Prefix - vein, e.g. venopuncture
W
• Wedge: Tapered leather, rubber, or other material used to elevate one
side of the sole and/or heel; also known as heel wedge; A device
incorporated into a shoes construction or inserted in the shoe sole to
provide elevation to compensate for biomechanical instability
• Windlass mechanism: A ‘windlass’ is a tightening of a rope or cable. In
this instance it is a foot mechanism in which the plantar fascia winds
around the metatarsal head when the toes dorsiflex and the heel rises off
the ground; leads to elevation of the arch and a shortens the distance
between the calcaneus and the metatarsal heads
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