(Report by Dr. George Girardi and Dr. Mariaca Iaia)

FUNCTION OF THE FOOT
The foot is the anatomical district which ensures a regular walking as well as the transmission of orthostatic load, it is basic for the physiology of movement and for the cellular trophism of the human being. Its predominantly motor function and supporting body weight is an adaptation to the change in posture occurred in the evolution of species. The foot is the link between the body and the soil. It is to provide energy expressed by the body during the walking, to adapt to the ground, to bear the body mass and the kinetic energy produced during the movement.

THE MOVEMENT OF THE FOOT
The foot touches the ground with the outside of the heel, then the arch rotates inward so as to fall slightly. This sequence of movements is called “pronazione”: this allows the foot to perform naturally the task of adapting to the ground and absorb shock in physiological way.
After the foot has found a sure support, supporting in the meantime the weight of the body, the direction of movement is reversed: the arch begins to rise and the foot rotates up and out, becoming stiff in order to lift the weight of the body and have it proceed. This phase is called “supinazione”.
In the execution of these movements there is an integral collaboration of articulations and muscles of the whole inferior limb.
If the foot passes from the “pronazione”to the “supinazione” in harmony and in time, there is no effort or loss of effectiveness of the movement, if there is an imbalance in the sequence, there may be effects that affect negatively to the back.
The surface of the foot is the channel for the transport of the device sensitivity.
Hence the importance of using the channel of proprioceptive transmission trough the pursuit of the best interface foot/ground that is the basis of the health of the foot and body.

CHOICE OF SHOE
There are three important considerations to focus on.
The first one concerns the evolution of footwear: the modern landscape is very attractive and varied, we now have an average standard of high quality. This wide range implies a minimum of knowledge in order to move adequately.
Another point concerns the over estimation, in some cases, of the shoe. The arguments showing the shoe as protagonist in relation to a disease, make this relationship too important in some cases.
The last point concerns the upper’s form. All the shoes are assembled around a form that should be an anatomical standard. If the customer’s foot comes out of this range, the shoe may not be appropriate even if other features are in line with its needs.
That is why a shoe should be tested, in feet, to see that the shape of the upper is compatible with that of the foot.
Let’s try to explain the effects of inadequate shoes:
a) Front part of the foot and relative upper too narrow, no anatomical internal seams.
Effects: bursitis of the first and fifth metatarsus. Morton’s neuroma.
b) Inadequate control of “pronazione’s” movement.
Effects: plantar wrapped, tendinopathy of the middle tarsus of the Achilleus tendon, hallux valgus.
c) Insufficient antero-posterior gradient.
Effects: Achilleus tendinopathy.
d) Inappropriate anatomical profile or excessive rigidity of the buttresses calcaneus.
Effects: calcaneus bursitis, syndrome of Achilleus – calcaneus conflict.
e) Inadequate padding of the upper front.
Effects: tenosynovitis of the extensors of the fingers.
f)Excessive rigidity of the inter sole in the front.
Effects: metatarsal pain.
g) Excessive rigidity of the inter sole in the back.
Effects: low back pain.

CONCLUSIONS
Following these considerations, it is clear that every foot needs its own shoes.