Dr. Comfort

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Dr. Comfort

• Professional Shoe Fitting Workshop
• The Finest Quality Extra-Depth Footwear PERIOD!!

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Dr. Comfort

• Thank you for your interest in Dr. Comfort
  Shoes!!!
• Take a few minutes to look at the shoes presented
  here Youll see smartly presented, stylish
  extra-depth orthopaedic footwear in many styles,
  colours, and sizes. What you cant see is how
  lightweight and downright comfortable they are.
  Slip your foot into a Dr. Comfort shoe and know
  that we live up to our name.

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Proper Shoe Fitting

• Proper fit is essential for long-term foot
  health.
• Do not assume that a persons everyday shoes are
  the correct size!! Many people wear shoes that
  are the wrong length or width. This workshop will
  provide you with guidelines to help you determine
  your patients correct shoe size, which Dr.
  Comfort shoe will best suit their foot, and how
  to get your patients feet happy and healthy!

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Using the Brannock
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Using the Brannock

• Use the Brannock Device to measure your
  patients feet.
• The Dr. Comfort Brannock is designed to measure
  both mens and womens feet.
• The patient should wear socks while measurements
  are being taken.
• Note all mens measurements are in BLUE and
  womens are in YELLOW.

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Using the Brannock

• Take three separate measurements
• Heel to Toe Length
• Heel to Ball Length (Arch)
• Width

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Heel to Toe

• With the patient seated, place the first foot
  in the correct position with the heel
  against the cup
• Have the patient stand
• Press the toes flat against the base of the
  Brannock Device and look straight down
  over the longest toe (not necessarily the
  first toe) to read toe length.
• Make sure the patients socks are snug against
  the toes (without drawing the toes back)
  to get an accurate measurement.
• Use the handy Shoe Fitting Form to write this
  number down

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Heel to Ball (arch)

• Place your thumb on the ball joint of the foot.
  
• Slide the pointer forward so the inside curve
  of the pointer fits the ball joint of the
  foot and the two high ribs come in contact
  with your thumb
• When the pointer is properly located, the lower
  middle rib will be against the center of
  the ball joint on the side of the foot.
• This yields the arch measurement.
• Write this number down on the Shoe Fitting Form

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Width

• Slide the width bar to just touch the edge of
  the foot
• On the sliding width bar, locate the length
• To determine correct length, use the midpoint
  between the heel-to-toe length and the
  heel-to-ball length (i.e. midpoint is
  defined as ½ way between heel to toe
  measurement and heel to ball measurement)
• Find the width measurement that lines up to the
  shoe length on the width bar.

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Width

• If the shoe size falls between widths, choose
  the wider width
• If the foot is extremely fleshy or has a high
  instep, it may be necessary to fit an extra
  width wider
• Make sure you use BLUE letters for men and
  YELLOW for women!!
• Translate this letter to correct width (Medium,
  Wide, Extra Wide) and write this width down
  on the Shoe Fitting Form

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Dr. Comfort Widths
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Next Foot!!

• Reverse the Brannock end to end and measure the
  other foot.
• It is common for people to have feet of
  different sizes
• Always fit shoes to the larger foot
• If one foot is significantly larger or wider,
  consider splitting pairs to acquire the
  right size and width for each foot
• SIMS Medical offers split pairs at a surcharge

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The Fitting Tower
The fabulous Dr. Comfort Fitting Tower holds 27
split pairs (i.e. 54 singles) of Dr. Comforts
most popular shoe styles. Functional as both an
attractive display and a comprehensive fitting
centre, the Dr. Comfort Fitting Tower is sure to
be a positive addition to your office!!
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Fitting Tower??

• Tower sets up quickly in four easy steps
• On castors, so you can move it wherever you
  need to
• Shelves rotate
• Sample shoes include every size in womens and
  in mens in different shoe styles
• All shoes come in Wide width if the shoe fits
  length wise but is narrow, order an extra
  wide in the shoe of choice or if too wide, order
  a medium
• E.G. Your patient is a size 8 womens, and the
  Lily is available to try on in size 8,
  however she wants a Move instead youve
  measured her feet, had her try on a size
  8, and it fits just great so you order the Move
  in the right size/width!!

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Check Fit

• Determine if fit is correct
• Check to see that the ball of the foot is at the
  widest part of the shoe. If ball is forward
  (toward toes), shoe is too short. If ball is back
  (towards ankle) shoe is too long. The area from
  the ball of the foot to the toes should NEVER be
  tight.
• Check toe location. There should be 1/4 to 3/8
  inch room at the toe for proper fit. Shoe can
  feel snug around the instep as leather will shape
  and form, but the shoe should not feel
  excessively tight at the instep. If it does,
  patient may need a half size longer or one size
  wider.
• Note as a general rule, longer is usually
  better.
• Never fit short!!!!

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Choose Your Style

• Help your patient select an
  appropriate style and colour
• You may also consult the Dr. Comfort
  full-colour catalogue or Quick
  Reference Index Card for more colour
  choices

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Specific Shoe Pointers

• Dr. Comfort shoes are all made on very similar
  lasts (if not the same) although design of a
  particular shoe's upper can affect the way it
  fits. 
• Keep in mind that fitting the right size for your
  patient does not only involve a quick Brannock
  measurement of length! Be sure to measure
  heel-to-ball, heel-to-toe, AND width.
• In conjunction with Brannock measurements, be
  sure to note the gait of the patient. For
  example, their degree of overpronation/oversupinat
  ion and whether or not they will be wearing
  orthotics in their footwear.
• We suggest taking a static impression of your
  patients feet to note where the pressure points
  lie, and to determine foot flat stance.
• Take into consideration any foot deformities that
  may affect the fit of the shoe style selected
• REMEMBER if you proceed with a full analysis of
  your patients feet before you order their shoes,
  you will decrease your exchange rate and increase
  your patient satisfaction rate!

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Specific Shoe Pointers

• Please remember that normally you never want to
  fit a highly symptomatic patient, and more
  particularly a diabetic patient, shorter or
  narrower than measured.
• However, by keeping in mind the following
  guidelines, you will be achieving a fit
  comparable to other shoes in our line.
• It is very important to remember that when you
  are fitting patients that have narrow heels, it
  will be easier to accommodate their needs with a
  lace shoe. Refer to the Lacing Guide for tips on
  different lacing techniques to achieve the best
  fit for your patient.
• NEVER sell the wrong size shoes. Remember YOU
  KNOW BETTER! Even if your patient insists, for
  example, that she always wears a size 7M but you
  measure her as a size 8W, go with YOUR expertise!
  That patient has visited you because she has
  foot problems she NEEDS your expert advice
  whether shes willing to admit it or not!
• Advise your patients to wear moisture-wicking
  socks. Cotton blend socks cause blistering, even
  when the shoe is the right size. Cotton, as you
  know, absorbs moisture. Moisture plus friction
  results in a blister. Have your patients wear
  moisture-wicking socks, and blister problems are
  solved!

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Mens Shoes
PATRICK MIKE? the Patrick Mike are classic
deck-style shoes. They have a lower heel counter
than all of the other men's shoes and do not push
the foot as far distally.  Order these styles a ½
size shorter or one width narrower to achieve a
similar fit. NB Mike is the Velcro version of
the Patrick  
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Mens Shoes
CHAMPION ENDURANCE ? the fantastic athletic
shoes absolutely will not slip in the heel! Based
on the same last as the rest of our product line,
these light-weight athletic shoes are lasted to
fit full in the forefoot, but snug in the heel.
The firm heel counter ensures that the back of
the shoe will not break down like some counters
used in lower quality footwear. In addition, the
lightweight EVA and rubber outsole contains a
composite shank and a stabilizer bar for extra
plantar support and is sufficiently wide to
provide stability on all surfaces. Both styles
are available in Velcro and Lace versions.
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Mens Shoes
BRIAN ? the Brian shoe has an upper made of
Lycra to fit patients with hammer toes, bunions,
and other similar forefoot deformities. Lycra
is a stretchable material comprised of fibres
which move easily with the bodys natural
movements. In turn, this upper can make the shoe
feel roomy. If you feel this shoe is too loose,
order the Brian one width narrower to achieve a
better fit.  
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Mens Shoes
DOUGLAS ? the Douglas shoe has two Lycra strips
that run distally on the sides of the shoe. This
shoe is designed to stretch from plantar to
dorsal. The Douglas is great for patients that
have thick, swollen feet, high insteps, or wear
an internal brace. The throat of the shoe is more
open to allow the foot easier entry. If you have
a patient that likes this shoe but does not have
any of the above criteria, order this shoe one
width narrower to achieve a great fit.
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Womens Shoes
MERRY JANE ? the Merry Jane is an open top shoe
and can fit very roomy for the patients foot.
It is very important to order the Merry Jane at
least one width narrower and in some cases,
depending on the foot, ½ size shorter. This shoe
is not recommended if you think heel slippage is
going to be a problem.
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Womens Shoes
LULU ? The Lulu shoe is another open top shoe
that allows room for a high instep foot. It is
important to order this shoe one width narrower
to achieve proper fit in those patients who do
not have a high instep. This shoe is NOT
recommended for pes planus foot deformities.
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Womens Shoes
ANNIE ? like the mens Brian, this shoe has a
Lycra upper to fit patients with hammer toes,
bunions and other forefoot deformities. As
Lycra is a stretchable material comprised of
fibres which move easily with the bodys natural
movements, this upper can make the shoe feel
roomy. Order the Annie one width narrower if you
feel this shoe is too loose.
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Womens Shoes
BETSY ? The Betsy womens dress shoe has a unique
styling and functional design on the lateral side
of the shoe called a gusset. This feature
allows the shoe to flex and stretch dorsally by
adding breadth, reducing metatarsal stress, and
increasing breathability. This gusset appears as
a triangular flap and is a sewing technique
used to reinforce the connection on the lateral
border.
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Womens Shoes
BETTY ? highly similar to the mens Douglas, the
Betty also incorporates two distally running
Lycra strips. If your patient does not exhibit
a swollen foot or high instep (for example),
order the shoe one width narrower.
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Womens Shoes
SPIRIT VICTORY ? these womens athletic shoes
are lasted to fit full in the forefoot but snug
in the heel, which means they wont cause heel
slippage! The firm heel counter ensures that the
back of the shoe will not breakdown. As with the
mens athletic shoes, the lightweight EVA and
rubber outsole contains a composite shank and a
stabilizer bar for extra plantar support and is
sufficiently wide to provide stability on all
surfaces.
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Order Time!!

• For single patient orders, use our Single
  Patient Shoe Order Forms
• For multiple shoe orders, use our Stock Shoe
  Order Forms
• These can be faxed to 1-866-933-2922 or emailed
  to simsmedical_at_gmail.com
• If the patient you are ordering for requires
  custom foot orthotics, please do not fax
  your order!! Send all paperwork, for both the
  footwear and the custom orthotic (use the
  Prescription Orthotic Form) with the
  plaster cast or foam impression to our head
  office
• For shoe modifications, include the Shoe
  Modification Order Form with the Shoe
  Order Form (this can be faxed or emailed)
• The specially designed Dr. Comfort inserts are
  also available for purchase should you
  require extra for your patient or for stock
  purposes

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• Single Patient Shoe Order
• Use this form to record your order, fax to head
  office, and keep in your patients file for
  future reference

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• Stock Order Form
• Use this form to order inventory for stock
  purposes

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• Prescription Orthotic Order Form
• We can manufacture orthotics specific to your
  patient and fit them directly in the footwear
  selected we accept plaster, foam or STS
  impressions

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• Shoe Modification Order Form
• We can modify the footwear for you externally and
  internally

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Tricks of the Trade

• Size Variation
• If the right and left foot vary by more than ½
  or 1 full size or width and cannot be filled in,
  consider ordering two different sized shoes
• NB Split Pairs _at_ 50 surcharge
• If your patients sizing variation is
  significantly large, such as with a post-polio or
  amputee, SIMS can create a transmetatarsal filler
  on a custom orthotic or on the existing Elite Dr.
  Comfort Inserts

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Tricks of the Trade

• FITTING
• If the instep of the shoe feels slightly snug
  when trying on a sample shoe from the Tower, that
  should not pose a problem as the leather will
  shape to the foot
• However, if the shoe feels extremely tight,
  patient should wear the same length shoe, but one
  size wider.
• Patients frequently wear shoes that are too
  short and wide.
• Do not be influenced by a patients stated shoe
  size
• YOU ARE THE EXPERT!!

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Tricks of the Trade

• HEEL COUNTER
• If the heel counter feels stiff, or digs into the
  patients heel, then remove the shoe and flex the
  counter of the shoe with your palm but pushing it
  forward towards the end of the shoe
• Remember to tell your patients to use the Dr.
  Comfort shoehorn (provided with each pair of Dr.
  Comfort shoes) to place their heel inside the
  shoe this will avoid any damage to the heel
  counter caused by slipping the heel in and out of
  the footwear

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Tricks of the Trade

• FILLING
• If the patients shoe is slightly too large (e.g.
  too deep, too wide), but the variation does not
  constitute increasing the size or width, you can
  snug it up by placing a Dr. Comfort blue flat EVA
  filler under the Elite Heat Mouldable Insert.
• Complimentary pair of blue EVA fillers is
  included with each pair of shoes ordered.

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Elite Insert Moulding

• First and foremost, verify that the insert is
  the correct size for the patients foot and that
  it matches the size of the Dr. Comfort extra
  depth orthopaedic shoe.
• During the direct moulding process, the patient
  may be seated or standing depending on how you
  are creating their customized insole
  (weight-bearing or semi weight-bearing).

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Heating Process

• Please wear heat-resistant gloves!!
• HEAT GUN using a heat gun at a minimum of 230
  degrees Fahrenheit, heat the prefabricated insert
  on the top and the bottom of the device until it
  is soft and malleable (approximately 2-4 minutes)
• OVEN heat the convection oven to 250 degrees
  Fahrenheit and place the device until it is soft
  and malleable (approximately 1-2 minutes)
• Both heating methods normally take a few minutes
  maximum per insert.
• DO NOT place inserts in the microwave!!
• Word of Caution do not heat the inserts to a
  point where they can be dangerous to the
  patient!!

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Heating Process
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Positioning Moulding

• Cover the patients foot with a sock or other
  protective material
• Place the heated insert on a foam block that is a
  minimum of two inches thick
• Position the patients foot on top of the heated
  insert
• Have the patient step down on the insert
  (standing or sitting)
• Allow the insert to mould to the patients foot
  and arch while the insert is warm
• Remove the patients foot from the insert after
  the insert has cooled down (approximately 2
  minutes)

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Positioning Moulding
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Check for Total Contact

• Remove the insert from the foam block and place
  on the floor
• Position the patients foot on top of the moulded
  insert
• Check to see if the arch on the insert is high
  enough to achieve total contact with the weight
  bearing surface of the foot including the arch

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Check for Total Contact
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Modifications

• The EVA base (blue material or sometimes beige
  colour) of the Dr. Comfort insert will maintain
  its shape (mouldable)
• In the case of a patient with a high arch or a
  heavy patient, you may determine that additional
  support material should be added under the arch
  for support (e.g. rubber scaphoids)
• Glue (cyanoacrylate preferred such as in
  Dermabond or Traumaseal, Super Glue or Krazy Glue
  although Barge cement is ok) the appropriate
  size latex, poron, sponge rubber or moulded
  rubber scaphoid pad (longitudinal arch pad) onto
  the bottom of the EVA portion of the insole
• The pad may be cut or tapered for better fit and
  comfort
• Once complete, check to see that you have a
  properly fitted insert

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Modifications
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Additional Protection for pre-ulcerative or
healing site

• Cut a piece of 1/8 rubberized cork, slightly
  larger than the diameter of the lesion, or the
  area to be protected, and tape it directly to the
  foot of the patient on the area that you want to
  provide extra protection
• Put the sock on the patients foot and heat the
  insert as previously described, utilizing the
  heat gun or oven method, then place the warm
  insert on the moulding pad
• Have the patient step down on the insert for
  about 30 seconds, and then verify that the
  depression matches the lesion site

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Additional Protection for pre-ulcerative or
healing site

• You have just accurately offloaded the site
  without adding any extra loading or pressure to
  the adjacent sites
• To remove the cork and tape from the bottom of
  the foot, it is important to begin at the area
  closest to the toes, and gently push the skin
  away from the tape, remove the tape and cork from
  the top, down toward the heel.
• NEVER start at the bottom and go upwards, as that
  could cause the skin to tear. It is strongly
  advisable that only a health practitioner
  (podiatrist, chiropodist, pedorthist, orthotist)
  apply and remove the cork and tape from the
  patients foot.

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What if it STILL doesnt fit?

• Fortunately, SIMS Medical accepts returns and
  exchanges!
• Within 30 days of purchase, if the shoe is unworn
  (i.e. Outside wear), all components are included
  (i.e. Shoehorn, insoles, etc.), and the footwear
  is in resaleable condition, it will be accepted
  for FULL credit no restocking or surcharges as
  long as you follow the simple Shoe Return Policy
  
• Exchanges are permitted and are processed the
  same as a Shoe Return and Shoe Order would be
• Keep in mind that footwear returned after an
  excessive period of time will be credited 75
  (minus 25 of original value)
• Footwear that has been worn will not be credited

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• Shoe Return Form
• Use this form to return footwear for exchange or
  credit

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Dr. ComfortWell that was EASY! It was meant to
be!!!