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Clin Podiatr Med Surg. 2014 Jan;31(1):71-88. doi: 10.1016/j.cpm.2013.09.004.

Offloading of the diabetic foot: orthotic and pedorthic strategies.

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Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Baker Span 3, Boston, MA 02215, USA; Private Practice, Milwaukee Foot Specialists, 3610 Michelle Witmer Memorial Drive, Suite 110, New Berlin, WI 53151, USA. Electronic address:


The diabetic foot is more susceptible than the non-diabetic foot to collapse. This frequently leads to bony prominences followed by ulceration. Offloading of areas of increased pressure is paramount to ulcer prevention and healing. Several devices and accommodations can aid practitioners in saving patients' extremities and allow them to ambulate. A team approach works best, and patient education is a must. Regular assessment and modifications are required for longevity of each device. In this article, different therapeutic options are detailed. A variety of presentations and situations are discussed and the authors' best tips for avoiding complications are offered.


Bracing; Diabetes; Modifications; Monitoring; Offloading; Orthoses; Team approach; Ulceration

[Indexed for MEDLINE]

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