Cecelia Cox, CPed, fits minds before she fits feet. Patient trust comes
first, Cox, who practices pedorthics in Owensboro, Ky., said.
“I know I can help them when they say, ‘Okay, you’re the
expert, you know what’s best for me,’” Cox, who is one of three
board-certified pedorthists on staff at Shoe Stop Inc., a combination retail
store and an ABC- accredited pedorthics facility, said.
A new direction
Like her fellow pedorthists – Cindy Mattingly and Terra Blandford
– Cox did not plan on a career as a pedorthist.
“Absolutely not,” she said with a laugh. “I was a
pharmacy tech for 28 years in a drugstore here in Owensboro. I wasn’t
really looking to change jobs. But I haven’t regretted it.”
|Foot comfort, according to Cox,
is a blend of the right size and fit as well as the correct shoe for each
|Images: Berry Craig|
Most of Cox’s clients are diabetes patients.
“I have type 2 diabetes myself, so I understand their
problems,” she said. “My patients tell me their feet are the last
thing on the list of things doctors talk about. I understand. When I was
diagnosed, my doctor told me how diabetes can affect the heart, the eyes and
the kidneys and can cause strokes. But he never told me to look at my feet. He
never said a blister on my foot could lead to an ulcer and even an amputation.
So, patient education is a big part of my job. I tell my patients to check
their feet three or four times a day, especially if they have neuropathy. I
tell them to stop and shake out their shoes. Even a little pebble can cause a
cut, then an ulcer if you have no feeling in your feet.”
A larger mission
Cox said she, Mattingly and Blandford also inform doctors about how
proper footwear can save limbs and even lives.
“A lot of doctors still don’t know what certified pedorthists
do,” she said. “We let them know that we are here to help them. We
let orthopedists and podiatrists know we are not a threat to them. We all want
what’s best for the patient. As a CPed, I can round out the services
provided by the orthotist or podiatrist with the correct fit and style of
Cox confessed she had never heard of pedorthics before she went to work
at Shoe Stop.
“I also learned when I was taking pre-certification courses that
shoes aren’t just something people wear,” she said. “A shoe is a
medical device. If it’s the right shoe and fits properly, it can help you.
But if it is the wrong size – if it is too tight, too short or too long,
it can cause pain and, if you have diabetes, rub a blister and cause you to
lose your foot or half of your leg. So as a certified pedorthist, my job is to
make sure the fit is correct.”
She, Mattingly and Blandford also stress the importance of shoe fit to
the local diabetes coalition.
“Education is a big part of what we do,” she said.
She confesses that teaching the importance of “sensible shoes”
to fashion conscious diabetes patients can be challenging.
|Cox does not divulge what the
Brannock reveals and instead, fits patients into shoes that meet their
“Usually, they will give them up when they are really
hurting,” Cox said. “My goal is to get them into a comfortable shoe
they are going to wear at least 80% of the time. It’s okay for most people
to wear dressy shoes for a little while for a special occasion like when you go
out to dinner or to church or to a wedding.”
But if “sensible shoes” are a full-time must, Cox has a ready
answer for the unwilling.
“I tell them that when you go to church or to a wedding or a
funeral, you need to look nice. But the important thing is that you are there,
she said. “That’s what people appreciate – that you are there.
They don’t notice or don’t care if you have on a comfortable pair of
Growth through experience
Cox said shoe comfort is a combination of the right size and the right
kind of shoe. She speaks from experience.
“Right after I came to work here, I bought this pair of cute shoes
in the retail store,” Cox said, grinning. “They were tight and hurt
my feet. But I was going to make them work. I wore them for 2 weeks. But I
didn’t make them work. So I ended up giving them away.”
Cox said diabetes patients with
neuropathy often want shoes that feel tight.
“They have no feeling and poor circulation. Wearing shoes that are
too small makes things worse.”
Cox added that many of her clients come to her in shoes too small for
their feet. She measures their feet with a Brannock device, but she does not
always reveal the size the instrument shows.
“They say ‘I wear a six’, but I measure them an eight. A
lot of times I don’t tell them the size. I just fit them in the shoes they
need and when they say they feel great, I just fill out the paper work, if they
have a prescription, and send them on their way. When a shoe feels good, they
aren’t going to argue with you about needing a different size
She said a few people – again mainly women – come in wearing
shoes that are too long.
|When patients report pressure on
the fifth or sixth metatarsel, Cox marks the foot to see the impression on the
“They measure a seven, but they are wearing a nine to get the wide
width. Most shoes in a retail store are medium widths. But we have the widths
to fit them.”
Shoe Stop also has an in-store lab for making custom orthotics.
“When you send out for orthotics, they come back and you end up
having to modify somebody else’s work. With a lab, I know it’s my
work and know what I need to do to adjust the orthotic.”
Cox gets paid for her work in more than dollars.
“Patients sometimes bring us gifts,” she said, chuckling.
“They bring us candy but not sugar free. But one of the nicest things
I’ve ever gotten from a patient was what this gentleman said to me after I
fitted him with shoes and orthotics. I asked him how they felt. He said,
‘they feel like Heaven.’ When they feel like Heaven, you know
you’ve done your job.”