Dr. Comfort
Professional Shoe Fitting Workshop
The Finest Quality Extra-Depth
Footwear… PERIOD!!
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Dr. Comfort
Thank you for your interest in Dr. Comfort Shoes!!!
Take a few minutes to look at the shoes presented here…
You’ll see smartly presented, stylish extra-depth orthopaedic
footwear in many styles, colours, and sizes. What you can’t
“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.
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Proper Shoe Fitting
Proper fit is essential for long-term foot health.
Do not assume that a person’s 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 patient’s
correct shoe size, which Dr. Comfort shoe will best suit
their foot, and how to get your patient’s feet happy and
healthy!
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Using the Brannock
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Using the Brannock
Use the Brannock Device to measure your patient’s feet.
 The Dr. Comfort Brannock is designed to measure both
men’s and women’s feet.
 The patient should wear socks while measurements are
being taken.

Note: all men’s measurements are in BLUE and women’s
are in YELLOW.
SIMS Medical Corp. © 2006
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Using the Brannock
Take three separate measurements:
1) Heel to Toe Length
2) Heel to Ball Length (Arch)
3) 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 patient’s 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
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
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
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
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
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Dr. Comfort Widths
Men’s
Women’s
Narrow
AA
Medium
D
Medium
B
Wide
EE
Wide
D
Extra-Wide
EE
Extra-Wide
EEEE
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
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
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
The
Fitting
Tower
The fabulous Dr. Comfort
Fitting Tower holds 27 split
pairs (i.e. 54 singles) of Dr.
Comfort’s 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!!
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Fitting Tower??
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
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 women’s and in men’s 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 women’s, and the “Lily” is available to try on in
size 8, however she wants a “Move” instead – you’ve 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!!
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Check Fit
Determine if fit is correct
1.
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.
2.
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.
3.
Note: as a general rule, longer is usually better.
Never fit short!!!!
SIMS Medical Corp. © 2006
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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
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
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/oversupination and
whether or not they will be wearing orthotics in their footwear.
We suggest taking a static impression of your patient’s 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!
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Specific Shoe Pointers
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•
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 she’s
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!
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Men’s 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
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Men’s 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.
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Men’s 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 body’s 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.
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Men’s 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.
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Women’s Shoes
MERRY JANE  the Merry Jane is an
open top shoe and can fit very roomy for
the patient’s 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.
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Women’s 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.
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Women’s Shoes
ANNIE  like the men’s 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 body’s natural movements,
this upper can make the shoe feel roomy.
Order the Annie one width narrower if
you feel this shoe is too loose.
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Women’s Shoes
BETSY  The Betsy women’s 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.
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Women’s Shoes
BETTY  highly similar to the
men’s 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.
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Women’s Shoes
SPIRIT & VICTORY  these women’s
athletic shoes are lasted to fit full in the
forefoot but snug in the heel, which means
they won’t cause heel slippage! The firm heel
counter ensures that the back of the shoe will
not breakdown. As with the men’s 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.
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
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@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
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Single Patient
Shoe Order
•Use this form to record
your order, fax to head
office, and keep in your
patient’s file for future
reference
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Stock Order
Form
•Use this form to
order inventory for
stock purposes
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
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
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Shoe Modification
Order Form
•
We can modify the
footwear for you
externally and internally
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
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 @ 50% surcharge
• If your patient’s 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
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
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 patient’s stated shoe size –
YOU ARE THE EXPERT!!
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Tricks of the Trade
HEEL COUNTER
• If the heel counter feels stiff, or digs into the patient’s 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
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Tricks of the Trade
FILLING
• If the patient’s 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.
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Elite Insert Moulding
• First and foremost, verify that the
insert is the correct size for the patient’s
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).
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Heating Process
Please wear heat-resistant gloves!!
1. 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)
2. 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!!
SIMS Medical Corp. © 2006
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Heating Process
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Positioning & Moulding
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Cover the patient’s 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 patient’s 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 patient’s foot and arch
while the insert is warm
Remove the patient’s foot from the insert after the insert has
cooled down (approximately 2 minutes)
SIMS Medical Corp. © 2006
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Positioning & Moulding
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Check for Total Contact
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Remove the insert from the foam block and place on
the floor
Position the patient’s 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
SIMS Medical Corp. © 2006
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Check for Total Contact
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Modifications
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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
SIMS Medical Corp. © 2006
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Modifications
SIMS Medical Corp. © 2006
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Additional Protection
for pre-ulcerative or healing site
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•
•
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 patient’s 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
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
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 patient’s foot.
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
What if it STILL
doesn’t fit?
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•
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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
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Shoe Return
Form
•Use this form to
return footwear for
exchange or credit
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com
Dr. Comfort
Well that was EASY!
It was meant to be!!!
SIMS Medical Corp. © 2006
SIMS Medical Corp * 1-888-655-4499 * www.simsmedicalcorp.com