People with diabetes and associated neuropathy or ischaemia are susceptible to injury caused by their footwear. These injuries may lead to foot ulceration (Reiber et al, 1999). Patients with sensory neuropathy have a reduced perception of pressure; for example, the pressure caused on the foot by inappropriate footwear. These patients may also develop toe deformities owing to atrophy of the small muscles in the foot. The resulting muscle imbalance leads to structural changes, such as hammer or retracted toes.