Biomechanical factors act as significant contributers to the development of pressure wounds and neuropathic joints (Charcot joint), collectively referred to as the `diabetic foot`. Treatment of such disorders caused by diabetes, complicated by concomitant diseases and advanced age, may be possible only when the underlying mechanical factors can be understood. Restricted joint movements, contractures, acquired deformities and some developmental variations may create different types of mechanical load distribution in the foot. To evaluate the pressure gradients in the foot objectively and create an insight into the mechanical problems, pedobarogaphy is performed. In case of patients with chronic wounds in the foot and Charcot joints, load distributions may be normalized by the use of ortheses and casts. A range of ortheses and casts, ranging from insoles to full contact casts may be used for this purpose. Simple shoes are inappropriate for patients with chronic wounds; boots and casts are recommended. Cast immobilization and nonweight- bearing is preferred primarily for deep and infected wounds. After closure of the wound with these conservative non-weight-bearing measures, the causative mechanical factor may be eliminated permanently with surgery.