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Do you walk like a duck or a pigeon?

I know very little about birds but I’m often asked “do I walk like a duck?” and “do I walk like a pigeon?” Walking like a duck means walking with your toes pointing outwards. Walking like a pigeon is the opposite, walking with your toes pointing inwards. Although these sound like funny questions, they actually provide me with a good starting point for any pain or mobility difficulties a patient may be experiencing.

During a patient’s initial pedorthic consultation, I conduct a gait assessment, which is an analysis of how they walk. Although I watch how the patient walks, I am really analyzing why they walk the way they do.

Walking like a duck or a pigeon can stem from alignment problems in the hip and lower leg. Depending on how the knees and feet are aligned and function mechanically, will determine how severely the toes turn outwards or inwards and the overall impact the condition has on a patient’s function. Leg and hip alignment problems can lead to lower back, knee, and foot pain as the body tries to compensate. Walking with toes pointing out or turned inwards can also cause arch and heel pain, bunions, hammertoes, arthritis and neuromas, which is a burning sensation between the toes and in the ball of the foot.

If you walk like a duck or a pigeon ask your family physician for a referral to a Canadian Certified Pedorthist. Canadian Certified Pedorthists have extensive training in the assessment of lower limb anatomy and muscle and joint function so they will determine why you walk the way you do. Once your Pedorthist has completed a thorough assessment of your individual condition, he/she will recommend a customized treatment program to help keep you healthy and pain free. Treatment may include custom foot orthotics, different or modified footwear and possibly recommendations for physiotherapy or chiropractic treatment.

By Mike Neugebauer, C. Ped (C), Port Coquitlam and Langley, BC.

How long does it take to adjust to a new orthotic?

Every day I see individuals with a wide range of conditions, from very simple and straightforward to very complicated, involving a wide scope of medical practitioners. I also see patients who have never had orthotics to individuals who are being assessed for their tenth pair of orthotics.

The most common question I hear during an appointment is “how long will it take me to get used to my orthotics”. Unfortunately this is never an easy question, nor a straight forward question, to answer as everybody adjusts to orthotics in their own time. However, it usually takes about two weeks to get used to wearing an orthotic.

When my patients come for a fitting appointment, I make sure I have the contact and control I am striving for, the foot feels comfortable on the orthotic and the orthotic fits into the patient’s footwear. During the break in period for your first pair of orthotics, things will feel different day to day as your soft tissue gets used to having pressure in different places and the tissue gets used to being in a more mechanically efficient position.

To comfortably break in a new orthotic, I recommend my patients wear it for an hour on day one, two hours on day two, and continuously progress each day so that by the end of the two weeks, they can wear the orthotic comfortably all day. Due to the nature of soft tissue, a number of people are able to comfortably wear their orthotics right away. The break in period is very much a “listen to your body” time. If things are feeling good, wear them longer each day, even all day.

The second most common question I get is, “How do I know if I need an adjustment?” If you have never had an orthotic, it can be difficult initially to know if an adjustment is needed, especially during the first two weeks as your body needs time to get used to it. And even after two weeks, your foot may still need some time to adapt. The best way to know if an adjustment is needed is the duration of your discomfort. I tell my patients if an area is in pain for one day but it is not painful for the rest of the week, something prior caused the inflammation and the orthotics aren’t the cause. However, if you have pain every day of the week following the onset of the initial discomfort, the soft tissue is interacting with your orthotic incorrectly and it needs to be adjusted.

Orthotics are great devices but they do need a break in period to become comfortable. If your orthotic is causing you discomfort after two weeks, contact your Canadian Certified Pedorthist and book an appointment to see if any changes are necessary. As orthotics are custom made to fit your feet perfectly it is not unusual to require some adjustments in the early days.

By Steve Stredulinsky, BSc KIN, C. Ped (C), Abbotsford, BC

When Should I See a Pedorthist?

I have worked as a Canadian Certified Pedorthist for 10 years but I continue to be surprised by the number of patients I see who have delayed pedorthic treatment for months, needlessly living with pain or decreased mobility. When I ask these patients why they waited so long, many say they believed the pain and reduced activity were simply things they had to live with.

If you are unsure if you should book a consultation with a Canadian Certified Pedorthist, ask yourself the following questions:

• Are you experiencing pain in your heels, forefeet, toes or ankles?
• Are you suffering from unexplained pain in your back, hips or knees?
• Are you living with diabetes or arthritis?
• Is discomfort in your lower limbs preventing you from participating in all the activities you would like?
• Do you have difficulty finding footwear that fits comfortably?
• Are the wear patterns on the soles of your everyday shoes uneven?
• Have you experienced a serious foot or lower limb injury?

If you answered yes to any of the above questions you should definitely seek pedorthic treatment.

As foot orthotic and orthopaedic footwear specialists, Canadian Certified Pedorthists provide a wide range of services to help patients with an extensive array of foot and lower limb conditions. They undergo extensive training in lower limb anatomy and biomechanics to ease pain and increase mobility. Your Pedorthist will:

• Assess your feet and lower legs and evaluate how you walk or run
• Educate you about your foot or lower limb condition and the recommended treatment
• Provide custom-made foot orthotics or over-the-counter devices if appropriate
• Professionally fit you with orthopaedic footwear that is appropriate for your foot type and condition
• Modify footwear to accommodate problem areas

To arrange a consultation with a Pedorthist in your community, book an appointment with your family physician and ask for a referral to a Canadian Certified Pedorthist. When you go for your initial assessment with your Pedorthist wear a pair of shorts or loose pants that can be rolled to your knees and take your everyday/work shoes and sports shoes if appropriate. Also remember to take your physician’s referral.

Your Pedorthist will quickly get you on a treatment program to ease your pain and get you back doing the activities you enjoy.

By Paul Mäkinen, C. Ped (C), Halifax, Nova Scotia

Don’t let a fall dampen your retirement

Falls are a serious health concern for Canadians 65 years and older as each year one in three seniors has a fall. For the seniors who break a large joint, such as a hip, the fall can be life changing as they may never walk unassisted again. Although age brings an increased risk of falling, there are steps you can take to reduce your risk.

The first and most important step is to keep active. Daily activity, whether you participate in a formal exercise program or sport, run errands on foot, or work in the garden, helps to maintain the muscles in your feet and lower limbs and improve your balance. Exercise is important at all stages of life so make sure it remains part of your daily routine as you age.

Wearing proper supportive footwear, both inside and outside the home, also plays an important role in fall prevention. Supportive, proper fitting shoes increase balance and stability which in turn reduce the risk of falling. Although it is tempting to wear a comfortable pair of soft, loose slippers at home, slippers don’t provide any support and fall off easily, particularly on stairs, possibly causing you to trip. As we age painful foot conditions such as arthritis, foot ulcers, bunions and hammertoes become more common, making slippers an even more tempting choice. However, replace your slippers with a supportive pair of comfortable, indoor shoes to increase your balance and stability. Be sure to look for shoes with a wide toe box and no irritating seams running across tender areas as well as laces or Velcro fasteners so you can adjust the fit. Most importantly look for shoes with non-stick soles.

Walk through your home and look for tripping hazards. Get rid of loose throw rugs that slide when you walk on them or have edges you can trip over. If you have clutter on the floor put it away. Also consider increasing your lighting so that you can clearly see where you are walking.

If you are experiencing foot or lower limb pain, don’t assume it is a natural part of aging and something you have to live with. Painful lower limbs throw off your balance and reduce your ability to lead a healthy active life so you should address it right away. Ask your family doctor for a referral to a Canadian Certified Pedorthist. Your Canadian Certified Pedorthist will conduct a full assessment of your lower limbs and recommend ways to reduce your pain and increase your mobility.

By Meghan Knox, C. Ped (C), Guelph, Ontario

Give Dad Sport Specific Shoes for Father’s Day

Many people find Father’s Day one of the most difficult gift buying occasions of the year. The days of giving ties and coffee mugs are long gone and the ever-popular grilling tools and shaving sets are losing their appeal. Finding a thoughtful gift for Dad that he’ll get much enjoyment from is a tough assignment but I have a suggestion. Buy Dad a pair of sports specific shoes.

As a Canadian Certified Pedorthist I cannot stress enough the importance of wearing shoes that are designed for your specific sport. Sport specific shoes greatly increase comfort and performance and most importantly they reduce the risk of injury. Many men, who participate in a recreational sport don’t wear sport appropriate footwear. Father’s Day is a great opportunity to buy Dad the shoes he needs and will love.

Getting A Rheumatoid Arthritis Sufferer Back On Her Feet

When I was completing my Bachelor of Science at the University of Waterloo I had the opportunity to work with a number of professors and graduate students who were doing biomechanical research. This experience sparked my interest in foot biomechanics, particularly how people adapt to walking on varying terrain and how they modify their techniques when they are injured or in pain.

Today, one of the aspects I enjoy most working as a Canadian Certified Pedorthist is assessing abnormalities in patients’ walking cycle and following the evaluation, determining the pedorthic treatment that will help them achieve their personal activity goals. I get a deep personal satisfaction each time I am able to help a patient who has been struggling to perform their daily activities.

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