As a Canadian Certified Pedorthist who sees many different foot conditions each day, I don’t believe any condition is greater than another. Foot pain is foot pain and nobody should have to live with it. I am trained to figure out the cause and solution to foot pain and seeing my patients feel and move better following treatment is one of my favourite parts of my job.
Each day, the average person stands for up to five hours and walks about 10,000 steps with their feet serving as a shock absorber. As each foot has 26 bones, 33 joints, 20 ligaments and more than 100 muscles there are many different parts absorbing the shock from the daily pounding. If any of these parts are damaged through overuse, medical conditions, injuries or poor fitting footwear, pain and mobility issues will result.
The most common problems I see in my clinic are:
- Plantar Fasciitis – heel pain
- Heel Spurs – bony growths on the back or bottom of the heel
- Achilles Tendonitis – dull pain near the heel or along the back of the leg
- Metatarsalgia – forefoot pain
- Neuromas – a painful bundle of nerve tissue that grows between the toes
- Stress Fractures – a tiny crack in the bone
- Sesamoiditis – inflammation under the big toe joint
- Bunions – a hard red bump at the base of the big toe
- Hammertoes– toes that have an irregular, permanent bend in the joint
- Tarsal Tunnel Syndrome – pain along the inner leg behind the ankle bone
- Haglands Deformity – a bony enlargement on the back of the heel
- Corns and callusing – painful patches of thickened skin
In addition to these conditions, I also regularly see patients living with diabetes, arthritis, fibromyalgia and gout as these diseases affect the feet and lower limbs.
As you can see, there are many causes of foot pain so it’s important to seek professional advice to determine the cause of, and an appropriate treatment program for, your foot pain. Treatment options to reduce foot pain and increase mobility, include foot orthotics, footwear recommendations and modifications, stretching, icing and more.
If you think you have any of the above conditions, don’t self-treat. Book an appointment with a Canadian Certified Pedorthist in your community. Your Pedorthist will conduct a comprehensive assessment of your feet and lower limbs to determine the cause of your pain and will design a treatment program for you. Click here to find a Canadian Certified Pedorthist near you http://www.pedorthic.ca/find-a-pedorthist/
By Mike Neugebauer C. Ped (C) Vancouver, BC
My feet are two different sizes, how do I buy shoes that fit?
For your foot health and comfort, it is important to buy properly fitted shoes but if your feet measure two different sizes (and most people’s do) how do you decide which size to purchase? I recommend three different solutions, depending on your situation:
If your feet measure within a half size of each other and you don’t have any other problems with your feet, purchase shoes to fit your largest foot. Although, you should buy footwear that fits your larger foot, it’s also important to make sure it fits your smaller foot. For example, my right foot is a 9.5 EEE and my left foot is a size 9 EEEEE. I can usually wear a 9.5 EEE shoe as long as it is a generous EEE width and the shoe is square at the toes. To make sure the shoes fit both of your feet, try them on and walk around in the store before purchasing them.
Some people have about one size difference between their feet. For these individuals it will be more difficult to get both shoes to fit comfortably without modifications. If you fall into this category, you should visit a Canadian Certified Pedorthist to find a shoe that fits your larger foot and then have the second shoe modified to fit your smaller foot. Your Pedorthist may need to put a pad in the front of the shoe to draw your smaller foot towards the heel. A tongue pad (shown at the left) is a pad that is glued on the tongue of the shoe to help ensure a proper fit. A tongue pad makes the shoe fit tighter to keep the shoe from sliding around.
Mass shoe stores may suggest you put a heel cushion into your shoe to accommodate your shorter foot. However, the objective is to pull the back of your foot into the heel of the shoe and putting a heel pad in will achieve the opposite as it forces your foot to the front. Forcing your foot forward will make the shoe harder to wear because your heel will slide up and down. It also increases the risk of toe injury as your toes will bang the front of the shoe.
A smaller group of people have more than a two size difference between their feet. These people usually had trauma or surgery on their feet when they were growing up. They may also have a leg length discrepancy. It is unlikely footwear can be modified to fit such varying size feet. However, there are a couple of solutions for this situation, depending of the type of shoes the person requires.
- If you require the shoes immediately, I recommend you purchase two pairs (one to fit the larger foot and a second to fit the smaller foot).
- If you have time to do some research, some specialty shoe manufacturers make mismatched pairs. They may charge a surcharge, but it is generally less expensive than buying two pairs of shoes.
- A few places such as the National Odd Shoe Exchange (http://www.oddshoe.org/index.php) provide people with different size feet a place to trade shoes that do not fit. You simply look on the exchange to find if there is someone with the opposite shoe needs. You then purchase two pairs of shoes, and send the pair that does not fit to the exchange. The exchange then sends you back a second new pair to meet your needs.
- Custom made shoes – shoes that are made specifically for you – are also an option. Although this is the most expensive option, custom made shoes are the most likely to fit perfectly.
If you are having difficulty finding shoes to fit your needs, contact your Canadian Certified Pedorthist. Your Pedorthist is a footwear expert and will recommend the best solution for you.
By Jim Pattison, C. Ped (C), Prince Albert, SK
Heel spurs are a frequent culprit of foot pain seen in pedorthic clinics. The pain can range from a dull nagging ache that feels like there is a rock in your shoe, to an excruciating pain that prevents you from walking, standing or doing your regular activities.
Also known as calcaneal spurs, heel spurs typically develop from repetitive damage to the heel which causes calcium deposits to form. Ongoing damage can lead to a buildup of calcium, which causes frequent pain. X-rays are often used to confirm heel spurs but they can also be detected through a medical exam and palpation.
There are two common types of heel spurs:
- An Inferior Calcaneal Spur results from repetitive stress to the bottom of the heel, causing the area to become painful. As this type of heel spur causes discomfort similar to plantar fasciitis pain, it is important to take an X-ray to ensure it is not mistakenly treated as plantar fasciitis.
- A Posterior Calcaneal Spur results from repeated trauma to the back of the heel where the Achilles tendon attaches. This specific spur is often present to the naked eye and easy to feel.
There are a number of successful treatment strategies for heel spurs. Custom made foot orthotics are commonly used to reduce pressure areas. Typically, the orthotic is designed with a heel well, a hole cut out of the bottom of the heel cup, which is then filled with soft material, to cradle or cushion the inflamed area and reduce pressure and impact forces when walking, standing or being active. Physiotherapy is also often used to strengthen and stretch the area. Icing the bottom of the foot is recommended to reduce inflammation. Some individuals may also find relief with heel spur cushions, which are soft pads put under a patients heel inside their shoes, while other individuals may be advised to purchase new footwear if their existing footwear has lost its cushioning capabilities or its structural integrity.
If you think you have a heel spur, check with your doctor or consult a Certified Canadian Pedorthist to determine which treatment course is right for you.
By Steve Stredulinsky C. Ped (C) Calgary, Alberta
A hammertoe is a toe that has an irregular, permanent bend in the joint, in some instances causing the toe to resemble a hammer. Often painful or difficult to move, hammertoes may affect a single toe or all of the four lesser toes (toes that have two hinge joints).
The most common cause of hammertoes is poorly fitting footwear. Footwear that is too tight at the toes or has an excessive heel height that forces the toes to be crushed into the toe box of the shoe will cause hammertoes to form over time. Hammertoes are frequently seen in conjunction with bunions, as ill-fitting footwear also causes bunions to develop on the big toe.
There are a number of treatment options for hammertoes.
Braces – over the counter soft hammertoe cushions or braces can help to reduce pain and decrease pressure on the tops of the toes inside the shoes. A hammertoe cushion has soft padding under the foot and an elastic piece that the toe fits into so the wearer can adjust the resistance against the toe.
Footwear – investing in properly fitted footwear is paramount to reducing pressure on the affected toe and ensuring it doesn’t get worse. A deeper, wider toe box will reduce stress on the joints and top of the toes. To ensure you are getting a proper fitting pair of shoes, make sure you visit a footwear professional who measures both of your feet with a Brannock device.
Physiotherapy – in mild cases, a strengthening and stretching program can help reduce areas of discomfort and minimize the deformity from worsening.
Orthotics – custom made foot orthotics can help reduce pressure points and areas of discomfort and also help the foot fit more efficiently into footwear.
Surgery – in more severe cases, surgical intervention may be required to reduce pain and discomfort in the affected area.
If you have hammertoes, check with your family physician or book in an assessment appointment with a Certified Canadian Pedorthist to explore all of your treatment options.
By Steve Stredulinsky C. Ped (C) Calgary, Alberta
When I am fitting a patient for foot orthotics for the first time, they often ask if they can wear their orthotics in all of their shoes. This is a great question. Custom made foot orthotics are highly effective as Canadian Certified Pedorthists make them to precisely fit your feet. However, to receive the full benefit of the orthotic, the orthotic needs to fit properly in your footwear.
Often custom made foot orthotics can be transferred between similar types of shoes. For example, the orthotic that is made for your running shoes will likely fit in your walking or hiking shoes. However, the same orthotic may not fit, or be as effective in, a pair of lady’s dress shoes, sandals, skis or skates.
As each brand and style of shoe is made differently it is important to carefully check how your orthotic fits when you transfer it to a different pair of shoes. To check the fit, slide your hand into the front of your shoe and feel the length and width of the orthotic in comparison to the shoe. If your orthotic fits correctly, it will lie flat on the base of your shoe – it will not tilt up either side of your shoe. If you can feel a bulge or space between the side of your orthotic and your shoe the orthotic doesn’t fit. A poor fitting orthotic may slide within, or stretch, your shoe and it will not provide you with the support you require.
When you are being fitted for orthotics, it is important to take the footwear you will be wearing them in to your pedorthic appointment so your Pedorthist can take the style into account during the design and manufacturing stage. If you plan to wear your orthotics in multiple pairs of shoes, take both pairs to your fitting appointment as your Pedorthist may need to make some minor adjustments to the orthotics or the footwear to ensure a proper fit.
Discreetly hidden within footwear, orthotics can make an enormous difference to your comfort and mobility. However, ensuring the orthotics fit properly within your footwear is essential. Canadian Certified Pedorthists are orthotic and footwear experts so work closely with your Pedorthist to make sure you are getting the maximum benefits from your orthotics. Your Pedorthist will also advise if two pairs of orthotics would be best for your lifestyle needs.
By Alison Smith C. Ped (C) Moncton, New Brunswick
Working out is great for your health but if you haven’t used fitness equipment before or you’re starting an exercise program for the first time it’s important to take some precautions or your goals of improved health may experience a frustrating and painful setback.
Newcomers to the gym often head straight to the elliptical trainer because it provides a great workout, is easy to use and is usually in plentiful supply. But an elliptical can cause overuse injuries in the sensitive forefoot area as the foot never leaves the ground, and instead bends right at the forefoot. Injuries can result from any exercise equipment but equipment that requires repetitive weight-bearing motions, such as the elliptical or similarly popular treadmill, have a higher risk of injury. If you have poor technique, wear improper or worn out footwear or have a muscle imbalance or biomechanical problem with your feet or lower limbs your risk of injury is even greater.
A variety of injuries can occur from fitness machines but heel pain, shin splints and forefoot pain are the most common. Here are some tips to reduce your risk:
- If you’re new to the gym, ask a staff member to show you how to use each piece of equipment. If you’re using a fitness machine at home, carefully read the instruction guide or watch an instructional online video before getting started.
- Whichever equipment you’re using, start slowly and gradually increase the intensity of your workouts over time.
- Make sure you are wearing appropriate footwear for your individual biomechanics, foot type and activity.
- If you experience foot or lower limb pain following a workout, consult a Canadian Certified Pedorthist to determine if different footwear or a custom made foot orthotic will help.
When used properly, exercise machines are great tools for helping you achieve your fitness goals. However, don’t let your enthusiasm for improved health and fitness hurt you. Take the time to learn how to use the equipment correctly, don’t do too much too quickly and consult your local Canadian Certified Pedorthist if you experience ongoing pain in your feet or lower limbs.
By Anne Putnam C. Ped (C), Saskatoon, Saskatchewan