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What are hammertoes?

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


Will my orthotics fit in all of my shoes?

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

Don’t let a workout hurt you

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

Turn family time into active time

Spending time together as a family has numerous benefits for parents and kids alike and scheduling a weekly family dinner has often been touted as a great way to stay connected. In this digital age when Moms, Dads and children are spending much of their days on screens, a weekly family physical activity is an equally great way to bond as a family and also get in some much needed exercise.

If each of your family members like different activities, alternate your activity each week so each family member gets to have a turn choosing the activity. Alternately, if you have family consensus, plan to do the same activity all season long. Just make it clear that only activities that every family member can participate in are acceptable.

To maximize enjoyment and prevent injuries, it is important to make sure every family member is wearing appropriate footwear, particularly if you’re participating in the same activity each week. Although worn out running shoes may seem like a good choice for a wet and muddy hike, if hiking is your regular family activity, you should invest in hiking shoes for each family member. Hiking shoes provide extra ankle support for uneven terrain as well as extra cushioning and shock absorption and they dry quickly.

Many charitable organizations host fun family runs so training for a non-competitive 5K can be a great family activity too. However, before you start training, take a close look at everyone’s running shoes. Old running shoes – even if they have just been sitting in a closet – do not provide adequate shock absorption or stability as they break down over time. If running shoes are more than one-year-old they should be replaced or the wearer will be at an increased risk of suffering a lower leg or foot injury.

If you have multiple children, resist the temptation to pass outgrown sports shoes down from your older to your younger children. Even if the shoes are the correct size, they won’t fit the second child properly as everyone has different biomechanics so the wear patterns of the first child won’t be right for the next one.

By paying attention to your family’s footwear you will ensure your family’s weekly physical activity is fun, comfortable and injury free for every family member.

By Kevin Fraser C. Ped (C) Toronto, ON

Do you have a stress fracture?

If you have pain in a specific spot in your foot or lower leg that you barely noticed at first but is getting worse over time, yet decreases when you rest, you may have a stress fracture. A stress fracture is a tiny crack in the bone, typically so small it cannot be seen by X-ray for 4-6 weeks. Unlike other fractures that are caused by a single event, stress fractures are caused by repetitive activities such as walking and running that exceed the bone’s ability to recover.

Although anyone can experience a stress fracture, people that are involved in high impact sports like basketball, volleyball and running are most at risk. Stress fractures also often occur in people who were not previously active, who start an aggressive exercise routine.

“March fractures” are a type of stress fracture that often occur in people who are participating in basic training. Long marches in boots they are not accustomed to and a new level of exercise can cause March fractures and in some cases the bones may actually break.

If you have flat feet, high arches or weakened bones (i.e. from osteoporosis) you’re at an increased risk of suffering a stress fracture.

Here are the most common treatments for stress fractures:

Rest – Most stress fractures take six to eight weeks to heal.  Stay off the affected limb. And resist the urge to resume your activities until your doctor says you can bear normal weight. Participating in an activity too quickly may cause larger, harder-to-heal stress fractures to develop. Re-injury can also lead to the stress fracture never healing properly.

Reduce stress on your foot and leg – A stiff-soled shoe, a wooden-soled sandal, or a removable short-leg, fracture brace shoe may help to protect your feet until the fracture heals.

Apply a cast – Stress fractures in some bones take longer to heal. Your doctor may apply a cast to your foot to promote healing and remove stress on your leg.

Ice regularly – Icing the injured area 3 or 4 times a day for 10 minutes at a time will help to reduce swelling and relieve pain.

Resume activity slowly – When your doctor approves, slowly progress from non-weight bearing activities to your usual activities. If you like to run, pay careful attention to how quickly you add time and distance.

Consider custom foot orthotics – Custom foot orthotics can ease pain when you are recovering and reduce the risk of the stress fractures recurring. Canadian Certified Pedorthists will advise you if a custom foot orthotic is right for you.

When it comes to stress fractures, prevention is always best. Here are some tips to help you remain fracture free:

  • Don’t wear worn out shoes.
  • Pay attention when walking on uneven terrain.
  • When engaging in any new sports activity, start slowly and gradually increase weekly.
  • Cross-training is important. Instead of running every day, run and bike on alternating days.
  • Maintain a healthy diet. A diet that includes foods rich in calcium and Vitamin D helps the body to recover.

By Jim Pattison, C. Ped (C), Prince Albert, SK

Compression therapy can help your body recover

If you are recovering from a surgical procedure, participating in a running race, taking a long flight or have a job that requires you stand for long periods of time, compression therapy can help your body recover. Compression socks, stockings, pantyhose and bandages help move blood up your leg towards your heart.

Compression therapy falls into two main categories: medical and performance. Although both categories frequently use the same products, the outcome and purpose are often vastly different.

Medical Compression

Medical compression garments are typically used to aid with issues or deficiencies relating to the veins or to aid the recovery from minor and major surgical procedures. Most medical compression garments and devices are prescribed by a physician and have a specified degree of compression.

Compression socks are the most common medical compression garments. They are frequently used to prevent deep vein thrombosis (blood clots deep within the body) when flying and to reduce fatigue from standing or working on your feet for long periods of time. Compression socks are also used to limit pain and discomfort from varicose veins.

Another common use of medical compression therapy is in post surgical recovery, such as Achilles Complex surgery or circulatory related surgery. Many people use devices such as Game Ready and Cold Rush systems and compression to decrease recovery time and get back to activity sooner.

Performance Compression

Performance compression garments are used to increase the connection between the mind and the muscle, and increase an individual’s abilities before, during and following activity. Performance compression is seldom prescribed by a physician but it is frequently recommended by physiotherapists and athletic therapists

Performance compression can greatly aid in running activities – from compression socks which aid in distance activities to calf sleeves which minimize the effects of shin splints. Performance compression can also be beneficial in the gym as it increases physical performance and decreases muscle soreness. Knee sleeves and elbow sleeves help with lifting, squatting and pressing movements and compression shorts reduce hip and hamstring discomfort.

Like medical compression, performance compression can also be used to aid in recovery, with devices such as Game Ready and Game Legs.

If you think compression therapy could help you return to activity or improve your performance, speak with your family doctor and ask for a referral to a Canadian Certified Pedorthist. Compression garments are only effective if they fit properly. A Canadian Certified Pedorthist will determine which compression garment is appropriate for you and will professionally fit it.

By Steve Stredulinsky C. Ped (C) Calgary, Alberta

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