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August 2019

Monthly Archives

Kickstart Your Child’s School Year with Comfortable Feet

As a parent of a ten-year-old stepson, the most recent topic of discussion in our house has surrounded the idea of him wanting a certain pair of shoes for back to school. These are shoes that I, as a Pedorthist, know won’t do his feet much good when it comes to providing him with proper support.

But as many of you can relate, a child this age typically doesn’t care about the function of the shoe, but rather what’s in with the latest trends. I struggle with his request for several reasons: First, he already has good sneakers for back to school. Second, the ones he wants are way overpriced for the quality of the shoe. Third, he has had foot issues in the past, and even though he wears proper supportive orthotics, I know these shoes won’t aid in supporting his feet. Try explaining that to a ten-year-old!

Through much thought and several discussions with my husband, we came to the conclusion that we would allow him to get the shoes, with the stipulation that they are to be worn in moderation. Note that “moderation” is the key word here. They are only to be worn to and from school, with the proper sneakers to be worn all day during school. 

Why is it so Important for Children to Wear Proper Footwear?

Growing children often experience hypermobility in their joints due to the developmental stages of their growing bones. Often the bones aren’t fully fused until late in their teens. It is crucial that we choose the right footwear to support the development of good foot structure throughout these important years.

Muscles and other soft tissue structures typically are not as strong at this age, so we want to avoid any unwanted strain or movement to these structures as well. This will help prevent the onset of injuries and unwanted mechanical foot and lower limb issues such as flat feet, ankle pain, shin pain, knee, hip and low back pain. 

One thing we have to consider is that children spend approximately eight hours a day in their school shoes. That’s a significant amount of time each week. The vast majority of their activity throughout the day is during recess, lunch and physical education class.

Choosing the wrong footwear can be detrimental to their daily well being. Your feet support your entire body. Therefore, choosing the wrong shoes can contribute to foot pain and/or lower limb pain. At the end of the day, this will result in a less happy child. 

Choosing the Right Shoe

I know many parents struggle with the idea of what shoes to buy or even the concept surrounding the importance of proper footwear. Often through advertisements and endorsements, you think you are getting a good shoe, when in actual fact you are not. How can this be? You’ve spent an arm and a leg (maybe even your firstborn child!) on this shoe and it’s not the proper shoe? Yes, you read that correctly, many times companies sell you this idea so that you buy their product. 

Below are some features you should look for when outfitting your children for back-to-school footwear:

  • Sneakers, typically nothing too heavy, are always my preference as they offer the most structure and support for the feet. 
  • Testing for proper bend and flexion points will ensure the shoe bends properly with the natural mechanics of the foot. You can check for this by making sure the shoes bend at the forefoot (metatarsals) and not throughout the arch, have good torsional stability when you twist the bottom of the shoe, and have a proper firm backing to the shoe (heel counter). If the shoe bends too much, it is no good. 
  • While cushion is nice, it is also important to recognize when an outsole is made of materials which are too soft and not solid in structure. For example, EVA rubber (the rubber typically found in most sneakers) outsoles are ideal, but soft EVA or EVA with holes in it will break down more quickly and you will find yourself having to replace them more frequently.
  • Lace the shoe closure for proper fit and ankle support. Remind your children to always lace and unlace their footwear!
  • Avoid flat shoes. Ideally, a 6mm incline from the front to the back of the shoe will take strain of the posterior heels, legs and low back. 

Tips for Proper Fit and What to Avoid

  • Size both feet. Remove the insoles from the shoes and have your child stand on the insole. There should be approximately a quarter inch to a finger space in front of the longest toe (not necessarily always the big toe). This will also likely give them a little bit of room for growth and hopefully get them through the school year. 
  • Fitting the shoes too big doesn’t support the foot and allows for more play in the bones, joints and soft tissue structures surrounding the foot.
  • Ensure adequate width and depth throughout the shoe. You don’t want their feet feeling cramped up. 
  • Breathable meshes and leathers are often more ideal. Avoid synthetics as much as possible as they may irritate the toes and cause odour issues.  
  • Avoid shoes with little padding and thick seams inside as this will likely irritate the feet.

Recognizing Issues with your Child’s Feet/Footwear

If you notice your child is wearing through a pair of shoes rather quickly or see signs of uneven wear, you should bring them to your nearest Canadian Certified Pedorthist and have a proper assessment done to determine if treatment is needed. This may include a more specific type of footwear or off the shelf or custom orthotics.

By Jodi Basha, BPE, Dip. Ped., C. Ped (C)


Meet a Pedorthist – Vince DeVito

Vince DeVito, C. Ped Tech (C), C. Ped (C)

When Vince DeVito’s grandfather emigrated from Italy in 1916, he opened up a shoe repair shop in British Columbia. Now, more than a century later, Vince is continuing to build on the family business.

After hearing requests from his footwear customers for help with their foot pain, Vince decided to pursue certification as a pedorthist. Once certified, he first had a small foot clinic in his retail shoe store, and later opened a larger clinic two doors down.

“Starting as just a shoe repair store, expanding into retail footwear, then on to specialty footwear, and then the pedorthic practice, kept my brain sharp and my interest high,” he says, adding that the shoe business and pedorthics go hand-in-hand.

He says the business is continuing to change through his sons, who are helping to grow it online.

“That’s the future,” he says. “Online will keep us moving forward.”

After 23 years as a pedorthist, Vince says he still enjoys his job every day – particularly working with his great staff and meeting with clients. “Having someone tell me they were unable to walk three blocks without pain, and since receiving their orthotics, they are back to hiking mountains. Changing people’s lives sounds like a cliché, but it really is true.”

Vince plans to stay in pedorthics until retirement – which he says is still far off. “Having just turned 60, I plan on doing this until I can no longer get to the clinic,” he says. “I’m still having far too much fun. I love this profession and the people I spend time with.”

In his spare time, Vince enjoys cross-country skiing with his wife in the winter months. In the summer, he enjoys spending time with his family and friends at their summer retreat on Kootenay Lake. He also enjoys cooking and entertaining for family, and particularly spending time with his new grandson.

 

 


On the Beaten Path: Preparing your Feet for the El Camino Trek

 

Have you heard of El Camino? No, not the car. The word camino is Spanish and simply translates to path. Technically, there are so-called caminos or paths all over the world. However, I’ve especially noticed a significant increase in the number of patients I see who are preparing for the Camino de Santiago. Here’s a quick look at what it is and how a Canadian Certified Pedorthist can help you to prepare for taking on the challenge.

What is the Camino de Santiago?

Camino de Santiago, the Way of Saint James, is the common name for a network of walking paths which all lead to the cathedral in the city of Santiago de Campostela situated in the northwest of Spain. For over 1000 years, pilgrims have been making the trek to Santiago, where it is believed that the remains of Saint James are today. In 2017, an estimated 300,000 people made their way to Santiago via these walking paths. Whilst it has historically been used as a literal path for spiritual growth, the Camino de Santiago has quickly become a destination for people from all over the world, of all age groups and abilities wishing to participate in Active-Tourism by hiking and cycling these paths.

A Variety of Routes & Terrains

A map of the network shows numerous routes beginning all over Europe. The most popular being the Camino Francés (the French Way), Camino Portugués (the Portuguese Way), Camino Primitivo (the Original Way), and Camino del Norte (the Northern Way). The Camino Francés, consistently the most famous route taken by Active-Tourists, begins in St Jean Pied de Port (loosely translating to “at the foot of the harbour”), courses through the French Pyrenees mountains, and goes on for about 800km to the stunning cathedral in Santiago. While it’s not impossible to cover the 800km (a traditional pilgrimage may be completed in 40-45 days) many people opt to complete the trek in one- to two-week blocks over the course of several years. Some folks also choose to focus on the last 100km from Saria to Santiago.

In any case, an average of 20km per day of walking is to be expected as some accommodations are that far apart. For comparison’s sake, a 2017 study published in Nature: International Journal of Science found the average Canadian walks less than 4km a day. On the Camino Francés, walkers are subjected to a variety of terrains. As one of my patients put it, “The Camino is a literal cornucopia of different walking experiences, from asphalt and crusher dust to pebbles to stones to rocks of non-uniform size and shape and spread along and up and downhill slopes of many different degrees and durations.” Needless to say, it’s not a walk in the park and can be taxing on both mind and body.  

There’s a profound expression on the trail, “The Camino provides.” It is often a boost to the state of the mind or body. Those who have been will tell you stories of moments on their journeys when the one thing or person they needed the most seemed to surface out of nowhere. A Band-Aid, a place to stay, a new friend… wine. The Camino truly provides what you need, even when you don’t know you need it yet. That said, it doesn’t hurt to prepare yourself well before your own journey. Here are some Pedorthic pointers to get you ready for your trek.

Consider your Footwear Options

Footwear considerations should be at the top of your to-do list. Unfortunately, there is no perfect pair of shoes or boots that is ideal for everyone who takes on the Camino. On the trail you’ll see walkers wearing everything from hiking boots to sneakers, sport sandals to flip flops, and even toe socks!

Work with your Canadian Certified Pedorthist well in advance to determine what your needs are related to your feet and the route you’ll be taking. Be sure to take into consideration the possibility of your feet swelling (this can be related to travel, heat, changes in diet, and more) and the type of socks you’ll be wearing. Play with different lacing techniques to figure out what will work best for you. (For lacing techniques check out this article.) I regularly recommend using a sturdy hiking shoe or boot and a pair of sandals, preferably with a strap that goes around the back of the heel, to change into after the day of hiking.

Get Used to Walking

Start walking at least three to four months before departure. Slow and steady build up is best as the body needs time to adapt and build up aspects of fitness like strength and endurance in the process. If you’re not accustomed to walking much at all, start with 30-40 minutes twice a week. A quick Google search populates an assortment of training plans. Don’t forget to incorporate the footwear and any gear you plan to use, and a variety of terrain and elevations to simulate what you’ll encounter on the trails.

Look into Orthotics

If you experience foot or lower leg pain that is increasing with training, you may need to provide extra support or cushion for your feet by way of custom or off-the-shelf foot orthotics. Consulting with a Canadian Certified Pedorthist – C. Ped (C) can determine if foot orthotics will help make for a more comfort, pain-free Camino experience.

Choose the Right Socks

Socks are right up there with shoes and orthotics when it comes to comfort in walking 20km a day. Use your training time to test different socks. Wool socks with extra padding under the heel and ball of the foot seem to be a favorite for hikers. Be sure to take enough pairs so that you have a fresh, dry pair as often as you need them. Some people benefit from changing their socks multiple times in the run of a day. You may also wish to incorporate compression socks. There are off-the-shelf and medical-grade compression options. Consult your Pedorthist to determine if either option would be suitable for you.

Put Safety First

A small First Aid kit is a must. Even if you didn’t get a single blister or damaged toenail while training, you’re still at risk for getting one while you’re on the Camino. Suggestions include Moleskin, blister Band-Aids, talc, scissors, nail clippers, and anything else your feet might thank you for. There are also some small pharmacies along the route where you can pick up some Compeed.

Invest in Some Walking Sticks

Walking poles or sticks are nice to have to distribute body weight and provide an added stability while walking for long distances or on tough terrain. You can purchase lightweight, collapsible poles prior to departure, or you can do as one of my patients did and pick up a walking stick that was left behind by another hiker.

 

By Jaime Nickerson, C. Ped (C), B.Sc. (Kin), Dip. Pedorthics

References:

https://en.wikipedia.org/wiki/Camino_de_Santiago

https://www.nature.com/articles/nature23018