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Why Lacing Matters

From an early age we’re taught the importance of keeping our shoelaces tied, and if we didn’t listen to this advice we quickly learned why it is not safe to run around with untied laces. Tripping hazard aside, tying your shoelaces is very important as it affects how your footwear fits and functions. Different lacing techniques benefit different foot types. Here are some guidelines to help you determine which technique is best for you:

Standard Feet

If you have standard-sized feet and don’t suffer from any foot issues, the traditional criss-cross lacing technique will likely be most appropriate for you as it will hold your feet snugly in place in your shoes. For this technique to be effective, you need to pull your laces securely, starting with the eyelets at the toe of the shoe and working your way up towards your ankle. If you use the criss-cross technique but continually leave your laces tied so your shoes are loose enough to slip into, the benefits of the technique will be lost and your shoes will not provide the support they are designed to, even if they are the correct size.

Narrow Heels

If your heel slips in the back of your shoes, you can keep it in place by using a lock lacing technique which tightens the shoe around the heel and ankle, preventing your heel from slipping. To do lock lacing, simply lace your shoes as normal to the second from the top set of eyelets. Then, instead of running your laces across the shoe, thread each straight up through the eyelet above it. Next feed each lace through the vertical loop between each of the top two eyelets opposite from each other and tie the laces as normal. This video shows how to do lock lacing.

Wide Feet

If you have wide feet, you’ll want to make as much space as possible in your shoes for your feet. To maximize space, lace your shoes using the eyelets that are nearest to the ankle, leaving the eyelets closest to your toes empty.  This will allow you to tighten the laces properly without restricting the space across the front of the shoe where the foot is widest.  

High Arches

If you have high arches, the top of your feet may become rubbed by the tongue as your arches force your foot against the top of your shoes. To reduce the risk of this, try gap lacing which minimizes the pressure on the top of your foot but still ensures your shoe fits securely. To do gap lacing, simply lace your shoes using the traditional criss-cross technique until you reach the middle of the shoe or the area of your foot which is being rubbed. Instead of continuing the criss-cross pattern, thread the laces directly into the eyelet above them and then continue criss-crossing up the rest of the shoe. This video shows you the gap lacing technique.

Lacing Tips

Regardless of the shape and size of your feet, these lacing tips will help ensure you get maximum benefit from your shoes:

  • Always loosen your laces before you put your shoes on. Forcing your feet into shoes with tied laces will stress the eyelets and the backs of the shoes, creating unnecessary wear.
  • To get the best fit, always start lacing your shoes at the eyelets closest to your toes and tighten the laces one set of eyelets at a time.  
  • When buying shoes, select shoes that have the most eyelets. This will enable you to easily adjust the laces to ensure the shoe best fits your foot.
  • Remember to adjust your laces throughout the day. Feet expand with activity and temperature so you’ll need to loosen your laces as the day progresses.
  • When lacing your shoes, make sure the laces are lying flat as twisted laces may rub the tops of your feet.

Canadian Certified Pedorthists are footwear experts. If you’re not sure which lacing technique is best for you, ask your Pedorthist at your next appointment.

By Heather Orosz, C. Ped (C), Calgary, AB

 

 


Shoe shopping should be done in-person, not online

Online shopping is a wonderful time saving tool that continues to grow in popularity. The convenience of being able to order the products you need at any time of day or night and have them shipped directly to your door is invaluable. However, when it comes to footwear, online shopping is rarely a good decision. 

Wearing properly-fitted footwear is important for your comfort, mobility and overall well being. Ill-fitting shoes can cause numerous problems including bunions, hammertoes, blisters and ulcerations as well as balance issues. In addition to proper fit, wearing the right type of shoe for your individual foot and biomechanics, lifestyle and daily activities is important. Only a professional shoe fitter who is able to see and measure your foot and discuss your lifestyle with you can accurately recommend the most appropriate type and size footwear for you.

Few people realize that our feet can change in size over time. As we age, our muscles and joints relax which can cause our feet to increase slightly in width or length. Aging, sports and lifestyle factors can also lead to the fat pads on the bottom of our feet becoming thinner and calluses, corns, bunions, hammertoes and other sensitive areas developing. All of these factors have a direct impact on the size and style of footwear you require. Having your feet professionally measured at least once a year is important as your shoe size may have changed even if your feet look and feel the same.

Regardless of whether your feet have changed sized, different brands of shoes fit differently. A size 7 may fit you perfectly in one brand of shoe but a 7.5 or 8 may provide the correct fit for another brand. You can only gauge a shoe’s fit and comfort by trying it on and walking around in it.

When you purchase shoes online, there is no opportunity to measure your feet accurately. Although some online retailers provide a sizing guide these are very general and cannot replicate in-personal, professional measuring. Compounding the sizing issue is the growing problem of vanity sizing. Like clothing manufacturers, some shoe manufacturers label larger products with smaller sizes, which makes it very challenging to order the right size.

Costly returns are another reason buying correct fitting footwear online is difficult. As online shoe retailers are continually searching for ways to decrease returns, they are increasingly selling shoes that are marginally larger than the requested size. Shoes that are too tight are returned but shoppers tend to keep shoes that are too big and use insoles or thick socks to improve the fit. Fast fashion has driven the demand for offshore, mass produced shoes. Although different populations have different shaped and sized feet, mass produced shoes are created for universal sizes. The result is footwear that doesn’t fit anyone well.

When it comes to footwear, save online shopping for the pair of shoes you only plan to wear occasionally. For all of your everyday needs, visit a local shoe retailer in your community and have your feet properly measured. If you are experiencing ongoing foot pain, have mobility issues or are living with diabetes or arthritis, book a full assessment with a Canadian Certified Pedorthist.

By Derek Gilmer, C. Ped (C), Ottawa, ON


Cycling orthotics can improve your performance and your comfort

As cycling doesn’t require you to bear any weight on your feet, you may be surprised to learn that foot orthotics can make a significant difference to both your performance and comfort. How can foot orthotics help in a sport where your feet never touch the ground?

Our central nervous system does not clearly recognize our feet while cycling. When we walk and run the pressure on the band of muscle on the bottom of our feet sends feedback to our brain. However, when we cycle there is little or no change in the pressure on this band of muscle so our bodies are not keenly aware of the part of the body that is responsible for transmitting the power we produce to the bike.

Both over-the-counter or custom-made foot orthotics can solve this problem by creating some contact between the insole of your cycling shoe insole and the arch of your foot. The arch support, provided by the orthotic, helps give your central nervous system more complete or better-quality information about load, position in space or relationship to gravity of your body. This in turn enhances your ability to globally coordinate your actions. Today’s cycling shoes are designed to help you cycle further and faster but they also put significant force on a small, unstable area of your foot. This is why foot orthotics, specifically designed for cycling, can make a huge difference.

Orthotics that are designed for your cycling shoes can look and function differently to orthotics that are designed for weight bearing activities and may not be able to be transferred to other sports shoes. As cycling places stress on the forefoot, cycling orthotics typically have a very low hindfoot profile. Frequently made from supportive, yet light weight material, cycling orthotics are designed to distribute pressure over a wider area, support your arch and re-align your foot structure. A foot that overpronates because of an issue with the front part of the foot, will likely benefit greatly from custom made foot orthotics in a cycling shoe. In addition to making your foot more comfortable, your cycling orthotics will help re-align your lower limb mechanics and therefore maximize the power that is transferred through your feet to your pedals.

If you experience knee, arch or forefoot pain or foot numbness during or after your rides, consult a bike specialist to make sure your bike is properly adjusted to fit you. If your bike fits and you are still experiencing any of these symptoms, book an appointment with a Canadian Certified Pedorthist. Be sure to take your cycling shoes with you to the appointment. Your Pedorthist will assess your foot structure, biomechanics and cycling shoes and then recommend a treatment plan. If foot orthotics are recommended, your Pedorthist will design, manufacture and fit them so you can achieve maximum performance and comfort.

By Shannon Gordon, C. Ped (C), Calgary, Alberta


What is a pedorthic assessment?

Pedorthic assessments are one of the most important aspects of my work and a considerable portion of my weekly clinic time is devoted to them. Many patients come to my clinic with persistent and unexplained foot, ankle, knee, hip or back pain. A complete and thorough pedorthic assessment enables me to determine if the pain they are experiencing is related to poor foot structure or biomechanics. At the end of the assessment, I am able to clearly explain their medical condition to them and to recommend an individualized treatment plan that addresses the causes of, and contributing factors to, their condition rather than just the symptoms.

All Canadian Certified Pedorthists conduct similar assessments; we evaluate your lower limb anatomy, muscle and joint function, as well as the interaction of your feet and lower limbs with the rest of your body. If you have an upcoming pedorthic assessment or are trying to determine if you should schedule one, here is what you can expect:

What to bring:

On the day of your assessment, dress in loose clothing or shorts so your Pedorthist can easily examine your feet and lower limbs and wear, or bring, your everyday footwear with you. Walking or running shoes are ideal. Make sure the footwear you bring is well worn as your Pedorthist will look closely at the wear pattern at the top, bottom and insole inside of your shoes as part of the assessment. If your assessment was booked following a referral from your physician, also bring the prescription your physician provided.

What to expect:

A pedorthic assessment typically takes between 30 and 60 minutes. Your Pedorthist will begin by taking a thorough history to identify patterns and expose causes of your pain. Questions will probe:

  • Symptoms
  • Previous injuries
  • Family history
  • Systemic diseases
  • Lifestyle and activities
  • Occupation
  • Footwear

Following the history, your Pedorthist will perform a series of weight bearing and non-weight bearing tests including:

  • Testing the joint range of motion in your feet and ankles to make sure that each joint moves in its full range
  • Testing the strength of certain muscles
  • Checking to see the type of foot you have: normal, flat or high arched
  • Identifying any boney prominences, swelling, discolouration
  • Examining the alignment of your knees and lower back
  • Analyzing how you walk and run particularly the position of your foot at each phase of the step

Treatment:

Your Pedorthist will analyze the findings of each aspect of the assessment and will recommend a treatment plan to address your condition. Depending on what your assessment reveals, your treatment may include:

  • Custom-made or over-the-counter foot orthotics
  • Stretching and strengthening exercises
  • Different style or brand of footwear or possibly modifications to new or existing footwear
  • Ice therapy
  • A recommendation to consult with another healthcare professional such as a physiotherapist, chiropractor or a massage therapist

Like all pedorthic treatment plans, your individualized plan will be designed to help alleviate pain, improve your mobility and enhance your quality of life.

If you are experiencing pain in your feet or lower limbs don’t ignore it or assume it is something you have to live with. A pedorthic assessment will provide you with valuable insight into its cause as well as a plan to address it. To schedule a pedorthic assessment you can either contact a Canadian Certified Pedorthist in your community directly or ask your healthcare practitioner for a referral.

By Steve Stredulinsky, C. Ped (C), Edmonton, AB


Numb, tingling or painful feet should not be ignored

If you’re experiencing numbness, loss of feeling or stabbing/burning pain in your feet and hands you may have peripheral neuropathy. Peripheral neuropathy – damage to your peripheral nerves – is a condition Canadian Certified Pedorthists see frequently as it can have a significant impact on the health of your feet and your mobility.

Individuals who have peripheral neuropathy are at increased risk of falling as the lack of sensation, loss of coordination and muscle weakness make it more difficult to move around safely. They’re also at increased risk of serious foot wounds and ulcers as the reduced sensation makes it difficult to feel a small injury developing. Left unnoticed a small rub, blister or nick can quickly become a difficult to treat wound.

Although peripheral neuropathy is commonly caused by diabetes there are a wide variety of other causes including: traumatic injuries, alcoholism, vitamin deficiencies, exposure to toxic substances, infections, diseases, genetics and more. If you have any of these risk factors and are experiencing any of the symptoms above, consult your family doctor and add a Canadian Certified Pedorthist to your healthcare team.

If you have peripheral neuropathy, these safety tips will reduce your risk of developing a serious foot wound or having an accidental fall:

• Inspect your feet daily for abnormal redness, rubs or blisters. If you have trouble bending, use a small mirror to inspect the bottom of your feet.

• Always wear properly-fitted, supportive footwear. Footwear that is too tight will pinch and cause blisters and irritations. Footwear that is too loose is a tripping hazard.

• Book a consultation with a Canadian Certified Pedorthist. Your Pedorthist will do a full assessment and determine if you require foot orthotics or different footwear to ease the pressure on sensitive areas of your feet.

• Avoid putting hot water bottles on your feet and always check the temperature of your bath with your elbow before getting in.

• To protect your feet, wear shoes indoors and outdoors;avoid slippers inside your home. Purchase a pair of supportive, well-fitting shoes for use at home.

• Keep moving. Exercise regularly and avoid sitting down for long periods of time.

As with many healthcare issues, peripheral neuropathy requires the support of your full healthcare team; working closely with your family doctor and Pedorthist will ensure you stay healthy and can continue to participate in all the activities you enjoy.

By Alyssa Milton, C. Ped (C), Cambridge, ON


High heels should be an employee’s choice

In October, Ontario MPP Cristina Martins introduced a private member’s bill to prevent employers in Ontario from requiring workers to wear unsafe footwear (specifically high heels) to work. Ms. Martins says high heels should not be a requirement of an employee’s uniform or dress code; it should be employees’ not employers’ choice whether they wear them. Earlier this year, British Columbia adopted similar legislation banning mandatory high heels at work.

I applaud Ms. Martins and British Columbia for taking these important steps. High heels can cause foot, back and knee injuries and no employee should be required to wear them. High heels force your weight onto the ball of your foot, a part of your body that is not naturally designed to bear weight. Shoes that lift your heels, also shorten your calf muscles. To prevent you from toppling forward, the muscles in your knees, hips, pelvis and lower back are forced to work harder than normal. The higher the heels and the more frequently you wear them the greater the pain and the risk of long term damage to your body.

Employers in industrial workplaces or construction have strict guidelines in place to protect their employees’ feet from workplace accidents and steel toed safety shoes and boots are the norm. Healthcare facilities have similar requirements; it would be absurd to see healthcare employees in anything other than soft soled, supportive shoes to help them through the long days they spend on their feet. Why then should our standards be different for women working in the hospitality industry who spend equally long periods on their feet?

If you choose to wear high heels, for work or pleasure, I recommend the following:

  • Select heals that are 2.5 cm or less and have a solid, wide base. This will maximize your support and reduce the pressure on the ball of your foot.
  • Limit heels higher than 2.5 cm for special occasions such as weddings or parties. When purchasing higher heels select ones that have a platformed forefoot and incorporated toe spring as they will provide some cushioning to the ball of your foot.
  • Avoid heels that have very narrow toes; look for styles that accommodate your foot’s length and shape. If your high heels don’t fit well you are at risk of developing corns, bunions, blisters and even nerve damage.

When it comes to high heels, Canadian Certified Pedorthists recommend balancing style and comfort. If high heels are part of your personal style, follow the tips above to reduce your risk of injury. However, nobody should be told they must wear high heels to work. It’s time for Ontario to adopt legislation that protects workers’ feet in all industries.

By Amy Chapman, C. Ped (C), Kingston, Ont.


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