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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


Foot Care and Self Care Go Hand-in-Hand

Summer is well underway and amidst all the outings, events and social gatherings you are likely attending, you may be finding it hard to find time for yourself. It is important in any season to take time to focus on self care, which includes caring for your feet as well. Taking a little extra time to ensure your feet are well taken care of will get you through this season and the ones to come!

Foot care is an important part of overall health care. If not done right, foot complications can arise and people definitely don’t want those! One way to ensure that you are taking good care of your feet is to educate yourself. Foot care is not very complicated and in fact can be done as a part of your regular daily routine. Here are a few tips for self foot care:

Wash your feet often. Keep your feet clean by washing them every day in warm, soapy water. While doing this, check if there are any red areas or sores on your feet. This is especially important if you have diabetes. There are changes that take place in your feet that you need to watch for every day in order to avoid those nasty complications that come from this disease! For more on how diabetes affects feet, read our blog article on the topic.

Dry your feet well. Dry your feet thoroughly after washing them, especially between the toes. Bacterial and fungal infections like athlete’s foot can develop in between the toes and drying the feet is an important way to keep from developing these conditions.

Moisturize and file. If your skin is dry, apply moisturising cream all over the foot, except between the toes. If you put lotion between the toes, it can help developing infections or other problems between the toes. Gently remove hard skin and calluses with a pumice stone or foot file. Do this when the foot is dry if you have diabetes and not after you have washed or soaked your feet. Work with the pumice in only one direction. If you rub in both directions, you could overdo it and cause soreness or ulcers in or around the calluses. You could also damage fresh skin underneath.

Cut toenails carefully. Cut your toenails straight across and never rounded, at an angle or down the edges. Make sure that the edge of the toenail is sitting on the edge of the toe past the nail bed. Cutting the toenails too short or improperly can cause ingrown toenails. Trim your toenails regularly using proper nail clippers. Seek the help of an expert if you have trouble doing this on your own.

Shoe shop in the afternoon. Have you been eyeing a new pair of sandals for awhile? Remember to buy them in the afternoon. Your feet can swell as the day goes on and if your shoes fit in the afternoon when you are active and doing activities, you can be assured they will fit correctly and be comfortable all day long. Be sure that the shoes fit the shape of your feet. When you take the insole out of the shoe and stand on it, no part of your foot should hang over the side of the insole. You will want to see about a thumb thickness beyond the longest toe for general wear. (When you walk, the foot expands. If the shoe is too short, your foot could rub against the end and be uncomfortable or cause and injury.)

Protect your feet in communal areas! Wearing flip-flops or pool shoes will help you avoid getting athlete’s foot and other foot infections when using public areas such as gym showers or swimming pools. Having said that, take care with flip-flops! Don’t wear flip-flops all the time. They don’t provide enough support for your feet and can lead to arch and heel pain if you wear them too much.

Wear appropriate footwear at work. Depending on the type of work you do, you may need to wear specialized occupational footwear with features like hard reinforced toecaps or anti-slip soles. If you wear high heels at work, don’t wear heels more than 2.5” high because the shoes need to be comfortable to work in. Also, be sure to wear comfortable shoes on your way to work and change into your heels when you get there. A note about high heels: You should limit your time wearing high heels because they can damage the feet if worn regularly. It is better to wear them just for special occasions. If you need to wear heels, try to vary the height of the heel.

Change socks daily. This should go without saying, but I’ll say it anyway. Changing your socks daily reduces smells that are caused by bacteria and other organisms that are on the feet. If you are live with diabetes, this is important because it reduces the chances of getting an infection. As well, look for socks made of cotton-polyester blend and have extra fibres to wick moisture away from the foot while you wear them. The correct sock allows your feet to breathe and help keep them at the right temperature. Wear socks that fit you as well. If you get socks with a narrow elastic band at the top, it can promote swelling in the foot. If you have diabetes, getting a seamless sock will be better for you because there is no seam to irritate the toes or the end of the foot.

Your local Pedorthist can give you more advice on caring for your feet, and because Pedorthists take a team approach to our patients’ health care, if something is out of our scope, we can recommend another type of specialist to see. A little self foot care can go a long way and will offer many benefits to help keep you active, on your feet, and enjoying life!

For more information on foot care, visit https://www.pedorthic.ca/foot-health/

By Jim Pattison, B.Sc, C. Ped (C)

 

References:

  1. Rao Li; Li Yuan; Xiao-Hui Guo; Qing-Qing Lou; Fang Zhaod; Li Shen; Ming-XiaZhang; Zi-LinSung 2014 “The current status of foot self-care knowledge, behaviours, and analysis of influencing factors in patients with type 2 diabetes mellitus in China” International Journal of Nursing Sciences Volume 1, Issue 3, September 2014, Pages 266-271
  2. Siti Khuzaimah Ahmad Sharon; Hejar Abdul Rahman; Halimatus Sakdiah Minhat; Sazlina Shariff Ghazali; Mohd Hanafi Azman Ong A self-efficacy education programme on foot self-care behaviour among older patients with diabetes in a public long-term care institution, Malaysia: a Quasi-experimental Pilot Study https://bmjopen.bmj.com/content/7/6/e014393
  3. NHS ND “Tips on foot care” https://www.nhs.uk/live-well/healthy-body/tips-on-foot-care/

 

 

 

 


The Importance of Choosing a Canadian Certified Pedorthist – C. Ped (C)

July is here and if you’re like me, you have just celebrated this great country of ours on Canada Day! As Canadians, I think we can all agree that Canada is a great place to live; it has some amazing things to offer all of us at any time of the year. Summer in particular is a coveted season for many of us: a time to get outside and enjoy the warm weather and take part in more physical activity than usual.

Being more active means that you need to think more about your foot and lower limb health: pain or injuries in the lower limbs or feet can not only affect your level of physical activity, but can deter you from being active in the first place. Worse still, attempting physical activity without considering your foot health can lead to pain and injury as well.

Your local Canadian Certified Pedorthist – C. Ped (C) – can help you stay on the right track when it comes to taking care of your feet when physically active. Here are five reasons why you should consider visiting a Canadian Certified Pedorthist near you:

  1. Your C. Ped (C) can help with many foot and lower limb problems

Canadian Certified Pedorthists provide excellent conservative care to their patients. They treat, manage and can even resolve many lower limb and foot issues including plantar fasciitis, bunion and toe pain, injuries related to sports or overuse, complications/pain from diabetes and arthritis, various pediatric conditions, and neurological and mobility impairments, just to name a few. A Pedorthist can also help with anything from a simple shoe fitting, to lacing techniques to improve your shoe fit and prevent blisters, to complex mobility challenges from a serious condition.

  1. Canadian Certified Pedorthists are highly educated and trained

Canadian Certified Pedorthists are one of the few healthcare professionals trained in the assessment of lower limb anatomy, and muscle and joint function. Pedorthists in Canada complete a unique diploma program at Western University that includes a practicum for hands-on training and specific education on foot orthotics and footwear. As a result, they have the skills and training to actually custom build and manufacture many of the devices they dispense, including custom-made orthotics and footwear modifications. Many clinics will also often have an onsite lab at the clinic where they practice, so they are able to make orthotics and adjustments to shoes in a timely manner.

  1. Canadian Certified Pedorthists must practice and abide by a strict code of ethics

Anytime you see someone’s name with C. Ped (C) beside it, you know that the person has been certified and is a member in good standing with The College of Pedorthics of Canada, a national, self regulatory body whose primary purpose is to protect the Canadian public who receive services from Canadian Certified Pedorthists. The College ensures that certified members are accountable to the highest standards of practice by enforcing ethical conduct. Through the Code of Ethics, the College achieves and maintains high standards of professional integrity toward clients, colleagues, partners, stakeholders and the public. Above all, protecting you, the patient, is the focus.

  1. Pedorthists are health care professionals recognized by private insurance companies

Your C. Ped (C) will provide and/or manufacture custom foot orthoses, custom made footwear, orthopedic footwear and footwear modifications to individuals. Often these services and products are covered by health insurance providers, which can lessen the financial burden on patients. The Pedorthic Association of Canada and its members value the profession’s relationship with Canada’s insurance industry. Insurance providers often consult with the Association so as to continually devote time and attention to guarding against insurance fraud.

  1. Your Canadian Certified Pedorthist is an important member of your health care team

When you visit a C. Ped (C), you know that you will receive the best care possible for your foot and lower limb condition. You can expect that he or she will work closely with other primary and allied health professionals to ensuring the highest quality of care. This includes working with your family physician, physiotherapist and sports medicine specialists. For more on Pedorthists as part of a team approach, read our previous article.

If you are living in Canada and are experiencing foot or lower limb problems, find a Canadian Certified Pedorthist near you who can provide exceptional care to get you “back on your feet” and enjoying the outdoors again!

To find a Canadian Certified Pedorthist – C. Ped (C) – visit the Pedorthic Association of Canada’s website to search for one today.

By Derek Gilmer, C. Ped (C)


Seniors’ Month: A Recap

In case you missed it, June was Seniors’ Month here at the Pedorthic Association of Canada! This month we shared information on the topic of aging and footcare. Here’s a recap of the what we shared this month:

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Pilates is an excellent activity for most seniors. If you’ve never tried Pilates this article will help you get started https://www.verywellfit.com/is-pilates-good-exercise-for-seniors-2704632

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Here are 8 reasons why you need to pay more attention to your feet as you age #aging #footcare https://www.verywellhealth.com/how-aging-affects-your-feet-1337806

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You’ve earned your retirement. Don’t let a fall ruin your plans www.pedorthic.ca/dont-let-a-fall-dampen-your-retirement/

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If your back hurts, the cause may be your feet https://www.pedorthic.ca/videos/sore-back-take-a-look-at-your-feet/

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While issues with our feet do not discriminate against age, there are a few conditions that become more common among older adults. Read on to learn more https://www.pedorthic.ca/4-common-conditions-associated-wi…/
#PACSeniors #CPedC #Pedorthist

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If you’re a senior, spending 30 minutes a day walking briskly on a treadmill will help maintain your mobility, balance and fitness. Try this treadmill workout plan https://www.verywellfit.com/treadmill-walking-for-seniors-3436652

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Most falls are preventable. These tips will reduce your risk #seniors #fallprevention  www.pedorthic.ca/dont-let-a-fall-dampen-your-retirement/

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Foot pain can be treated. Don’t let sore feet slow down your retirement plans https://www.pedorthic.ca/pedorthic-advice-for-retirement/

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Wondering how a pedorthist can help you? https://www.canadianliving.com/health/prevention-and-recovery/article/this-is-why-you-need-to-see-a-canadian-certified-pedorthist

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Custom foot orthotics can help alleviate foot, knee and back pain. Here’s Lori’s story https://www.pedorthic.ca/videos/patient-profile-custom-orthotics-for-back-pain/

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Even though June is coming to a close, it is important to consider why your feet need special attention as you age. If you’re a senior, or if you have seniors in your life, encourage them to make a Pedorthist part of their foot health care plan—find a local Pedorthist here.


4 Common Conditions Associated with Aging Feet (and How a Canadian Certified Pedorthist Can Help)

Estimates suggest that, on average, if you live to the age of 80 years old you will have taken enough steps to walk the Trans-Canada Highway between Victoria, British Columbia and St. John’s, Newfoundland over 20 times! That is a lot of ground covered on a pair of feet that must get us through a lifetime.

If you knew how many steps you would be taking in your life, would you care for your feet a little better than you are now? Maybe you already have a concern about your feet? While issues with our feet do not discriminate against age, there are a few conditions that become more common among older adults. Read on to learn more about them and how Canadian Certified Pedorthists – C. Ped (C)- can help.

Fat Pad Atrophy

We are all born with large fat pads in our feet. It is why babies’ feet are so cute and plump. When we learn to walk, these fat pads serve the purpose of cushion and shock absorption, reducing the amount of stress on the other soft tissues and bones of the feet. Unfortunately, as we get older, the fat pads begin to break down, thin out, and stop doing their job so well, otherwise known as atrophy. When this atrophy occurs, clients will often describe it as the sensation like they are walking directly on the bones of their feet, most commonly at the heel or ball of the foot. Not only is the sensation unnerving, it can also lead to other complications such as ulceration.

Treatment: To treat fat pad atrophy, a Canadian Certified Pedorthist may recommend supportive footwear with cushion in the areas where thinning has occurred. They may also design custom foot orthotics with extra padding applied to the areas that feel most like they are lacking natural cushion. The foot orthotic may also include features such as a deep heel cup to contain the fat pad under the heel or a metatarsal pad to take some pressure away from the ball of the foot.

Corns & Calluses

Corns and calluses are regularly grouped together; however, they are two unique changes that can happen to the skin of our feet. A corn is a dry thickening on the outer layers of skin with a hard, central core, about 1cm or less in diameter, and commonly found on the side of the 5th (baby) toe, on top of or between the other small toes, and on the bottom of the foot. The most common cause of corns is ill-fitting footwear. Similarly, calluses are formed by a thickening of the skin. However, calluses often appear in areas of high friction and pressure. They can range in size, even covering the entire bottom of the ball of the foot.

Treatment: To treat corns or calluses, a Canadian Certified Pedorthist may recommend better fitting footwear and can help you to choose shoes with a toe box that matches the shape (including depth and width) of the foot. If footwear isn’t the cause they may introduce pre-made or custom spacers to keep the areas separated. Custom foot orthotics can help to positively alter the mechanics of the feet such that pressure and friction can be reduced. Your C. Ped (C) can excavate or dig material out of the shoe or foot orthotic to accommodate a corn or thick callus.

Hammer, Claw & Mallet Toes

Hammer, claw, and mallet toe deformities each refer to a different orientation of the small joints in the lesser toes (toes two through five). They are often the result of an imbalance between the muscles that point the toes down and those that pull the toes up. They are exacerbated by footwear that is too tight and there is a higher occurrence of lesser toe deformities in women than men. Our small toes are meant to help stabilize the foot, and when this function is compromised it increases the risk of falling. This is especially the case among older adults, who have other risk factors for falls as well. Toe deformities are best treated early on when range of motion is still available in the joint.

Treatment: Because ill-fitting footwear is associated with toe deformities, a Canadian Certified Pedorthist will first make recommendations on features and fit to look for. In most cases, extra depth will be required in the toe box of the shoe. Neoprene or mesh can allow for more stretch over the toes compared to a leather or vinyl. Something as simple as having your shoes stretched can also be a big help. If you have a hammer, claw or mallet toe that is due to another problem with your foot your C. Ped (C) may modify an off-the-shelf device or make custom foot orthotics for you. An off-the-shelf or custom toe prop or crest can also be used to offload the tips of the toes in question; this is particularly useful if a painful callus has formed. (For more on conditions of the toes read https://www.pedorthic.ca/foot-health/toe-conditions/)

Osteoarthritis

While changes to the surfaces of our joints, also known as osteoarthritis (OA), can occur as naturally as getting wrinkles on our skin, people over the age of 55 are four times more likely to experience the effects of OA than those in younger age groups. OA can also be brought on by a history of injury and generally poor alignment of the joint. The most common areas of OA in the feet occur at the big toe joint, the ankle, subtalar joint, and midfoot. (For arthritis myths debunked read https://www.pedorthic.ca/pedorthics-arthritis-debunking-common-myths/)

Treatment: Those who are living with OA in their feet or other joints are encouraged to remain active with low impact activities. Depending on the affected joint, your Certified Canadian Pedorthist may recommend footwear features such as a stiff rocker to help reduce painful range of motion and quickly propel the foot during the gait cycle. Custom or off-the-shelf foot orthotics are a conservative treatment that can be used to alter motion and loading of the joints. Selection of the materials a C. Ped (C) might use for someone experience pain due to OA in the foot or ankle will be dependent on what is found during the assessment and could be anything from soft foams to rigid plastics.

To learn more about foot conditions that could be affecting you and your mobility, visit our website to find a Canadian Certified Pedorthist near you visit https://www.pedorthic.ca/find-a-pedorthist/

By Jaime Nickerson, C. Ped (C)


June: A Focus on Seniors

June is Seniors’ Month and Canadian Certified Pedorthists – C. Ped (C) – across Canada are ready to deliver top tips and advice on how to help your feet age gracefully. Here are some facts about seniors and footcare to start off the month:

  • According to the 2016 Census the population of seniors now outnumber children in Canada 5.9 million to 5.8 million. It is anticipated that the scale will continue to be tipped for years to come.
  • Though frequency of health problems rises with increase in age, over half of seniors report they are in “good health”, defined by the World Health Organization as “a state of complete physical, mental and social well-being.”
  • As such, seniors are maintaining an active lifestyle for longer and they’re remaining in the workforce longer.
  • Age-related foot problems include fat pad atrophy (breakdown), boney deformities such as hallux valgus and bunions, hammer, claw or mallet toes, neuromas, corns, callouses, nail disorders, arthritis, reduced circulation, and peripheral neuropathy. These problems can lead to discomfort or pain.
  • Canadian Certified Pedorthists – C. Ped (C) – can help to determine helpful approaches to alleviate the discomfort associated with these conditions through assessment and implementing a treatment plan that could involve thorough shoe fitting, off-the-shelf or custom orthopaedic shoes, off-the-shelf or custom foot orthotics, compression socks, bracing, toe props or spacers, and more.

Quick tips for footcare:

  • Develop a habit of checking your feet daily. If you have trouble seeing your feet, it’s important to get someone to look at them for you or use a mirror.
  • When possible, choose footwear that has an adjustable fit instead of slip-ons. Laces, buckles, and Velcro straps can accommodate conditions such as painful boney prominences, swelling, and toe deformities.
  • Consult your health care provider if the texture, colour or temperature of any part of your feet change.

Be sure to check back frequently this month as we share more tips and facts about aging and footcare!


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