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Pedorthic Pointers for Neutral Arches

A normal, or neutral arch, is defined as an arch that is neither flat nor high. Often a neutral arch is also normal in its characteristics, such as having a normal range of motion in the different joints of the foot and at the ankle. At first glance one might think that this foot would be pain free but this is not necessarily the case.

A neutral arch put under abnormal stresses will still falter. After about 6 hours of time on our feet, the muscles in the lower legs and feet fatigue and become overused. When this occurs, the muscles have to work harder to do the same job as they were previously. For example, the tibialis posterior, which helps control the motion in the arch, can’t do its job in the same way and therefore more motion will occur through the arch as we walk. Generally, this occurs as overpronation through the midfoot. As the arch collapses the other muscles in the lower legs have to work harder to do their job. Also, muscles higher up the leg try to compensate and rotate the leg in the opposite direction. This can lead to knee pain or IT band tightness.

Often people think they have a neutral, or normal arch, but in fact when they stand the arch collapses and in turn when they walk overpronation occurs and the foot acts like a flat foot. Check for callusing on the side of the big toe which may indicate your foot is overpronating when you are walking. Another sign that there is too much motion occurring in your gait is callusing on the tips of the toes. To help stabilize the foot our toes grab the ground to create a more stable base.

If your neutral foot has limited range of motion, this may mean that your foot doesn’t absorb shock well. When a foot doesn’t absorb shock, the ground reaction forces that should be absorbed through the foot transfer up the chain. You may find that you experience ankle pain or shin splints that can occur when there is not proper shock absorption happening at the foot. While the knees and low back are further up the chain, they can certainly be affected by what is happening, or not happening, at the foot level.

Recommended Footwear

Footwear recommendations for a neutral arch will vary depending on the way that the foot acts when you walk. One feature that is recommended is a heel counter. A heel counter helps hold the heel in place. A strong shank is also important. The shank stiffens the middle of the shoe and makes it resistant to bending and twisting.  Shoes used for walking or running should also have ample cushioning. Cushioning provides protection and shock absorption for the feet. A Canadian Certified Pedorthist can help you determine which shoes are right for you and if an issue arises from your foot type, a Canadian Certified Pedorthist can give recommendations to help you move more comfortably.

Benefits of Orthotics

If you experience pain or discomfort in your day to day lifestyle or during activity, you may consider off the shelf insoles or custom made orthotics. These devices help to control excessive motion as well as absorb shock. Custom made orthotics can be made from a variety of material which is chosen to provide you and your feet with the best features to treat your specific issues.

Schedule an appointment with your local Canadian Certified Pedorthist to learn more about your foot type and what footwear and treatments are best for you.

By Jasmine Basner, C. Ped (C)

 


Your Foot Type Speaks Volumes About You

Did you know that there are multiple foot types? Have you ever compared your arch to your friends and family? If you have, you may have noticed different arch shapes between people. In a broad sense, we tend to categorize arches into three different foot types: pes planus, pes cavus and a normal arch. Each foot type has its own set of issues that can develop.

Pes Planus (flat foot)

Pes planus is the medical term for a flat foot/low arch. This is probably the most common foot type a Pedorthist will see in their clinic.

There are varying degrees of pes planus from mild to severe. Milder pes planus foot types have a low arch that is much lower to the ground than what is considered normal. A severe pes planus is the easiest to recognize because this arch is completely flat on the ground. The more severe the pes planus, the more likely that a bone on the inside of the foot will start to protrude out.

This foot type can lead to pain in different parts of the lower limb. Pain can develop on the bottom of the foot because as the arch flattens, it pulls all the structures under the foot/arch. The inside of the foot and ankle can also be affected because the ankle will also roll in, straining the structures trying to keep the arch in a normal position. The knee, hip and lower back can also be affected because when the foot rolls in, the lower and upper leg also roll in.

Callusing may also develop with this foot type due to excessive pressure where there shouldn’t be. Common areas of callusing are the inside of the big toe and the bottom of the arch. Toeing off of the inside of the big toe is common for the pes planus foot type, creating pressure and a callus. As mentioned earlier, the bone on the inside of the foot may protrude out. This bone may start to rub on a shoe or the ground, creating a callus (rough skin) or redness.

A bunion is another common issue that may arise with this foot type. If constantly toeing off of the inside of the big toe, the pressure can gradually push this toe towards the rest of the toes, which can lead to a bunion.

Pes Cavus (high arch)

Pes cavus is the medical term for a high arch, the opposite of pes planus. This arch is considered higher than what would be considered normal.

This foot type may lead to pain in the feet, knees, hips or lower back. If the foot is rigid, there may be an issue with shock absorption. The foot should naturally move slightly to absorb shock. Without this shock absorption, another area of the lower limb may absorb this additional shock and lead to pain. If this foot type is combined with a flexible foot, issues may arise with excessive motion because the arch has a longer distance to travel.

With a high arch, more pressure is put on the points at the ball of the foot and the heel. This may lead to callusing in these areas. The additional pressure on the ball of the foot may also lead to a shift in the fat pad as well as a collapse to the arch at the ball of the foot. Clawed toes may also develop with the shift and the collapse of the ball of the foot.  

Normal Arch

A normal arch is in the middle of pes planus and pes cavus, which is not too low and not too high.

Even with a normal arch, issues may still arise. If the foot is very flexible, the normal arch may become a flat foot when standing. This can lead to similar issues as a pes planus foot type. Sometimes there may be muscle imbalances or other issues in the lower limb which are affecting the feet.

Treatments

Custom made foot orthotics are commonly used to address issues originating from your foot type. They help to control excessive motions, absorb shock and address issues at the level of the feet. In the case that muscle imbalances or other issues are causing pain, support may be used in the treatment plan to accelerate or aid the main treatments.

Proper shoes are important to complement an orthotic device as well as provide support and prevent exaggerating issues from your foot type. Look for footwear with the appropriate support for your foot type without overcorrecting. A Canadian Certified Pedorthist can help you determine which shoes are right for you.

If an issue arises from your foot type, a Canadian Certified Pedorthist can give recommendations based on many factors, including your foot type and complaints.

By Julia Hayman, C. Ped (C)


Best Shoes for Indoor Workouts

In the winter, indoor workouts tend to be appealing to more people. While working out indoors, shoes are still an important consideration. Wearing the proper shoes is one of the best ways to avoid injury, even while exercising indoors.

Shoes can be easily forgotten during indoor workouts because not everyone will be walking all day in their athletic shoes. Rowing, cycling and weightlifting are some activities that may be performed without much thought in regards to footwear. However, these activities increase the demand on core muscles. This higher demand to the core will in turn shift the feet to absorb and support the change in body positions. Performing these activities barefoot may strain calf muscles and soft tissues in the feet. When overworked, you may experience pain and could strain a muscle. This may require weeks or even months of rehabilitation to correct, so prevention is the best medicine.

When looking for an appropriate shoe indoors, running shoes are a great choice as they work well for most activities. They are light weight, promote forward motion of the feet and contain many other features to help avoid injury. Here are a few great features to keep in mind:

Cushioning

A cushioned sole is great indoors, especially while on a treadmill or a hard surface. Cushioning will help to decrease pressure on your feet and legs during exercise. The shoe will help to absorb shock that the body may take on as a potential injury. Cushioning becomes very important during high impact activities, such as plyometrics, HIIT (high intensity interval training) and other jumping activities. If your feet and legs typically perform these exercises with shoes, they are not adapted to perform these exercises while barefoot.

Heel Counter

Another shoe feature that is highly recommended is a heel counter. The main purpose of the heel counter is to absorb the ground reaction forces when the foot makes contact with the ground. It also helps to prevent your heel from moving around excessively. Protecting the heel is important to reduce injury to the heel and the structures interacting with the heel. To test for a good heel counter in your shoe, push down on the back portion of the shoe. There should be some resistance, otherwise the heel counter is absent.

Arch Support

High impact workouts place higher stresses on the feet and require features that complement the exercise being done. In addition to cushioning to provide shock absorption, arch support is also important to avoid putting yourself at risk for injury. This arch support can be found in a couple different ways.

First, take a look at the stiffness at the midsole of the shoe (thick sole area). When the shoe is extremely flexible in the midsole, it increases the workload on your arch. Your arch contains your plantar fascia and other connective tissues, which are common areas of injury. Stability in the midsole is also important for side to side movements, as it will help to control motion in the legs and avoid injury to your ankles and knees.

Additional arch support through a foot orthotic may be necessary if the shoe is not enough. A foot orthotic helps to control excessive motion related to the way your feet are moving. An assessment with a Canadian Certified Pedorthist can help you determine if additional support is necessary.

 

Adjustability

While slip on shoes can be appealing for the ease of use, footwear with adjustability, like laces or velcro are always recommended. An adjustable closure will provide a more comfortable fit. Your feet can swell and change shape during the day, which can affect your shoe fit. An adjustable closure will help with shoe fit, even if your feet are slightly swollen. It also helps to keep your feet in place to reduce the risk of rubbing or slipping in the heels.

Remember to consider cushioning, a strong heel counter, arch support and adjustability as ideal features for your indoor workouts. These features are a great place to start when looking for shoes! In addition to these features, there are different styles that work better with flat feet versus high arches. A Canadian Certified Pedorthist will perform an assessment of your feet and legs to help determine what shoe would be most important for you. They will also give you recommendations on which of the above features are most important, and if any others would be beneficial. Visit your local Pedorthist to get a jump start on finding the best shoe for your indoor exercise routine.

By Kathrine Simpson, C. Ped (C)

 


Pedorthists can Help you Achieve Goals for a Healthier 2021

Did you kick off the new year with a resolution to be more active? Healthy feet and lower limbs have a huge impact on your overall wellness and mobility. Make an appointment to see a Canadian Certified Pedorthist as a part of your resolution to be healthier in 2021. If you’ve never seen a Pedorthist before – click here to find one near you.

What can you expect from your first appointment with a pedorthist?

What to bring & wear:

  • Shoes you primarily wear for different activities – for example your running shoes, everyday walking shoes and shoes you wear to work
  • A prescription from your doctor if you have one
  • Details about the pain you may have and when it occurs and what it feels like. Write down descriptions of the pain or discomfort you’re having in the weeks leading up to your appointment so you can provide as accurate details as possible
  • Wear shorts or loose-fitting pants that can be easily pushed above your knees for the assessment

Topics for discussion:

Your Pedorthist will ask you many questions including:

  • Where and when is your pain and discomfort?
  • What activities you do and what footwear you use in those activities? The activities you take part in may be related to your foot problems
  • Related medical issues? For example, if you have diabetes or broken bones with pins in, it will affect how well you move and what kind of pain you will have.

Your Pedorthic assessment will include:

  • The Pedorthist will examine your shoes for fit and the pattern of wear on the shoes
  • Assessment of your foot type
  • Your feet and legs will be examined to see how much motion is found at certain joints and to see where the pain might be found in the feet and legs.
  • The Pedorthist will watch you walk or run. How you walk can be causing some of your troubles and could be compensating for the pain that you have 

Finally, if the Pedorthist recommends custom orthotics for treatment, a copy of your foot will be made to make the orthotics to the exact specifications of your feet. This is called “casting” and it can be done with casting foam, plaster or with a 3-dimensional scanner. Once your custom orthotics have been made by your Canadian Certified Pedorthist (usually at their on-site lab) you will be asked to come back to get your orthotics. At this point you will get a chance to try the orthotics in your different shoes and have any minor adjustments made before taking them home to start wearing.

Your Pedorthist may also recommend purchasing new shoes and can help you find the perfect model and fit for your feet. The shoe fit is important for comfort and being pain free. There needs to be enough room at the toe for length and width to fit your feet and the orthotics. The shape of the shoe also needs to fit the foot properly to avoid rubbing and friction issues.

For more information about your first visit to a Pedorthist, watch this video.

By Jim Pattison, C. Ped (C)


Work From Home Foot Health

As this New Year rolls in, many Canadians are either starting to or continuing to find themselves working from a new office; their homes. While the commute is great, there are some things to keep in mind that will help keep you and your feet healthy and happy.

If you normally work outside of the house, your feet will be used to wearing socks and footwear which provide you with both cushioning and support. Sitting and walking around your house in bare feet is quite a shock and can have a negative effect on your comfort levels. Imagine going from 8+ hours a day of support to a sudden drop off; the intrinsic muscles in your feet are suddenly being asked to do a lot more work than they are used to.

If you are experiencing aches in your feet or even in your lower legs after a couple weeks or months of being at home, the lack of footwear may be the cause. Step one will be to choose a pair of soled footwear: slippers, sandals or shoes will work. Soft soled or knit slippers do not offer the stability that your feet are seeking. Check that the footwear is strong and stable through the midsole and if you are spending blocks of time on your feet, 30 minutes or more, consider grabbing a pair of runners or adding an insole to your indoor footwear.

If your job has you sitting from morning until night then you should be checking your feet and ankles for signs of swelling. When you do not walk more than a couple steps in a row, the blood has a difficult time being pumped up against gravity. Normally the calf muscle acts as a pump to keep the blood flowing well. Compression socks are a useful tool that aid blood that has been pumped to your extremities back up to your heart. Compression socks come in different compression levels along with different styles and materials to match your needs. It is always suggested you talk to someone with experience before starting to wear compression socks. It is also a great idea to set a timer/schedule time for some 5-10 minute breaks that allow you to get up and walk around the house…or even better a quick stroll around the block.

You may find that after sitting for an hour or more, you have some stiffness when you do get a chance to stand. Try a couple gentle ankle twists and knee flexes, some soft movements while seated to help your feet and legs prepare for you to stand. If you have slipped off those indoor shoes then remember to slip them back on before you get up from your desk. These small and simple steps can go a long way in keeping you pain free.

If you are finding yourself glued to your seat for most of the day, there are different tools that you can use while at your desk. Foot massage balls, foam rollers, calf stretchers can all be used in a seated position and may be helpful for you.

Canadian Certified Pedorthists are working within the new COVID-19 protocols and are happy to provide you answers to questions or concerns you may have about your feet and legs and how to keep your feet happy and healthy while working from home. To find a pedorthist near you visit www.pedorthic.ca/

By Jasmine Basner, C. Ped (C)


New Year’s Resolutions – Don’t Forget Your Feet!

A new year tends to bring on new exercise routines! The gyms (when open) get busier in January and February, but by March, pain tends to provide a good excuse to move on from the resolution. To help prevent the resolution from falling off by March, it is important to take care of your body in the beginning stages of the routine! Your feet are very important when beginning an exercise routine because they can affect other parts of your body!

Exercise

Specifically looking at the exercise routine, it is important to start small and gradually build the intensity and duration of the exercise. It is similar to running a full out sprint without warming up the body; you are very likely to hurt yourself. To ensure you are appropriately building the intensity, it is a good idea to talk to someone who has more knowledge about building exercise routines.

In addition to the exercise, stretching regularly helps to prevent injury. Building muscle can shorten the muscles. If muscles are continually shortened at one area, and not on the opposing muscle, this can create an imbalance. Because imbalances can also come in different ways, it may be beneficial to speak with a physiotherapist or chiropractor to address your specific condition.

Get your feet checked

An imbalance can originate from the feet. When starting a new exercise routine, the proper support becomes more important even if you haven’t been in pain previously. Pain can develop from a specific event or can accumulate over time. Exercise puts more stress on the body, which can exaggerate any gait abnormalities or imbalances already present.

Also, look at signs of pressure, especially in the first few months of starting the new exercise routine, or when changing up your regular exercise routine. Signs of pressure can be seen as redness, calluses (thick skin), corns or bruising. These pressure points may worsen if not dealt with.

Footwear

Wearing the proper shoes is also important. First, the correct type of shoe can make a difference. A casual or dress shoe will not provide the appropriate support, fit and cushioning for an exercise routine. If your exercise does not involve high impact or running exercises, a walking shoe can be appropriate. A walking shoe will have a wide and solid base for increased stability. A running shoe is very popular for exercise because it is a lighter shoe and can be used for any type of exercise. These running shoes come in different levels of support: neutral and stability. To determine which one is best for you, talk to your local Canadian Certified Pedorthist. There are also sport specific shoes which have the appropriate features for the specific activity they are meant for.

The proper shoe fit is also important to prevent excessive motion or compression in the feet. Make sure the length, width and depth are all appropriate for your feet. Your local Canadian Certified Pedorthist can also help you with the appropriate shoe fit. When the shoe fit is not appropriate, blisters, redness or other signs of pressure and shear can develop.

Once you have the appropriate shoes for your feet, your work isn’t complete! Make sure to check for wear on the shoes. Even the best shoe will wear down and lose its support. The lifespan of a shoe varies from each person and the type of shoe worn, but shoes typically last between six months to a couple years. If you are quite active, make sure to monitor your shoes very frequently. Signs of shoe wear can be seen at the bottom (sole) and at the midsole (above the sole). Look for the sole starting to wear down, and creasing on the midsole. Another sign that the midsole is wearing down, is to look for the front of the shoe (toe) bending upwards.

For more information about your feet and footwear, talk to your local Canadian Certified Pedorthist!

By Julia Hayman, C. Ped (C)


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