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Managing Arthritis Day-to-Day: How Canadian Certified Pedorthists can help you improve your quality of life

September is Arthritis awareness month and many Canadian Certified Pedorthists across the country see people every day that struggle with foot and lower limb pain as a result of their arthritis. Arthritis is a collection of conditions affecting the body’s joints and other tissues. It can cause pain and inflammation in joints, restrict mobility and diminish one’s quality of life. There are more than 100 different forms of arthritis, many of which affect the foot and ankle.

Did you know that 1 in 5 Canadians have arthritis and experience pain every day as a result of their arthritis? Arthritis is more common in women than in men (1 in 4 women, compared to 1 in 6 men). Arthritis remains one of Canada’s most prevalent chronic health condition for which there is no cure. According to the Arthritis Society, by 2040 the number of Canadians living with arthritis is expected to grow by 50%. The Arthritis Society also says that in 40% of Canadians living with arthritis, their pain is severe enough to limit their daily activities. This means that significant foot and lower limb pain and discomfort disrupt the lives of millions of people living with arthritis in Canada.

Common Types of Arthritis

The two most common types of arthritis include Osteoarthritis (OA) and Rheumatoid Arthritis (RA).  Foot and lower limb pain is often more prevalent among people with certain types of arthritis, including RA and OA of the knee, hip, ankle and foot. Arthritis can affect people of all ages and becomes more common at older ages. While it is more common at older ages, more than half of Canadians with arthritis are younger than 65.

Osteoarthritis is a chronic disease that is caused by inflammation, breakdown, and loss of the cartilage in joints that occurs as one ages. Osteoarthritis affects over 60% of people in our population and is commonly referred to as degenerative arthritis. The prevalence of OA increases with age. Osteoarthritis is the most common type of arthritis affecting millions of Canadians. The joints most commonly affected by OA are the knees, hips, big toes, hands and spine. Osteoarthritis can affect people of all ages. Age is not a cause of OA but the prevalence of OA increases with age.

Rheumatoid Arthritis is an inflammatory disease that causes pain, swelling, stiffness, and loss of function in the joints. It can occur at any age, but tends to develop between the ages of 25 and 60. The joints commonly affected by RA are the small joints of the hands and feet.

Can Orthotics Help with Arthritis?

Pedorthic Treatment for Osteoarthritis:

  • Custom made foot orthotics or over the counter arch supports
  • Recommendation of appropriate and proper fitting orthopedic footwear
  • Off-the-shelf orthopedic footwear with built in rocker sole feature
  • Modifications to other footwear such as rocker sole to help reduce pressure to forefoot

Pedorthic Treatment for Rheumatoid Arthritis:

  • Custom made foot orthotics can help reduce plantar pressures under the feet of patients with RA
  • Off-the-shelf orthopedic shoes with rocker soles
  • Rocker soles modification is beneficial in reducing plantar pressures on the forefoot
  • In shoe accommodations can be used to relieve pressure on specific painful metatarsal heads by removing material from the inside of the shoe directly under the affected area
  • Footwear may need to be modified with Velcro closures, or alternative closures to help accommodate hands/fingers of patients with RA

Pedorthists can offer alternative or complimentary treatments to medication for people with arthritis to help improve mobility and flexibility in their feet and lower limb joints through the use of custom-made foot orthotics and footwear. Custom-made foot orthotics can improve the alignment of the lower body, reducing abnormal stresses on the body. They can also provide optimal cushioning to improve shock absorption and reduce pressure on any painful areas on the feet. Footwear is an important treatment option for reducing pain and improving mobility and function in people with arthritis. Footwear with a firm forefoot rocker sole is particularly beneficial for people with painful arthritis in the forefoot and toes as it promotes forward motion during gait while limiting toe flexion and pressure on the foot.

If you suffer from symptoms related to any form of arthritis, it is important to educate yourself on the condition so that you can help manage it and live your life to the fullest. Talk to your health care provider and visit your local Pedorthist to discuss treatment options. To find a Canadian Certified Pedorthist in your area visit

By Amanda Bushby, HBKin, Dip. Ped, C. Ped (C)




Delzell, E. (n.d.). Feet Hurt? Slip in Some Relief With Shoe Inserts [Blog post]. Retrieved from

Irish, Lisa. (2018). Rheumatoid Arthritis. Pedorthic Association of Canada Clinical Practice Guidelines (Second Edition).

Loranger, L. (2014, September 1). 7 Common Arthritis Myths Busted [Blog post]. Retrieved from

McColman, M.; Archer, G; Tso, D; Bajic, T; Pagtakhan, E. (2018). Osteoarthritis – Foot and Ankle. Pedorthic Association of Canada Clinical Practice Guidelines (Second Edition).

Arthritis Society. Arthritis Facts and Figures. Retrieved from and figures

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)

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


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

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



  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
  3. NHS ND “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:


Pilates is an excellent activity for most seniors. If you’ve never tried Pilates this article will help you get started


Here are 8 reasons why you need to pay more attention to your feet as you age #aging #footcare


You’ve earned your retirement. Don’t let a fall ruin your plans


If your back hurts, the cause may be 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…/
#PACSeniors #CPedC #Pedorthist


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


Most falls are preventable. These tips will reduce your risk #seniors #fallprevention


Foot pain can be treated. Don’t let sore feet slow down your retirement plans


Wondering how a pedorthist can help you?


Custom foot orthotics can help alleviate foot, knee and back pain. Here’s Lori’s story


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.

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