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Shoe Shopping Tips for Seniors

Shoe shopping for seniors can be a challenge, but it is not impossible.  As we age, soft tissue and fat pads thin out making the foot more sensitive. Additionally, the size and shape of our feet can change which means the shoes we used to wear may no longer be the best fit.

A comfortable shoe helps put some cushioning under the foot to make up for what is lost through the years of wear and tear. It needs to fit the foot right and accommodate any abnormalities found like bunions, hammertoes, braces that you have. 

Here are a few criteria and tests to keep in mind the next time you’re shopping for new shoes:

Soft Shoe Material – Softer, more flexible uppers (part of shoe above the sole) make the shoes more comfortable and accommodate any abnormalities in the foot. Mesh uppers and softer leathers are generally preferred for most people. For some with larger bunions and hammertoes, an upper made from a two-dimensional elastic material like Lycra may be required to provide comfort in a shoe and have it be comfortable. Stiffer uppers made from material like Box leather would not be flexible enough to wear in comfort for most seniors.

Foot Shape – As we age, the foot lengthens and widens more at the front. The shoe needs to be wide enough at the front and narrow enough at the heel. This generally means a split width shoe is required. You can tell when a shoe has a split because it gives the size and width in this form 9.5 EEE/D showing the 9.5 size with an EEE toe width and D heel width.

Foot Shape Test – Make sure the shoe fits the exact size and shape of your foot by removing the insole and placing the foot on it. There should be about a thumb thickness past the longest toe to the end of the insole. There should not be any part of the foot hanging over the side of the insole.

Non-slip Sole – A non-slip sole is important as well. There is an increased risk of falling as people age and it can lead to significant changes in where the person lives and how much they can do. What “non-slip” means changes by circumstance. Walking in snow, cold weather or on ice calls for a certain type of sole. These soles will likely have lugs on the sole and be made of rubber so that it is flexible in the cold. If a person who shuffles their feet in gait wears these shoes while walking on polished concrete floors, they are at risk of falling because the grip is too much and they will fall. In such an instance, the more appropriate sole material would be more like Topy Elysee that has smaller texture and does not grab the ground with as much force so that a person wearing these shoes will not be as likely to fall because the sole does not grip the concrete too hard.

Heel Counter Test – A stiffer heel counter will help keep the shoe on the foot and help keep it more stable. If you can put your hands on both sides of the heel and feel something in there that keeps the edges from touching will help keep the shoe stable on the foot. If it is soft at the back, the shoe may allow your foot to slide sideways inside it and lead to a fall.

Torsional Stability Test – If you can’t twist the front of the shoe sideways when holding on the heel, the shoe is said to have torsional stability. This helps the shoe also be stable on the foot and to make it work better.

Fasteners – Velcro strap attachments may be more suitable for some who have difficulty in using laces to tie up their shoes. Shoes with fasteners (Velcro, laces, etc) are recommended for seniors vs slip on shoes as they provide greater support and stability.

In short, comfortable shoes can make it easier to partake in activities. Keeping active is important in so many ways. It helps maintain fitness in the general body. It is especially important to help with fitness of the heart and lungs. Activity is one thing that can regulate blood sugar in diabetics and helps all people reduce weight. Keeping active helps delay the progression of arthritis.

If you want to know more about comfortable footwear, please contact your friendly local Pedorthist https://www.pedorthic.ca/find-a-pedorthist/

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


Are you Wearing the Right Shoes for At-home Workouts?

While treadmill running and outdoor running have their differences, for the average recreational runner, your outdoor running shoes should work well on the treadmill. However, it may be a good idea to switch shoes for your other workouts in your home gym.

Treadmill & Free Weights Footwear

If you typically run outdoors, it’s advised to keep similar parameters as you get started on your treadmill (such as distance, speed, shoes). At the onset, it’s not recommended to start on an incline if you don’t typically run hills outdoors. As you progress, start to include progressions into your workout routine.

Running shoes typically feature:

  • cushioned sole
  • firm heel counter (squeeze the back part of the shoe – it will feel firm and unyielding if it offers good support) and
  • a stiff shank (twist the front and back of the shoe to ensure it is stiff)

The shoes you wear on the treadmill should have these features too.

In most cases, you can use the same shoe for treadmill use as well as free weight routines. If you have a goal to strengthen lower limb musculature and improve foot function, then perhaps a more flexible shoe will give those muscles a workout; again, this should be done with caution and each individual has their own unique circumstances.

Training Shoes vs. Running Shoes

A training shoe is often quite different than a running shoe. Training shoes are typically more flexible and have less cushioning – they are designed to engage the muscles to a greater extent, giving the feet, ankles, calves and upper legs a more purposeful workout. For at-home fitness equipment like treadmills, steppers, and ellipticals, a running shoe is likely best. At-home activities like circuit training, plyometrics, and agility workouts where you are using your own body weight are best for training shoes. Some examples are squats, lunges, burpees, jumping jacks, bear crawls, ladder work, and box jumps.

Barefoot Workouts

If you have never worked out barefoot before, you should not start without consulting a health care professional such as a Canadian Certified Pedorthist. Doing exercises barefoot can have tremendous benefits, but you need to know where to start. Starting with barefoot exercises too fast, too soon, without proper guidance can result in all kinds of foot, ankle, knee, hip, and/or back problems.

However, contrary to too fast too soon, gradually introducing your body to some barefoot exercises can have considerable positive outcomes for healthy individuals. The first step is understanding your foot’s neutral alignment – your Pedorthist can help you with this – essentially it is the central position where your foot is positioned for optimal function. Once established, start building resilience around this corrected position by simply balancing on one foot for 20 seconds at a time in this aligned position. Gradually progress to 1 minute over the course of a few weeks. Active individuals who are used to dynamic and plyometric exercises can progress in a more dynamic fashion, such as barefoot ladder work, clockwork single leg jumps and bosu ball balancing.

Orthotics

If you typically wear your custom orthotics and shoes regularly, then exercising at home should be no different. Be cautious not to use an orthotic that is designed for something else. i.e. an orthotic designed for long periods of standing at work can have vastly different properties for one that is designed for running. If you are unsure, reach out to your Pedorthist for clarification. Even if their practice is currently closed due to the COVID-19 lockdown, many clinics are assisting patients virtually.

By Darius Dinshaw B.Sc. Kin, C. Ped (C), CAT(C), CSCS


Safeguard your Foot Health During the Lockdown

Canadian Certified Pedorthist Kelly Robb answers questions about how to maintain the health and comfort of your feet during the COVID-19 lockdown, whether you’re WFM or physical distancing at home.

Why is it a good idea to wear footwear inside the house during lockdown?

The quick and easy answer – is because your feet are used to wearing shoes! Consider the idea that you would normally be working all day. Your feet are generally happy and contained within a structured environment. They are typically supported, cushioned, and used to encountering consistent stresses. These consistent stresses will vary person to person, and may include a combination of sitting, standing, and routine walks around your office’s neighbourhood. All of a sudden your lifestyle has drastically changed. Your activity level has diminished and you’re no longer supporting those precious feet.

Secondly, without this structured environment, the small muscles of your feet have to work much harder during walking. They are not used to this demand, and you’re expecting this increased workload throughout the entire day. Above that, the flooring in your house is probably different than the flooring in your office. If you have the opportunity to keep your feet in a structured environment throughout all these changes, it can decrease the likelihood of the rapid development of new aches and pains.

What types of shoes or slippers should people wear in the house?

I would consider two things: are you simply looking for footwear to wear around the house, and/or do you have any history, or current problems with your balance?

Let’s start with the first one. If you’re looking for something around the house, a hard-soled slipper and/or running shoe are great options. Also consider adjustability. Shoes are manufactured to accommodate many feet – of all different shapes and sizes. If your slipper or shoe has adjustable features, such as laces, Velcro or buckles, these options will better match the fit of your personal feet. For example, if you have the option between a slip-on soft-soled loafer versus a hard-soled slipper – I would suggest the slipper. Better yet, if that slipper has strapping to better wrap your foot, that’s a step up. Lastly, if you’re starting to developing aches and pains in your feet, I would suggest moving to a more supportive running shoe during prolonged standing throughout your day.

Secondly, let’s briefly touch on balance. Very commonly, anyone that has balance concerns, or has a previous history of falling, is usually looking for the most comfortable shoe. Oftentimes, this comfort comes at the level of adding padding and cushioning around the foot. It’s important to realize that softer, cushioned soling of footwear can actually impair your stability. In other words, a softer shoe is not always best! If you experience balance concerns and/or have a previous history of falls, I would encourage a thinner, harder soled shoe choice when navigating around the house.

Are there foot/lower limb stretching exercises you recommend for people spending so much time inside their homes?

Stretching is wonderful if you know what muscle needs to be stretched. If you don’t, I personally encourage my patients to routinely use rollers. You may not have a traditional foam roller in your house, however a rolling pin or PVC piping are wonderful alternatives. Rolling can help your tissues in several ways, including a reduction in muscle soreness, improving blood flow to an area, and breaking down fascial adhesions. Unless you’re rolling over a bone, or getting tingling from a nerve, you can often roll the tissue or muscle that’s causing you discomfort. Specific to your feet, pain along the plantar surface (bottom) of the foot is quite common.

If this sounds familiar, try rolling the tissues under the foot! Place the foot roller (or rolling pin or even a tin can) under the heel of one foot and roll it from the ball of the foot to the back to the heel. Repeat this 10 – 15 times, then switch to the other foot. This can be done standing or sitting, and use your own discretion as the amount of pressure placed on the roller. As general rule of thumb, rolling may be a bit uncomfortable (uncomfortable, not painful!), however this discomfort should be gone immediately once rolling stops. This can be repeated several times a day.

What other footcare steps do you recommend during the lockdown?

My biggest piece of advice, especially if aches and pains are starting to set in, is to contact your local pedorthist. Even if their practice is currently closed due to the COVID-19 lockdown, many clinics are assisting patients virtually. Based on any previous history and assessment details, your pedorthist is best educated to provide tailored, individual advice to help you through any challenges.

 

 


Warm Ups for Walkers

It is always important to begin your walk with a warm up and then some light stretching to aid in preventing injury and sore muscles. Begin walking at a light pace or even do a warm up exercise such as jumping jacks to get the blood flowing and muscles moving. Do a few minutes of static stretching (standing still) and then move on to dynamic stretching (during movement).

A few recommended static stretches – hold each stretch 20-30 seconds – include:

  • Hamstring stretch – Stand with legs straight and bend at the waist to try and touch your toes.
  • Calf stretch – Standing with one leg in front of the other. Bend front leg at 45 degree angle and straighten out back leg. Try and push the heel of the back leg toward the ground until you feel a slight stretch in the calf.
  • Groin stretch – Stand with legs a little wider than shoulder width apart, while keeping them straight. Bend at waist and reach for the ground. For added stretch, move to one side by bending the knee while keeping the opposite leg straight. Alternate sides. You should feel a stretch on the straight leg side.

Examples of dynamic stretching include:

  • Walking lunges – Walking while bending the forward leg at about 90 degrees, keeping torso up right, lowering your pelvis toward the ground and bending the back leg at about 75-90 degrees (whatever feels most comfortable).
  • Butt kicks – Exactly how they sound. As you lift your foot off the ground after taking a step, reach your foot back to kick your buttocks.

Once you have completed your walk, you will want to finish your exercise by doing a cool down. Slowly decrease your pace and end your walk with a good 10-15 minutes of post workout static stretching.

If the walking is making your feet tired and sore, try working the intrinsic muscles (smaller muscles) of the feet pre and post exercise. This will help build strength and flexibility in the feet. Practice spreading your toes apart from one another, or pretending to play an imaginary floor piano with your toes. You can also try picking up small objects with your toes and scrunching a facecloth under your foot and then away from your foot using your toes.

Happy Walking!

By Jodi Basha, C. Ped (C)

 


Footcare Tips for New Walkers

Whether the goal is to become more active, get out and spend more time with family, or just to keep mental health in check during these unprecedented times, a lot of people have incorporated walking into their new daily routines. There has been a noticeable increase in outdoor foot traffic since the start of COVID-19, especially now that the weather is getting nicer.

For any physical activity, especially long-distance walking, it is important to take into consideration the type of footwear you are wearing. Wearing proper footwear with adequate support will help decrease unwanted strain in the muscles and joints of the feet and lower limbs by structurally helping to keep the body aligned and the foot functioning more properly. This in turn will provide more comfort to the feet and lower limbs as well as decrease or prevent any injuries or painful conditions that may be experienced such as arch and/or heel pain, forefoot pain, knee, hip and low back pain.

Choose the Right Shoes

When choosing the right pair of shoes to walk in, look for shoes that structurally offer support – which means nothing too flexible. The shoe, ideally an athletic shoe/sneaker, should consist of:

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  • Proper flexion points i.e. flexes at the forefoot and not throughout the arch.
  • Sturdy structure with good torsional stability. To test this, try twisting the base of the shoe, if you can twist it, chances are it will not support your foot.
  • Firm heel counter (back part of shoe directly behind your heel). This will help prevent the foot from rolling which is important when trying to avoid unwanted movement in the feet.
  • Ideal heel height should be approximately 6mm from front to back of the shoe.

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Make sure your footwear is the proper size both in length and width. Wearing ill fitting shoes can further contribute to painful foot conditions, poor circulation as well as corns and callouses experienced usually at the base of the feet or around the toes. Ideally, you should have one finger space in front of the longest toe during weight bearing and there should be no side-to-side squeezing of your foot once placed in the shoe.

Buying Shoes Online

If you are ordering footwear online or you are doing local curb side pick up, make sure you do the research ahead of time to be certain you are getting the right type of shoe to properly support your feet. If you do not have access to purchase new shoes, make sure when choosing from your existing footwear, you chose the ones that best match the features listed above.

Socks

Wearing the right kind of socks is also important. When choosing socks to wear for long distance walking, you want to make sure the top of the sock is higher than the height of your footwear. This will prevent rubbing and irritation at the back of the heel as well as prevent the sock from slipping down into the shoe. You want to chose a material that consists of wool (preferably marino wool) or equivalent or a mixture of wool and cotton blend; wool for its moisture-wicking properties and cotton for its added cushion. Wearing cotton alone is poor for wicking away moisture (perspiration) and can cause rubbing and friction which can lead to hot spots or blisters on the feet.

Orthotics

If you wear orthotics on a regular daily basis, it would be beneficial to wear them during this increase in physical activity. However, if this is the first time wearing them during exercise, I would encourage you to build up your tolerance to wearing them a little more every day for the first couple of weeks until eventually you are able to comfortably wear them during the entire duration of your walk.

A Few More Tips

Callousing occurs in high pressure areas. If you notice callouses forming, typically on the bottoms of your feet, usually under the heels or balls of your feet, make sure to moisturize your feet regularly and file down these callouses as they build up.

Wearing footwear around the house, such as a supportive sandal, slipper or running shoe will help keep feet supported and comfortable while home, which in turn will have overall positive effects on how comfortable your feet feel throughout the day, including during exercise. If your feet are tired from going barefoot, getting the courage to exercise will be a lot more difficult.

Lastly, the best piece of advice I can probably give you is to start off slow and work your way up to a distance and pace that is comfortable for you. If you do too much too soon, you may cause yourself more harm. It is better to be proactive than have to seek help after the fact, especially during these unparalleled times when seeking advice from a foot care professional may be difficult.

Good luck and happy walking!

By Jodi Basha, C. Ped (C)

 

 


The Food-Foot Connection

With March being Nutrition Month across Canada, we decided to dig a little deeper and interview a Dietitian to explore how healthy eating can improve our overall health and more specifically, the health of our feet. Dietitians are the trusted professional when it comes to reliable evidence-based food and nutrition advise as Pedorthists are for footwear and orthotics.

Tomorrow, March 18th, marks the eleventh year of celebrating Dietitians in Canada. In keeping with this celebration and helping to shine the spotlight on the profession, Pedorthist Derek Gilmer interviewed his wife Alia Khudhair-Gilmer, a Registered Dietitian.

 

Q: As a Pedorthist our role is to help manage and treat many foot conditions caused by chronic or acute inflammation by providing support and reducing mechanical stress on affected tissue in the feet. Are there specific foods that will help reduce inflammation or foods to avoid that cause inflammation?

A: While there is no definitive “anti-inflammatory diet” there are definitely foods that help us fight many diseases including arthritis, heart disease and diabetes.  Foods such as fruits and vegetables provide phytonutrients which help reduce inflammation in the body.  Studies suggest that people with Rheumatoid arthritis could benefit from eating more Omega 3 fatty acids (found in salmon, sardines), while other studies suggest that foods high in uric acid (found in red meat, alcohol) will increase painful inflammation in patients with Gout, a type of arthritis.  Refined grains, sweets, junk food, soda pop and excessive intake of saturated fats, found in red meat, can increase inflammation.  Increased inflammation will cause increased pain in the feet by increasing the swelling and pressure on sensitive nerve endings. 

 

Q: We see many clients for Pedorthic care who have problems with their feet due to diabetes. A Pedorthist will help provide protection and off load high pressure areas to assist with helping heal foot ulcers. What role does diet play in managing diabetes and supporting wound care? More specifically, how can diet aid in the healing of ulcers?

A: The most important factor in preventing diabetic foot ulcers is to have optimal blood sugar.  Having a balanced diet that includes vegetables, fruit, whole grains, lean protein and some healthy fats, along with limiting high sugar foods is key to managing good blood sugar levels.  Proper blood sugar control will help reduce foot problems such as neuropathy.  Diabetic neuropathy is nerve damage, specifically nerve damage in the feet caused by long term high blood sugar levels and is a serious complication of diabetes.  As for managing a pressure ulcer, increased protein and fluids, along with a balanced diet are required for optimal wound healing.  

 

Q: Pedorthists receive referrals from physicians to help heal and manage stress fractures in the feet and to help prevent injuries from occurring with people who have osteoporosis. What type of diet should someone with osteoporosis consider? And will this help prevent fractures and other injuries from happening?

A: Osteoporosis is associated with increased risk of fractures, including stress fractures in the foot.  Ensuring you are having adequate calcium intake and vitamin D from food or/and supplements is important in reducing the risk of fractures.  Calcium rich foods include milk (cow’s milk or alternatives such as soy milk or almond milk), yogurt, cheese and green leafy vegetables.  There are also many products on the market that are fortified with calcium and vitamin D.  Living in Canada most people don’t get enough vitamin D “the sunshine vitamin”, in my practice I always recommend a vitamin D supplement for anyone who is 50 years or older. 

Help celebrate Nutrition Month by loving the food you eat and making healthy food choices that have the potential to improve your overall wellness from head to toe. To learn more about Dietitians and nutrition visit www.dietitians.ca, to find a Canadian Certified Pedorthist in your area please visit www.pedorthic.ca/find-a-pedorthist/

 


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