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Tips for Injury Prevention

With the arrival of summer and nice weather, more and more of us will be getting out and being more active. 2020 has so far been a trying year for many people, with COVID-19 interrupting people’s normal routines and greatly effecting physical fitness levels.

Now, with a surge in people getting back to their chosen activities, it is inevitable that injuries will occur. Injuries though, can be prevented. Here are some simple tips to keeping you pain free and out enjoying the things you love to do.

  • Warm Up. This sounds almost too easy of a tip to mention, but for many of us, time is of the essence. With work, family and life, tasks taking up more and more time, we often only get a small window to be active. Still, warming up is key. Take the time to do some simple stretches, get moving and gradually increase your intensity level before going all out in your activity.
  • Again, you’re reading this and thinking, really? Really! Most of the population doesn’t drink enough water during the day as it is, but bringing something to drink is a commonly overlooked part of any activity. Whether you are lifting weights, going for a walk, a run or a hike, bring water. This is even more important now, as many public water stations will be closed due to COVID-19 restrictions.
  • Proper footwear. This is a big one for us in the pedorthic community. Proper and appropriate footwear is key to injury prevention no matter your activity is. Would you wear flip-flops to play ice-hockey? Sounds silly doesn’t it? Well, take that example and apply it to any other activity. You wouldn’t wear soccer cleats to go golfing or roller blades to go biking. Choosing the appropriate shoes for the appropriate activity is key and while there is an expense to buying shoes, if it is an activity you plan on pursuing, it’s worthwhile to invest in it.
  • Be prepared. This one is the biggest aspect that is often overlooked. If you are planning on doing a 5K run, make sure you work up to that distance. If you are going for a hike, know the route and make sure you have water, proper shoes and you can do the hike. By being prepared for your chosen activity you will greatly reduce the chances of suffering an injury doing something you love.

So, there you have it. Four quick tips to help you stay injury free. If you have any questions on any of the tips, definitely make an appointment with your local pedorthist and we’d be happy to guide you!

By Steve Stred, C. Ped (C)


Foot Strengthening for a Barefoot Summer

As warm weather and sunshine returns to Canada so do summer wardrobes, flip-flops and sandals. Some people enjoy going barefoot more often than they are used to and who can blame them?! Personally I love the feeling of grass under my feet and mud squishing between my toes.

One condition that pedorthists see frequently in the summer months is a condition that we like to call ‘seasonal barefoot-itis’. Folks who normally wear footwear most of the time are now wearing sandals and are going barefoot and they come into clinics with aches and pains in the toes, feet, knees and low-back.

Here are three simple exercises that can fine-tune some of the muscles in your feet and ankles to prepare yourself for sandal and barefoot season.

  1. Calf raises. Standing on both feet, slowly raise your heels off the ground as high as you can and hold this position for 5 seconds. Slowly lower your heels to the ground. Touch the ground (do not rest) and repeat. This is strengthening muscles in your calf as well as the arch of the foot.

  1. Single-leg balance. While holding something sturdy, stand on one leg. Close your eyes and focus all your mental awareness on the pressure on the bottom of your foot and the contractions of your muscles in your feet and ankles. Try your best to completely stabilize your ankle without twitching side-to-side. If you find this easy, put a slight bend in your knee to make things a little trickier. This is more of an exercise for your brain than for your ankle muscles. Your brain is trying to find the perfect position for balance without using your eye-sight as a short-cut. This is training your nervous system! A healthy neural connection between the brain and your feet will keep you balanced and avoid injuries.
  2. Toe-curls. For this one you will need a stretchy exercise band. Sit in a chair so that your knee and ankle are at 90 degree angles. Place the band underneath your foot from heel to toe. Ensure that your small toes are on the band, and your big toe is off to the side of the band, firmly on the ground. The end of the band should stretch from your toes to about your knee. Keep your heel, big toe, and the ball of your foot firmly on the ground and allow the stretchy band to pull your toes up in the air. Now, while keeping your toes straight, contract (or curl) your toes to the ground. Hold for 5 seconds and slowly allow the band to bring your toes back up into the air. Repeat.

The number of recommended repetitions and sets of these exercises is different for everyone. As a general rule, if you find yourself getting tired and unable to perform the technique of the exercise or hold it in the correct position, you should stop and record that number. The next time you workout try to match that number or surpass it by 1-2 repetitions. Remember, these are introductory exercises and you will master them within a few weeks. Your local pedorthist or physical therapist can guide you on how to improve upon these basic exercises.

Always keep in mind that if you are used to wearing supportive footwear and orthotic devices, you are going to need several weeks to get used to being barefoot, even for short periods of time. The feet need time to adapt to this change in pressure on the bones and load on the muscles of the foot and ankle. Start slow and gradually increase your time in sandals or barefoot. If you run into problems or encounter any new aches or pains, always consult your local pedorthist who will have the best understanding of your individual biomechanics and what you can and cannot tolerate.

by Brandon Nethercott, R. Kin, C. Ped (C)


Easy At-Home Foot Care Tips for Seniors

Feet are one of the most overused yet overlooked parts of your body. Your feet help you get around and stay mobile and active. Staying active is what keeps you and your body healthy. So everyone needs to pay more attention to your feet – especially seniors. Healing rates can decline in seniors and there can be issues with circulation in the feet that also decrease the rate of healing.

Ingrown toenails are a common problem for seniors and can decrease a person’s activity especially if the ingrown nail gets infected. This can severely curtail activity because it is uncomfortable to walk. If a person has ingrown toenails, having shoes that are not wide enough and deep enough to avoid putting pressure on the foot can aggravate the current situation. These shoes can also be responsible for causing the ingrown toenails to reoccur.

Because the soft tissue in seniors’ feet is diminished, corns and calluses are more frequent and need proper care to make them go away and keep them from returning. Gradual removal of calluses is the best way to proceed. The root cause of corns is point source pressure between the foot and shoe. It is important to find the root cause and deal with it. If it is a problem with a broken insole in the shoe, replacing the insole or shoe may be required. If it is a problem with the corn being on the top of the toes, the upper may be too tight at that spot. Stretching of the upper will help relieve pressure at the point source and the corn can diminish when the area is not irritated.

Footcare tips for Seniors:

  • Above all, “bathroom surgery” is to be avoided!! This especially applies to people with circulation issues and diabetes. Taking any harp item like a knife blade to cut off calluses and corns is a very risky business. With circulation being diminished, healing is slower and resources to combat infections is also diminished. This is why it’s crucial these procedures are only done by a trained professional.
  • Examine your feet at least once a week – Putting your feet on a stool can help you to see your feet and provide care yourself or for others who provide the care if you can not do it. You should be on the look out for cuts, scratches, cracked skin, growths, numbness or any other new developments. If you find a sore that’s not healing, lo
  • oks infected or any other abnormalities get it checked out by your doctor or Canadian Certified Pedorthist as soon as possible.
  • Nail care is an important aspect of foot care. Cut the toenails square and have the length just beyond the weight bearing surface to avoid the possibility of the nails being ingrown.
  • When you finish bathing, pay particular attention to drying the foot especially between the toes. Wet skin is a lot more easily injured as moisture can help promote skin and nail infections.
  • Moisturize your feet except between the toes at least once a day if you are a senior. If your skin is cracking, it is important to do this a couple of times a day. I recommend moisturizing creams with shea butter and cocoa butter for natural moisturizing.

If you have any questions, please contact your friendly local pedorthist https://www.pedorthic.ca/find-a-pedorthist/

By Jim Pattison, B.Sc, C. Ped (C)

 


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.

 

 


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