The Dos and Don’ts for Sandal Season

Over one quarter of the bones of your entire skeleton are in your feet. Deciding what to wear on them should be a top priority. Between your two feet there are 52 bones, 66 joints and over 200 muscles and tendons. When treated poorly, your risk of injury increases exponentially.

Do – Ditch the plastic, single board “flip flop”. (the ones you get at a grocery store, clothing outlet and retail stores)

Don’t – Leave home without taking care of your feet.

Think about it this way, would you opt to purchase poor quality tires for your brand new vehicle?

Unsupported flip flops create a multitude of injuries. I have to say I am tempted to attach my business card to each flip flop I see in department, grocery and retail stores. Let’s face it, if you invest $10 or less on a pair of plastic single board flip flops, and then walk any distance, it is highly probable an injury will follow.hammer toes

In the body there are small muscle groups and larger muscle groups. As your body starts to fatigue, usually the smaller muscle groups tire first. These small muscles often impact important joint positioning and associated function. When this happens the larger muscle groups pick up the slack as they are generally more powerful. Over time the larger muscles are forced to do more work. However, as the tired smaller muscles fail to support proper joint positioning, the function of the larger muscles becomes compromised and injuries to supporting muscles, tendons, ligaments and joints are probable. The principles described above are the same principles seen in the foot.

Within the foot the larger (long) flexors and extensors that operate the toes originate in the calf and run under and over the arch. The smaller muscles in the foot originate under the heel and through the midfoot. These muscles follow the arch of the foot in multiple layers ending at the toes.

When you wear a plastic flip flop your toes work extremely hard to hold that sandal on. They grip, pull and bend to keep that little poor footwear choiceplastic board on your foot. Overuse (walking all day in a flip flop, walking on the beach, hiking (Gasp and cringe!! I have seen this from the Bruce trail, Escarpment lookouts, to mountain hikes in Banff Alberta), you are bound to develop an injury (check out this article for interesting facts on plantar fasciitis). I came across the picture to the left and it perfectly depicted this experience.  Injuries such as calf strain, Achilles tendinitis, plantar fascia conditions are all probable under these conditions.
Toe deformities such as clawing toes, hammer toes and mallet toes are all related to muscle/tendon dysfunction along with ligament and joint damage.

Do – Avoid injuries by adding a moulded sandal or a sandal that can accommodate your orthotics to your shopping list

Mephisto sandals such as the Helen and Zach models are built for optimal comfort. This brand of sandal has secured the top spot on the list of our most recommended sandals. The heel, arch and forefoot are tailored for comfort, function and the straps are designed strategically to reduce strain to the long flexors and extensors within the feet.

Many companies offer sandals that have the option of removing the foot bed to discreetly insert your custom orthotic. These sandals often include features that assist with comfort for all day wear. They are lightweight with a firm sole, include strategic strapping for security over the foot and ankle, and are available in a multitude of styles for various activities.

Don’t – Opt for cheap and poor quality sandals.

Good arch contour and gentle support reduce plantar foot strain and allow the joints, muscles and tendons in your foot to be positioned for better function. Adequate straps are placed and positioned on the sandal to allow the foot to work properly and reduce potential injuries.

For more information on custom orthotics in sandals or for footwear education email us at info@aalignment.com. We can make your summer more comfortable.Supportive Sandal

The Right Fit – A Guide To Proper Fitting Footwear

Image 1

When searching for a new pair of shoes, finding the right pair that fits you the best can be a difficult and daunting task. Understanding shoe anatomy can assist you when we dive deeper into fit. Take a look at image 1 to help guide you through the different parts that make up a shoe.

Important Things To Consider When Making Your Footwear Choice

Consider the shape of your foot

Are your feet wide or narrow?
Do you have high arches or low arches?
Do you have any abnormalities or bony prominence’s that affect fit of footwear?

Not all shoe widths, sizes and shapes are the same. Individuals can vary in size from brand to brand, so don’t get hung up on the size number when choosing a shoe. Consider the last shape, fit of the toe box, and features such as seamless uppers, or the type of closure (laces, velcro, slip on) as it relates to your foot.

Every shoe is made on a last which can vary between each individual shoe manufacturing company. Additionally, different last shapes can vary between shoe models within the same brand. In general there are three different categories of lasts. These are the straight last, semi-curved last and curved last.

Typically the wider and flatter your foot, you should gravitate towards a shoe that is made on a straight last. Low arched (Pes Planus) feet generally need a sole unit that mimics the shape of your foot, broad and more rectangle in shape. If you are not sure what the last of the shoe looks like, a trick is to look at the bottom of the shoe and check the shape of the sole unit. If the sole is narrow and cuts into the arch this shoe is not for you. Your foot will overhang the base of the shoe and be squished into a position that is not natural to your shape, this can create balance and stability problems.  With a low arch or flat foot, check to see if the shoe you desire comes in different widths and try them on. You may be surprised how simply increasing your width can improve your comfort!

3 Lasts

Individuals with high arched (Pes Cavus) feet will typically fit better in a shoe that is made on a semi-curved or curved last. The semi-curved and curved last tends to contour to the foot structure, offering a glove like feel and hug into the arch. High arched feet generally require more depth and adjustability through the instep. This foot structure takes up more space height wise through the instep as the bony structure and arch is raised significantly.  Shoes with less volume such as slip on shoes can be a struggle for the high arched foot structure. Less space and a lack of adjustability can lead to uncomfortable pressure, toe clawing, and numbness. In conjunction with the curve of the last, you need to consider the toe shape of each last. This can range from narrow tapered toe boxes, a circular toe box, square toe box, and an anatomical toe box. High arched feet can be deceiving, and can often be wider at the ball of the foot, have elongated toes and dropped metatarsal arches. Similar to the low arched foot, if the shoe you desire comes in different widths, try them on!

** Tip – when trying on the shoe, remove the factory liner and stand on it. Does your foot fit within the shape and space of this liner? This is a good indicator of fit.

Upper construction and design can assist with fit and comfort as well. Many shoe companies now design their uppers with less stitching and printed designs. Less stitching improves flexibility of the upper material, thereby reducing irritation to the top of the foot and providing a better overall fit. Feet that have characteristics such as clawing of toes, bunions and any other bony prominence’s appreciate the flex and stretch of material that make up the upper as well.

Lacing For Common Fit Issues

Heel slipping because of a narrow heel and wide forefoot?
Do your toes go numb when your shoes are laced?
Do you need more space for the big toe because of bunions, arthritis or gout?

Changing your lacing technique can go a long way with comfort and fit, allowing for more space in the shoe for areas of high pressure or friction. In clinic we often see patients who loosen their shoes to accommodate for any of the above issues. Although a loose shoe relieves pressure, it also reduces foot security and the overall function of the shoe.  Loose footwear can lead to tripping, toe clawing as toes work harder by gripping to hold the shoe on, calf and arch discomfort from the improper/overuse of the long toe flexors, it can also increase inversion ankle sprains as the foot slides more easily within the unsecured and unstable shoe. If lacing techniques do not seem to make a difference, then re-consideration of the width, depth, last, style and size of the shoe is necessary.

What About Off-Set or Shoe Drop?

Off-set of this shoe is 16 mm-10 mm = 6 mm.

The off-set or shoe-drop is the difference between the amount of material under the heel and the amount of material under the forefoot (front) of a shoe. The material in-between is classified as the midsole of a shoe. Commonly shoes incorporate more material under the heel in order to help absorb the impact of landing as we heel strike. This absorption helps our bodies with the distribution of force as we make contact with the ground. In other words, it eases the initial impact on the joints and tissues of the feet and lower legs.

The recommended off-set for footwear will vary between different activities. For instance, running shoes may range from 8 mm to 12 mm off-set, while fitness and training shoes, court shoes and cleats will range from 0 mm to 4 mm off-set. Protection from injury and optimal performance are considered when shoes are designed with or without an off-set.

Clinically, the off-set is also important to consider when making recommendations for our patients who are dealing with specific injuries, present with an anatomical or structural need and for assisting/complementing neurological conditions. If you have a goal to reduce your off-set, this can be done strategically and via the assistance/guidance of a gait and lower limb specialist.

Foot and Lower Limb Mechanics

Do you supinate (foot rolls out) or overpronate (foot rolls in) upon landing?
Do you have an abnormal alignment of the lower leg, knees and feet? Bowlegged, knock-kneed, or leg length difference?
Do you notice that the wear pattern on the bottom of your shoes are different left to right? Maybe there is excessive wear on the sole of each shoe?
Do you have any chronic injuries that do not seem to resolve with replacing footwear?

If you answer yes to any of the above questions, consider getting a second opinion from a Pedorthist before committing to a shoe. Biomechanical anomalies and functional restrictions can impact how a shoe will interact and respond to your specific mechanics. During your assessment bring older footwear for us to evaluate the wear patterns, ask any questions you may have, and tell us your goals! We are here to help find a shoe that will  work best for you, your mechanics and activities.

Stay tuned for our analysis of walking vs. running shoes; and a list of some of our favourites!