Tuesday, December 9, 2008

Flat Feet, High Arches or Pronating, What is Your Foot Type?

Most of my clients are surprised to learn that there are generally 9 factors that determine a person's foot type. I say generally, because there are always exceptions to any organizing system. As a Certified Pedorthist of almost 2 decades and fitting technical athletic footwear since 1970, I've seen many different types of feet. I've developed this list to categorize feet so that I can most quickly identify a orthotic client's concerns and help them. Here are the 9 factors:

Foot Physiology:
  • Low Arch foot with Flexible Joints (sometimes referred to as a flat foot)
  • High Arch foot with Stiff Joints
  • Neutral Arch foot with Moderate Joint Movement
Foot Shape:
  • Oblique Toe (Big toe is longer and foot tapers angularly to the small toes).
  • Square Toe (Little toes are exceptionally long and big toe is short - The toes are close to the same length).
  • Round Toe (Second toe extends longer than the big toe).
Volume: How thick or thin your feet are. Including how much tissue the foot has and how big the bones are of the foot.
  • Low volume (Foot could be wide or narrow, but there isn't much bulk to the foot.)
  • Mid Volume (Foot is well proportioned.)
  • High Volume (Foot is thick, bulky, large boned)
The reason it is important to know that there are nine classifications of feet is to identify the key characteristics of your foot type so that you can focus on comfort footwear or sports performance features that best suit your foot type.

Often a person will choose a shoe based on looks or the advice of a friend, and not really have any idea if the shoe properly fits their foot. As you can see from the list of foot characteristics, there are many variables involved with shoe fitting and depending upon the type of foot you have, you may not easily find the best shoe for your foot without some professional advice.

At Footform Performance Center in Bend, Oregon, we analyze feet, mold and make custom foot orthotics (shoe inserts), then fit the orthotics into the client's footwear. Part of our orthodics service includes shoe consultation and recommendations. Footform custom shoe inserts increase foot comfort and sports performance. I am also available to consult to the shoe industry to create footwear that is designed for the widest variety of foot types.

Call or contact Footform Performance Center, 541-389-4547, 345 SW Century Dr., Bend, OR

Wednesday, December 3, 2008

Why are Custom Orthotics Better for You than Off the Shelf Footbeds

Clients will sometimes ask me what the difference is between prefabricated foot orthotics and custom foot orthotics, even sometimes claiming that both orthotics feel the same. Though there is that rare person that has the exact foot match to a generic orthotic contour, usually a person is responding to the cushion of the foot orthotic, a trait that doesn't have a lot to do with performance of the footbed.

Just to look a prefab foot orthotic is impressive. Mass production techniques often result in a snazzy looking foot orthotic  (also called a insole or footbed). Despite the appearance and marketing, a pre-made foot orthotic is generic. The cushiony feel of most pre-fab insoles helps to cover up the lack of a perfect fit.

What really counts when you buy a foot orthotic is the arch contour and how the orthotic fits into the shoe. A foot orthotic you put in your shoe is there to optimally guide your foot so that you can make changes and adjustments in your foot position.

A pre-fab orthotic or insole is low-performance (despite the appearance) because since the contours of the orthotic are generic, you won't notice that your foot is out of position until the movement is obvious. 

A custom made foot orthotic is high-performance because of the exact fit with the contours of your foot. Every move your feet make, you can feel. This is important, because when your foot is moving well, fatigue, over-use and injuries are reduced.

The next step to a successful application of an orthotic is to fit it into a shoe. This requires cutting and grinding skills that fit the foot orthotic into the existing contours of your shoe. It also requires that you are wearing the best shoes for you feet. My next post will be about foot types and shoes.

When you buy a custom foot orthotic you should buy them from a trained technician who can tell you about the optimal use of your foot. They'll educate you about the types of shoes you should wear for your foot type and also fit the orthotic into the shoe. They will give you stance and gait training so that you can get the best out of your foot orthotic.

At Footform Performance Center  we give you that kind of orthotic, shoe and gait training service. Your foot orthotics will both be effective and last for years (rather than most pre-made foot orthotics that compress out of shape within months then live forever in the landfill).

Call or contact Footform Performance in Bend, Oregon for an appointment. 541-389-4547

Wednesday, November 19, 2008

Custom Ski Boot Fitting

Fun and pain don't go together if you want to excel in sports. Of all of the sport footwear that can really hurt your feet, ski boots are at the top list. Finding a solution to alleviate painful ski boots takes an experienced technician. Custom ski boot fitting is the solution.

In 1966 I was a Certified Ski Technician in Bend, Oregon. I went on to manage, then own a ski shop and spent decades in the ski business before I became a Board Certified Pedorthist. It was a long time ago, and I've learned a lot since then, following snow sports of all types through their life cycles.

During most of the 20th Century, Alpine Downhill skiing was the dominant snow sport. By the 1990's diversity was the trend and now people are on the snow in a variety of ski boots. Custom fitting snow-sport boots is my favorite specialty.

My custom snow sport and custom ski boot fitting service at Footform Orthotics Center in Bend, Oregon is: (We do this process quickly and efficiently because we charge by the hour.)
  1. Analyze the boot fitting problem during the appointment which includes a full professional foot exam.
  2. Isolate the fit problem determining the footwear compatibility with the foot.
  3. Perform alterations.
  4. Ski Boot Canting - Check for cant angles and alignment.
  5. After the custom shoe or boot alterations are done, the client tries the ski boot, skate boot or snowboard boot out on the snow.
  6. If necessary, the client returns for a short visit to get the fit tweaked.
At the Footform Performance Clinic in Bend, Oregon I custom fit the following snow riding boots: Footform custom orthotics are included in the process unless the client has an orthotic that is acceptable.
Telemark Ski Boots, AT Boots, Alpine Downhill Ski Boots, Nordic Cross Country Ski Boots, Nordic Skate Boots, Snowboard Boots.

We also sell the Daleboot for Alpine Downhill Skiing. The Daleboot can be a custom fit ski boot with custom shell modifications and thermo formed ski boot liners combined with custom ski boot foot orthotics. The Daleboot can accomodate the wide ski boot customer with alterations. My price includes my custom orthotic footbed for the ski boot. The Daleboot is the ONLY ski boot made in the U.S.A., which means that if a client has a particularly challenging fit problem, it is more likely to be solved in my office by customizing both the ski boot shell, liner and ski boot footbed. Because I work in partnership with the Daleboot factory to fit my client, true custom ski boot fitting is possible in a variety of ski boots size.

Call us at the Footform Performance Clinic 541-389-4547 to set your snow sport and custom ski boot fitting appointment. We're located at 345 SW Century Drive in Bend, Oregon. Century Drive/14th Street is the road to Mt. Bachelor ski area. Get a ski boot fit and test it on the mountain during your visit to Bend, Oregon.

Wednesday, November 5, 2008

Growing Pains: Why Kids Complain

Kids complain about pain in the back of their legs -- calf and hamstring muscles. Commonly referred to as growing pains, these twinges occur because bones grow at a much faster pace than muscles. The problem that youth (ages 10-16) have as they grow is that as soon as their muscles start getting tight during and after a growth spurt, they compensate for the muscle tightness with actions such as toe-walking and pronating. 
  • Toe-walking - not "tiptoe" walking, but a stride where the heel does not touch the ground. The pivot point in the stride is at the forefoot instead of the ankle.
  • Pronating: The mid-foot collapses inward and  gives the appearance of ankle bend, but is really stress on the foot. 
These gait compensations create strains in the tendons connecting muscles to the foot (plantar fascia and achilles tendon). Then the muscles that attach up the leg become tighter, hence a kid will experience more growing pains. Muscles need to be used, stretched and worked to grow bigger and longer. (This is true at anytime of life.)

When a youth has growing pains, here's what you do:
  • Explain to them what's going on.
  • Keep them in physically active recreation or sports that don't have a lot of sitting-around time.
  • Teach them this simple stretch: Sit on the floor with your legs straight out in front of you and your feet against a wall or piece of furniture. With your back straight, use your hands to push your torso forwards until you feel a stretch. Hold this 30 seconds. Repeat 3 times.
  • Remember: Feet straight, bend your knees (just a little) as you walk and stand.

Friday, October 31, 2008

Fallen Arches - Fact or Fallacy?

Is there such a thing as "fallen arches"? Usually when people say they have flat feet or fallen arches, they have flexible feet, though there are exceptions.

The plantar fascia band on the bottom of the foot is similar to the bow-string of an archery bow. Over many years the plantar fascia band may gain length. Partially this is true because of bony growth called a heel or bone spur.

Another result of this fascia lengthening is that people think their feet are growing longer, but they didn't "grow". With the loosening plantar fascia band the foot elongates or spreads out. This is especially common if a person has put on a lot of weight. 

Oddly enough, the most flattening of the foot occurs on hard flat man surfaces. If you step in sand or soft earth, even a flexible foot is firmer than the ground, so instead of the foot giving to the ground, the ground gives-in to the foot. This is why Footform custom orthotics mimic the natural footprint in sand, so that the foot remains in a natural state while weight-bearing.

Monday, October 20, 2008

Prevent Fractures: Tips for Better Balance

Have you ever lost your balance? Of course you have, and it's usually no big deal. But if loosing your balance results in a fall, the result can be serious. According to a recent Swedish study, impaired balance is associated with triple the risk of hip fracture! 

As we age, bones may become more brittle and the risk for fractures increases. As a person gets more sedentary and moves less in their life, they lose flexibility and balance along with other types of fitness. This can happen regardless of a person's age, and is especially important for older people. 

Balance requires mobility in motion. Have you ever balanced a yardstick or pole vertically on the palm of your hand? You'll notice that to keep the pole vertical you must move your hand around. If you hold your hand still, the pole falls off your hand.

So how does this relate to keeping your balance as you're standing "still". Well, when you stand, if you keep your knees soft (slightly bent), your pelvis/hips are free to move. Your potential for mobility is increased. If you lock your knees (keep them straight), you lose mobility, and your balance worsens. This is a subtle difference, but a difference that is very important as we age. 

The ASBMR (American Society for Bone and Mineral Research) published the article, Lack of Balance Predicts Fractures. They cited a recent medical study in Sweden, and Karl Michaelsson, M.D., P.H.D., of the Uppsala University Hospital in Uppsala Sweden. In the study, impaired balance was associated with double the risk of any fracture!

Here are some tips to improve your balance as you stand:
  • Bend your knees a little EVERY time you stand AND Walk.
  • Keep your hips loose. Visualize the Hula dance and practice bending your knees and moving your hips in circles.
  • Feel the ground with your feet. Concentrate on "sinking" your weight through your feet into the ground.
For advanced practice, do all of the above while standing on one foot. Be sure to alternate feet.

Thursday, October 16, 2008

Using Gait Analysis to Spot Terrorists

The scientists at JPL (NASA's Jet Propulsion Lab in Pasadena, California) have taken gait analysis to a new high. So high, that scientist Adrian Stoica says it should be possible to identify a person (from a satellite) by the shapes and patterns their shadow makes as they walk across the earth. At least, this is what New Scientist Tech reported in their article, Shadow Analysis could Spot Terrorists by their Walk, Sept. 4, 2008. Stoica claims that satellite and aerial footage could be analyzed to extract the useful gait data necessary to catch a terrorist from the sky.

Yes, it's true that a person can be identified (more or less) by his gait, though it's not a fingerprint, more of a generalization. But the problem is with the premise behind this effort that says people cannot easily disguise their gait. People can change their gait. Everyday at my Footform Performance clinic in Bend, Oregon, we train people to change their gait.

Besides, this idea of satellite gait analysis seems like a really dumb idea that costs a lot of money. Every actor in a play or movie changes their gait to match their idea of the character they are playing. What happens if the person being looked for takes off his hat? Or puts one on? Maybe he'll wear a speedo one day and a raincoat the next. What happens if he opens an umbrella or walks over a pile of rocks? Gait Analysis from space is an unnecessary expenditure of brainpower and money.

Set an appointment at Footform for gait training and gait analysis and you'll walk back and forth in front of and alongside a mirror as I coach you. No shadows and satellites. Just down to earth gait analysis. You'll feel better for only a fraction of the cost of an aerial photo.

call for your appointment 541-389-4547

Tuesday, October 14, 2008

The Low-down on High Fashion Heels

Six inch dress heels for women are selling. In fact, according to today's article in The Wall Street Journal, "Women Fall Head Over Heels for Shoe Makers' Arch Designs", by Teri Agins, this super-high segment of the shoe industry is selling so well that Manolo Blanik says it accounts for about 30% of his company's business.

Despite the craziness of fashion, the most disturbing thing to me was to read was that Podiatric Surgeons are injecting cosmetic fillers such as Restylane or Juvederm to plump up the balls of the feet (metatarsal area of the foot) in an effort to ease the painful pressures on the forefoot caused by these high heels.

So here's what I have to say about these sky high shoes -- Don't wear them!  Sprained ankles, artificial interventions (like injecting cosmetic fillers), and strained joints(from the gait change the shoes impose) can cause injuries that can impact your life for years.

If you want to appear tall, improve your posture. But more than that, remember that others don't see you statically, like in a photograph or the way you see yourself in front of a mirror. People perceive your age and attractiveness before they ever get close enough to see if you have a wrinkle. How you carry yourself in motion can convey confidence, athleticism, flexibility and strength.   

High heels seen in motion promote the opposite of this. High heels hobble your body's motion and athleticism. You may think you look great standing still, but do you want to be hobbled and risk injury? Hobbling is defined as strapping together the legs of an animal (such as a horse)to slow it down and prevent it from straying, or to cause a person to limp. Psychologically, hobbling yourself for the sake of fashion creates a conflict between the fashion desires of your mind and the natural health of your body.

Your body has a wisdom and intelligence that knows when it's being impaired by a terrible choice of footwear. Choose to look at fashions that hobble your movement as promoting weakness rather than strength.

Thursday, October 9, 2008

Repetitive Strain Means its Time for a Change

 I used to watch the Canadian TV comedy program, The Red Green Show (when my local Oregon Public Broadcasting OPB carried it). They often ended the show with a group of roughneck guys in the Possum Lodge repeating their credo, "I'm a man, but I can change, if I have to, I guess."

To many people, change is a concept they resist. Repetitive strain injuries, such as plantar fasciitis, shin splints, etc., are small injuries that are repeated until they become chronic. Keep doing the same thing and the injury only gets worse. The solution is to change your gait and stance habits. Albert Einstein is reported to have said, "The definition of insanity is to doing the same thing over and over and expecting different results."

Here's the list of things you can do to eliminate repetitive strain by changing your habits:
  • Accept that you have to change.
  • Obtain the information/education that offers you an alternative to your usual habit.
  • Seek out training aids such as orthotics.
  • Think of a slogan or mantra to repeat to yourself as a reminder. My favorite reminder is, "Feet straight, bend the knees."
  • Visualize proper form. Picture in your mind someone who's moving the way you would like to move and emulate that vision whenever you think about it.
  • Affirm to yourself that you are improving. My favorite mantra is, "I'm getting better and better."

Change takes time. Don't be too hard on yourself or expect to much too soon. Positive change happens daily, one step at a time.

Read more of my Gait Training articles on this blog.

Monday, October 6, 2008

Athletics and Orthotics: Fencing

Orthotics are the necessary foundation when you're on your feet in a sport, wearing footwear. Whether you're in an athletic shoe, bike shoe, ski boot, water sandal, fishing waders, mountaineering boots, golf shoes, etc, shoe insert orthotics are key to top performance.  

You can't see the orthotic, but it's in the shoe enhancing the performance of the athlete. The orthotic facilitates optimal foot position by providing a cradle contour for the foot's optimal position on the ground, guiding the foot to the strongest biomechanical function. 

I began making custom orthotics in 1980 (in the Alpine Ski Industry) and have been learning and developing my expertise and shoe insole product ever since. Research involved in creating my custom footbeds is both observational and experiential. Not only do I make custom orthotics for a variety of athletes and skill levels, I also participate in sports so that I personally understand the demands an athlete makes on their body. 

Epee Fencing is a sport I took up about 3 years ago, following my 14 year old daughter Isabella Acosta Barna into the sport. Learning a new sport at any age is exciting mentally and physically. Isabella has inspired me to get off the sidelines and get on the fencing strip. Sharing the sport of epee fencing is a joy and a delightful bond with my teenage daughter.

Isabella is a natural fencer. At age 14 she won a Bronze in the under 20 age group (Junior) at the U.S. Fencing Summer Nationals 2008 in July, also earning her "A" rating as a fencer. Comparatively, I'm a duffer, but I workout hard with Isabella and she's training me well. This year I did win 3rd (a Bronze medal) in the Oregon State Games Veterans Epee division. The competition was held at the Northwest Fencing Center in Beaverton, Oregon where Isabella is trained by the head coach, Sebastian Dos Santos.

Sports not only develop fitness, they are important for relationships of all types. My involvement with fencing has led me to volunteer at our local club, the High Desert Fencing Club in Bend, Oregon. I'm the President and along with a Board of supportive parents we're building a non-profit club that develops young fencers in the Central Oregon area. It's a great place for kids and adults to connect through sports.

Here are some photos of Isabella and I fencing. The top photo is of me (on the left) fencing in a regional competition at the Northwest Fencing Center in Beaverton, Oregon. The second photo is of Isabella in a North America Cup competition.  Of course, both Isabella and I are wearing Footform orthotics

The Northwest Fencing Center in Bend, Oregon is a 501C3 non-profit. All donations are tax-deductible. Contact me at my Footform Performance clinic phone 541-389-4547 to make a donation to the Fencing club. Donations pay for both infrastructure (rent, equipment, etc.) and for youth scholarships.  Fencing skills are in demand at good universities and are a big plus on any young person's college application

Thursday, October 2, 2008

Walk with Gravity (But Remember to Smile!)

Gravity is the relentless force that you feel as weight on your feet. Good thing, because we'd all be flying off into space without gravity. So what is so important about remembering the basic law of gravity?

There are 2 ways to think about gravity as it relates to your gait. You work with gravity or you fight it.
  • When you fight gravity your gait is mostly up on your toes (or forefoot).
  • Work with gravity by bending your ankles and sinking into the ground (exagerate ankle bend so that your entire foot is on the ground).
Here's a test you can do to find out how you're working with gravity.
  1. Stand with your knees and ankles slightly flexed.
  2. Now bounce gently.
If your first movement is up -- you're bouncing on your toes and tend to be working against gravity. (And developing strains and pains in your body.)

If your first movement is to slightly bend your knees and go down before you go up, you are working with gravity. Good for you!

Bouncing "up" mostly on your toes doesn't use your entire foot and places strain on your toes and forefoot. You'll tend to lean forwards to move with each step. The result is strain and eventually pain.

Bending your knees and ankles has the opposite effect. Your balance becomes grounded, steady and secure. You expend less energy and are stable.

So what do you do when you walk so that you are working with gravity? Keep your feet straight and bend your knees and ankles as you walk. Exaggerate the movement when you first practice this. Integrate knee and ankle bend into every step of your day and you'll find your balance and muscle tone improving and minor aches and pains related to walking will diminish. Less pain and more strength is surely a reason to smile.

Thursday, June 5, 2008

Personalizing Your Footwear with Custom Orthotics

If you want luxury for your feet replace a removable shoe insert with Footform Orthotics. Most mid to high-end sport specific footwear have removable inserts. Taking that shoe insert out and replacing it with a Footform orthotic gives you a custom fit that makes your footwear the foundation of a positive experience. Whether that's in the field, on a golf green, ski slope, bike, bowling alley lane or on the dance floor. During the second half of your appointments at the Footform Performance office in Bend, Oregon, we fit the orthotics to the shoes that you either wear most often, or the shoe in which you specifically intend to use the orthotic. One of our satisfied customers, Terry Scoville, of Womens Hunting Journal, shared her experience of a hunting boot she customized with a Footform orthotic.


Review from Woman's Hunting Journal: LaCrosse AlpahaBurley Sport Insulated by Terry Scoville

I recently spoke with a representative at LaCrosse Footwear, to find out what they'll be offering women hunters this Fall. I was surprised to learn that they are discontinuing a few styles. The good news is that the model I have they are going to continue providing. Specifically the AlphaBurley Sport Insulated 18" Realtree Hardwood HD 800 Gr. boot, style #200037 (soon to be style # 200044) as of July 2008. I bought mine last Fall and used them alot throughout the waterfowl season. Firstly, they are offered in whole sizes only, so go up to the next whole size if you wear a half size. With that said, mine are awesome and show no signs of abuse after their first season afield. I replaced the factory foot bed with my own custom orthotics http://www.footform.com/ and the fit is wonderful. I found the Alpha Burley boots to be nimble, lightweight and not cumbersome. The sole has sufficient traction and support, so as not to be flimsy in any way what so ever. The fleece lining has held up to my abuse and shows no sign of wear. There is an adjustable gusset at top back with a cam buckle if you want them snugged up, for real nasty mud. They weigh in at 5.5 lbs. per pair. I used mine for late season goose hunting and my feet were toasty warm. Even late season goose hunting in my layout blind, & on snow for 4-5 hours at a time. My backside got a bit frosty, but not my feet. In conclusion for women hunters, I highly recommend the AlphaBurley boots. Especially if you're wanting something other than hip waders or your leather field boots for hunting. http://www.lacrossefootwear.com/

Monday, June 2, 2008

How to Walk Like a Very Old Person

Of course you don't really want to walk like an old person. What may surprise you is that the impression of age starts long before you get close enough to a person to see a wrinkle. A person's gait and posture conveys their strength, balance, and flexibility.

Walking is propulsion. As toddlers we all start with a stiff-legged stance and leaning forwards to create motion. I call this "The Leaning Tower Stride". Once you're past the age of three, this stride will only make you look old.

I see variations of the Leaning Tower Stride constantly in my Footform Performance clinic in Bend, Oregon. This stride uses fewer joints: the hip and toe (metatarsal) joints -- therefore a person with a injury or ache may default to this style of movement. The hip is used as a hinge joint instead of as a ball and socket. The forward momentum of the stride is created by jutting the neck and shoulders forward. This brings the top of the body in front of the feet creating a "fall" where each leg "catches up" with the rest of the body.

The result of this bio-mechanical movement is that the body is on the edge of losing balance constantly and the hip and toe joints get undue stress. All sorts of problems come with too much stress on joints.

The solution is a balanced stride. The body is in an athletic position with the knees slightly bent. Pretend you are receiving a tennis serve or flexing before a golf swing. As you go through your daily activity here are the things to keep in mind for healthy movement:
  • Bend your knees and point your feet straight ahead as you walk.
  • Focus on the back foot in the stride staying on the ground as long as possible and pushing you off from behind.
  • Do a few practice hula dance movements to loosen the hips.
  • Keep your abs toned (Keep your stomach muscles firm, pulling inwards towards the spine.)
  • Wobble your head and shoulders loosely to feel the center of the joints. (This takes practice - a mirror and a coach helps here).
When you're ready for some one-on-one training, call Footform Performance and schedule an appointment. We offer stance and gait training appointments, including a private walking lesson at my clinic in Bend, Oregon
www.Footform.com 541-389-4547

Wednesday, May 21, 2008

Feet Can Change - Chinese Foot Binding

Have you ever wondered if abuse to your feet changes their form and function?

Ever been a slave to fashion? The Chinese practice of foot binding distorted the feet for fashion to the point that the woman was permanently disabled. Though these photos show you the terrible physical deformation that is the result Chinese foot binding, don't think that the Chinese are the only culture that has a tradition that damages feet. If your feet ever ached in terrible shoes for the sake of fashion, all you have to do to see the painful result of a cultural aesthetic ideal is to look down.

Foot pain caused by shoes is not harmless! These pictures illustrate how much feet can change if abused. The tradition of foot binding was to shorten the length of the foot thus fitting it into tiny, pointed toe shoes. The feet were distorted with tight wraps and crammed into tight shoes to the point where they were permanently disfigured. In turn, the women were completely hobbled.

As arcane as the practice of foot binding seems it is still practiced in the fashions of today in both Europe, Asia and the Americas. These pictures of the sleek new styles are examples of what is hot in Japanese fashion now. Notice the resemblance of the modern shoe to the cultural aesthetic of the past?

Shoes have a purpose and that is to protect your feet. Shoes are unique in the fact that they are absolutely necessary, yet also quite frivolous. Be careful when you buy shoes. Try to make the shoes a healthy choice that is good for you, not the other way around. Don't damage yourself in the name of fashion.

To find out how "dressy" you can go, get your feet and footwear checked at: www.footform.com

Tuesday, April 29, 2008

Knee Pain Isn't Inevitable

Knee pain isn't inevitable as you age. Barring injury, how you use your knee with each step determines how wear and tear of use affects your body. The knee is a hinge joint designed to bend in a straight line. Knee strains and pains occur when the arc of the bend becomes twisted. The beginning of a twist starts with the foot pronating (or rolling inwards on the big toe side). Twisting the foot results in twisting the ankle which carries the stress to the knee. The knee will rotate inward. Repeating this movement throughout the 10,000 steps you take in a day can result in a repetitive strain injury.

If you're sedentary you take less than 10,000 steps per day. If you have a job that requires walking like a nurse or postal worker you'll be taking even more steps.
So what can you do to protect your knee as you walk?
  • Bend your knees slightly (keep a soft knee) with every step and while you stand.
  • When you're walking, concentrate on keeping your heel on the ground as long as possible (this discourages toe walking).
  • When you walk, concentrate on keeping your foot pointing straight ahead with every step and keeping the direction of your knee bend straight over the foot.
  • Keep your hips loose and rotating with each step.
  • Look for shoes that are stable such as an athletic shoe or walking shoe that bend easily in the forefoot.
  • Foot Orthotics help to guide your foot so that it doesn't pronate.
All of this may sound a bit complicated. At my clinic I coach clients to walk and stand so that they protect their knee joints. If you are unable to find a gait training specialist in your area, I suggest you find a friend to video you walking straight towards the camera and from the side. When you watch yourself on the video check the alignment of your leg bend and foot position.

Wednesday, April 23, 2008

Ask Randall: Generic Insoles

April 16, 2008 11:45 AM

Hi Randall, I was wondering if you can tell what elements are needed for a generic insole that would bring comfort to a shoe wearer. What material would you use? By the way your blog is amazingly full of facts and I am enjoying reading each post. SA

Dear SA,

In the shoe industry, the term generic insoles refers to what's also called a sock liner, contoured insole, or generic orthotic.
  • Sock liners are generally a flat cushion layer, sometimes removable, but usually glued into the shoe.
  • Contoured insoles are formed from molded foam to fit the shoes interior and cup the the mid-foot and heel around the edges. Generally this insole has little to no anatomy.
  • Generic orthotics are formed from molded foam or/and other materials. It is like a contoured insole, but has actual arch contour and more anatomy.
Here's what I think are the best choices in each category:
  • Sock Liners: Multi-density foam layers. One layer that forms to the foot layered over one resilient layer that springs back to the original shape.
  • Contoured Insoles: The same as a multi-density sock liner, but with the upper layer being a molded foam shape.
  • Generic orthotics: Typically an after-market product, sometimes they are actually built into a shoe such as a Birkenstock. The most important thing is that the contour doesn't offend the user's foot contour.
The object to orthotic contours is to guide the foot to it's optimal use. The closer the contours are to the foots natural contours, the higher the performance of the orthotic. Peoples feet are different, therefore a mass market product will only address one type of foot over another.

The optimal high performance is a custom orthotic. Because this option isn't available to everyone, the next best thing is to try on a multitude of generic orthotics to seek a good match.

Note: I offer consulting to manufacturers and designers seeking information about foot contours, orthotic shapes and materials. In the past I've patented two systems relating to this research.

Tuesday, April 22, 2008

3 Things to Know Before You Buy Slip-on Shoes

Slip-on shoes are so convenient that they are a popular segment of the shoe market. People love to put on or take off their shoes without bending over. Despite the apparent comfort and convenience of a slip-on shoe, unless the shoe is a perfect fit, it is a compromise. To fit the tight spots, other places on the shoe are too loose. This isn't a problem if your feet are perfect and you don't have any pain, but if you have any problems at all, proper shoe choices are crucial.

Slip-on shoes often don't have adjustability. Or if they do, they must often be too tight to slip in and out of easily. This can effect your gait, promoting shuffling and toe gripping, which can lead to foot problems. If you must wear a slip-on shoe here are the things to look for:
  • Choose a slip-on shoe that fits high onto the foot (towards the ankle).
  • Elastic stretch panels.
  • Adjustable straps or laces.

Friday, April 18, 2008

Foot Arches - Two Per Foot

The arch is one of the founding principles of architecture. It is also one of the strongest shapes as an arch spreads the load it's supporting to the 2 foundations on either side. The arch of your foot uses those same principles of architecture. The two foundations of the arch of your foot are the heel and the metatarsal joints (the part of your foot where the toes attach to the foot).

A big surprise to most people is that each foot has two arches! The arch on the medial side (the inside, big toe side) of your foot is the arch you commonly think of, but there is also an arch on the lateral (the outside, little toe side) of your foot. The lateral arch is much lower and is structurally simpler and more aligned with the leg bones.

The big error a person makes is thinking that they have to support their medial arch by putting something under it that contacts it so that they can lean onto the arch. An orthotic that only contacts the medial arch but doesn't address the presence of the lateral arch will hurt like crazy.

A proper foot orthotic offers full contact with the medial arch but does not "support" it with that contact. The architecture of the foot moves during the gait cycle. When you're standing still, you don't have that movement, so it's impossible to guage if the orthotic will work rather than just "feel good". The correctly made foot orthotic guides the force upon the foot into the orthotics valley on the lateral side. The valley is the contour the foot sits in with every step. Walk in sand and you'll notice that the foot slices into the sand on the lateral (little toe) side leaving the deepest impression.

With proactive efforts from the wearer to step correctly (knees softly bent, feet straight, hip rotation), the foot orthotic will guide the foot. An orthotic alone will not usually alleviate arch pain. The combination of the custom orthotic, gait training and proper fitting of the orthotic into a appropriate shoe for the person's foot are necessary for the best result.

Monday, April 14, 2008

Plantar Fasciitis Heel Pain

The most common repetitive strain injury I see in my clinic is Plantar Fasciitis. The symptom that indicates a possible diagnosis of Plantar Fasciitis is pain in the heel on the bottom of the foot especially when taking the few first steps in the morning or after resting. Micro tears and resultant inflammation in the tissue at the connection point between the plantar fascia and heel bone are responsible for the pain. Resting at night, the plantar fascia repairs a little bit, then tears again in the morning with those first steps.

Most of us take 10,000 steps per day. Those steps constantly irritate the plantar fascia. The plantar fascia is part tendon and part soft tissue, the only structure like this in the body.

Though the pain of Plantar Fasciitis is felt in the heel, putting weight on the heel (or a strong heel strike) is not the cause of Plantar Fasciitis. Mistakenly, most people treat the problem with heel cushions. Though a person may feel relief with heel cushions, the true problem won't be addressed. The usual gait compensation is to walk on the toes. This causes a shortening of the calf muscles and more toe walking, creating a vicious cycle, resulting in chronic cases of plantar fasciitis. I've seen people in my clinic that have had chronic plantar fasciitis for years.

The true problem is a strain on the entire plantar fascia along the bottom of the foot. To reduce the strain, it's important to keep the heel down during the stride and to let the entire foot linger on the ground with every step, rather than walking primarily on the forefoot and toes.

Full foot orthotics and proper shoes along with gait and stance training will alleviate the strains that caused the Plantar Fasciitis. With the proper care and attention to gait, most cases improve dramatically in 6 weeks.

If you keep doing the same thing over and over, ten-thousand steps a day you will get the same result. Step by step, changing the habits you've developed in your stride, along with an excellent foot orthotic will promote healing of the plantar fascia.

Tuesday, April 8, 2008

Hip How-To: Learn to Walk Well From Your Hips

Bio-mechanics is the science that explains how the structures of the body function mechanically. Each joint in your body has a design that moves optimally certain ways. The joint may also allow types of movement that the joint is not best designed to handle.

For example, your elbows and knees are hinge-joints. They bend back and forth in the same direction. They don't allow much rotational movement. If you do over-rotate those joints you'll often incur a sprain or more severe injury.

The hip joint is different from the knee in that it is a ball and socket joint that allows your hips to move both rotationally and as a hinge joint. Here's what you need to know: Your hips are designed to move best as a rotational joint. If you walk, hike or run and don't rotate your hips adequately, your hips move like a hinge joint. Too much of this type of movement in the hip joint causes over-use injuries/damage.

To practice what a rotational movement of the hip feels like, do the Hula. Really!
  • Stand with feet shoulder width apart and knees gently bent.
  • Rotate your hips in circles, first clockwise, then reverse directions.
  • Now, walk backwards slowly and notice how the hips automatically rotate, taking the leg back.
  • Slowly walk forwards, seeking to maintain the sensation of hip movement. Remember to keep your knees slightly bent.
When you use your hips as a ball and socket joint, you are using the joint optimally. This is very important if you are running or walking as correct use, reduces (and sometimes, eliminates) hip problems and pain.


Thursday, April 3, 2008

Custom Shoes & Personalized Shoes: What is the Difference?

Custom shoes are not all the same. Cowboy boots are a good example. You can go to a custom boot maker and they'll trace your foot and make a boot. Sure, it's "custom" but it's not enough. People mistake being able to choose the leather colors and trims with the attributes of a comfort fit shoe. The shape of your foot is only a piece of the shoe-fit picture.

A good shoe conforms to the outline of your foot and supports the bio-mechanics of your foot, including:
  1. Structural elements such as rocker-toe, heel counter, heel height.
  2. Medial & lateral support.
  3. Degree & type of shock absorbing cushion.
  4. Compatibility with orthotics.
The solution for most people is a personalized shoe. At Footform Performance, we combine our knowledge with a select grouping of shoes we sell that are hard to find in mainstream shoe outlets. Personalizing involves how your foot is fitted to a shoe, considering the length, width, shims, stretching, grinding and custom orthotics. Our shoe selections offer unique features such as comfort, fit, durability, quality, function and compatibility with orthotics that other brands simply cannot provide. We pride ourselves on our ability to deliver a personalized fit that will feel like a custom shoe.


Monday, March 31, 2008

What is Your Orthotic Made Of? Viscork is our Choice

When I first began researching custom orthotic materials, I was looking for flexibility, durability and shock absorption. Though I was doing this research in the early 1990's (and the environment was not as trendy then), I felt that my materials should also be as environmentally safe as possible and result in a custom orthotic that would last a long time (rather than being "disposable").

I realized that foam and hard plastic or other reinforced rigid materials don't have the range of properties clients need in a custom orthotic. Those materials lose their shapes soon or sacrifice one quality for all others. Over-the-counter orthotics made of foam rarely outlast the life of a shoe. The foam compresses and looses it shape and shock absorption. Clinicians may try to remedy the faults of various orthotics materials by gluing a variety of products together, hoping for the best. It is an ineffective compromise at best.

Through years of research, trial and error I developed a material I sell called Viscork. Viscork orthotic material is a visco elastic polymer. Viscork is a unique combination of visco elastic polymer with cork granules. Cork is a renewable resource. Properties of Viscork replicate as closely as possible the natural protective tissues of the foot. Viscork absorbs shock and permanently maintains it's shape, therefore ensuring support for years. Clients often use their Viscork orthotics upwards of 5 to 7 years, longer than most people own their cars!

All of the orthotics we make at Footform Performance Labs are made using Viscork orthotics materials. If you represent a orthotics lab, contact us to buy Viscork for your custom orthotics production.

Thursday, March 27, 2008

Gait Analysis: How Well are You Walking?

Watch a person walk down the street. Even from a distance you are making unconscious assumptions about their age, athleticism, and self confidence.

There are two main styles of walking:
  • The Leaning Tower: When a person leans forward and puts out a foot to catch themselves as they walk. They are using gravity to keep moving. Typically, when a person walks this way, their leg is straight and their hip joints are stiff, because their hip joint is being used like a hinge joint (like the knee) rather than as a ball and socket. The focus of the stride is on the beginning of the step. This is linked to hip problems, knee problems and lower back pain.
  • The Balanced Stride: When a person has a upright (centered) position over the stride. The knees are flexed (very slightly bent), the ankles bend, the hips (and core of the body) rotate with each step. The focus of the stride is on the finish of the step. Each joint is moving as it should, pain and future (or past) problems are minimized.
The non-verbal impression of the Leaning Tower Stride is old, non-athletic and lacking self-confidence. Your impression of the Balanced Stride is youthful, fit and confident.

Tuesday, March 25, 2008

Jimmy Choo is Not a Shoe

If you're a fashionista or within the range of one, you know what Jimmy Choo shoes are. They're sexy, stylish, elegant, expensive, glamorous beautiful things a woman can put on her feet. But just because something goes on the foot, doesn't mean it's really a shoe.

And designer footwear brands like Jimmy Choo know it. They are not selling comfort and support. They're selling something else entirely. (Though you may see a flat shoe from those brands as their concession to "comfort", it really isn't as most fashion "flats" don't offer support to the foot.)

So, am I saying you shouldn't wear designer women's shoes? No. Just don't wear them and then act surprised when your feet hurt. Human feet are not shaped to tiny points in the front with 4" heels in the back. Be reasonable. If you must wear designer dress shoes, limit the time you're going to wear them, and have a back-up pair of comfort shoes tucked into your handbag. That way, when your feet hurt, you won't push the pain into a lasting injury by continually wearing the wrong shoes.

Thursday, March 20, 2008

Barefeet and Babies

"Our bare feet are conscious of the sympathetic touch of our ancestors as we walk over this Earth."
~Chief Seattle, Duwamish Suquamish~

There was a time when bare feet or handmade footwear were the only options for our feet. And, as we all know, all of the earth is not soft sand or soil. Rocks, thorns and rough terrain make walking without shoes a daunting and often dangerous thing to do. The ancients knew this and made shoes out of both animal hides and plant products. The oldest intact shoes (a pair of sandals over 10,000 years old) in North America were found in a cave near my town of Bend, Oregon.

Times have changed. As natural as bare feet are, if you are walking outside, shoes are usually the right choice for the modern foot.

The exception to this statement is young children who are learning to walk. If the walking environment is safe and soft (such as a clean carpet or sandy beach), barefoot is the best for babies. Babies don't have arched feet. They need a lot of toe wiggle-room and a flexible soft surface that encourages their feet to move and to develop without artificial influence. Don't be fooled into thinking that a toddler's foot needs "support" with a stiff shoe/boot. Even a sandal is too much if it has a stiff sole. A stiff-soled toddler shoe is confining and clunky for a kid. Lifting the foot and turning in a stiff-soled shoe is hard for a toddler, promoting tripping and awkward balance.

The best shoe for a baby/toddler is a moccasin or similar type of shoe such as a flexible Aqua sock. Test a baby shoe by bending the sole between the toe and heel. The baby shoe should easily crumple and bend.


Monday, March 17, 2008

What is a Good, Supportive Shoe?

There is no correlation between price and support in the shoe world. A beautifully made shoe that doesn't fit well or isn't meant to offer support (like a women's high heel dress shoe or sandal) is not good for your feet no matter how "well-made" or expensive it is.

What is a supportive shoe? It's a shoe that puts most of your foot in contact with the ground (through the surface of the sole) while offering your foot protection from twisting, pounding, and strain. Here are the main things that make up a supportive shoe:
  • Wide solid platform for the sole.
  • The shoe has a heel counter - the stiff structure of the shoe surrounding your heel.
  • The heel is slightly elevated - approx 1/2" to 5/8"
  • The shoe has a primary bend point (or flexion point). This is at the ball of the foot. Hold the shoe between the toe and heel and bend it. Where it bends is the flexion point. If it's behind or ahead of where the ball of your foot is, it will stress your foot.
So what do you do with any gorgeous designer high heel shoes that kill your feet? They are beautiful objects, sculpture really, not fit for feet. Fill them with plaster and turn them into paperweights.

Thursday, March 13, 2008

If the Shoe Fits

How do you know if your shoe fits?

It may seem like this question has an obvious answer. Most people would say, "Because it feels good." The surprising answer to that is, "That's not enough." Sometimes how the shoe initially feels doesn't mean it's the right shoe for you. Surprised? Clients may say to me when describing a shoe they really like, "It feels like I'm wearing slippers." Forget about slippers. A shoe needs to support you as you walk on hard unforgiving surfaces all day. Slippers don't give you support. Neither do most women's dress shoes, but I'll talk about those types of shoes another day.

Today we are talking about sensible shoes like athletic shoes or a walking shoe (usually a model that ties and has a low heel). Here's how you know if the shoe fits.
  1. Get measured. No matter what you think your size is, get measured to be sure. Feet change over time.
  2. Put your bare foot (you can leave your sock on) next to the shoe before you put it on. Look at the front of the shoe and the shape of your foot. They should be similar.
  3. While you are sitting down, loosen the laces, put your foot in the shoe and cram your toes into the end of the shoe to check compatibility of your toe shape and the shoes toe shape.
  4. Ideally, all of your toes should contact the end of the shoe with equal pressure.
  5. Insert your index finger between the back of the shoe and your heel. (Remember, you're still sitting down.) If you can't get a finger in there when your toes are crammed to the front, go bigger in size.
If the front shape of the shoe matches the shape of your foot and you have enough room, you are on your way to finding a shoe that fits.


Monday, March 10, 2008

Can Orthotics Banish Back Pain?

Remember the children's song, Dem Bones, about the ankle bone connecting to the shin bone, the shin bone connecting to the knee bone, etc.? Whether the anatomy lesson in the song is accurate or not, it's an important reminder that everything in your body is connected to everything else. Every part of your body in some way affects the rest of your body.

So, can orthotics/insoles eliminate back pain? Maybe. This probably isn't the answer you're looking for, but it's the honest answer. Back pain can be caused by a myriad of things, so it would be highly unusual for one thing to cure it. Orthotics are not a cure-all. Orthotics are a tool. As much as they give you comfort and support, orthotics serve as a reminder to walk and stand properly.

Do you remember my best tips for orthotics success? Feet straight, bend your knees! So how does this help your back? Keeping your knee soft (slightly bent) during your entire stride enables your hips to rotate more easily. A flexible pelvis/hip region eases the lower back muscular tension that causes so many problems for people. Bending your knees and standing with your feet straight encourages your hips to move forwards (like a dog tucking it's tail) and puts the stress of standing mostly on the large muscles of your hips and thighs rather than the smaller muscles in your lower back that exhaust easily.


Sunday, March 2, 2008

Getting Better and Better Feet First

You can improve your body. Your body's base is your feet.

I often have people ask me, "How do I know if I need help with my feet?" My answer is, "If it works don't fix it!" Why bother if you feel great? You need motivation to get better and (for many people) pain is the final motivator. Pain definitely gets your attention. But it's not the only motivator, you have to be interested in change. Then, you have to be willing to change.

Strangely, quite a few people are just fine with being miserable. Whatever their reason, they don't try to change their circumstances and for that reason will stay the same. Keep doing the same thing, you will keep getting the same result.

If you think you can't change, think again. Change happens, like it or not! You're not the same person you were fifteen years ago. You've changed. Practice good habits. Strive to make your changes positive not negative. Change is hard and breaking bad habits is harder.

So, if you've got some strain or pain and are motivated, interested, and willing to change, I'm happy to share this information with you. I like to use the term better and better because it depicts a dynamic progression. This is a great affirmation for improvement. Next time someone asks how you're doing, just say "better and better".


Wednesday, February 27, 2008

What is an Orthotic?

Chances are you've heard of the word orthotic. If you're wondering exactly what a orthotic is, the dictionary isn't much help. Though an orthotic can be a brace or artificial limb, the word usually refers to an insert or insole a person wears in their shoe for extra support for their feet.

The orthotic is most often made of foam rubber, cork, plastic, leather or wool, even metal or some combination of these items. Orthotics/insoles cost as little as $30.00 to has high as $800.00. You can purchase a pair over the counter, at a shoe or athletic store, mail-order, or from a medical professional such as a physical therapist, chiropractor, podiatrist or pedorthist.

The over the counter pre-made types are self-explanatory. Custom orthotics are a different story and it is confusing to sort through the variety. There are several types of custom orthotics: pre-made then custom fitted, pre-made "blanks" that are heated and molded around the bottom of your foot, glued together components, or custom molded/custom made orthotics.

My specialty is the custom molded/custom made orthotic. There are four important parts to orthotics success.
  • The molding method of the orthotic (how the orthotic shape is determined).
  • The materials the orthotic is made of and the properties of those materials: shock absorption, flexibility, durability, etc.
  • Shoe fit and compatibility of the orthotic in the shoe.
  • The client's efforts to change gait and stance habits for the better.

Monday, February 25, 2008

Do You Need to Learn to Walk All Over Again?

If you're like most people you learned to walk somewhere between the ages of 1 to 3 and haven't thought much about it since. Sure, life can send you a curve ball and you may have hurt yourself and had difficulty walking at some time. But after you recovered you were back to normal. Any aches and pains that linger you may think of as inevitable signs of aging.

The good news is that you're younger than you think. Aches and pains may be a lot less inevitable than you think. Here's why: Most of us don't walk as well as we could. Walking seems simple enough. One foot in front of the other seems pretty obvious. But walking well isn't. How we walk is a lot less "natural" than we think. How we walk is influenced by both nature and nurture. Along with civilization came shoes and roads. The ever-changing surface of the earth under our feet is now most often a hard floor or sidewalk. Fashion dictates a shoe wardrobe that may be all wrong for your feet.

So how can you learn to walk well? How can you finally get comfortable on your feet? I'll cover the many answers to this question on this blog. For now, I have two tips for you:

1. Bend Your Knees - ALWAYS, ALWAYS, ALWAYS keep your knees "soft". Don't straighten your leg mid-stride. Do this EVERY time you stand and through EVERY step you take.
2. Feet Straight -- Keeping your feet pointed straight forward when you stand and stride sets-up the alignment with the rest of your body. Think about driving a car with the wheels splayed out. It would cause a lot of unnecessary wear and tear. Keep your feet straight.

Randall Barna