Saturday, June 11, 2016

Comfortable Wedge Heels for Summer 2016 - Pikolinos - Podiatry Recommended


Two great choices for Summer 2016

Podiatrist Recommended

Pikolinos Mykonos

Pikolinos Madeira

Much thanks to my stylish patient who found these sandals! Both of these wedge heels are great choices for wearing on smooth, concrete surfaces. I would not recommend them for significantly uneven pavement or cobblestone. If possible, I recommend that you try on these shoes at the store so that you can get a good fit and make sure that they are comfortable. What makes both of these wedges so good is that they meet the criteria of what makes a good shoe. 

The four criteria required for a comfortable shoe:

1. A thick, rigid and non-flexible sole, so that there is no motion through the foot joints. Eliminating motion through foot joints decreases the progression of bunions, hammertoes and arthritic joint changes as well as decreasing inflammation, swelling and pain of tendons, muscles and ligaments. If you have arthritis or any joint issues in your feet (degenerative changes, history of a fracture or injury, ect) then wearing a shoe that is flexible will cause more wear and tear on the joints, which will cause more damage and pain. If you are recovering from a foot injury and are trying to transition from your below-the-knee walking boot into normal shoes -- the trick is to ease into shoes that do the same thing that the CAM walker did -- stop motion through the area of pain so that you can continue to heal and be comfortable. 

2. Wide toebox. A wide, soft toebox will decrease the progression of hammertoes, bunions, corns and calluses and other issues such as Morton's neuromas. If water can slowly wear down boulders into sand, then what do you think the pressure from pointy-toed shoes are doing to your joints throughout your lifetime? 

3. Rearfoot Control. In my opinion, there are no flip-flops that are good enough for anyone's feet! If you are not wearing a strap around the rearfoot, then you are forced to grip down with your toes, which helps promote hammertoes, mechanical strain and tired-leg syndrome.  

4. Arch Support. Although there is no significant arch support in these two sandals, you can get an over-the-counter cushion from the pharmacy that will adhere to the top of the footbed to give added arch support.  

These shoes are recommended for patients with:
*Mild to moderate Hallux Limitus
*Mild to moderate Functional Hallux Limitus 
*Hallux Rigidus (Mykonos)
*History of a 1st toe joint implant or fusion (Mykonos)
*Mild Osteoarthritis
*Mild Rheumatoid Arthritis (clear with your podiatrist) 
*Mild to Moderate Metatarsalgia
*Morton's Neuroma
*Plantar Plate Injury
*Over-Pronation (try to add a self-adhesive arch support and only wear for social occasions and not for all day walking)
*Plantar Fasciitis (heel pain)
*History of a previous Lisfranc's injury or fracture that has healed (please check with your podiatrist to see if this shoe is appropriate for you)
*Mild Hammertoes
*Mild Bunions
*Mild Tailor's Bunions 
*Mild Achilles Tendonitis
*History of healed tendonitis (check with your podiatrist)

These shoes are NOT recommended for patients with: 
*History or Ulcerations
*Charcot foot
*Balance Issues
*Moderate to Severe Hypermobility or Ligament Laxity 
*History of Falling
*Peripheral Neuropathy (nerve damage)
*Charcot-Marie Tooth
*Neurological Issues
*Peripheral Arterial Disease (poor circulation)
*Excessive swelling
*Moderate to Severe Lymphedema

For more information, please refer to my other articles on this blog:

My Feet Hurt: Top Ten Things to do to Alleviate Foot Pain.

Shoe Recommendations for Patients Recovering from Lisfranc's Foot Injuries.

I hope this was helpful and I thank you for reading the blog!

Have a wonderful day,

Dr. Cathleen A. McCarthy


Sunday, February 28, 2016

Top 30 Comfortable Sandals for Summer 2016 - Podiatrist Recommended.

Podiatrist Recommended 

Top 30 (Plus!)
Comfortable Sandal List

Summer 2016 

My summer sandal list is chock-full of options for those of you looking for a good-looking summer sandal that feels good on your feet. The recommendations are pathology specific, so what works for one foot type doesn't always work for a different foot type or pathology. I will offer tips for picking the best sandal for you. Keep in mind that, no matter what I recommend, the shoe must feel good on your feet. If the shoe is not comfortable on your feet then that shoe is not for you. 

For a shoe to be comfortable it must meet four criteria. You can get any shoe you want as long as the shoe meets the four criteria of what makes a good shoe and it passes the acid test - it has to feel good on your feet! 

The four criteria a shoe must have to be comfortable are:

1. A thick, rigid and non-flexible sole. This is crucial. If you are wearing a shoe with a sole that you can bend or is flexible, then you are setting yourself up for arthritic joint changes, injuries and stress through joints, tendons, ligaments as well as knee, hip and lower back issues. The concept is counter-intuitive, but having a shoe sole that is thick, rigid and non-flexible will put less motion through your foot joints. Less motion through your foot joints translates into less inflammation, swelling, injury and biomechanical strain. If you are recovering from a foot injury or foot pain of any type, the last thing that you want to do is force motion through the area of previous injury or current pain. If you are skeptical, give it a try and judge for yourself. 

2. A wide, soft toebox with as little pressure on the toes as possible. Pointy-toed shoes or ill-fitting, tight toeboxes can cause painful and cosmetically unpleasing bunions, hammertoes as well as corns and calluses. 

3. Rearfoot Control.  At the very least, you need to wear a shoe with a rearfoot strap. You will notice that there are no flip-flops or mules on any of my shoe lists. Without rearfoot control, you are forcing all of you tendons, ligaments and joints to work harder to stay in the shoe, which causes mechanical strain and can contribute to knee, hip and lower back issues. Also, without rearfoot control, you are forced to scrunch down you toes to stay in the flip-flop, which will speed up the progression of hammertoes and bunions. 

4. Arch Support. Ideally, you want to wear arch support, but in sandals that is not always possible. Arch support, in the form of over-the-counter products or custom-molded orthotics, can help to control over-pronation and decrease mechanical strain on the foot joints as well as the knees, hips and lower back. Ten percent of patients cannot tolerate arch support, so if arch support hurts your feet you might be one of the ten-percent of patients who should not wear arch support. Be aware that if your arch support hurts, then you might have it in the wrong shoe or you might have the wrong arch support. Talk to your podiatrist about what type of shoes and arch support are appropriate for your foot type.

Sandals are not appropriate for patients with:
*History of Foot Ulcerations or Open Sores
*Neuropathy (Nerve Damage)
*Peripheral Arterial Disease (Poor Circulation)
*Charcot Foot
*Custom-molded Ankle-Foot Orthosis
*Drop Foot

If there is any doubt about what type of shoes are appropriate for you, I recommend that you make an appointment with your local Podiatrist for a biomechanical evaluation. Avoid surgery and opt for conservative treatment options first. The goal of foot surgery is to take an abnormal, painful foot and turn it into an abnormal, non-painful foot. You should exhaust conservative treatment before you consider foot or ankle surgery.  

Ash Vera Crackled Leather Sandal

Ash Vera Crocodile Embossed Leather Sandal

I am loving the Ash sandals! They both are nice adaptations of the Birkenstock and, in my eyes, I like how funky cool they look. They meet the four criteria of what makes a comfortable sandal and they have the added benefit of possibly being able to accommodate your dress custom-molded orthotic. If you have severe over-pronation, the high interior edge might cause skin irritation, blisters or pressure which is uncomfortable. If you have ligament laxity, hypermobility or instability of the ankles (rolling outward) and a history of ankle sprains, the high outside flair should help to hold your foot in a more stable position.

Birkenstock Milano Soft Footbed Super Grip Shoes

The Birkenstock Milano is a great choice for almost any foot type. The thick, rigid sole is covered with a soft footbed for added comfort and the straps are all adjustable so you can get a better fit. This is the perfect sandal for anyone with Hallux Limitus (limited range of motion through the 1st toe joint), Osteoarthritis of the forefoot and midfoot joints, plantar fasciitis (heel pain), mild over-pronation, Morton's Neuroma, metatarsalgia and plantar plate injuries (to name a few). This may not be the best choice if you have chronic Achilles tendon issues as you will need a sandal that has a slightly higher heel in the back so there is less tension on the Achilles tendon.   

Born Bastille Sandals

I love the look of the Born Bastille sandals! The thick, rigid and non-flexible sole is perfect for anyone with Hallux Limitus, Functional Hallux Limitus, metatarsalgia, Osteoarthritis of the toe joints and history of a previous Lisfranc's injury. This sandal also is a good choice for anyone with heel pain. 

Born Emmy Sea Green 

I love this look and wore this heel height and brand for many years. If you are able to wear this heel height comfortably then this shoe should work for you. At some point in your life, you will no longer to be able to comfortably handle the heel height and you will have to transition into a lower heel. Your body will tell you when you hit that point and then you just make the change into...

Born Lucee

A lower heel! I think this sandal is adorable. It doesn't have arch support, so if you have severe over-pronation, this sandal might not work for you. 

Born Petulla

Born Tera

Circus by Sam Edelman

Clarks Caslynn Shae

Clarks Clarene Award

Dirty Laundry Ballroom

HKR Sandals

I love the look of this sandal and, with a price tag of thirty dollars, it's a steal. It does come in limited sizes, so if you like it, get it quick.

Clarks Hazelle Amore

Kenneth Cole Reaction Pepe Pot

Clarks Auriel Finn

Alegria Verona Sandal

The Alegria sandals has a sturdy sole with a wide base that helps with stability. This is a good pick for anyone who has Functional Hallux Limitus (decreased range of motion through the 1st toe joint), plantar fasciitis (heel pain) as well as knee, hip and lower back issues.  

Birkenstock Sydney Sandal

This is a great choice for anyone with large bunions and severe hammertoes that do not comfortably fit in enclosed shoes or sandals with forefoot strapping. Although I typically like sandals to have more forefoot control, that is not always an option if you have large, painful bunions and hammertoes. 

Chaco Z1 Sandal

This is an excellent choice for the beach. It is an amphibious sandal as you can wear it on the beach as well as in the surf. I highly recommend that you wear an amphibious sandal when you go in the surf at the beach. It will help prevent injuries such as stepping on broken glass, coral, sea urchin spines and sharp rocks. 

Dirty Laundry Gung Ho

Kork-Ease Myrna 2.0 Metallix Wedge

Kork-Ease Ava

I recommend that you try the higher-heeled sandals on at the store to make sure that they are comfortable. These can be found at Dillard's as well as other major department stores. 

Mephisto Barbara Wedge Sandal

This sandal works better on tiny petite women who are not over-weight. My experience has been that the sole in the forefoot of this shoe starts to break down a little quicker than it should if you are heavier. The patients who are petite tend to do well with this shoe for a longer amount of time than the more voluptuous, Rubenesque women. 

Naot Paris 

Naot Kayla Sandals

The Naot sandals are wonderful! The Naot Kayla offers similar benefits as the Birkenstock Milano sandals (reviewed above). It has excellent strapping for more biomechanical control and a thick, rigid sole covered with a soft topcover for more comfort. The Naot Paris has a topcover with more cushioning than the Naot Kayla and is excellent for anyone with painful calluses.

Steve Madden Nylee Flatform Wedge Sandals

You're going to have to try this one on at the store to see if it works for you. I wish it had an extra midfoot strapping for more biomechanical control, but I do love the look and this should work for some patients. I do not recommend this sandal if you have balance issues or you know you are going to be walking on uneven surfaces like cobblestone. This wedge sandal will work best on flat, even surfaces such as concrete floors. This sandal is also not ideal for anyone with moderate to severe over-pronation as there is no arch support. 

Wolky Jewel

A classic and my personal favorite! This in one of the best sandals you can get. Make sure that when you purchase it that you double- check that the sole does not bend or flex as quality with any shoe can vary. Always get the shoe with the sole that bends and flexes the least. 

Wolky Lily

Wolky Rio White Crush Suede

Keen's Newport H2

Keen's Newport H2 is a great option for an amphibious sandal to wear to the beach. Wear it in the sand and in the surf to help prevent foot injuries and pain. This is also the sandal that I recommend for patients who do water aerobics to help protect the feet while in the pool. 

Dansko Lolita

Dansko Stevie

The Dansko brand is not for every foot type or every patient, but they can be an excellent shoe for anyone with Functional Hallux Limitus (limited range of motion through the 1st toe joint), Osteoarthritis of the toe joints, a history of a previous Lisfranc's injury and heel pain (to name a few). I highly recommend that you try on the Dansko shoes in the store to see if they are right for you. Dansko sandals work best when you are walking on hard, flat surfaces such as concrete. They do not work well on cobblestone or severely uneven surfaces. 

Fly London Yito

Fly London Yuta

I love the look of the Fly London sandals! I have many patients who swear by them, but they do not work for everyone. My personal experience was that I found that the forefoot was a tad too narrow for my foot. I highly recommend that you go to the store and try these on to ensure a comfortable fit. These shoes are an excellent choice for anyone with heel pain and a history of mild Achilles issues in the past. They also work well for some patients with mild Functional Hallux Limitus (limited range of motion of the 1st toe joint). The Fly London sandals have a rigid and non-flexible sole and they have the added benefit of extra-cushion within the sole for added shock absorption. 

Fit Flop Sandals 

The Fit Flop sandals are a great pick for anyone with large bunions that hurt with any pressure. When you purchase the Fit Flop sandals, make sure that you double-check that the sole is rigid and not flexible. Quality can vary greatly! If you get one that has a flexible sole (especially in the forefoot area) do not purchase it. Keep looking until you find one that offers no motion through the forefoot area. Remember that the more rigid the sole is -- the more comfortable the sandal will be and it will also last longer. The Fit Flop sandal is a good choice for anyone with Functional Hallux Limitus (limited range of motion through the 1st toe joint), Morton's Neuroma, metatarsalgia, plantar fasciitis (heel pain) and painful 5th hammertoes with corns. They are not the optimal choice for anyone with severe over-pronation as there is very little arch support. 

Naturalizer Ardel Wedges

If you know that you can handle this heel height, this Naturalizer sandal should be comfortable for you. I like the wider strapping in the rearfoot and the extra cushioning in the footbed.  

Ash Fool Platform Sneaker

Okay, it's not a sandal, but it is adorable! 

*   *   *   *   *

I hope that this list was helpful and, if you need more information, please refer to my other articles on this blog:

My Feet Hurt: Top 10 Things To Do To Alleviate Foot Pain Today.

Shoe Recommendations For Patients Recovering From Lisfranc's Injuries. 

I'd love to hear your feedback on any of these shoes and, if you ever want to thank me for any help that I've been able to offer you - the nicest thing you could do for me is, if you enjoy detective murder mystery novels, I would love it if you would read my novel 'Gunning For Angels' and give me an honest review on Amazon. As much as I love writing this blog and helping people with their foot pain, I love writing detective murder mystery books even more. Fair warning, the book is rated-R so, if that is not your cup of tea, you can choose to thank me by sharing my blog on your social media. Or you can just kick your feet up, relax and watch a good movie. I'm enjoying one of my favorites right now - Ricky Gervais and Tea Leoni in Ghost Town. I particularly love Kristine Wiig's performance as a hospital surgeon who has to tell her patient that there was a slight glitch during his surgery - he died for seven minutes and now he can see ghosts. Fun stuff!

Thank you and have a lovely day!

Dr. Cathleen A. McCarthy


Check out my latest review of the Audiobook
'Gunning For Angels'
on Audiobook Reviewer

Saturday, January 9, 2016

Podiatrist's Secret to Giving Your Child The Competitive Edge in Sports.

Podiatrist's Secret to Giving Your Child 
the Competitive Edge in Sports.

My name is Dr. Cathleen McCarthy and I am a doctor of podiatric medicine and I've been in private practice since October 2, 2000. I treat patients of all ages and I have the privilege of treating many pediatric patients with a wide variety of biomechanical foot types and sports-related injuries. 

You can give your child a major competitive advantage by making smart choices when shopping for athletic shoes. And the good news is you don't have to spend a fortune! All you have to do is know what you are looking for when shopping for athletic shoes. 

To simplify matters, I will be referring to the child as a 'he', but, of course, this method also works for girls.  

What makes a superior athletic shoe? 
The answer is surprisingly counter-intuitive. To give your child a competitive advantage in sports using better shoegear, we have to refer back to the 3rd century when Archimedes mathematically discovered the 'lever principle'. The lever is the most simple and perfect of human-made machines. Archimedes stated, "Give me a place to stand and I shall move the Earth with the lever."

Imagine the sole of the shoe as the rigid board in the above picture. If you put your child in a running shoe with a thick, rigid and non-flexible sole, then when he runs, the sole of the shoe will provide more snap, which translates into:

1. Mechanical Advantage.  With a rigid-soled shoe, when your child runs, he will be placing less mechanical strain through his foot structures such as joints and tendons, which gives him a mechanical advantage. Instead of the child forcing his tendons and muscles to do all the work, the rigid-soled shoe is now doing more of the work, which translates into more...

2. Efficiency! Once the rigid-soled running shoe makes your child a more efficient runner, now he can put the previously lost energy (while wearing a flexible-soled running shoe) into speed and performance. Not to mention a decreased chance of injury! 

3. Energy Conservation. If your child is running in a flexible-soled running shoe, then he is forcing the foot joints, tendons, and muscles to work harder, which means he is now expending more energy trying to stabilize his foot as well as putting more energy into compensating for an underlying foot-issue (such as flat-feet). This will make him slower, more prone to injury and can cause tired-leg syndrome. Running in a flexible-soled running shoe, your child could be wasting 15-20% of his energy in trying to stabilize his foot because he is dealing with an underlying foot issue (injury, flat feet, ect) or an old injury. 

The secret is to get your child into an athletic shoe that has a thick, rigid and non-flexible shoeIf you add arch support (orthotics or a good over-the-counter insert such as Powersteps) then that translates into superior biomechanical control of the foot and now your child can put the previously lost 15-20% of energy into speed and performance and decreased chance of injury.  

Try an experiment: Buy a pair of rigid-soled running shoes and add the Powerstep inserts and then time your child running a certain distance. Now place him into flexible-soled running shoe with no arch support and then time him running the same distance. As I always say, the proof is in the pudding. 

An intriguing study showed that children with flat feet have a higher chance of going to college. Why? When a child has flat feet (pes planus), he has to expend more energy to keep up with the other kids. The child with flat feet often feels slow, clumsy and gets 'tired-legs' that makes running an unpleasant experience. The study shows that children with flat feet tend to drop out of sports in the 6th grade. Kids do not say things like, "Mom, I don't want to play soccer because I'm slower than the other kids and my legs ache." They are more likely to say something like, "I don't want to" or simply refuse to play the sport and will not offer a logical explanation, which leaves the parents confused and frustrated. 
Once kids drop out of sports, they will get more into sedentary pursuits such as computers, the chess club or books, which is fine, but we also want to keep them having fun in sports and staying active. 

So, if your child is trying to drop out of sports when they are in the 6th grade, I recommend that you try placing them in a rigid, non-flexible-soled shoe with the Powerstep inserts. If that is not helping, then take the child to your local podiatrist for a biomechanical foot evaluation. 

Avoid surgery! Your child probably does not need surgery. Your child needs to be wearing excellent shoes with arch support. If the underlying biomechanical foot issue is severe or if they are hypermobile and have something called 'ligament laxity', I place those pediatric patients in a tri-lock brace for additional biomechanical control and support, which significantly enhances their game. I have the pediatric patient run up and down the halls of the office (or around the parking lot!) while wearing rigid-soled running shoes, arch support and a tri-lock brace. I love watching their eyes light up with happiness as they realize that they are now able to run faster! 

Recommendations for Running Shoes:

Brooks Beast
For boys - once they are in adult-sized shoes
"Brooks Men's Beast '12 Running Shoe,Deep Royal/Silver/Black,9.5 D US"

New Balance 1540 V2
Boys and girls - once they wear adult-sized shoes
New Balance Women's W1540V2 Running Shoe Running Shoe,Silver/Grey,10 B US

Nike Boys and Girls Air Max 90 Running Sneakers

Stride-Rite Shoes (for younger kids)

Powerstep Kid's Arch Support

Arch Angels Comfort Inserts for Kids

Not all Brooks, New Balance, Nike or Stride-Rite shoes are good enough for your child's feet.  When shopping, remember that you are looking for the athletic shoe with a thick, rigid sole that has the least amount of flexibility that you can find. This can be challenging as 80-90% of all shoes are too flexible and do not meet the criteria required to make a shoe good for your feet. The reason for this is that shoe companies are selling people what the want and not what they need. 

I hope that this was helpful!

Dr. Cathleen A. McCarthy