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Tuesday, December 16, 2008

Boy's Running Shoe at Kid's Foot Locker...


This is an excellent boy's tennis/running shoe with a rigid, supportive sole. It can easily accommodate a custom-molded orthotic or a good over-the-counter insert. 


Cost: $85

Rating: 8/10 on a scale of zero (arch enemy) to ten (foot friendly). 

Sunday, December 14, 2008

What do flat feet & winter sports have in common??

If you've got super-flat feet - you may want to consider taking up ice skating, skiing, or rollerblading!!

Think about it this way: if you come into my office with a broken bone in your foot, I put you in a cast. A cast, because it allows no motion across the site of the fracture, eliminates pain, inflammation, and swelling and allows the fracture to heal. 

If you have a super-flat foot - doing normal activities (even in the best of shoes and inserts) may cause foot, ankle, knee, and leg pain due to "biomechanical strain" of your foot trying to stabilize your body. 

By placing yourself in a ski or ice skating "boot" - you are in effect putting your foot into a "cast" which will significantly limit motion so that you can perform the sport with minimal or no pain. 

Over the years, I've noticed that many of my patients with severe hypermobility (super-flexible feet) and flat feet have tended toward what I call the "winter sports." 

Special Note: Custom-molded orthotics can be made specifically for ski and ice skating boots but, if they are not covered by insurance or too costly to purchase out of pocket for a quickly growing child, a good over-the-counter insert or heat-molded insert will work very nicely. 

If you have a child who has severe flat feet and they are inactive - try getting them into one of these activities!! They may love it and it could lead to a more active and healthy lifestyle. 

**One thing they stressed in our pediatric podiatry classes, if your child is complaining of foot and ankle pain, take them to your podiatrist to get a evaluation and treatment! Kids may fake stomach aches and coughs to get out of school but, trust me on this, they don't fake foot pain. Weird but true...

Hope all is well!
Cathy McCarthy 

Wednesday, November 12, 2008

Stretch Walker at Foot Solutions...

Bad news for MBT lover's!! 

MBT was bought out by another company and the things that made the shoe so wonderful are changing. They are trying to appeal to a larger market which means that they may be sacrificing the MBT's stability to aesthetics. 

A new shoe that is as good if not better than the old MBT is the STRETCH WALKER at FOOT SOLUTIONS on the SW corner of Scottsdale Rd and Acoma.

This shoe has a rigid sole which is excellent for a multitude of forefoot and midfoot problems with the added advantage that's it's lighter than the MBT. It has a midfoot stabilizer and stretchable fabric across the wide toebox. All of the patients who have purchased this shoe have all loved it! 

This shoe is excellent for almost any foot type or any foot pathology including diabetic and neuropathy patients. It is not appropriate for patients with severe deformities who require custom-molded shoes. It's also excellent for people who are on their feet a lot such as retail employees, post office employees, teachers or anyone with chronic foot problems. 

Cost: $280
*Remember, if you have chronic foot pain, shoes are an investment. Although this shoe is not for everyone - think about how much you spend in co-pays and medical bills and I bet anything it's more economical and time saving to invest in an excellent pair of shoes than spend all that money and time going to the podiatrist! 

Rating: 8-toes on a scale of zero-toes (arch enemy) to ten-toes (foot friendly).

Have a wonderful day!
Dr. McCarthy

Thursday, October 30, 2008

New Balance 926...


This is an excellent walking shoe for men and women. It has a rigid sole and a removable insole that can be replaced by a custom-molded insert or a good over-the-counter insert. It has excellent stability as well as a wide toebox and good rearfoot control. This shoe is good for almost any foot ailment including heel pain, tendonitis, mild to moderate bunions and hammertoes, Morton's Neuroma's, arthritis, and joint instability. It is also recommended for patients with knee, hip, and lower back pain. 

It is almost impossible to find in stores but can be ordered from ZAPPOS.COM which offers free shipping and free return. 

Cost: $95

Rating: Nine Toes.


Monday, October 13, 2008

Women's Casual Dress Shoes at Dillard's at Paradise Valley Mall...

First, a general overview of what you're looking for in a women's dress shoe...

1. You need a thick rigid sole to limit motion across the forefoot and midfoot.

2. Depending on your foot type, you can wear heels - the trick is to wear a wedge heel so that there is no motion across the bottom of the foot. If you have a condition called Hallux Limitus (meaning limited range of motion across the big toe joint) you will be limited on the heel height or  you may not be able to tolerate a heel at all. 

3. No pointy toes!! Look for a dress shoe with a square-toe box because the "cockroach killer" pointy-toe shoe's are a little bunion factories.

4. Very important - try to get a dress shoe that gives you some form of rearfoot control - whether it be with a strap or an enclosed heel. 

5. Arch control. Sometimes this is hard to find in dress shoes but they are out there. If the dress shoe has a removable insole, you can often put in a over-the-counter or custom-molded insert. Sometimes the dress shoe already has arch support in the shoe. 

Special Note: It is a common fallacy to think that your foot needs freedom and motion. Your foot actually needs rigid biomechanical control. If you are walking barefoot or wearing flip-flops or a flexible/flimsy shoe - you will have more motion across your many joints, which will cause more inflammation, pain, wear-and-tear (osteoarthritis and degenerative joint disease) that will not only put you at risk for foot problems but also knee, hip, and lower back pain. 

Remember, no matter what the shoe, this is what you need:
1. Thick, rigid sole.
2. Firm arch support.
3. Wide toe-box.
4. Rearfoot control (strap or enclosed back).  


Casual dress shoe with a wide toe-box and no arch support. It has an adjustable strap across the mid-foot. 

These two shoes is very similar to the Dansko enclosed clog (which is excellent) although this shoe is somewhat lighter. 
Cost : $130
Shoe Rating: 7-8/10

A women's enclosed sandal with a wide toe-box and a thick, rigid sole. There is no arch support but it has a removable insole for an OTC or CMO insert. It also has an adjustable strap. 
Cost: $100

These two women's dress clogs have a thick rigid sole and a wide toe box. There is minimal arch control and no rearfoot control and you won't be able to fit in a custom molded insert. 
Cost: $79
Rating: 6-7/10

This is a women's dress casual shoe with a three inch heel, a square toe-box, a strap across the midfoot, no rearfoot control, minimal arch control, and a thick rigid sole. 
Cost: $95
Rating: 7-8/10

Has a thick rigid sole with a wide toebox that may need some addtional stretching for people with bunions. It has minimal arch support and straps for mild rearfoot control. 
Cost: $79
Rating: 8/10

Very similar to the Nurture Bay 201 but is more casual. 
Cost: $89
Rating: 8/10

A closed dress shoe with a 2-3 inch heel. It has a thick, rigid sole. The toe-box may is slightly tapered which may not work well for people with moderate to severe hammertoes or bunions. It does have removable inserts so that it can be replaced with OTC or CMO arch inserts. 
Cost: $145
Rating: 7/10

This is a 4-5 inch platform heel dress shoe with a rigid sole, a chunky heel for more stability. it has rearfoot control. The toe-box is a little narrow but, overall, if you don't have any serious foot problems, this could be a good dress shoe.
Cost: $89

This shoe has a 4-inch heel with a wide, soft toe-box that would be good for people with bunions. It has an open toe and some rear-foot control. 
Cost: $255

This is a 3-inch heel dress shoe that has some arch support, minimal forefoot control (two straps) and mild rearfoot control. This is not a shoe for all day wear but might work well for an occasional dress-up occasion. 
Caost: $245
Rating: 6/10

Very similar to the above rated shoe although this shoe does have more forefoot strapping. 
Cost: $215
Rating: 6/10

This is a 2-inch dress shoe (For a wedding, ect...) with some forefoot control although it does have a narrow toe-box and some mild rearfoot control. There is no arch support but it does have a rigid, thick sole. 

This 2-3-inch dress shoe has a wider toe-box and rearfoot control. It's sole is rather thin but somewhat rigid.   
Cost: $79
Rating: 7/10

Remember: No matter how much I recommend a shoe, if you try it on and it's not comfortable - don't get it! 

Saturday, September 20, 2008

Granola Anyone???

I'll take a little Birkenstock with that Granola please...


Lot's of good stuff I can say about the Birkenstock - it has lovely arch support, a rigid sole, a deep heel cup for some heel control and good forefoot strapping. The only negative thing I can say about this shoe is that it doesn't have a rearfoot strap which would allow for more rearfoot control. Also, please avoid the Birkenstock flip-flop (thong) as it does not allow for enough forefoot and midfoot control. The Birkenstock I'm talking about is the one with the wide straps across the forefoot and midfoot area and, preferably, with rearfoot straps. 

This is a great shoe for kicking around the house and what I call "puttering." I wouldn't wear it for more aggressive activities like all day shopping or hiking, ect...

This shoe is not recommended for patients with: diabetes, peripheral neuropathy, foot-drop, Charcot, people with nerve disorders or history of paralysis or stroke. Also, any sandal with no rearfoot control will force you to grip your toes down to grip onto the sandal (or flip-flop) which can aggravate and cause progression of such forefoot problems as hammertoes, metatarsalgia, bunions, and metatarsal capsulitis. Saying that, the Birkenstock is still far superior to walking barefoot or wearing a flimsy flip-flop.  

This shoe is recommended for: light wear in the house, mild bunions, and Morton's Neuroma.

Many stores carry the Birkenstock and at my recent visit to Famous Footwear at Desert Ridge (NE Corner of Tatum & 101), the men's Birkenstock was $69.99. 

Rating: Eight Toe's. 


The "Chuck Taylor" shoe. 

The infamous...
The Rebel Without A Cause Sneaker...
Kids love it.
Adults love it. 
It's been around since 1917...
My husband owns a pair.

There are only two things I can say about this shoe:
1. It's better than barefoot.
2. It's better than flip-flips (maybe)...

Okay, there are more things I can say - if you have perfect feet than you might be able to tolerate this shoe. If you have foot pain, don't do it - don't torture yourself. 

My husband hasn't been able to find his Converse sneakers...
Wonder where they went???? 

Girl's Shoes at Famous Footwear at Desert Ridge...

Please see the previous blog comments for some insights into arch control options for children...

Has a thick, rigid sole with a removable insole that can be replaced by a custom-molded insert of and over-the-counter insert. It also has good rear-foot control.
Cost: $59.99
Rating: Seven to Eight Toe's. (On a scale of Zero-Toe's "Arch Enemy" to Ten Toe's "Foot Friendly").

This shoe has rigid-midfoot control although it does have some bend at the forefoot area. No arch control. 
Cost: $49.99
Rating: Six Toe's. 

This is a white and silver sneaker with some slight flexibility to the sole but it is not such an issue because there is a curvature to the bottom of the shoe in the forefoot area to accommodate for this during gait. 
Cost: $39.99
Rating: Seven to Eight Toe's. 

This sandal has a rigid sole (although no arch support) with forefoot and rearfoot ankle straps that will help biomechanically control the foot. 
Cost: $26.99
Rating: Seven to Eight Toe's.

I am a little torn about recommending this shoe. This sneaker has pop out roller skates so if you have an accident-prone kid, this might not be the right shoe. Ignoring the roller skate part of the the shoe, this is a great shoe due to it's rigid-sole. It does have a removable insole that can be replaced with a CMO or OTC insert for arch support. If your child does get this shoe - tell them to tie the laces and put on a helmet! 
Cost: I forgot to write it down...
Rating: Seven to Eight Toe's. 

Sandals? I didn't see any that I would particularly recommend. I'll keep looking...

Boy's Shoes at Famous Footwear at Desert Ridge...

Famous Footwear at Desert Ridge (NE side of Tatum Blvd & 101) has some pretty decent shoes and prices...

A word of caution - I've noticed that the exact same brand of shoe can often have different material strength in the sole so I highly recommend testing the rigidity of the sole for yourself. Try to get the shoe with the most rigid sole so that it is more protective of your child's foot. 

Also, no matter how great I rate the shoe, if your child doesn't like it or says it doesn't feel good - don't get it. Every shoe does not work for every person. One thing you learn in medicine is that there is always an exception to the rule! 

Also, I am constantly surprised that shoe manufacturer's rarely put arch support in kid's shoes - it's very strange that they consistently ignore this element of the shoe. If your child has flat feet, you're going to have to be careful to try to find a shoe with either built-in arch support or you can purchase an over-the-counter firm arch support for the shoe. 

Speaking of arch control for children, you have several options:
1. Custom-molded orthotics are the best but, I don't often like to put children in CMO's as they outgrow them so quickly and are expensive (@ $400). If your insurance covers them, that's great, but if not, I often tell patients that if they get the child an excellent shoe, the child will usually do just fine with a good over-the-counter pediatric insert. Ask your podiatrist to check your insurance for orthotics if you're not sure about your insurance benefits. 
2. I have a very nice over-the-counter pediatric insert that costs $65 and, for older children, we carry another that costs $40. I tell patient's that an insert, whether custom-molded or over-the-counter is like icing on the cake - but the cake is the shoe. You must have a good shoe!  
3. You can also buy over-the-counter insert for children in various retail stores. What you're looking for in an insert is firm arch control - not soft or gel support. For proper biomechanical control in children - you need more rigid control - not soft, compressible materials that offer minimal control.  

Also, if your child is complaining of foot pain, something is wrong! Kid's don't make up foot pain - they may fake a stomach ache but if a child says their foot hurts, make an appointment with your podiatrist and get him or her checked out. Most problems are treatable with conservative treatment. 

This is good boy's sandal that is black/silver/red. It has the best sole strength of any of the sandals although it has no arch support. 
Cost: $19.99
Rating: Six to Seven Toes on a scale of Zero Toes (arch enemy) to Ten Toes (foot friendly)  

An adorable boy's sandal with a rigid sole and adjustable velcro straps. No arch support. 
Cost: $31.99
Rating: Eight Toe's. 

This is more a skateboard look that has a more rigid sole although no arch control. 
Cost: $29.99
Rating: Eight Toe's.

A miniature little workboot shoe that would be very good for a child with weak ankles and/or severe collapsing arches. There is still no arch control but the insert is removable so that you can put an over-the-counter arch support in it. 
Cost: $24.99
Rating: Eight-Nine Toe's. 

A very nice dress shoe appropriate for church or weddings. It has a thick, rigid-sole with a removable insert (will some effort) that can be replaced by an over-the-counter or CMO.
Cost: $24.99
Rating: Seven-Eight Toe's. 

A supportive sneaker with a rigid sole and adjustable velcro straps. No arch support. 
Cost: $39.99
Rating: Eight Toe's. 

Has a rigid-sole with a hard-to-remove insole that has no arch support. 
Cost: $34.99
Rating: Seven Toe's.

1. The Skecher Commando with Three-Toe Rating due to it's atrociously flexible sole.
2. Converse. (I am going to devote a special blog just to this Rebel Without A Cause shoe...) 


Saturday, September 6, 2008

The MBT - All Hail The King!

The MBT is the ultimate shoe - one of the best I have ever seen! Whenever I have patients who come in with chronic foot pain caused by "Overuse Syndrome" - usually caused by a job where they are on their feet all day (i.e. Retail, Teachers, Postal Employees) - I try to get them into an MBT. 

I have a patient who works for the Post Office and she suffers from chronic foot pain due to the fact that she is on her feet eight to ten hours a day. She has several more years till retirement and the only thing that is keeping her going is the MBT. She told me that once she started wearing the MBT, she isn't willing to wear any other shoe. I have another patient who went to many doctors from many different specialties over the last five years and they all told her the same thing - "you just have to live with the pain." Once I got her into the MBT, she came back in eight months later and hugged me. She had lost thirty pounds because she was able to return to exercising and she told me that she's never been happier in her life because now she's able to do all the things she'd been wanting to do but wasn't able. That really made my day!! I could tell more success stories about the MBT, but you get the point...

I own the MBT myself and my goal is to walk at least one hour a day - not that it always happens but when it does, I'm always in my MBT's. Also, whenever I have lower back pain, I immediately put on my MBT's and it's almost instant relief. Remember, if you continue to have lower back pain, please follow up with an orthopedic surgeon for proper evaluation and treatment. 

The shoe is a little funky looking but my experience has been that when someone is dealing with chronic pain that is effecting their lifestyle and activity level, they are usually quite willing to give the MBT a try. I sometimes write prescriptions for my patients who need MBT, which can make it tax deductible. I always counsel people to go to the store, usually Foot Solutions on Scottsdale & Acoma (SW Corner), as they have excellent customer service and they work with you one-on-one to make sure that you're comfortable with the shoe. There is a break-in period with the shoe - usually one hour the first day, two hours the second day, ect... until you are up to a full day of wearing the MBT. I've heard the people at Foot Solutions sometimes tell people that you don't need a custom-molded orthotic with the MBT, but I would have to respectfully disagree. I feel the arch support, whether it's a CMO or an Over-the-Counter Insert only adds to the MBT's power. 

A word of caution! Not everyone can tolerate the MBT. If you have balance problems or a history of falling, this may not be the shoe for you. Also, not everyone can tolerate arch support so I always advise patients to try the MBT and if they don't like it, don't get it. But I also tell them to keep an open mind - the shoe is weird - but in a fabulous "don't your feet feel better" way!   

This shoe is recommended for people with: metatarsalgia, mild to moderate hammertoes, mild bunions (may need some shoe stretching and to prevent progression of the bunion and the MBT will need arch control with a CMO or OTC Insert when you have a bunion), mild to moderate degenerative joint disease of the forefoot and midfoot, mild Morton's Neuroma, mild Tailor's bunions, diabetic patients, neuropathic patients (with particular care to make sure you are measured and in the correct size shoe), tendonitis, plantar fasciitis (heel pain), as well as knee, hip, and lower back pain. 

This shoe is not recommended for people with: gait instability (i..e balance problems and history of falling), elderly patients with weakness in the legs or a shuffling gait, Dropfoot, moderate to severe hammertoes, Achille's tendonitis, and moderate to severe bunions (the toe-box may not be wide enough - may need to be stretched).  I would never put an elderly or weak patient in this shoe as it is too heavy - they need a lighter shoe. 

This is an expensive shoe! If you have mild foot problems, you can now buy this shoe at Dillard's for $250. If you have more severe problems or chronic foot pain, go to Foot Solutions at Acoma & Scottsdale so you get more one-on-one attention and more gait training. It is slightly more expensive but worth it.

I give this shoe a solid Nine-Toe Rating on a scale of zero-toes (arch enemy) to ten-toes (foot friendly).

Let me know how you like the shoe!

Have a lovely day...
Cathy McCarthy. 

Wednesday, September 3, 2008

"Anne's Wide Shoes" at NE corner of Bell and 59th Ave.

This independently owned and operated shoe store specializes in providing shoes for people who need wider fitting shoes - from Men's size 7-16 EEE-EEEEEE and Ladies size 5-13 D-EEEE.

Wow! This is an impressive line of shoes/sandals that were designed by a Dutch Podiatrist. The have rigid soles with cushioned (although non-removable) insoles and I think they look pretty darn nice. 

Recommended for patients with: mild to severe hammertoes, mild to moderate bunions (may need some stretching of the leather which can be done at the store or in our office), metatarsalgia, tendonitis, LisFranc Joint Injury, osteoarthritis, Rheumatoid patients, forefoot and midfoot mild to moderate degenerative joint disease (depending on the patient and location of the problem), mild to moderate Tailor's bunions, sesmoiditis and mild to moderate Morton's Neuromas. 

Not Recommended for patients with: Diabetes or peripheral neuropathy, Charcot foot, severe bunions, and severe Tailor's bunion. 

This line of shoes/sandals are rated a solid Nine-Toe rating (from zero-toes "arch enemy" to ten-toes "foot friendly"). 

**The Wolky Liana is the #1 seller for comfortable slip on sandals. It has adjustable straps, which is very helpful for patients suffering with bunions/bump pain. It has a cushioned insole and sells for $129. 

Also very impressive! This is another sandal/shoe that has a rigid sole with a cushioned insert and decent arch support. The insole is removable so that you can replace it with either a custom molded orthotic or a more aggressive over-the-counter insert with more arch support. Aravon is a division of New Balance, which is one of the few shoe companies that engages in active research and development to create a better shoe. 

The recommendations and non-recommendations are approximately the same as the Wolky (see above). 

Cost: approx $134

A special shout out on this one to patients with large bunions!! This is technically not the best or most supportive sandals out there but the sandal has a soft, stretchy fabric over the bunion area that will put less pressure on the bunions. The sandal is made in Italy and has a removable insert so that you can put in a custom molded orthotic or a more aggressive over the counter insert. The insert that comes with the shoe is very decent and has some arch support. Although the sandal does not have rearfoot control/strapping - it could be an excellent shoe for people with bunions for light activities or around the house. 

I give this a Six to Seven-Toe Rating on a scale from zero to ten for most patients but for patients with bunions - this could be a Nine-Toe Rating...

Okay, Bunion patients, you may not like this one but...
Not the prettiest shoe you've ever seen but if you have painful hammertoes or bunions this is an excellent shoe for more intense walking activities that you may want to do. It is an extra-depth shoe that will give more room to forefoot problems such as hammertoes and bunions. Keep in mind, that if you still need more room in the forefoot area, the shoe can be stretched to further accommodate any problem areas (can be stretched in the store or at our office). You're going to see this shoe and not want to buy it but I would say to you - buy a Wolky or Aravon for more dressy occasions and then purchase this shoe for when you hit the casino's or or the Mall for some power shopping. Remember, even if you have a shoe that's not so easy on the eyes and you don't want to wear it because it's not "pretty enough" - if it improves your quality of life by allowing you to do more and stay active, than put on the shoes and get out there and have some fun!!! Live life to the fullest - even if you have to do it in some funky shoes...

I give this shoe a Nine-Toe Rating...

**Annette and Erin run the store and are very knowledgeable about the shoes and will happy to help you. Please support them as small independently owned shoe stores that specialize in people with special foot needs are hard to find and, when we do find one (like this one), we want to support them.

Have a great day!


Tuesday, September 2, 2008

Women's Dress Sandal at REI (Near Paradise Valley Mall)

The Dansko Lolita Sandal:
For a dressier sandal that will work well in a casual work environment, this is an excellent choice. It has a thick, rigid sole that will protect the forefoot, midfoot, and rearfoot as well as a good strapping system that will help to biomechanically control the foot. It has leather straps and it is a more dressy sandal than the previously reviewed sandals. 

Recommended for patients with: Forefoot problems such as hammertoes, metatarsalgia, mild bunions, mild Tailor's bunions, mild Morton's Neuroma, forefoot and midfoot osteoarthritis, degenerative joint disease and pain, mild LisFranc's Joint problems, and mild tendonitis.

This shoe is not recommended for: diabetic and neuropathic patients. 

Cost: $79.93

I give this sandal a rating of Eight-Toes on a scale of zero-toes (arch enemy) to ten-toes (foot friendly).

Women's Sandals at REI (Near Paradise Valley Mall)

There are two stand-out Women's Sandals at the REI near Paradise Valley Mall (Tatum and Cactus). 

Chaco Z1 and Z2: 
This is a very good sandal with a rigid sole and aggressive arch support. It has adjustable straps, which may be of some help to people with bunions. The Z2 has slightly more supportive strapping than the Z1. They come in various colors and designs and can also work as a good water shoe. 

This shoe is good for patients who want to wear a sandal but need arch support. It will also work well for patients with mild to moderate hammertoes, mild bunions, Morton's Neuroma, Tailor's bunions. plantar fasciitis (heel pain), mild tendonitis and mild metatarsalgia.

This shoe is not recommended for: patients with diabetes or peripheral neuropathy (numb feet), severe bunions (may be irritated by the strap), or patients with painful calluses (although the sole is rigid enough, these patients may need more cushion).

Cost: $95 (Look for their sales!!)

I rate this sandal as a solid "8-toe rating" on a scale from (arch enemy) zero-toes to (foot friendly) ten-toes.  

Teva Open-Toachi Sandal:
This is a decent sandal. For some patients it will be excellent while it won't so well for other patients. Things I like about the sandals are that it can work well as a water shoe as well as a land shoe. It has very good forefoot and rearfoot control and some arch support. Not as much arch support as the Chaco but much better than most sandals. Also, both of these sandals, the Chaco and Toachi, are great for patients who suffer with sweaty, wet feet as well as frequent athlete's foot fungal infections since they can be easily cleaned.  

This sandal will work well for patients with: plantar fasciitis (has lots of heel cushion), mild tendonitis (peroneal and Posterior Tibiale Tendonitis), mild bunions, mild to moderate hammertoes, and mild Tailor's bunions.

This sandal will not work for: patient who are diabetic or have peripheral neuropathy, people who have severe forefoot pain (may not be rigid enough across the ball of the foot to prevent damage and/or pain), and moderate to severe Morton's Neuroma's (not wide enough).

Cost: $69.99 at Sports Authority on Scottsdale & 101.
Cost: $59.93 at REI at Paradise Valley Mall.

Overall Rating: I give this sandal a Seven-Toe rating. 

I purchased this sandal and enjoy wearing it around the house and for light walking/activities. I usually exercise in an MBT (I will review at a future date) and my custom-molded orthotic but on Monday I decided to test the sandal by exercising in the Teva Toachi. I walked 3-1/2 miles on asphalt and some dirt paths and did quite well. I will say, however, that the MBT's and CMO's gave me more stability and less joint tenderness (lower back). I would not recommend exercising in a sandal - you will be much better off exercise-walking in a walking shoe, hiking shoe, or MBT - depending on your foot problems. 

Saturday, August 30, 2008

A GREAT Men's casual sandal...

The All-Rounder by Mephisto "Alligator" gets a "nine-toe" rating!! 

This is an excellent sandal and will work well for: patients with plantar fasciitis (heel pain), tendonitis, mild to moderate hammertoes, and mild bunions.

I would not recommend this sandal for: diabetic patients, patients with neuropathy (nerve damage), or patients with moderate to severe bunions. 

This shoe can be purchased at: 
Nordstrom's at Fashion Square in Scottsdale for $190 
Zappos.com for $194
Mephistowebstore.com for $190
The Mephisto Store on the NE corner of Scottsdale & Shea (near the movie theater) - unsure of the cost at the store but probably the same.

*Please remember that if you continue to have foot or ankle pain - please follow up with your podiatrist for a full evaluation and treatment. I have often had the experience with patients who come in upset because "my shoes hurt" or "my orthotic doesn't work" and what is really going on is that the patient is walking around on an undiagnosed foot or ankle problem that needs treatment. Remember: you can be in the best shoe or orthotic in the world, but if you're walking around on a stress fracture - nothing is going to feel good! I recently had a patient, a lovely elderly woman who came in with "chronic foot pain for twenty years." The poor woman had been suffering with foot pain for twenty years and I was the first doctor she went to to address the issue. An MRI confirmed the diagnosis of a "severe stress fracture most likely caused by chronic, repetitive microtrauma" (i.e. walking around in poor shoegear). My treatment goals for her are to heal her stress fracture and, after she is healed, get her into good shoes so that the problem will not reoccur. 

From You Friendly Neighborhood Shoe-Geek Podiatrist...
Have a Great Day!

P.S. If you get this shoe - I would love your feedback!


Finding a fashionable dress shoe for a patient with heel pain and sesmoiditis.

I have a wonderful friend and patient who has suffered from plantar fascitiis (heel pain) and sesmoiditis (pain under the ball of the 1st toe joint) who has been looking for a fashionable dress shoe to wear to work. He works in a rather glamorous profession and is a handsome bachelor who does not want to wear "ugly shoes." He requested that I look in Nordstrom's at Fashion Square in Scottsdale for a pair of dress shoes and, by sheer coincidence, we ran into each other this morning in the men's shoe department at Nordstroms! Needless to say, I was there for forty minutes before he came in so I had plenty of time to look through the entire men's shoe department and had some ideas for him. Overall, because of his heel pain, we wanted something with some heel cushion (if possible) to absorb shock with each step and because of his forefoot issues, I wanted to get him into a shoe with a rigid sole to prevent too much flexibility in the forefoot, which can cause aggravation to the sesmoid bones as well as more damage. We found a black boot by Kenneth Cole called "N-Different." I got the distinct impression that although he was not completely thrilled with the aesthetics of the boot, it was something he could live with -  and this guy is very fashionable and I would describe his overall style as contemporary with a European flair. 

On a rating system of "zero-toes" (arch enemy) to a stellar "ten-toes" (foot friendly), I rate this shoe in the six-to-seven toe area. The boot may move up in my estimation depending on my friend's feedback. The boot lacks good arch control but that can easily be remedied with a custom-molded orthotic, heat-molded dress orthotic, or a good other-the-counter insert that controls the arch within the shoe. 

This shoe will not work if you have: moderate to severe bunions, moderate to severe hammertoes, if you are diabetic or have neuropathy (nerve damage), have a painful Morton's neuroma, bone spurs across the top of your midfoot area, a very high arch, or have forefoot issues such as degenerative joint disease or Rheumatoid arthritis. 

This shoe will work well (assuming you have at least an other-the-counter insert for arch control) if you have: ankle instability due to tendonitis or hypermobility of your joints and/or ligaments, or if you have a history of chronic ankle sprains. 

Ultimately, this shoe has it's limitations but, overall, it is a decent shoe for a young, healthy man who wants a fashionable dress shoe.  

Rating: Six-to-Seven Toes. 
Price: @$275

Special Note: I met a lovely salesman, Mr. Lucas Mitry, who was very helpful and is a certified shoe fitter who I would recommend requesting if you are in the Nordstrom's at Fashion Square. 

Preview: I am very excited about an upcoming visit to Target where I plan to review Children's shoes - stay tuned!

Thursday, August 28, 2008

The Basics...

The first and most important rule is you have to stop walking barefoot! I tell my patients, "If I had a sign in my reception room that said stop walking barefoot and my patients followed that advice, I'd lose most of my business." 
If you stop walking barefoot, you will have a significant decrease in foot, ankle, knee, hip, and lower back pain over the next several week. I'm not kidding!
It's that crazy simple...
Some patients argue that "Cavemen walked barefoot so therefore it must be natural and good for your feet." 
I would argue that cavemen weren't walking around on concrete and often probably didn't live past thirty so they didn't have to worry about developing degenerative joint disease that would plague them when they are seventy and wanting to retire and relax. 
People fight this rule. I don't know why. What's so great about walking barefoot? It's the perfect way to:
1. Pick up verrucae (Warts).
2. Foreign bodies like cactus spines (remember, I'm in Arizona) and glass - which can turn into an out-patient surgery under anesthesia. 
3. Tendonitis.
4. Plantar Fasciitis (If you've had it, you know how debilitatingly painful it can be)...
5. Breaking a toe slamming it into a bedpost or door in the middle of the night. 
6. Stress Fractures from continuous low-grade micro-trauma (I see it all the time).
7. Callused heels (painful and ugly).
8. Fungus. And once you have an athlete's foot fungal infection of the skin, it's just a matter of time until it infects the toenails. 
9. There's lots more but it's time for me to put on my walking shoes and hit the treadmill...

I plan to review shoes and give recommendations based on:
1. Types of shoes (Running, sandals, dress, ect...) 
2. Types of pathologies (Heel pain, bunions, hammertoes, ect...)
3. Types of patients (Pediatrics, Sports Enthusiasts, Geriatrics, and, yes, the fashionista with foot issues!)