Ten Things You Need To Think About BEFORE You Have Foot Surgery. 1. You need to exhaust conservative treatment before you decide...
Saturday, September 20, 2008
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 CONVERSE SNEAKER.
The "Chuck Taylor" shoe.
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????
Please see the previous blog comments for some insights into arch control options for children...
SNEAKERS/TENNIS SHOES - SKECHER SPORT ENERGY:
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.
Rating: Seven to Eight Toe's. (On a scale of Zero-Toe's "Arch Enemy" to Ten Toe's "Foot Friendly").
SNEAKERS/TENNIS SHOES - RED BY MARC-ECKO-PHRANZ-PHLUTTER:
This shoe has rigid-midfoot control although it does have some bend at the forefoot area. No arch control.
Rating: Six Toe's.
SNEAKERS/TENNIS SHOE - SKECHER GIRL - PREMIUM - HEARTBREAKER:
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.
Rating: Seven to Eight Toe's.
DRESS SANDAL - BUSTER BROWN - VANESSA (WHITE):
This sandal has a rigid sole (although no arch support) with forefoot and rearfoot ankle straps that will help biomechanically control the foot.
Rating: Seven to Eight Toe's.
SNEAKER SKATES - HEELY'S HURRICANE:
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...
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.
SANDAL - CAR'S ACCELERATOR:
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.
Rating: Six to Seven Toes on a scale of Zero Toes (arch enemy) to Ten Toes (foot friendly)
SANDAL - S-LIGHTS BY SKECHER:
An adorable boy's sandal with a rigid sole and adjustable velcro straps. No arch support.
Rating: Eight Toe's.
SANDAL - SUPER Z-STRAP SKECHERS -NOLLIES FREESTYLE:
This is more a skateboard look that has a more rigid sole although no arch control.
Rating: Eight Toe's.
BOOT - BUSTER BROWN - HARDHAT:
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.
Rating: Eight-Nine Toe's.
DRESS SHOE - BUSTER BROWN CONNER:
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.
Rating: Seven-Eight Toe's.
SNEAKERS/TENNIS SHOES - S-LIGHT SKECHER - STARSTREAK:
A supportive sneaker with a rigid sole and adjustable velcro straps. No arch support.
Rating: Eight Toe's.
SNEAKERS/TENNIS SHOES - SUPER-Z-STRAP FRONTIER SKECHER:
Has a rigid-sole with a hard-to-remove insole that has no arch support.
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 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...
Wednesday, September 3, 2008
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
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.
I give this sandal a rating of Eight-Toes on a scale of zero-toes (arch enemy) to ten-toes (foot friendly).
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.