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Saturday, April 14, 2012

Shoe Recommendations For Patients Recovering From Foot Fractures and Injuries.


Shoe Recommendations 
For Patients Recovering From
Lisfranc Injuries...
(As well as any Sprain or Fracture of the Foot)




I know this sounds terrible but 
I love treating fractures...

I enjoy treating patients with fractures because:

1. On the 1st visit, patients will leave the office in significantly less pain than when they walked into the office using simple non-painful conservative treatment. 

2. Once the fracture is healed - we focus on getting patients into proper shoegear, arch support and possibly bracing so they can get back to doing all the activities they enjoy! 

I love my profession because I have the opportunity of helping people heal from foot and ankle injuries and get back to their lives.
Over the years, I have discovered that if patients follow the recommendations below - our success rate is amazingly high!


LISFRANC'S INJURIES.

So, let's talk about Lisfranc Injuries...
The Lisfranc Joint (also known as the Mid-Tarsal Joint) is in the midfoot and, in my opinion, it is the most common foot injury. 
Although it can be caused by direct trauma (and if that happens - you are going to the Emergency Room and possibly having surgery), I find that the wide majority of Lisfranc Fractures or Sprains are caused by an often minor twisting of your foot on a stair or curb and, if you happen to be barefoot, wearing flip-flops or a shoe that bends through the midfoot area - there is a very high probability that you are going to break a bone or pop a ligament.  

I see this type of fracture every single day
One day last week I saw four Lisfranc fractures before lunch. The amazing thing was not one of them knew how they did it!


In my opinion, this fracture is caused by taking a
wrong step in a crappy shoe!
And it's not you're fault because 
80% of shoes out there are crappy 
and there is tons of misinformation about what makes a good shoe...

One of the main reasons I started the blog was because of my frustration with all of the misinformation about shoes.
I'm passionate about this topic because I have spent the last twelve years in private practice striving to help people heal foot injuries and get back to their lives.


So...
These Rules Are Stringent 
BUT
You ARE Recovering from a Foot Fracture
and you need to protect your foot!
You went through a lot of pain and time in "the boot" or on crutches to take the chance of wearing bad shoegear and re-injuring...


So...




THE RULES 
FOR WHEN YOU ARE RECOVERING FROM A FRACTURE OF THE FOOT:

1. No barefoot! 
Ever. 
The only time you are barefoot and standing is in the shower. 
2. No Flip-Flops. 
I don't care how "good" they say the flip-flops are - they're not. 

3. No Walking Around the House Wearing
Only Socks.
 Zero biomechanical protection. 

4. No Flimsy Bedroom Slippers.
Any slipper that bends or flexes is garbage.

5. As a bedroom slipper around the house - wear Croc RX Clogs with the strap 
in the back.  
As soon as you get out of the shower, dry yourself, put on your Crocs.
If you get up in the middle of the night to go to the bathroom, when you get out of bed, straight into your Crocs and off you go.
Yup, the strap MUST be to the back. 



IF YOU ARE RECOVERING FROM A FOOT INJURY / FRACTURE / SPRAIN 
ANY SHOES THAT YOU WEAR 
MUST HAVE:

1. A Thick Rigid Sole
If you can bend or flex it - it is garbage.
Put some muscle into it, please - no wimpy "bends"...

2. Arch Support
Whether it is Custom-Molded Arch Support or an Excellent Over-The-Counter Insert - you need arch support.
Unless you are one of the 10% of people who can't tolerate arch support in which case, do not wear arch support. 

3. A Wide, Soft Square Toebox. 
Google: Extra-Depth Shoes and there are many brands of shoes that have extra-depth for the toes.
No cock-roach kickers, please -- they are bunion factories. 

4. Rearfoot Control. 
Every single shoe MUST have rearfoot control. 
If you are not biomechanically controlling the rearfoot - you are not controlling the mid-foot - which will lead to more chance of re-injury, pain, strain as well as knee, hip and lower back mechanical strain. 
To stay in a backless shoe, you are gripping your toes down when you walk. There are tendons that start below the knee and go all the way down to your toes - they are also passing through or connecting into the bones that make up the Lisfranc's Joint and a biomechanically uncontrolled rearfoot equals more strain, more pain and more chance of re-injury. 



ONE "SHOE DAY"
IN  THE LIFE OF SOMEONE RECOVERING FROM A LISFRANC'S FRACTURE
(Any midfoot fracture or Injury)


 6am
Good Morning!
 I have to let the dog out so I guess I'll get out of bed and right into my Crox RX Clogs 
(making sure that the strap is to the back) and let the dog out. She's fascinated with the Geckos and Hummingbirds...

6:30am
Exercise
I'm going to put on my Diabetic socks (even though I'm not diabetic), my Tri-Lock Brace, which I got from my Podiatrist and I use when exercising (for at least 6-12 months after a Lisfranc's Injury) and I'm going to put on my 
New Balance walking shoes so I can take my dog for a thirty minute walk. 
Luckily, my Podiatrist sent me to the New Balance store and gave me a prescription for:
RX:
New Balance Walking Shoes
with Roll Bar Technology and
a wide base for more stability
(Because it's an RX and medically necessary it should make them tax deductible...)



9am
Work
My foot feels pretty good so I don't need to wear my brace to work today -- but I'm going to take my Tri-lock brace to work so that if my foot hurts I can put it on. 
I went to Dr. McCarthy's blog and found the search box (top right hand corner) and searched for:
"Top 20 Women's Comfortable Dress Shoes"
and found a great shoe for work. 
I wrote down what I liked and went to the store to try them on -- my brace fit into some of them but not all so, in the early days of recovering from my injury, I wore the chunkier shoes with my brace and once I was further along in the healing process, I didn't need my brace anymore. 
Anything on this list would be fine with someone who has healed from a foot fracture
because I know all of these shoes meet her criteria on that stringent list from her blog...



2pm
Go Play!
Wow, I can't believe it! Work shut down early and now I can go do whatever I want! 
Let's look and my options...

Beach:
I'm going to wear my Amphibious Teva's or Chaco's (with a rearfoot strap) whether I am on the sand or in the water because it'll be more comfortable and I'll have more fun. 

Water Aerobics
Am I going to do water aerobics barefoot? 
Oh heck no! 
My Pod told me she sees a surprising number of fractures from women bouncing around in the swimming pool -- I think I'll wear my Amphibeous Teva's (with rearfoot strapping). Right after I was recovering from my foot fracture, I had to wear a pair of New Balance Walking Shoes with Roll Bar Technology and a wide base (for more stability) in the pool


Hiking
I didn't like any of the hiking boots Dr. McCarthy featured on her blog so I went to REI and I picked out a boot I liked but I made sure that the sole didn't flex or bend. The salespeople must have thought I was crazy because I walked around -- bending and flexing all the shoes before I tried them on. I then picked a great boot that felt the best on my foot and met all Dr. McCarthy's criteria for proper shoes. 
She told me that no matter what she says, 
I'm the acid test. 
 If I try on a shoe and it's not comfortable -- 
I don't get it. 
Yoga
I don't care what anybody thinks! 
I went through too much to get my foot healed to risk re-injuring it by being barefoot so I am going to wear my New Balance walking shoes with Roll-Bar Technology and a wide base
I love Yoga and I want to keep doing it so 
Dr. McCarthy wrote me a prescription that I gave to my Yoga studio that says it's medically necessary for my to wear my shoes in class. 

7pm
Home at Last!
I used to not want to wear my Croc RX Clogs around my husband because I thought they were goofy but, guess what -- I got him in Crocs Rx around the house and he had the following benefits:

1. 
30% Improvement in knee, hip and lower back pain within 3 weeks.

2. 
We saved a truckload of money in medical bills - everything from foreign bodies, warts, tendonitis, fractures, heel pain, calluses, ect.

3. 
His feet are prettier! 
Turns out that kooky Dr. McCarthy was right! She said, "You're either beating up your feet or you're beating up your shoes -- think what your shoes look like after a couple of years -- that's what's happening to your joints."


10pm
Good Night!
I'm so glad that my day tomorrow doesn't include going to see my Podiatrist! 
We got the fracture healed and as long as I do the right things when it comes to protecting my feet, 
I don't need to see her. 
I can live my life and have fun!

Gee, 
I wonder why a Podiatrist would be giving out advice that would decrease her business?
 Hmm, I wonder if it's because she figures it's a better marketing plan to fix people's foot problems and then protect their feet with proper shoes so they don't need to keep constanly coming back and she gets new clients from "Word of Mouth" referals from happy patients? 
That must be it...



Have a Great Day!


Dr. Cathleen A. McCarthy

:)