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Monday, May 12, 2014

Top Running Shoes - Podiatrist Recommended


Podiatrist Recommended

I'm glad that the hype over the Vibram FiveFinger minimalist running shoes are being exposed for what they really are - a poor excuse for shoegear. The Vibram company just settled a class action lawsuit for $3.75 million for making false claims about health benefits runners get from wearing the Vibram FiveFingers. I suspect that the $3.75 million is peanuts compared to all the medical costs associated with the injuries caused by the FiveFinger shoes. 

Here are my top three picks for running shoes:

New Balance 1540

Brooks Beast

Hoka One One - Stinson Tarmac

Each shoe has a thick and rigid sole so there is less motion through the foot, which allows for more protection of the foot and ankle joints, tendons and ligaments. Less motion through the foot translates to less damage to your joints, decreased chance of injury, decreased mechanical strain, and improved performance. 
As far as improving your performance, think of it this way: if you are running around barefoot or in a minimalist shoe and if you have 'biomechanically challenged' feet, then you could be wasting a certain percent of you energy because you are being forced to use 'x' amount of energy trying to stabilize your foot and ankle or by compensating. When you biomechanically control your foot with a thick, rigid sole and a more  protective running shoe, then you can put that previously 'wasted' energy into performance and speed. 

One of the analogies that I use when discussing the advantages of a protective running shoe to my patients is: the car industry has robots that close the car door over and over to see at what number the car door hinge breaks. Think of the joints in your foot as 'hinges'. All hinges have a 'tipping point' where damage is done and the hinge will eventually break down. By wearing a running shoe that protects the 'hinge', you have increased the life of that hinge, which means more miles of running over the course of your life. 

Runners love to run and, as a Podiatrist, my goal is to keep you running for as long as possible and with as few problems as possible.  

I know that the minimalist runners get upset when anyone suggests that minimalist shoes are not good, but I would like to say that all of the information that I am offering is designed to keep you running longer with less problems so you see less doctors. The minimalist enthusiasts love to knock what I am saying, but I would also remind them that as a Podiatist I have a very specific point of view. No one comes to my office and pays me a $50 co-pay to tell me how great their feet are feeling. By the time someone makes an appointment with me, they are having enough pain to interrupt and disrupt their lives, not to mention their running activites. 

I also recommend combining a great running shoe with a custom-molded orthotic, which is often covered by health insurance. If you can't get a custom-molded orthotic, I recommend an over-the-counter insert such as Footsteps or Powerstep. If you are recovering from a Lisfranc's injury or any foot or ankle injury and you are trying to return to running, I would recommend talking to your Podiatrist about possible bracing and physical therapy as you ease back into running activites. 

I recently returned to light jogging and I am wearing the Hoka One One, which I purchased from the Runner's Den, located at 6505 North 16th Street in Phoenix. Scott was very helpful and advised me that if you have a history of Achilles Tendonitis, it is important that you stretch before running in the Hoka One One. The shoe has so much shock absorption that it can cause some added 'play' in the  Achilles tendon, which can cause issues if you have ever had Achilles tendonitis. 

Scott also told me that the shoe that gives them the least amount of returns are the Brooks Beast. He stated that people who get the Brooks Beast periodically return and simply request a new pair. 

I have been recommending the NB 1540 for years and it has roll-bar technology with heel cushioning and is a great choice for anyone having heel pain or Hallux Limitus. 

I hope this was helpful! 

Dr. Cathleen A. McCarthy


Monday, May 5, 2014

Comfortable Sandals at Dillard's - Podiatrist Recommended.

Podiatrist Recommended
Top Comfortable Sandals at Dillards
Spring 2014

Clark's Lexi Sumac

What's great about this sandal is that the sole is thick, rigid and not flexible, which offers more biomechanical protection for the foot. An excellent feature is that this is an exceptionally light-weight sandal. This is a great option for older or more sedentary patients who need a comfortable and light-weight shoe. 

Alegria Kleo

This sandal is appropriate for a multitude of podiatric conditions. The sole is thick, rigid and not flexible and it has a soft topcover with good arch support. I love that it has wide strapping for forefoot, midfoot and rearfoot control, which translates to more biomechanical control to the foot and ankle structures. I have the Alegria enclosed shoe, which has the same sole and it is amazingly comfortable for all day wear. 

This is, in my opinion, the best sandal on this list, so I am including a pathology specific recommendation list:

Alegria Kleo is recommended for patients with:
*Mild to Moderate Bunions
*Mild to Moderate Tailor's Bunions
*Heel Pain (Plantar Fasciitis)
*Hallux Limitus
*Hallux Rigidus
*Plantar Plate Injury
*Mild Achille's Tendonitis
*Mild Tendonitis
*Mild to Moderate Rheumatoid Arthritis
*Mild to Moderate Over-Pronators
*Mild to Moderate Hypermobility
*Morton's Neuroma
*Patients Recovering from Lisfranc's injury
*Knee, hip & lower back pain

Alegria Kleo not recommended for patients with:
*Peripheral Neuropathy (Nerve Damage)
*Arterial Disease (Poor Circulation)
*Charcot Foot
*Drop Foot
*History of ulceration

Dansko Sonnet

This is my new Spring sandal and I love the thick, rigid sole with a wide base, which means less motion, which translates to more comfort, less mechanical strain and decreased chance of injury. Also, the low heel height and the adjustable velcro straps and soft topcover add to the comfort. 

One word of caution with Dansko, they do not work well if you are planning to spend lots of time walking on cobblestone. If you are going to Europe or vacationing anyplace with lots of cobblestone, you need a shoe with a thick, rigid sole but something with just a touch of "give" like the Alegria Kleo, Romika Fidji or Ecco Yucaton. 

Naturalizer Tanner

This sandal is a good option for anyone who can wear a slight heel. The sole is thick and rigid and it has excellent forefoot, midfoot and rearfoot control. If you have any significant forefoot issues, this is not the best choice because of the heel height. 

Teva Capri

For anyone who can wear a heel, this is a good choice. I would not recommend this sandal for anyone who has any significant forefoot issues such as Morton's Neuroma, Hallux Limitus or if you are recovering from injury or fracture of the metatarsal joints. 

It may work well for anyone who might have mild Achille's tendonitis because the heel lift decreases tension on the Achilles. 

Fit Flop Sandal

I like the Fit Flop sandals for anyone with prominent bunions because it offers the thick, non-flexible sole as well as midfoot and rearfoot control, but it doesn't have any straps causing pressure on the bunion or Tailor's bunion area. It also has enough shock absorption to help with anyone suffering with mild heel pain or Achilles tendonitis. I wish it had more midfoot strapping, but it you have large bunions that hurt with shoe pressure, this is a good choice. 

It's very important that you get the Fit Flops with rearfoot strapping as it offers more rearfoot control, which helps with forefoot issues as well as knee, hip and lower back issues. If you get the Fit Flop flip-flop with no rearfoot strapping, you are forcing all your tendons, muscles and joints to work harder to stay in the flip-flop, which causes more mechanical strain and "tired-leg syndrome".

Romika Fidji

The sole doesn't flex or bend and this sandal has excellent forefoot, midfoot and rearfoot control. It also has decent arch support and the wide base makes it a stable shoe. It's well made, sturdy and should work well for anyone with painful bumps on the top of the midfoot area (Lisfranc's exostosis) as well as forefoot problems such as Hallux Limitus, metatarsalgia, and hammertoes. 

Ecco Yucaton

If you get this sandal, make sure you purchase one that doesn't bend or flex for more comfort and biomechanical control. I've noticed that the quality can vary significantly from sandal to sandal. If you happen to get one that bends too much, ask the saleperson to let you try another in the same size. The adjustable straps and excellent arch support make this sandal comfortable for all day wear. If you have severe forefoot issues, you would be better off with the Alegria Kleo. 

Born Emmy Mouton

I love this sandal, but it is not appropriate for anyone with Hallux Limitus or any forefoot issues. If you know that you can comfortably wear a shoe this height, this should be a comfortable sandal for you. I like the wide forefoot, midfoot and rearfoot strapping that allows for more biomechanical control. 

I hope this was helpful!

Dr. Cathleen A. McCarthy