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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 


Friday, January 1, 2016

Sketcher Shindig & Fortress - Podiatry Recommended Shoes for Comfort and Warmth

Podiatry Recommended
Two Comfortable Shoes for Winter Wear

The Sketcher Shindig & Fortress

The Sketcher Shindig & Fortress are two wonderful shoe choices for wearing around the house as a bedroom slipper or dressing up for casual wear with jeans. What makes the Sketcher Shindig & Fortress so comfortable (and podiatry recommended) is that they both meet the four criteria required to make a shoe comfortable:
1. A thick, rigid and non-flexible sole with a wide base
2. Wide, soft toebox
3. Rearfoot control
4. Arch support (although this shoe doesn't have exceptional arch support built into the shoe it should be able to accommodate a dress orthotic). 

The thick, rigid and non-flexible sole is the most important part of the shoe. If you are wearing shoes that you can bend and flex, you are setting yourself up for possible arthritic joint damage, stress fractures and deformities such as bunions, hammertoes and neuromas. Over 80% of shoes available in stores have soles that bend and flex because that is what sells. There is a common misconception that flexible, soft shoes are comfortable and good for your feet, but the truth is the exact opposite! What makes a comfortable shoe is a thick, rigid and non-flexible sole that protects your joints and tendons from excessive strain and damage. Cushion (usually in the form of cushioned arch supports and insoles) is then placed on top of the thick and rigid sole. The concept is similar to when you purchase a new mattress. You want a firm mattress for more support for your joints and spine and then you have a cushioned topcover for more softness and comfort. If you are recovering from a foot injury or trying to slow or stop the progression of foot deformities such as bunions and hammertoes, then it is crucial that you wear shoes that protect those joints from further stress, mechanical strain and damage. 

A wide, soft toebox puts less pressure on toenails, bunions and hammertoes. If water can wear down rock to sand - then it stands to reason that a tight or pointy-toed dress shoe can slowly deform your toes into bunions and hammertoes with painful corns. Not to mention promoting ingrown and fungal toenails. For more information on the important role that proper shoes play in getting rid of toenail fungus, please refer to my article in this blog: 

I don't recommend mules (shoes with no rearfoot control), but the Sketcher Shindig has enough of a reafoot 'lip' to secure the heel in place for more biomechanical control of the foot and the ankle. Without rearfoot control, your tendons, joints and muscles have to work harder to stay in the shoe, which causes mechanical strain and tired-leg syndrome as well as promotes forefoot issues because you have to clench your toes down to stay in the shoe. If you want to slow the progression of hammertoes, bunions, neuromas and other forefoot issues, then you need to wear shoes with rearfoot control. And if you have any rearfoot issues or knee, hip or lower back issues, then it is absolutely crucial that you wear shoes with rearfoot control. 

The Sketcher Shindig & Fortress are recommended for patients with:
*Plantar Fasciitis (heel pain) (wear with a dress orthotic for more biomechanical control of the arch which alleviates pressure on the plantar fascia) 
*Tailor's Bunions
*Corns and Calluses
*Morton's Neuromas
*Hallux Limitus (limited range of motion of the 1st toe joint)
*Functional Hallux Limitus
*Hallux Rigidus (no range of motion of the 1st toe joint)
*Mild Degenerative Joint Disease 
*Recovering from Lisfranc's Injury (without surgery)  
*Mild Peroneal Tendonitis 
*Mild Posterior Tibial Tendonitis
*Haglund's Deformity (without Achilles Tendonitis) 
*Mild to moderate swelling in feet and ankles
*Raynaud's Disease
*Ingrown toenails
*Mild to moderate Over-Pronation (wear with dress orthotic if possible)
*Mild to moderate Hypermobility (wear dress orthotic if possible) 

The Sketcher Shindig & Fortress are not recommended for patients with: 
*Charcot Foot
*History of foot ulcerations
*Achilles Tendonitis (there is not enough rearfoot control) 
*A history of an Achilles rupture, tear or surgical repair
*Ankle Instability 
*Severe Hypermobility
*Conditions that require that they wear an Ankle-Foot Orthosis (custom-molded ankle brace) 
*History of chronic ankle sprains or fractures (you need more rearfoot control) 
*Moderate to Severe Posterior Tibial Tendonitis
*Moderate to Severe Peroneal Tendonitis

Check with your Podiatrist to see if these shoes works for you if you have:
*Rheumatoid Arthritis
*Peripheral Neuropathy (nerve damage) 
*Peripheral Arterial Disease (poor circulation)
*Moderate to Severe Degenerative Joint Disease of midfoot or rearfoot joints
*History of Lisfranc's joint surgery with fixation (hardware such as screws and plates that fuse the joint) 
*Midfoot or Rearfoot joint fusions (surgery that stops motion at the joint with hardware such as screws and plates) 
*Geriatrics (might be too heavy for them)
*High Fall Risk 

For more information, please refer to my other articles on this blog:
My feet hurt! Top 10 things to alleviate foot pain today.
Shoe Recommendations for patients recovering from Lisfranc's Injuries.  

Happy New Year!
Wishing you health and happy feet!

Dr. Cathleen A. McCarthy


**Word of caution: do not get the Sketcher GOwalk shoes -- they are hideous for your feet and a perfect recipe for a fracture!