Feet

Think twice before using cushioning

A lot of our patients request us to make insoles with “extra” cushioning or insoles that are ultra soft as they perceive them to protect the foot and provide comfort. And not just with our patients, it’s common perception when we go to a shoe store that we want footwear that has a highly cushioned foot bed. A lot of runners feel that they are protected from injuries if they use expensive shoes with high levels of cushion.

Today, we will shed some light on the importance of cushioning under the plantar surface or the sole of your foot. The human foot has natural cushioning on the sole in the form of fat pad. This fat pad gets worn out for a lot of people with time due to reasons like ill-fitting or ill-designed footwear, walking or running on hard surfaces, aging and related wear and tear, diabetic foot neuropathy, etc. When this fat pad under the heels and the metatarsal heads (the ball of the foot region) gets worn out, it is important to compensate for the same by using artificial cushioning in your footwear in order to protect the bones, tissues, ligaments and nerve endings of your feet from getting damaged on impact with the ground.

However, when the fat pad is intact or adequate, there’s no need to use excessive cushioning in your footwear. It can cause you more damage than you might realize. Too much cushioning between your feet and the ground reduces the proprioceptive function of the foot. The sole of your foot has thousands of nerve endings which sense the ground or the terrain and send signals to the brain that send signals back to the foot so that it can manouver efficiently over the ground without getting injured. This function of the foot is called proprioception and it’s these signals sensed by the nerve endings and send to the brain that help the foot act as a stabilizer, shock absorber, booster and providing balance to the body. With excessive cushioning, the nerve endings cannot sense the ground level signals and they start losing their functionality over a period of time.

We had a patient who visited us and insisted on silicon insoles as he’d been advised by his doctor to use only these. He had severe pain from plantar fasciitis and on evaluation, his fat pad was intact. We advised him to get custom insoles made to change his foot mechanics but he left since he wanted to silicon insoles only. After six months, he visited again. He said he purchased silicon insoles from the market and they didn’t make any difference to the pain. On the contrary, he started getting numbness in the soles of his feet. We made him a pair of orthotics, custom designed for his complaint, and he had relief from pain in less than three weeks. Also, his numbness disappeared as well within a month of discarding his silicon insoles.

There are several researches documented on many running websites that have proved that having increased cushioning in your footwear does not reduce the risk of injury. That’s why, cushioning should be used judiciously, with a lot of discretion, on a case to case basis. At Podiapro, we pride ourselves with the range of technical materials in our repository. For cushioning, on a case to case basis, we use different materials for eg. most of our sports insoles have Noene, a patented Swiss rubber that is not a cushion, but a highly effective shock absorber. This reduces the peak plantar pressure on the sole of your foot. Next, for those sports people that have reduced fat pad, the Sidas proprietory Podiane + is highly effective cushion that also provides shock absorption. For patients having diabetic feet complaints, we use a diabetic grade poron to provide cushioning and for those who have heel pain but are not actively into sports, Poron XRD has proved to be very useful.

So the next time you are tempted to buy a pair of ultra soft and highly cushioned footwear, think again if you really need them.

Rushabh

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Sidas Running Technology

Sidas Running Technology

Sidas, Podiatech’s parent company, is the creator of this amazing technology that works for you, under your feet, while you run! Protects your feet from injuries, blisters and fatigue. Call us today to get a pair, custom made for your feet, work in your shoes.

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Your shoe speaks!

The wear and tear on your shoe is a strong indicator of foot postural problems. Your shoe wear out pattern could give a sign into problems with the muscles and bones in your foot. Read more.

Any human being, on an average, walks a distance equivalent to the circumference of the earth in his lifetime. That’s around 40000 km. Zoom in deeper and you’ll realize that this narrows down to around 5000 steps a day that a person walks on a normal basis. This includes traveling to work and back, walking around in your office, your morning walk or run, etc. This adds a huge amount of stress on your feet and also on your shoes. Add to this the poor walking surfaces in Mumbai and it’s no surprise that our shoes wear out in a year or two. However, if you notice your shoes wearing out in specific areas sooner than others, or if you find a geographical pattern in which all your shoes normally wear out, it could indicate problems with your feet. And also problems with your knees, hips and back. This is what your shoe wear out pattern tells you about your body:

1.       Outer side of the shoe worn outOver Supination

If you observe that your shoe is getting excessively worn out at the outer edge, more than it’s worn out in the other areas, it is probably because you have a supinated foot. Those who have a high foot arch tend to supinate. A normal walking pattern begins with the heel striking the ground, then the mid-foot makes contact with the arch flattening to absorb shock and finally the forefoot propels the body forward. Those who have supinated feet have very high and strong arches that do not flatten while you walk. Therefore the body weight is likely to fall on the outer edge of the shoe.

Those who supinate are likely to suffer from ankle pain and sprains. Since the ankle isn’t aligned with the knee, faulty biomechanics put excessive pressure on the knees which can lead to erosion of the knee cartilage and bring on early arthritis.

Supination can be corrected by using orthotic insoles that are carefully crafted by moulding them into an impression of your foot cast in its corrected posture.

2.       Inner side of the shoe worn outOver pronation

If you observe the inner edge of your shoe wearing out faster than normal, it means your feet pronate excessively. Foot pronation means your foot arch collapses during walking which leads to your ankle rolling inwards when you walk. This is a very common problem with a majority of people in India. People whose feet pronate experience very little or no shock absorption as they walk. This leads to excessive strain on the ankles and may lead to pain and swelling. Also, it causes strain on the calf muscles and can lead to tightening and soreness in the calves. Over pronation can also lead to an anterior pelvis tilt – the front of the pelvis drops and the back of the pelvis rises since the ankle – knee- hip alignment is ruptured. This can cause low back pain.

Over pronation can be corrected with custom orthotic insoles that provide you with the exact amount of arch support needed for bringing articular alignment between your navicular and talus bones. Contact Podiapro for your pair.

3.       HeelHeel worn out

If you find the shoe wears out on the inside below the heel too fast, you are striking the ground too hard while walking or running, putting excessive pressure on your heel. Excessive pressure on the heel damages the fat pad that cushions the calcaneus. This could lead to pain in the heel or pathologies like plantar faciitis and Server’s disease.

Orthotic insoles with heal stabilizers and shock absorbing inserts will take off the excessive pressure off your heels.

4.       Ball of the great toeBall of foot worn out

Ball of the great toe is the big bone below your great toe that pushes against the ground when you lift your great toe. If you find excessive wear in the sole of your shoe below this region, you may be suffering from equinus deformity. A tight Achilles tendon limits the movement of your ankle. The most common methods of compensation are flattening of the arch or picking up the heel early when walking, placing increased pressure on the ball of the foot.

This condition can be caused by keeping the feet pointed downwards while sitting on a high chair or by wearing high heeled shoes frequently. It can cause pain in the ball of the foot region, corns and calluses (hard, dead skin) on the soles of your feet.

This can be corrected by insoles that release the pressure on the Achilles tendon and correct your foot timing. Contact Podiapro if you believe you have this problem.

5.       Great toeGreat toe worn out

If your shoe is wearing out under the great toe, it means you are putting excessive weight on the great toe while walking. This is probably due to over pronation of the forefoot  that transfers all the weight on the great toe even before the digitigrade or the toe-off stage. This could lead to corns and calluses under the great toe, can also cause the great toe to deviate inwards (hallux valgus) causing bunions.

Orthotic insoles that correct forefoot pronation and offload the pressure on your great toe should be used to correct such a problem.

 

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