Shoes Matter

Shoes Matter Blog

Every day, your feet take a beating. They hold up your entire weight throughout the day, day after day. You run, walk, stand, and climb, probably without giving a lot of thought to your feet unless they hurt.

Each step you takes involves an impact that reverberates from your foot up through your knee and into your lower back. The faster your pace, the stronger the impact. To help absorb those shocks, you need proper shoes.

What’s a “proper” shoe?

Your choice of shoe depends on what you’ll be doing. Going out for the evening but walking very short distances? Go for that strappy high-heeled sandal. If you’re walking slightly longer distances, you’ll want lower heels, more cushioning, and possibly more support. The more active you are, the more you’ll need a well-cushioned, supportive shoe, and if you work in a dangerous environment, you may need protective boots.

Consider your foot type

Feet come in three general types — neutral, pronator, and supinator. A physiotherapist or medical professional can help you determine which foot type is most like yours.

Neutral
Neutral feet aren’t flat, nor do they have a high arch. If you step with wet feet on a hard surface, you’ll see a footprint in which the inside of your foot makes a gentle C curve. Neutral feet need shoes that are well cushioned and have comfort, and stability.

Pronator
This is the classic flat foot. There’s no curve to the inside of the foot when you do the wet footprint test. People with pronator feet need a stability shoe with motion control, a firm midsole, and arch support.

Supinator
Also called a high arch, a supinator foot will leave a wet footprint with a marked C curve. If you have a supinator foot, you’ll need a comfort shoe with extra cushioning.

In any shoe, support and cushioning are very important and can help prevent injuries.

Get the right shoe fit

Don’t get caught up in the numbers game. Choose your shoe by how it fits, not by the size on the box.

If possible, measure your feet first. Always fit shoes to your larger foot, and make sure when you’re standing that there’s an extra 3/8″ to 1/2″ of space between your longest toe and the tip of the shoe.

The ball of your foot should fit comfortably in the widest part of the shoe, and the heel shouldn’t ride up and down.

If you’re looking for an athletic shoe, try to avoid ones with ankle support. They could weaken your ankles.

Never buy shoes that are too tight. No matter how much you wish, they won’t stretch out.

What to look for in a shoe

“Comfy and cushy” probably isn’t the best description of a good shoe. Instead, look for the right amount of cushioning and support.

Take the shoe off the shelf or out of the box and test it. Make sure only the front third of the shoe bends up.

If you can twist or distort the shoe easily, put it back on the shelf. Press on each side of the heel. If it flexes easily, it won’t give you the support you need.

Check the insole. If it’s removable, check it against the length of your foot. It should be about a thumbnail longer for the proper fit.

Look for a shoe made from a material that breathes, and never buy shoes with slippery soles.

Bad shoes, big pain

Any good physiotherapist will tell you that injuries from poor footwear can be painful. They can include plantar fascists, shin splints, tendinitis in the Achilles and patella tendons, and foot stress fractures.

Always have your foot pain assessed by a professional.

Foot and ankle injuries can require time in physical rehabilitation, where a qualified physiotherapist will look at the problem and determine the cause of the pain. The physiotherapist may prescribe exercises, massage, acupuncture, or use foot manipulation to treat the problem. Depending on the severity of the injury, a professional may also recommend additional high-technology treatments such as ESWT (extracorporeal shockwave therapy).

Your feet need to last you a lifetime. Take care of them by finding the best shoe for your planned activities — because shoes really do matter.

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

image

Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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