Friday, April 13, 2018

Spring Sports Injuries

It's springtime, and with that our kids are just ending basketball season and starting baseball season. While we love having our kids participate in organized sports, they are more susceptible to injuries than you might think.

Basketball Injuries to the Foot and Ankle

Basketball players put a lot of stress on their feet which can lead to injuries to the foot and/or ankle from jumping, running, quick starts and stops, and contact with other players. Some common problems that can arise from playing basketball are:

  • Ankle sprains that can damage the ankle ligaments, and can be associated with peroneal tendon injuries, fractures, and chronic ankle instability. 
  • Overuse and can lead to heel pain (plantar fasciitis), Achilles tendonitis, sesamoiditis, stress fractures, posterior tibial tendonitis (or PTTD) and calcaneal apophysitis in children and adolescents. 
  • Fracture of the fifth metatarsal base, which can be due to the constant, running and jumping, as well as foot structure.

Baseball Injuries to the Foot and Ankle

Every year, approximately three million children play baseball in the USA. Many of these kids play from elementary school throughout their middle and high school years. Common problems that can arise are:
  • Ankle sprains that may occur while running, fielding balls, stepping on or sliding into bases. Sprains should be evaluated by a qualified clinician to determine the extent of injury. Untreated they can lead to chronic ankle instability and recurrent sprains.
  • Overuse by focusing on only one sport can cause Achilles tendinopathy or heel pain such as plantar fasciitis, or calcaneal apophysitis in children and adolescents. 
  • Stress fracture
  • Catchers are prone to plantar fasciitis from squatting constantly
  • Peroneal tendonitis
  • Anterior Ankle impingement (especially in catchers)
  • Bruising can occur from impact with the ball or contact with other players
  • Cleats can cause aggravation of neuromassesamoidsbunions and hammertoes. It is important to make sure that cleats are fitted properly by someone trained to do so.
  • A common injury seen in pitchers and catchers is ingrown toenails. If ignored, they can lead to a nail infection and cellulitis.

 Some Common Signs of Foot Problems:

  • Your child has poor balance or coordination, awkward gait, or tends to trip and fall.
  • Your child habitually walks on their toes or walks with their feet turned in (“intoeing”) for no known medical reason.
  • Your child fatigues easily and often wants to be carried.
  • And Yes, If you child has any pain related to walking, or has frequent or severe growing pains.

Preventing Foot and Ankle Injuries in Kids

The growth plates in children’s bones are not mature until their later teen years, and these immature bones, as well as the surrounding tendons and ligaments, are more susceptible to both traumatic and stress injuries. 

Proper footwear, including shoes specifically designed and constructed for one specific sport, is also an important part of preventing sports injuries in kids.
Foot orthotics can be a part of your injury prevention scenario, and if you see any signs of difficulty or pain when your child is playing sports, they should be evaluated by a certified clinician immediately.

It’s important to choose the correct foot orthotic for your child. Consider littleSTEPS® foot orthotics for kids up to teens, and QUADRASTEP® foot orthotics for older teens. They are the closet to prescription foot orthotics that you can get in a prefab and they are more affordable than custom orthotics!

Friday, April 6, 2018

Looking for a Practitioner in Western CT?

Stride Pedorthic Center is located in Middlebury CT. Stride is a full service location where you can not only see a certified practitioner, you can also pick up shoes, orthotics, and accessories.

"Nolaro’s Quadrastep Orthotics are the closest thing to Stride Custom Orthotics that you can get without casting a patient’s foot. They’re more functional than many of the custom orthotics I’ve seen, thanks to the differing rigidity of each model and quad-specific rearfoot and forefoot posting. Quadrastep Orthotics can also be customized with additional posting, met pads and top covers! Nolaro co-founder Roberta Nole has invented a cost-effective bridge for the wide gap between over-the-counter insoles and custom foot orthotics."

Clinicians at Stride Pedorthic Center use a patented, proprietary method of gait evaluation that helps them to identify and relieve injuries that you may have sustained in weight bearing and gait. Stride’s system is so effective that it has helped clinicians to identify patients’ susceptibilities to injury which, consequently, has led to the prevention of foot, ankle, knee, hip and back pain.
Stride has a comprehensive Diabetic Shoe Program where you will be evaluated and fitted by our clinicians, who have years of diabetic shoe fitting experience and are eager to find the right fit for you. Stride provides diabetic approved shoe styles by New Balance, Anodyne, Orthofeet, and other premium manufacturers.

Stride Pedorthic Center has many different shoe styles to choose from, including running, casual, diabetic and sandals from premium manufacturers such as New Balance, Vionic, Aetrex, Revere and more! We also carry a full range of accessories such as socks, foot care products, and shoe products.

Stride clinicians successfully treat hundreds of patients per year by communicating with their primary care physicians, pediatricians, physiatrists, physical therapists, surgeons, orthopedists, chiropractors, custom shoe fabricators and any other professional that can lend to a multidisciplinary enhancement of patients’ biomechanical wellness. 

Roberta Nole, PT, MA, Cped and Scott LaBianco, BOCPD dispense custom and non-custom foot orthotics & ankle-foot orthotics, as well as footwear that effectively Improve How You Move.

Contact us today to learn more and to schedule a fitting at (203) 758-8307 or email

For more information EMAIL US
Twitter: @LSteps @QuadraSTEPS

Thursday, March 29, 2018

Common Foot and Ankle Problems

Here are some of the most common reasons for foot and ankle problems:
  • Injuries
  • Congenital foot deformities that occur at birth and can be hereditary
  • Infections (bacterial, fungal, or viral)
  • Arthritis affecting one or multiple joints
  • Tumors, abnormal growths, and neoplasms
  • Issues that arise from ill-fitting or improper footwear, stress, or mechanical changes
Here is a list of some common foot and ankle problems people experience:
Bunions: A bunion is a deformity of the big toe joint that results from bone misalignment or repositioning at the joint. Although bunions occur most frequently at the base of the big toe, they can also arise on the outside of the foot at the base of the small toe.
Fractures: Bones are susceptible to two kinds of fractures: stress and general. Stress fractures are small fissures or cracks in the surface of the bone and usually occur in the forefoot, or the area from the mid-foot extending to the toes. General fractures travel into the bone beyond its surface and can be stable or displaced, as well as closed or open. Stress fractures can become general fractures if not properly treated.
Hammertoe: Hammertoe occurs when the second, third, or fourth toe bends at the middle joint, often as a result of wearing ill-fitting shoes. Genetics, arthritis, and muscle imbalance can also cause hammertoe. With hammertoe, the toe bends downward, rather than pointing straight forward.
Plantar fasciitis: Plantar fasciitis is inflammation of the plantar fascia, the fibrous tissue that runs along the arch of the foot to connect the heel bone and ball of the forefoot. Heel spurs are not the same as plantar fasciitis; however, the two are often associated. Since the plantar fascia is subjected to great amounts of impact and pressure while supporting the foot’s arch, it can become inflamed and irritated. In some cases, it begins to deteriorate.
Heel spurs: Spurs are outgrowths of bone. In the feet, they most commonly occur in the heel. The spurs usually develop in areas subjected to constant pressure. Heel spurs, or bone spurs in the heel, occur on the bottom of the heel bone as a result of calcium deposits forming over time. They frequently accompany the condition plantar fasciitis.
Ingrown toenails: Ingrown toenails, known as onychocryptosis, most commonly occur on the big toe and are caused by pressure that drives the edge of the nail into the surrounding skin. This results in pain, redness, inflammation, swelling, and sometimes, infection. Clipping the toenails too short or exercising poor foot hygiene can also lead to ingrown toenails. Runners and those with toe deformities can also be prone to ingrown toenails.
Neuromas: Neuromas are benign growths of nerve tissue, or nerve tumors, that form when the nerves are irritated by surrounding tissue rubbing against them. Symptoms of a neuroma include intense pain, swelling, tingling, numbness, and/ or a burning sensation in the toes and forefoot area. Neuromas most frequently develop between the third and fourth toes.
Sesamoiditis: In the foot, there are two sesamoids underneath the top of the foot and near the big toe that allow the big toe to move up and down freely. These help with push-off activities such as walking, running, and climbing. Since the sesamoids are exposed to excessive force and pressure during weight-bearing activities, sports, and exercises, they are often prone to injury and trauma, as well as stress from overuse or from standing on hard surfaces for prolonged periods. Sesamoids can fracture or become inflamed.
Ankle Sprain: When the ankle bones twist or receive too much force, the ligaments surrounding the outside of the bones may suffer from over-stretching or tearing, resulting in a painful ankle sprain. There are different levels of severity when it comes to ankle sprains, and if the sprain is not properly diagnosed and treated, it can cause permanent, lasting ankle trouble.
Shin splints: Shin splints, a common condition, happen when the muscles or tendons surrounding the leg bone become inflamed, irritated, and painful, which can result from overuse, a collapsing arch, stress fractures in the lower leg bones, or imbalance between opposite leg muscle groups. Shin splints can be prevented by properly stretching prior to and after exercise, sports, or activity. Corrective shoes or corrective orthotics can also be used to prevent shin splints.
It is important for a patient to seek medical care as soon as possible, as immediate, proper diagnoses, treatments, and care can prevent problems from worsening or resulting in permanent damage.
For more information EMAIL US
Twitter: @LSteps @QuadraSTEPS

Friday, March 23, 2018

SPRING is HERE! Get Ready for Spring Sports

Spring is FINALLY here, although in the northeast it has been more like February. 😩 

With the coming of Spring our kids are getting ready for baseball and other spring sports. Make sure your kids are ready with the proper footwear and foot support. Part of that foot support should be a check if your child needs foot orthotics to help with balance, coordination, or pain.

The practitioners and retail establishments that carry our QUADRASTEPS® and littleSTEPS® are all qualified to do a foot evaluation to determine if any intervention is needed. Many have free foot screening clinics throughout the year, you should check your area stores and practitioners to see if there is one inear you. To find a list of practitioners in your area, visit our website 

Below are some helpful info for you to consider when trying to decide if you need to take your child to see someone.

Consider Genetics! Many adults recognize that they have feet genetically similar to their parents, but many not realize that they might have passed on these same foot traits to their children! Help your children avoid acquiring your foot problems by having their feet screened by a qualified clinician who can help you determine if treatment should be considered.

Foot Facts:

  • It is normal for a child's foot to appear flat up until about the age of 2 due to a thick layer of baby fat that fills the arch area.  As long as the child is otherwise healthy, and the foot is flexible and free of pain, then no treatment is necessary.

  • A child's arch becomes more apparent around the age of 3 when the fat pad begins to disappear. At this age it is normal to observe a good arch when the child is sitting or lying down. Upon standing however, the arch may look very low. In most cases, this may be completely normal.

  • It is uncommon for children to complain of foot pain.  Be aware that “Growing Pains” are not always normal and may be a sign that your child may have an unstable foot.  Any child complaining of pain should be seen by their doctor to rule out a potentially serious condition and to determine if they are a candidate for foot orthotics.  

Consider littleSTEPS® When:

  • Your child has poor balance or coordination, awkward gait, or tends to trip and fall.
  • Your child habitually walks on their toes or walks with their feet turned in (“intoeing”).   for no known medical reason.
  • Your child fatigues easily and often wants to be carried.
  • And Yes, If you child has any pain related to walking, or has frequent or severe growing pains.

For more information EMAIL US

Friday, March 9, 2018

Do You Know Your Foot Type is Genetic?

By Dr. Louis J DeCaro

I was recently asked what is the earliest I put orthotics on kids. I answered "When the egg meets the sperm!" Well today I had a child present with hypotonicity at 16 months who is delayed and just beginning to pull to stand. I also had dad take off his shoes. Dad, 36 y.o., was also seeing me as a new patient due to a lifetime of foot and ankle pain and posterior tendon dysfunction. This picture (the right foot shows better than the left because the child was squiggly) clearly illustrates genetics at its finest and the need for early intervention! littleSTEPS size 00 (not SMO's) for the child, custom UCBL orthoses (not surgery) for dad! Mission accomplished!

We would love to see your Family Pho-toes. Try to get several generation of your family together for a foot photo, you might be surprised at what you see. Email them to with a brief description of the feet in the photo - ages and relationships. Don't forget to have your kids screened by your podiatrist or therapist for potential problems, the apple doesn't fall far from the tree!

Friday, March 2, 2018

Having Trouble Finding a Practitioner in Your Area?

Try our terrific FIND A PRACTITIONER page on, and search a database of our practitioners who carry QUADRASTEPS and littleSTEPS foot orthotics in your area!

For more information EMAIL US
Twitter: @LSteps @QuadraSTEPS
FB: @quadrasteps

Friday, February 23, 2018

How Often Do You Need to Upgrade Your Child's Shoes?

How Often Do I Need to Upgrade My Child’s Shoes?

By Guest Author Timothy P. Barry, DPM  Family Foot & Ankle Care of Jasper

Shoe shopping for a young child can be a tricky affair, whether you’re a new parent or already raising your third or fourth!
Often, there’s a delicate balance that needs to be achieved. Err too far on one side, and your little one might not get the protection or support they need. Err on the other, though, and tiny toes get pinched in shoes that are too tight, or arches get restrained by shoes that can’t bend or flex.
Feeling lost? Don’t worry! Dr. Timothy Barry is here to help provide some clear, guiding advice on when and what to buy. With these tips, you can help keep your little one’s feet pain free and growing stronger every day!

Buying Baby’s First Pair

So, we’ll start at the beginning. When is it time to get junior his or her first pair of shoes?
Resist the urge to buy right away. For about the first year or so of life, your little one probably won’t need any shoes at all. Infants can wear very loose-fitting booties to protect them from the cold, but otherwise should go barefoot.
Heavy duty shoes
A child really doesn’t need shoes until they begin walking. And even once they do start walking, the shoes should mainly be restricted to outdoor activities.
The main reason is that soft bones and muscles are still hardening, tightening, and taking shape. When a child walks barefoot, they are exercising those muscles and learning to use them for balance and stability. Wearing shoes all the time can delay or impede this natural development. There’s also some evidence that the tactile feedback a toddler gets from feeling their bare feet on the ground helps them to keep their head up, maintain balance, and build confidence.
For indoor walking and play, you can get them socks with grippy rubber bottoms to protect their toes and keep them from slipping and sliding over smooth floors. For the outdoors, makes sure there is some flex in their shoes, as extremely rigid soles can restrict natural foot motion and play.

Sizing Up Your Options

Kids’ feet sure do grow fast!
How fast? During the toddler years (roughly age 1-3), a typical foot will grow about three quarters of an inch per year. From ages 3-10, the pace barely slows, at roughly half an inch per year. That translates to a new pair of shoes every 3-6 months for the youngest children, and every 4-12 months thereafter.
But, of course, your kid’s mileage may vary! Growth spurts can happen at unpredictable times, so you may notice the rate slow down, then speed up again!
Parents may be tempted to save a few dollars and buy shoes a size or two too big, and let their children “grow into” them. While we can sympathize with your plight, we strongly discourage this.
Shoes that are too tight, obviously, can restrict a child’s natural development and cause pain. But the same is true of shoes that are too big. Unfortunately, that may mean you need to replace shoes faster than you’d ideally like to—even well before the shoe wears out from use.
Just know that the occasional pain of purchasing new shoes is a much better alternative than the pain of your child developing costly foot problems!

Shoe Shopping Advice for Parents and Kids

How do you know what shoes will be best for your young one? Here are some key things to remember:
Skip the used shoes and hand-me-downs. This is another common money-saving technique parents might be tempted to employ, but it’s a very bad idea. For one, used shoes can harbor unwanted germs, fungi, and bacteria and spread problems like athlete’s foot. And two, used shoes have already “molded” to fit the unique foot shape of their original owner, and can be uncomfortable on anyone else’s feet.
Look for a stiff heel … Children’s shoes need a good, stiff heel for support and protection. If you place your fingers on both sides of the heel counter and squeeze, it shouldn’t collapse like a cheap tent in a rainstorm.
…But also a flexible sole. The bottom of the shoe needs to be able to flex and bend with your child’s feet. Shoes that are too rigid can delay foot development and make it more difficult for your child to run, balance, and play.
Shop with your child. Even if your child isn’t verbal yet, bring them along so that they can have their feet measured properly and you can test the fit in person. Older children, of course, can tell you directly whether a shoe feels comfortable or uncomfortable to wear. If possible, try to shop in the evening, since feet tend to swell slightly after a long day. (You want the shoes to still fit when feet are at their largest.)
Don’t rely on shoes “breaking in.” If a shoe is the right size and shape for your child, it should be comfortable and easy to wear right from the very start. Conversely, if the shoe is painful, it will probably continue to cause problems.
Buy activity-appropriate footwear. Your child’s “everyday” shoe can typically be a comfortable sneaker or casual shoe with good cushioning and support. However, just like with adults, kids who play certain sports and activities regularly should be fitted with a sport-specific shoe. That means, for example, running shoes for runners and basketball shoes for basketball players. All-purpose athletic sneakers are fine for gym class or general play, but probably not if your child is performing a specific sport several times per week.

Working Hard for Children’s Foot Health

At Family Foot & Ankle Care of Jasper, pediatric foot care is a core part of our practice, and a specialty of Dr. Timothy Barry. When a child experiences pain, it is a sign that further examination and care is needed. Foot problems that arise in childhood often need to be treated as soon as possible to prevent more serious complications as they grow older.
We provide a comprehensive range of pediatric treatments for children of all ages, with a special focus on conservative methods such as rest, physical therapy, and orthotic inserts. We also perform surgical procedures when necessary—and usually in-office—with the utmost care for your young one.
To set up an appointment with Dr. Barry for you and your child, give them a call today at (812) 481-7200.

More of Dr. Barry's blogs can be viewed here.

Timothy Barry is a doctor of podiatric medicine and the head podiatrist and owner of Family Foot & Ankle Care of Jasper. Tim received his doctorate of podiatric medicine from Des Moines University in 2004 and completed his surgical residency at St. Mary’s Medical center in Evansville Indiana in 2007. Dr. Barry is certified in foot surgery by the American Board of Foot and Ankle Surgery and has been a practicing podiatrist for 8 years.

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