Are you a B Quad?

The B QUAD Foot-Type is a mildly over-pronated foot type or Mild Pes Planus. The key characteristic of people with this foot type is that they tend to walk with a toe-in gait, which is commonly referred to as being pigeon-toed.

This foot-type is often only found on one foot, especially in adults, and if that’s the case it is usually associated with a leg length difference. This foot-type is not very common in adults and affects less than 10% of the adult population. However, it is very common in children and adolescents. Most of the adults who have this foot-type on both feet have what we describe as ‘child-like’ bodies, which means that they tend to be very petite, don’t weigh much and are more likely to be female. Or they just have it on one foot, most likely due to a leg length difference.

One of the reasons why this foot-type is common in children and not so common in adults is that the foot tends to be a little unstable and usually gets worse over time and changes into either a D or F foot-type as a child gets older. If you start off with a B Foot-Type, it is unlikely that you will stay a B Foot-Type into adolescence and adulthood.

In adults it is more likely that you will see this condition occur on one foot only with a leg length difference on the shorter leg. This is because of the way the foot functions helps to lengthen a shorter leg. When this foot-type occurs on one side only, we refer to this as a "foot disparity". When foot disparities occur, each foot functions differently from one another, as so each limb functions differently as well. This has a direct effect on the hips and low back, often leading to sacral-iliac pain. 

Heel and lower back pain is common. About 30% of the population has two different foot-types, this means that you would need two different orthotic styles, it doesn’t make sense to have to have the same orthotic design for both feet if they are functioning differently. If you do have a pronounced leg length difference, we recommend that you see your health care practitioner to evaluate if you may need a build-up or heel-raise for the orthotic on the shorter side.

To find QUADRASTEPS orthotics in your area, try our FIND A PRACTITIONER tool!

For more information about the B Quad, visit www.nolaro24.com/patient/quadbpatient.html.
To find a practitioner in your area, check our website www.nolaro24.com/patient/find.html.
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littleSTEPS Testimonial

This says it all!

Tips for Happy Feet this Holiday Season

Tips to Keep Feet Happy this Holiday Season

Holiday shopping, decorating, parties and traveling are all part of our holiday revelries. But while you’re making all that merriment, how happy are your feet?

You may be doing a lot of walking, dancing, standing and sitting in one position throughout the holiday season. Half of all Americans report experiencing foot pain at some point in their lives, according to a survey conducted by APMA. No one wants soreness or injuries to slow them down during the holidays, so it’s important to care for your feet so they can carry you through all those seasonal celebrations and chores.

Follow this advice to keep feet healthy (and happy) this holiday season:

• Moisturize – Dry winter air and cold temperatures can take a toll on skin. Moisturize feet daily to help avoid dry, cracked and irritated skin.
• Exercise your feet – Stretching is a good way to avoid muscle cramps. Stave off toe cramps by raising, pointing and curling your toes for five seconds. Repeat 10 times. Rotating your ankles can also help relax feet. Cup your heel and turn each ankle slowly five times to loosen ankle joints.
• Massage – Foot rubs not only feel good, they’re a great way to release tension, boost circulation and refresh skin after a long day on your feet. Take a few minutes to massage your feet at the end of a day of shopping and celebrating. Use lotion and take care of moisturizing at the same time!
• Pedicure properly – Picture-perfect toes are part of a great holiday wardrobe for many women. Whether you do it yourself or go to a salon, be sure your pedicure is done properly. Never use a razor to remove dead skin – opt for a good pumice stone instead. Don’t cut cuticles; push them back gently with a rubber tool made for this purpose. Use toenail clippers with a straight edge to cut nails straight across.
• Raise your legs – Feet and ankles can swell from sitting too long in one position (taking a long flight to grandma’s house for the holidays, for example) or if you’ve been on your feet all day (shopping, baking or cooking). Elevate your legs to reduce swelling. Lay or sit and lift your legs above your heart.
• Wear smart shoes – OK, so you’ll never give up your sparkly high heels when it’s time for that special soiree. But for other holiday activities such as shopping, traveling or cooking, ditch the high heels. When you know you’ll be on your feet all day, wear comfortable shoes with good arch support and a padded sole. See which types of footwear have received the Seal of Acceptance and Seal of Approval for promoting foot health.
• Get help – Feet shouldn’t hurt all the time. Persistent foot pain can be an indication of injury, irritation or illness. See a podiatrist if you experience pain; don’t wait until the holidays end.

And of course - wear your QUADRASTEPS and littleSTEPS orthotics every day to help lessen thepain and fatigue in your feet, ankles, knees, hips, back and neck!

@LSteps @QuadraSTEPS

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nolaro24.com

Blog originally posted on the APMA website http://www.apma.org/Learn/HealthyFeetTips.cfm?ItemNumber=9850

Foot Reflexology

Foot Reflexology is not just foot massage, it is an ancient art and healing practice for relief of all kinds of ailments from headaches and sinus problems, to neck pain and menstrual cramps. It works work by putting pressure on specific pressure points/nerve endings on the foot to stimulate a healing response in specific organs and areas of the body. This in turn stimulates nerve response, blood flow and nutrient movement to the corresponding areas of the body.

It's a wonderful way to relax and feel better this holiday season, but be sure to look for a qualified practitioner or spa in your area.

Are You A C Quad?

The C QUAD Foot-Type is sometimes referred to as a Subtle Pes Cavus foot or an under-pronator, which means that the foot is not able to roll-in enough for ideal foot function but it’s not as severe as in a high arched foot. This foot-type has a fairly normal looking arch, they don’t have excessively flat feet or an arch that is too high. A key distinguishing feature of this foot-type is an obvious toe-out gait pattern. We call people with this foot type the “John Wayne walkers” and it is one of the most common foot-types, with over a quarter of the population having this foot-type.

People with this foot-type walk very toe-out. Picture how a gunslinger from an old western movie made his entrance into the local saloon. If you're not a fan of the westerns, think of a penguin or a duck! Anyone who is walking toe-out to a large degree is probably the C Foot-Type. Furthermore, if a person with this foot-type attempts to stand with their feet straight ahead, they will complain that their hips hurt! Why? Because of the way this foot functions, loading the inner aspect of their feet is extremely difficult. As a result they will attempt to acquire the necessary motion by externally rotating at the hips and walking toe-out. The muscles that externally rotate the hips become chronically shortened as a result of this gait pattern. Thus, standing with their feet straight ahead is extremely uncomfortable.

Common complaints from people with the C Foot-Type include hip and back pain, this is because of the slightly rigid nature of this foot and its poor shock-absorbing characteristics, though it’s not as severe as the A. For every step you take, your feet have to work as shock-absorbers and a force equivalent to one and a half times your body weight goes pounding through your feet and then up the body if the feet don’t absorb that impact effectively. When you’re running, it’s a force of about three times your body weight. Therefore, the development of hip and lower back pain is common because these feet aren’t able to absorb the impacts and forces associated with very step you take. Because this foot tends to roll out more than it should someone with this foot-type is very prone to ankle sprains and anyone with a history of ankle sprains is probably going to be either the A or C foot-type.

Another common complaint is bony bumps or swelling on the backs of the heels which are commonly known as ‘pump bumps’. The toe-out nature of C gait means that the backs of your heels are rubbing against your shoes in the wrong place, plus there tends to be some extra sideways motion in the heels during walking. The toe-out gait pattern also can lead to callus formation under the big toes.

All QUADRASTEP Orthotics are available in Regular and Narrow Widths, and with a topcover an an additional charge.

To find QUADRASTEPS orthotics in your area, try our FIND A PRACTITIONER tool!

For more information about the E Quad, visit www.nolaro24.com/patient/quadepatient.html.
To find a practitioner in your area, check our website www.nolaro24.com/patient/find.html.
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Trying to Find QUADRASTEP® Foot Orthotics in Kansas?

If you are looking for a great place to buy QUADRASTEP® Foot Orthotics in Kansas, you should check out Comfort Plus Shoes & Footcare! They are Kansas City's full-service orthopedic and comfort shoe store, dedicated to improving your foot function, comfort and performance. With a wide selection of brand-name and custom-made footwear options, their mission is to fit you correctly with the best shoe for your purpose.

Their motto is: Don't just get your size.Get your fit.

Their footwear inventory is hand-selected by their expert staff. They carry Kansas City’s best and widest selection of European and comfort shoe brands, including Birkenstock, Finn Comfort, Joya, New Balance, Ecco, Naot, Mephisto, Vionic, Wolky, Haflinger, Waldlaufer, Samuel Hubbard, Drew, P.W. Minor, Apex, Aetrex, SmartKnit, Thorlo, and more.

They specialize in:

• Shoe repair
• Sandal repair
• Footbed customization
• Diabetic shoes
• Custom shoes
• Shoe modifications
• Orthotic recovering
• Orthotic modifications
• Shoe refurbishment
• Plantar fasciitis shoes
• Birkenstock repair

And of course, they stock our QUADRASTEP® Foot Orthotics! Here's what they have to say about QUADRASTEP®:

"We appreciate the QUADRASTEP® Orthotic System because of the many, many options that allows for us to fit our customers in near-custom orthoses. There are many options with the six different orthotic types in multiple widths. We don’t see many individuals with two identical feet. QUADRASTEPS® allow for us to provide a custom fit and support for the individual's differing feet. The customer also doesn’t have to wait for us to produce a custom orthotic AND QUADRASTEPS® are more cost-efficient for the customer as they are about half the price of a custom orthotic. All in all, QUADRASTEPS® are smart, sophisticated and affordable."

For all of your footwear needs in the Kansas City area, go to Comfort Plus Shoes & Footcare!

Jennifer Aniston and Why We Want to Help Her

Jennifer Aniston is known as one of the most beautiful women in Hollywood. A Hollywood lifestyle can be tough on your body, especially on your feet. All of the interviews, parties, red carpet events, not to mention filming in high heels! We would love to help Jennifer out, she can contact us any time for an evaluation :-)

A bunion is a deformity of the big toe joint that results from bone misalignment or re-positioning 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.

When the joint at the base of the big toe becomes enlarged, friction and pressure are created as it painfully rubs against footwear. Eventually, the big toe may press inward against the smaller toes, even overlapping as far as the third toe in some cases, a condition called hallux valgus. With some bunions, the big toe also rotates or twists inward, which is called hallux abducto valgus.

What Are Risk Factors that Can Cause Bunions?

• Overpronation, flat feet, or other neuromuscular problems that affect the feet
• Tight-fitting, narrow-toed, or high-heeled footwear
• Recurring stress to the foot
• Previous foot injuries
• Congenital defects
• Arthritis

What Are Symptoms of Bunions?

• Chronic pain and discomfort when walking, especially as the bunion becomes larger and rubs against footwear
• Swelling, redness, and tenderness at the site
• Thickened skin on the bottom of the affected area

How Are Bunions Treated?

• Apply ice
• Rest the area and avoid motions that apply pressure to the affected joint
• Wear loose-fitting, non-constricting footwear that does not put pressure on the bunion
• Insert orthotics into footwear to provide stability and correct positioning
• Take over-the-counter anti-inflammatory medications on a temporary basis for pain and inflammation (ask your doctor first)
• Stretch the area with specific exercises to keep the joint mobile
• Splint the area during sleep to encourage proper joint alignment, which is preferred for younger people suffering from bunions because their bones are still developing
• Receive a cortisone injection to reduce joint inflammation
• Remove corns or calluses
• Have a bunionectomy, or surgery to remove the bunion and realign the toe, if necessary

Untreated bunions can also lead to other toe deformities, such as hammertoe. Arthritis and bursitis may also develop in the joint area.

How Can Bunions Be Prevented?

• Wear properly fitting, supportive footwear or custom orthotics
• Seek early, correct diagnosis and treatment to slow or stop bunion development

Ask your practitioner how the QUADRASTEP SYSTEM orthotics can help with bunions and visit http://www.nolaro24.com/patient/qspatient.html for more information!

DO YOU HAVE KIDS?

Do you know that your foot type is genetic! That means your kids will inherit your feet, so if you are having any pain or symptoms higher up the chain (ankle, knee, hip, back, neck) you should get your kids checked out - the sooner the better!
If you don't have a practitioner, use our "FIND A PRACTITIONER" tool and get on the road to less pain NOW!

If you would like us to tell you your foot type, send a picture and age, weight, gender to us at info@nolaro24.com and we will tell you which one of our orthotics would best suit you!
Check out the symptoms here www.nolaro24.com/patient/qspatient.html

@LSteps @QuadraSTEPS
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Ryan Gosling “An E..or not an E?”

Looks like Ryan Gosling was working out again without his orthotics, or his recommended sneakers for that matter. It’s hard to tell just by looking at this picture but if I were to guess I might say Ryan is an E Quad and that is just be looking at those lower arches.
We always recommend wearing your orthotics during a hard workout, and check out our website which gives you shoe recommendations by foot type.
Ryan, if you are reading this we want to offer you a free consultation..and we hope to see you soon!

Are you a D Quad?

The D QUAD Foot-Type is a moderately over-pronated foot-type. This means that the foot rolls in too much and tends to be too flexible and loose, which makes for an unstable foundation. This foot typically has a fairly flat looking arch and someone with this foot type would be described as being ‘flat footed’, though several foot types have varying degrees of flat-footedness.

This foot-type is congenitally a partially unstable foot and is often diagnosed in children as developmental flat foot. Make no mistake, if you think that this child will "out-grow the deformity," just ask Mom and Dad and their older siblings to take off their shoes and socks. If family members demonstrate similar foot characteristics, chances are that this child is not going to develop an arch. 

If you want to know what it feels like to have the D QUAD Foot-Type, imagine walking barefoot in the sand at the beach for an extended time. Due to its unstable nature, all the bones in the feet tend to jiggle around too much and all the muscles and ligaments in the feet have to work double-time to try and hold everything in place in an attempt to stabilize the foot. People with this foot type tend to fatigue very easily and may not want to be very active, because their feet hurt. Common complaints for people with this foot type include: Forefoot pain, heel pain, knee pain and bunions.
We affectionately refer to people with this foot-type as the “Fred Flintstone walkers” because they tend to have a flat plodding type gait that is neither toe-in or toe-out.

D QUAD POSSIBLE CLINICAL SYMPTOMS

  • Plantar Fasciitis

  • Metatarsalgia

  • Functional Hallux Limitus

  • Patellofemoral Pain Syndrome

  • Posterior Tibial Tendonitis

  • Neuromas

  • Hallux Limitus

All Quadrastep Orthotics are available in Regular and Narrow Widths, and with a topcover an an additional charge.

Visit Nolaro24 for more information

Twitter: @LSteps @QuadraSTEPS

FB: @quadrasteps

Your Feet Could be the Gateway to Healing!

Did you know many therapist believe your feet are the gateway to whole body healing? Treat your feet right, start with Quadrasteps. You won’t believe the things you can improve when your body is in balance starting from the ground up.

Are You an E Quad?

The E QUAD foot-Type is one of the most unique looking feet, often with a reverse-lasted foot shape. This means that have a curved outside border on both feet with the forefoot curving out. This may be opposite to what most people think of as a ‘normal’ foot, which tends to curve toward the center but is fairly straight on the outside border. Often it looks like these people have their feet on the wrong way. So, difficulties with getting shoes that fit comfortably is a common problem because most shoes curve the other way. It is almost as if they would feel better wearing their shoes on the wrong feet.

The E foot-Type is one of the most destructive foot-types of all. It is a very rigid foot that is unable to provide the motions necessary to load the inner side of the foot during stance phase of gait. It is for this reason that when an individual with this foot-type is standing still, they will tend to stand on the outer borders of their feet with the inner side of the foot elevated from the ground. These people hate to stand still because the only way to ever really load the inner side of the foot is to get the heel off the ground! Once in propulsion, the medial heel pivot will allow the inner side of the foot to eventually load. But all this compensation gets tiring after a while, and causes a lot of damage to the foot. Even as a youth, and certainly by the time this person is in their teens, they are already showing signs of breakdown in some of the joints in the foot which results in the acquisition of that reverse last foot shape. The key note feature of this foot-type is by far the ballistic heel whip that is evident at heel rise. Often this results in people kicking themselves with the opposite leg.

We affectionately refer to people with the E foot-Type as “runway models” because they have a swagger in their gait style. Sometime people with this foot type have difficulty walking in a straight line and if you’re walking next to them down a supermarket aisle they tend to keep walking into you. The gait style tends to be a “scissor-gait”, which means that the heels are very close together and are whipping inwards in combination with the forefoot curving outwards.

Common complaints for the E foot-Type include: shin splints, heel pain, tailors bunionette and knee pain. Someone with this foot type needs a special orthotic design that addresses their main problem, which is in the rigid forefoot. Not all orthotics have this special adaptation and often people with this foot type have tried regular orthotics but found that they didn’t help and they may have even been uncomfortable. This is because they have never had an orthotic style that is designed to address the problems in the forefoot that are associated with this foot type, as standard orthotic designs tend to only correct the alignment of the heel and don’t usually address forefoot problems.

All Quadrastep Orthotics are available in Regular and Narrow Widths, and with a topcover an an additional charge.

For more information about the E Quad, visit www.nolaro24.com/patient/quadepatient.html.
To find a practitioner in your area, check our website www.nolaro24.com/patient/find.html.
@LSteps @QuadraSTEPS twitter
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Get Ready for Fall Sports with littleSTEPS®

Fall is here and kids everywhere are gearing up for fall sports programs including soccer and football, track and volleyball. over 30 Million kids are involved in at least one interscholastic sports program; 21.5 Million kids are playing on one or more organized sports teams! More than 2.6 million children are treated in the emergency department each year for sports and recreational-related injuries

According to statistics, nearly 35.8% of injuries in kids 5-17 relate to sports and recreation. Why are Kids more susceptible to sports related injuries? 

• Active bone growth precedes muscle and tendon lengthening creating limited flexibility and risk of overuse injuries.
• Kids have an actively growing musculoskeletal system. Motor strength imbalances can lead to muscle strains.
• Open physeal growth plates in kids can lead to a higher incidence of tearing injuries.
• Kids have limited skill levels and level of conditioning (coordination issues).
• Consider gender: Male-female ratio of injury 1.8:1, but some girls are more susceptible to particular injuries.
• Kids have greater ligamentous laxity.

Kids are not just small adults! Adults whose bones have finished growing might simply pull a muscle or a tendon after a fall. But in a child, that same fall could injure the growth plate. One of the most commonly injured parts of the body in adolescents is the foot and ankle, particularly those involved in sports. Here are some of the more common injuries by age group:

AGES 6-12

• Flat Feet
• Growing Pains
• Knee or Shin Pain
• Osgood Schlatters disease or syndrome
• Calcaneal apophysitis (Sever's disease)
• Poor Posture and Postural Weakness
• including Genu Valgus (Knock Knees)

AGES 13-17

• Patellofemoral Pain Syndrome (Runner's Knee)
• Plantarfasciitis
• Shin Splints
• Stress Fractures
• Ankle Pain
• Ankle Instability

littleSTEPS® foot orthotics for kids can help protect kids during sports activities. They can be worn in cleats or athletic shoes. littleSTEPS® products are specifically designed for kids to deliver a prescription based correction, closest you will find to matching custom UCBL devices! littleSTEPS® come in 11 sizes to fit toddlers to teens. For larger teens, a QUADRASTEP® orthotic may be more appropriate. Ask your practitioner about littleSTEPS® and QUADRASTEP® orthotics today! If you need to find a practitioner, visit our website nolaro24.com. Like us on Facebook @quadrasteps

#LSteps #QuadraSTEPS

The F Quad Foot Type is true adult flat foot, known as a Pes Planovalgus foot deformity because of its very poor alignment to the floor. There is great instability throughout the foot and ankle, and can be prevalent throughout the body. These feet look "very flat" at an early age, and can only worsen into adulthood.

Some common ailments for people with the F Quad Foot Type are:
• Plantar Fasciitis
• Splayfoot
• Hallus Valgus/Bunion
• Subfibular Impingement
• Posterior Tibial Tendon Dysfunction
• Patellofemoral Pain Syndrome
• Tarsal Tunnel Syndrome

This is a Foot Type you can see beginning in childhood, which is a great reason to have your children's feet screened at a young age. You can start to treat this early to help kids' bodies grow with better muscle tone and posture by getting them into a littleSTEP orthotic. To find a practitioner in your area, check our website http://www.nolaro24.com/patient/find.html.

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 info@nolaro24.com 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!

Foot & Ankle Fitness

General Information About Foot & Ankle Fitness

By Dr. Louis J DeCaro

Despite the wealth of knowledge feet provide about overall health and undetected health problems, they are one of the most ignored parts of the body. Even when foot or ankle pain is experienced during running, walking, or other forms of exercise, people tend to overlook it and chalk it up to a normal occurrence during exercise. It is important to always see a podiatrist for any type of chronic ache or pain in the lower leg, ankle, or foot after type of exercise.

The feet and ankles are a complex network of bones, joints, muscles, ligaments, tissues, and nerves that endures constant pressure and stress. Needless to say, the feet are susceptible to pain from injuries and general wear and tear. According to the American Podiatric Medical Association, improper foot care during exercise contributes to many of the 300-plus foot problems that can occur.

Aside from checking with a doctor or healthcare professional before starting any exercise or fitness regimen, be sure to have a podiatrist conduct a thorough foot exam to correct and/ or prevent foot problems that may worsen with exercise.

Lower Back and Leg Pain?

Feel like you’re missing out on all that summer has to offer because of lower back and leg pain?

Ask your doctor today how QUADRASTEP orthotics can get you back on your feet!

If you are having trouble finding a practitioner, visit our FIND A PRACTITIONER page and search by your state.

Still can't find a practitioner? EMAIL US

Are You a Runner?

Running and Jogging

by Dr. Louis J. DeCaro

Running and jogging are popular forms of cardiovascular exercise. Conveniently, running and jogging can be done alone or in groups, indoors or outside, any time of day, and during any season. However, proper conditioning, stretching, exercise, and footwear are important to avoid foot injuries during running or jogging due to the high impact on the feet during these activities. Injuries can be avoided by making sure to stretch the muscles, tendons, and ligaments before and after running or jogging, as well as gradually building up distances and speed over time as part of a regular routine. It is important to protect the lower legs, ankles, and feet from overstrain, and always see a podiatrist for any type of chronic ache or pain in the lower leg, ankle, or foot during or after running or jogging.

Common foot problems associated with running and jogging are shin splints, plantar fasciitis, and Achilles tendonitis. Athlete’s foot, blisters, corns, and calluses can also occur; good foot hygiene and care, as well as wearing clean, properly fitting socks and sneakers can be of help in these areas. Since running places a high impact on the feet, running shoes need to be cushioned to absorb the shock. The motion of running rolls the foot from the heel to the toe; the foot then bends at the ball to complete the step. Therefore, appropriate running sneakers must have flexibility at the ball of the foot, and the heel should rise when the forefoot presses down. The shoe’s heel should be low and slightly undercut; make sure the heel stays snugly in the shoe without slipping out. The middle of the shoe should be more rigid for support. Footwear made of a lightweight, breathable material is most comfortable when running.

When running or jogging, it is important to protect the feet with appropriate footwear that addresses your foot inclination and gait. Overpronation occurs when the ankles roll inward more so than usual when walking; this condition benefits from shoes that offer motion control and mid-foot support, along with less cushioning, a rigid sole, and a reinforced heel counter. Underpronation places pressure on the outside of the feet, which requires shoes that provide stability, extra shock absorption, additional cushioning at the forefoot, and reinforcement around the heel and ankle. Those classified as having a normal foot inclination can wear just about any type of shoe without issue.

To ensure a proper fit for running shoes, be sure to measure both of your feet while standing; buy a shoe size that accommodates the larger of your two feet, since most people have feet that are slightly different in size. There should be about half an inch between your toes and the front of the sneaker to allow for wiggle room. Try the sneaker on with the socks you will wear while running, and shop for running shoes in the latter part of the day, when the feet are more swollen. Test the shoes on a hard surface, not just carpeting. Remember to replace your running footwear about every 400 miles to maintain proper support, shock absorption, and fit. Consider having two pairs to rotate, which will make them last longer and allow time for them to air out and dry.

Aside from checking with a doctor or healthcare professional before starting any exercise or fitness regimen, be sure to have a podiatrist conduct a thorough foot exam to correct and/ or prevent foot problems that may worsen with exercise.

PATIENT TESTIMONIALS

littleSTEPS® foot orthotics

"Once he started using littleSTEPS® the problem stopped-Immediately! He can run and jump and play all day without any complaints at night. He has never complained of discomfort from the inserts and in fact won't wear shoes if they don't have the inserts in. littleSTEPS® are amazing! My younger daughter is now wearing them too. Thank you for making these littleSTEPS®!!"  -Janelle H

“Immediately upon using his orthotic inserts, his balance improved resulting in less falls, better coordination and he no longer complains of fatigue in his legs with walking and running. Best of all, his confidence has increased greatly!”
- Melissa D

QUADRASTEP SYSTEM®

“...After spending almost a year of getting cortisone shots in my heels, wearing various daytime and nighttime braces, as well as trying dozens of shoe/insert combinations with no appreciable relief I am happy to tell you that I have spent more pain free time on my feet in this last month than I had in the past year.”
- Craig S

“I've been amazed at the difference my QUADRASTEPS® insoles have made for my quality of life.  I'm an avid tennis player, and not long ago my chronic heel spurs and aching high arches left me limping off the court after only an hour. Since starting with QUADRASTEPS®, I can now play​ two to four hours a week with virtually no pain. I also just returned from a 10-day trip where I walked at least eight miles a day over the hard cobblestones of Europe without having to break stride!”  - Tom R

How Important is Footwear When Wearing an Orthotic?

Orthotics do not work without something to give it contact with the dynamic foot.  That is where the shoe comes into play.  With footwear, the orthotic becomes an extension of the foot (or at minimum a bridge between the foot and shoe). With that all being said, are shoes an important consideration when wearing orthotics?  Absolutely.

The Importance of Fit

The first thing to remember is that a shoe is only as good as the fit.  A $200 shoe that fits poorly has less value than a $40 shoe that fits properly.  You will benefit from having an expert select and fit your shoes.

Find a retailer that has a good selection of shoes, and has associates who are skilled at fitting and have a history of customer satisfaction.  It is best to find a retailer who has a certified pedorthist on staff or someone who has a good understanding of pedorthic concepts.  Once you have an idea of which retailers might meet your requirements, ask these questions.  Does the sales staff know their stuff?  Do they measure feet?  Are they listening to you? 

The Basics of the Fitting Process

One concept to remember is that shoe size is not foot size.  A person who has a size 9 foot may wear a size 9 shoe – or a size 10 – depending on the brand. Even within a brand you can find that different models can have fit characteristics.  The starting point in shoe selection and fitting is to be professionally measured with the Brannock Device.  This foot measuring apparatus measures the heel-to-toe length of the foot, the heel-to-ball and the linear width.  Using the Brannock Device not only indicates the foot size but helps to visually show foot expansion between non-weight bearing and weight bearing state.  It is also a great tool for help quantify a size difference between the two feet.

Shoe selection is very important and the general goal is to match the foot shape to a corresponding shoe shape.  If the foot is shaped like a loaf of bread, then look for a straight-lasted shoe.  If the foot is shaped like a banana, then look for a curved-lasted shoe.  An important consideration is the orthotic itself, as they will affect the effective shape of the foot.  As most orthotics tend to be more straight and full, often the best shoe options are those that are also straight and full.

When fitting the shoe, the professional should try and fit the widest part of the foot into the widest part of the shoe.  If that is achieved then the shoe will flex naturally along with the foot, enabling a more fluid gait and causing less irritation.  Beyond last shape and ball-of-foot placement, having adequate space at the end of the shoe is important.  In general, having at least 3/8^th of an inch of space at the end of the longest toe (which may not be the great toe).

Shoe Selection is Critical

Before buying shoes, it is best to assess your expectations.  Orthotics will not fit into all shoes.  In fact, they will fit into a minority of shoes found in a typical shoe store.  The shoe will need to tie, Velcro or otherwise be secured around the foot.  In addition, the shoe needs to have enough internal volume to accommodate the orthotic. Remember that any given shoe model might not be the best fit option for every person.  In addition, depending on your activity level, the shoe you need may not a running shoe.  A full-waisted walking shoe may be the perfect shoe or perhaps a casual oxford.  Instead of looking for specific styles of shoes, look for specific features.

Follow Up

Don’t be afraid to ask for a return visit so you can have your retailer check how the shoe fits and how it accommodates the orthotic.  It may take a little time for the orthotic to seat firmly into the shoe and start to feel comfortable. If you have any pain, you should go back to your retailer immediately to have them check that they have chosen the correct shoe for your foot type and your orthotics.



Information courtesy of Lamey Wellehan Shoes  •  Maine’s Shoe Store since 1914