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.
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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!