This is a very important video for everyone to watch.  If you know anyone with diabetes please pass this information along to them.  Education is the key to eliminating unnecessary foot amputations. 

How to Test for and Alleviate the Symptoms of a Morton's Neuroma

“These two toes go numb.”  “My toes are burning.” “I have to take my shoes off under the table.” If this is you.  If you find yourself describing your foot pain symptoms this way you may be dealing with an interdigital nerve entrapment or a mortons neuroma.  

Mortons Neuroma can effect any of the toes, however it commonly presents itself in the 3rd and 4th toes.  

With time and pressure the arch that spans across the ball of the foot, (the transverse metatarsal arch) can drop down.  When this happens the space between the metatarsal heads decreases and you can get friction and rubbing on the nerves that pass through this space.  This can cause numbness, tingling or even burning sensations.  Narrow shoes will aggravate this and if you find this pain decreases or stops when you remove your shoes you are most likely dealing with an interdigital nerve entrapment.  

If you allow this friction on the nerve to continue over a long period of time, the nerve will develop a fibrous mass around it to protect it.  This is what is referred to as a mortons neuroma and can be very painful, sometimes requiring surgery.  

If you feel that these symptoms pertain to you here are a few tests you can do at home.  If any of these are positive you should contact your local pedorthist to see if their services are right for you.  

1)  Mulder's Click Test, 

Massage out the ball of the foot, wiggle the toes a little and move the metatarsal heads up and down.  Now, with both hands, squeeze around the ball of the foot.  If this is painful or your feel a click or a pop this could be indicative of a nerve entrapment. 

2)  If you find that you only get pain in certain shoes, take a closer look at those shoes.  Are they narrower than the ones that don’t cause you pain?  If they are this can also be indicative of a nerve entrapment.  

3)  When you have pain and remove your shoes does the pain subside? If yes this is also indicative of a nerve entrapment.  

*Keep in mind that a nerve entrapment can be present even if you had negative results to the above three tests.*

How Do We Treat a Nerve Entrapment?

This is a diagram of an orthotic that has a 

metatarsal arch support.  This should be 

placed just behind the ball of the foot 

and not directly under the painful area

Well, a better question is how do YOU treat a nerve entrapment.  Responsibility has to be placed on the patient to ensure they are wearing shoes with a wide forefoot.  In nerve entrapment patients the test is easy, If the shoe hurts, its too narrow! 

What a pedorthist can do for you is to create a footbed for your shoes that incorporates a metatarsal arch support that will lift up in behind the ball of the foot and try to recreate the transverse arch allowing space again for the nerves to comfortably pass.

If you would like someone to come and assess if pedorthic services are right for your symptoms, contact Pedorthics In Motion:

                                                                          416-887-4109

                                                          email@pedorhicsinmotion.com

                                                          www.pedorthicsinmotion.com

Finding The Perfect Shoe For Your Foot Type

Selecting the right shoe for your foot type and running style is not an easy task.  I am going to lay out some guidelines that should make the decision making a little easier but I always recommend consulting with your local pedorthist.  

Running shoes basically fall into three categories with varying degrees.  These categories are neutral, stability and motion control.  There are many features within a shoe that can make it more or less stable but for this article we are going to focus mainly on midfoot stability.

First and foremost, before selecting a shoe you need to determine your foot type.  Are you an overpronator, a supinator or do you have a relatively neutral foot?  I have included some generalized diagrams of the heel bone viewed from the back relative to the bones of the lower leg and images of footprints as well to help you.  

From left to right, motion control, stability and neutral shoes.  Notice 

the dark grey plug on the motion control shoe and the similar but lesser 

plug on the stability and the lack there of on the neutral.  This is a way 

to identify which shoes fall in which categories.

If you find that you have a pronated foot type you should be looking at motion control shoes.  Motion control shoes tend to have a dense plug inserted under the midfoot in the sole of the shoe.  This plug gives the shoe aggressive support in the area of the foot that tends to collapse during the stance phase of gait.  If you have a pronated foot type, your foot is often quite flexible.  To avoid repetitive strain injuries, a motion control shoe will tend to offer the rigidity that your foot is unable to provide. Consulting a pedorthist before beginning to run is recommended so the root cause of your pronation can be determined and addressed.

If you have a supinated foot type you should typically be looking at neutral and cushioning shoes.  A supinated foot tends to be more rigid and does not absorb shock very well.  This foot type is prone to injuries resulting from a lack of cushioning, i.e. stress fractures.  A neutral shoe tends to have more cushioning properties to counter this.  In severe cases, there are a few shoes on the market that offer midfoot support, like the motion control shoe, but for this foot type, the plug is placed on the outside of the shoe.  If you feel this may be you, you should be professionally fit for proper shoes before beginning to run.  

If you find yourself fortunate enough to be in the neutral category, recommending a shoe is not as cut and dry.  Typically I would suggest a stability shoe.  This type of shoe offers similar properties as the motion control shoe but to a lesser extent.  Some people with a neutral foot find a neutral shoe that offers little support to be most comfortable.  With this foot type you have some flexibility to play around with different shoes within the stability and neutral category and find out what is best for you.  I would avoid a strong motion control shoe as you don’t want to over correct the foot.    

Determining which shoes fall under which category can be difficult to determine.  I recommend purchasing your footwear from a pedorthist or at a store that specailizes in running.  The staff at these places tend to be knowledgable and should be able to point you in the right direction.

This article should have helped you with the basics of shoe selection.  I always suggest that you contact a pedorthist to ensure that you have made the right choice. If you have any further questions please feel free to contact us at Pedorthics In Motion. 

email@pedorthicsinmotion.com

(416) 887-4109   

Dust Off The Old Sneakers! Spring Has Sprung!

It’s that time of year!  The sun is beginning to shine (sort of) and beautiful spring weather awaits us.  For all you committed runners that were out there all winter, kudos to you!  For the rest of us, we need to be kind and gentle to our bodies this spring.  

Launching yourself out onto the pavement after a sedentary winter is a sure fire way to injure yourself.  This article is a back to basics! It’s a de-thaw of the common sense that has been frozen away in the back of your brain. 

Always warm-up before you run!  A good warm-up dilates your blood vessels to ensure that your muscle are going to receive sufficient oxygen when activity begins.  It will also increase the temperature of the muscle for optimal flexibility reducing chances of injury.  Your heart will appreciate it as well. Raising the heart rate gradually will minimize the stress on the heart when activity intensifies.  Our heart doesn’t like going from zero to hero! 

Cooling down is just as important. Stopping rapidly can cause your heart rate and blood pressure to drop drastically leading to light-headedness. 

As runners we have to look out for each other, so I will remind everyone out there of the cardinal tips for safe running.  

Here is your check list:

1. Does someone know I am out running and are they aware of my route?
2. Am I visible? Wear white or bright clothing that have reflective pieces it.
3. If its dusk or dark, do I have a running buddy?  Safety is in numbers.
4. Do I have identification on me? 
5. Do I have my health card on me?
6. Do I have my cell phone on me?
7. Is my music turned down so I can hear whats going on in my surroundings?
8. Do I have some cash or an ATM card with me?
9. Do I have my ICE card? (a piece of paper with contact “in case of emergency” info on it will do)

Wearing the wrong shoes is the number one cause of 

running injuries.  Please contact a pedorthist to help

you find the best shoe for your foot and running style.

email@pedorthicsinmotion.com

Lastly, and in my opinion MOST importantly, get properly fitted for the correct shoe before you start running this year. Grabbing your old circa 1987 tennis shoes from the back of your closet is not going to cut it!  Running shoes are very specific and need to be matched to your foot type and running style.  Training in the wrong shoes is one of the most common causes of running injuries.

Stay tuned, I am going to post some guidelines later this week to help you understand which shoes are better for you, although I do recommend leaving it up to the professionals.  It is your health we are talking about after all! 

Contact your local pedorthist to help you find which shoe is best for you.   

If you would like someone to come to you and assess your running gait with video analysis and than properly match you to your future sneakers, contact Pedorthics in Motion.  A unique mobile foot care specialist.  

email@pedorthicsinmotion.com

www.pedorthicsinmotion.com