Do Flip-flops with arch support work?

Foot orthotics really are a effective modality used by podiatric physicians to manage a wide range of foot problems. All the clinical experiences and research evidence is that they are very effective. Nevertheless, one trouble with them is that they have to be worn in footwear. That is naturally a lifestyle option, but sometimes the options and the environment do not necessarily accommodate the use of the right footwear which foot supports could be worn in.

One query which you see asked frequently is that are those flip flops that come with an arch support built into them, can they be used instead of foot supports. There are a variety of manufacturers available on the market of flip flops that have different amounts of arch support built into them.

Are they as effective as foot supports?

That’s doubtful. The support that is included in them is just like what you will receive from a premade foot orthotics or one of the typical over-the-counter kind of foot supports. That is fine if you have an average arch shape. However, that is not good if you don’t. Foot orthotics usually are built to be specific to your foot type.

Should you use them?

There’s no harm in using these and they certainly might be used as an adjunct to foot supports when you’re not wearing footwear. As if they may be utilized as an alternative, you should discuss that with your foot doctor.

I do keep hearing about the Archies on the internet, however I haven’t seen them because they are from Australia. Evidently numerous podiatry clinics around Australia retail them.

The Chilblains Dilemma

Chilblains are a reasonably common problem once the weather is cooler. These are a painful and itchy reaction of the smaller blood vessels in the toes to the variations in temperature. They result in a painful red area, which later becomes a dark blue color should they become chronic. Chilblains have just lately been receiving some extra press in the media as a result of them being more common in those infected with the coronovirus, being given the term, COVID toes.

Chilblains are a seasonal condition and appear in all places in which the climate gets cold enough to result in the reaction in the skin. An instance of PodChatLive had a deep discussion of the problem of chilblains:

The easiest method to manage chilblains is usually to prevent these by keeping the feet warm. If a chilblain will develop then it must be kept warm and be protected to stop the skin from breaking down. There are several chilblain creams which you can use to help to promote the blood circulation.

Helping with Severs Disease

Severs disease or calcaneal apophysitis is a prevalent condition of the heel bone in developing children. At the back of the heel bone is a cartilage area that most of the development of the heel bone takes place at and this problem is an overuse injury of that cartilage area. It is more likely in kids that are active, are overweight and are taller. The typical signs of Severs disease is pain at the back and sides of the heel bone, primarily after sports activity. Severs disease is regarded as a self limiting problem, because the child will invariably at some point grow out of it as soon as growth of the heel pain stops and the developing region of cartilage inside the bone merges with the rest of the heel bone. That doesn’t suggest it shouldn’t be treated and may not be treated before that growth ceases.

This episode from PodChatLive was a comprehensive discussion into the issue of Sever’s disease/Calcaneal apophysitis:

A great way to take care of this problem can be managing the child’s and parent’s expectations and also lifestyle to help keep the signs and symptoms under control. The strains have to be managed via modifying and restricting activity levels. This is often challenging and may take some negotiation with the child. If the discomfort is severe after activity, then ice may be used to help relieve that. Often a cushioned heel insert might help protect the heel. Long term the prospects is good as they will grow out of this by the mid-teenage years.

The Diabetic Foot

Type two diabetes has become so common, it is almost as though we have become complacent regarding it. The incidence is rising in most places despite public health strategies are attempting to take care of the obesity crisis that is supporting the diabetes challenge. Diabetes has a number of complications that all combine collectively to put the feet at significant risk from complications. These complications vary from a mild infection to the more critical complications like a need to amputate a leg a result of a spreading infection or deceased tissue. The complications associated with diabetes have an effect on a wide variety of tissues in the body.

In relation to the feet, diabetes affects the blood supply and therefore any injury to the foot is more likely to be serious as there is insufficient good blood flow allowing healing to occur. Diabetes also damages the nerves, so that if there is some injury, either major or minor such as a blister, then no pain is felt, so the foot continues to be damaged resulting in the complication a great deal more severe. The body has numerous functions to fight infection, but in diabetes the response to an infection is much more sluggish than in those without diabetes. Diabetes can also affect the eye and while the eyes are a long way from the foot, ample vision is needed to see any issues that may have occurred to the foot so it may be dealt with. Even the renal disease that frequently occurs in diabetes impacts wound healing after the injury has been done and the presence of disease in the kidney can affect what medicines, for example antibiotics, may be used and sometimes that range can be quite restricted.

It is for all these complications, and others not brought up, that those with diabetes have to take additional care of their feet. They need to check them routinely to make sure that there is no injury and if there is an injury they must get medical help quickly. Most importantly, they must be regularly managed by a foot doctor.

Cuboid Syndrome

The cuboid is a smaller cube shaped bone on the lateral side of the foot around about the center of the foot. The bone is a bit bigger than a common gaming dice. The bone takes part in three joints and functions as a pulley for the tendon of the peroneus longus muscle to pass under. Because this is a powerful muscle it can move the cuboid bone too much if it is not steady and overload those joints that this bone is a part of producing a disorder known as cuboid syndrome. This is probably one of the more frequent causes of pain on the lateral side of the foot, particularly in athletes. The pain typically starts out quite mild and is located around where the cuboid bone is on the outside of the foot. The discomfort is only to begin with present during exercise. If the exercise levels are not lowered the problem will generally advance and then show up after exercise in addition to during. Occasionally the pain may radiate down into the foot. Although this is the commonest reason for pain here, there are others such as tendinopathy and nerve entrapments.

The main management of cuboid syndrome is pain relief. This is generally achieved with a decrease in exercise levels and the using of strapping to immobilise and support the cuboid. Mobilisation and manipulation is often used to fix the symptoms. Over the long run foot supports may be needed to control the movement and aid the lateral arch of the foot. This helps make the cuboid more stable so it is an efficient fulcrum or pulley for the tendon to work around. Generally this approach works in nearly all cases. If it doesn’t there are no surgical or more advanced methods and a further reduction in exercise levels is often the only alternative.

Cracked Heels

Splits in the epidermis at the back of the heel are frequent, are uncomfortable, and do not look very good. This occurs if the fat pad beneath the heel stretches out sideways beneath the foot and the dried-out skin cracks or splits to create a heel fissure. A good way to understand them is to use the analogy of a tomato being compressed. As you apply force to the tomato to squash it, the skin of the tomato cracks as the insides pushes outwards. So it is with the heel. As bodyweight squashes the fat under the heel it expands out laterally from under the heel, it attempts to tear the epidermis around the perimeter of the heel. If this succeeds or not is going to depend on how flexible and strong that the skin is. If the skin is dry, thicker or callused, it is going to tear quickly. If the skin is thicker with a layer of callus, that skin will crack easily and place stress on the good skin below that will become very painful, even bleeding. Each step that is taken with even further open the crack which will help prevent it from healing. Cracked heels are more common in those who wear open heel type footwear, as a closed in shoe should help keep the fat pad under the heel in position and help prevent or reduce the effects of this.

crackedheel

The most efficient short term management of cracked heels is to have the callused skin removed by a podiatrist and then use strapping to hold the sides of the split together so that it can heal. The long term prevention of cracked skin around the heel should be apparent from the mechanism that was described above. To start with, weight reduction will help lessen the problem, but this is a long term issue. To help stop the fat pad under the heel from expanding out sideways and trying to split the skin, a closed in shoe needs to be worn and frequently the use of deep heel cup insoles can help. A foot doctor should be consulted on a regular basis to debride any dry callused skin. Emollients really should be applied regularly to keep the skin flexible so that it does not fissure. The use of pedicure files to maintain the callus under control could also be used.

Chinese Foot Binding

There is a old process from rural China that involved the binding of the foot of female young people to stop them from growing. It was a barbaric practice and was painful and disabling to the feet. It was done as a small foot was thought to be an attractive characteristic in the female and a greater dowry can be demanded by the family for the bride-to-be if the feet had been bound. There was a substantial market in these rural communities for the ornamental and finely crafted shoes that these people would need to wear because of the smaller and misshaped feet. Around 100 or so years ago societal pressures did start to mount to ban the practice and this largely was successful and it is not carried out nowadays. The practice needed to stop as it was so debilitating and painful for the girls. When they became a grownup, the harm had been done and there was very little that might be done to deal with the pain and disability. Having said that, you can still find many older woman alive that had their feet bound when they were young children.

There are apparently commonalities to this practice of chinese foot binding that could be seen these days. Several commentators like to link the practice these days of females who push their feet inside the high heel footwear as being the same as the practice. In rural China the technique was all about the female performing something which pleases the male, no matter the outcomes in terms of discomfort and deformity. The practice today of using tight fitting high heel shoes by females has outcomes in the terms of foot deformity and foot problems. It is also apparently done in the perspective of the female doing something which is agreeable to the eye of the male. There is some argument if the connection between the two practices really do justify the kind of exploration that they have been subjected to.

Running Barefoot vs Running in Shoes

Running without running shoes had been very popular not long ago however interest in it and the number of runners doing it have decreased substantially. It was a fad which went on for several years and was mostly influenced by social media discourse. This was a short lived trend towards barefoot running which began around 2009 with an increase of interest in running free of running shoes. It was stated in numerous books, websites and magazine content that barefoot running was more natural, that it was a more economical technique to run and that you got a lesser amount of injuries running barefoot. Many runners tried out barefoot running instead of using running shoes and fascination with it peaked about 2013. The sales of minimal or barefoot running shoes furthermore peaked about that time, achieving almost 10% of the running shoe market.

After that initial interest and peak interest in barefoot running and minimalist running shoes were gradually decreasing. Runners lost interest in running barefoot. The sales of the minimalist running shoes have been dropping steadily since about mid- to late 2013. The promoted advantages for it did not eventuate to most runners that tried barefoot running but, naturally, those who publicized barefoot running just are convinced that those runners were doing it incorrectly. When the scientific research was published, the benefits were not just there. All of the running injury epidemiology reports were showing that the risk of injury was the same had you been running in footwear versus running without running shoes and most of the running economy investigations were also demonstrating that generally there weren’t any systematic advantages.

While some runners, that are rather vocal, still do their running barefoot the big trend has now been towards maximalist running shoes with the Hoka One One running shoe being the innovator in that category of running shoes. It has now reached the stage where that brand now outsells the entire group of minimalist running shoes which provides a clear indication of the popularity of cushioned running shoes compared to running barefoot.

Austin Bunionectomy

Bunions, or more precisely, hallux valgus or hallux abducto valgus occurs in many shapes or forms. The disorder is one of an enlargement of the big toe or hallux joint of the foot (bunion) and an angling over of the big toe or hallux laterally in the direction of the smaller toes (abduction and valgus). They become sore because of arthritis like symptoms from the deviation of the great toe or hallux and from stress on the enlargement of the bunion from the shoe. They’re one of the most frequent causes of pain in the feet and are caused by a combination of inherited features, weak biomechanics and also shoe fitting problems. Even though there are conservative options such as pads, splints, better shoe fitting, exercises and pain alleviation medicine which you can use, they don’t make the bunion go away nor straighten the hallux over the longer term. Often surgical treatment is the only permanent answer to bunions or hallux valgus. Nevertheless, unless the specific reason for the bunion had been attended to at the same time there’s a possibility that it may occur again.

There are various joints and bones involved in the development of bunions and each situation differs as differing amounts of each bone and joint are involved. Because of this the surgical repair must be directed at the bone or joint which is involved. If the great toe or hallux joint is just involved, then a straightforward chopping off the enlarged bone is perhaps all that is needed. If the angle of differing bones are a issue, then a V is going to need to be taken out of the bone and the bone reset. There are many different ways of carrying out that and it has been believed that this condition has more surgical options for it compared to all other problems!

The Austin bunionectomy is only one kind of procedure. This procedure entails removing the enlargement of bone and taking a v out of the head of the 1st metatarsal to realign it and hold it in position using a screw so it can heal. A special shoe or boot needs to be worn through the first few weeks following the surgery and go back to your typical footwear after about 4 weeks. It generally takes about 8 weeks to return to full activity levels following this surgery.

New Running Shoe from Asics

metarun1

Asics is just about the most well-known and widely used athletic shoes available on the market. Like any athletic shoe brand they will continue to innovate to keep that market leading position. Asics currently have a variety of running shoes with different versions to try and meet the needs of a wide range of runners. Each of those versions is frequently updated. Asics recently announced a different model to the range, the Metarun. Not much was initially known about the footwear, simply a taster video clip on the Asics website and a countdown clock ticking down to a launch on November 12 2015. When the clock reached zero a tweet was dispatched by Asics to a video which revealed more details and the web page was updated with more on the running shoe. They are certainly declaring that this is their best ever running shoe.

The Metarun shoe goes against the current tendencies of fewer gadgets and features in athletic shoes, adding several features which have patents associated with them. The midsole, labeled FlyteFoam, is their lightest and most sturdy midsole material. They mention “organic fibers” for the best level of cushioning. The shoe gets its stability from the patented AdaptTruss which is a carbon strengthened adaptive stability product. The “Sloped DUOMAX” is a dual density midsole which is meant to adjust efficiently to dynamic movement of the athlete. The upper features a glove-like, one-layer Jacquard Mesh as well as MetaClutch exoskeleton external heel counter with a built-in memory foam. There’s also a X-GEL hybrid high-tech gel in the midsole to aid cushioning.

Is it their finest running shoe ever? Time will tell. Athletes will vote with their feet after they test the Metarun. There was a bit of discussion in social media prior to the release. These shoes won’t be obtainable until late November plus they are likely to be expensive and just obtainable in restricted release.