LER: Foot Health – June 2016

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From the editor:

1Limb-Jordana-nolabelSmall muscles, huge potential

In recent years there’s been a lot of study and discussion—some of it quite contentious—of the relative merits of running barefoot, in minimalist shoes, or with various foot-strike patterns. But it seems to me that these debates are distracting foot specialists from a more important aspect of this research: the clinical implications of intrinsic foot muscle weakness.

As detailed in this issue of LER: Foot Health (see “Importance of intrinsic muscles for foot health,” page 15), one study suggests that runners who have difficulty transitioning from conventional running shoes to minimalist shoes are more likely to have undersized intrinsic muscles than those who make the transition more easily. Regardless of how one interprets this finding relative to the advisability of minimalist running, it clearly adds to a growing body of literature suggesting that weak intrinsic foot muscles are associated with a number of foot-health issues—including plantar fasciitis, diabetic neuropathy, and obesity-related foot pain.

Another recent running study found that habitually shod runners who gradually transition to minimalist shoes over a six-month period can significantly increase intrinsic foot muscle size. This suggests that a switch to barefoot or minimalist footwear can be an effective intervention to address intrinsic weakness. But that’s only true for patients in whom minimalist running is both feasible and safe. It’s probably not a realistic option for most patients with diabetic neuropathy, for example.

Foot strengthening exercises, on the other hand, offer an intervention that can be done by just about anyone. The effect of these exercises on intrinsic foot muscle size or strength has yet to be fully documented in the literature, but the findings so far are promising.

Running style preferences may always be up for debate. But, given the apparent prevalence of intrinsic foot weakness, it’s clear that intrinsic strengthening really should be considered as part of treatment for almost any foot issue.

By Jordana Bieze Foster


Region-specific foot pain doesn’t always match pressures, forces

Gait compensation may play role – The location of foot pain doesn’t always correspond with elevated plantar pressures and abnormal forces, which suggests the availability of region-specific compensatory gait mechanisms may play a role, according to recent research using Framingham Foot Study data.

By Emily Delzell


Bail’s Custom Footcare: Resilient business evolves and adapts over five generations

Few businesses can claim a heritage quite as long as the Bail family’s five-generation relationship with the shoe industry. But more than just a long history of selling shoes, the Bail family’s story is one of resilience.

By Nancy Shohet West

Crary Shoes: Pedorthic expertise complements decades of custom shoemaking

Crary Shoes has a motto: “The last is always first.” With a decades-long commitment to quality, the business provides custom shoes for clients with a spectrum of foot concerns, ranging from diabetes to unusually shaped or sized feet.

By Samantha Rosenblum  |  Photos by Monty Wolfe


Importance of intrinsic muscles for foot health

A growing body of research suggests the strength of small muscles in the foot can have big implications for a range of foot-health issues—including running-related injuries, diabetic neuropathy, obesity, flatfoot, and plantar fasciitis—and that interventions for strengthening the intrinsics may help.

By Barbara Boughton

Materials science targets foot odors and microbes

Silver fibers and other examples of nano­technology are increasingly turning up in shoes, socks, and orthotic topcovers in an effort to control odors, reduce the risk of infection, and improve foot health by making these devices moisture wicking, breathable, antifungal, and/or antibacterial.

By Shalmali Pal

Shoe Showcase

Help your patients step out in style

Samuel Hubbard Free

With the Un-Sneaker collection, Samuel Hubbard set out to make an “everyday shoe” for people with an active lifestyle. With soft upper materials, full glove-leath­er linings, a one-piece vamp, hidden padded collar, removable memory-foam…

Revere Santa Monica

The Santa Monica for women from revere Comfort Shoes features a stylish V front, a back strap, metal trim detail, and forefoot and rearfoot adjustability to provide a personalized fit. The sandal’s design also features a removable comfort insert, with enough…

Mephisto Jissy

The Jissy from Mephisto is a casual sandal with a stylish profile. Like all Mobils by Mephisto comfort footwear, it features all-over cushioning between the lining and the upper to pillow the feet, along with soft-air technology in the midsole to minimize shock.

Gem Caballo from Vionic

Vionic introduces a new silhouette. The Gem Caballo flat for women features a pointed toe with an envelope vamp detail, along with a removable footbed and stylish uppers made of suede, snake-printed leather, or haircalf.

Drew Tuscany

The Tuscany athleisure shoe for women offers a new, sparkling look from Drew. Tuscany shoes are walking shoes with added depth that can accommodate prescribed foot orthoses.

On Cloudster

The Cloudster, from Swiss footwear company On, features a very stiff flex and a slightly rockered speedboard, which keep the foot in a natural position while minimizing the loaded flex on the foot. A four-way adaptive-fit stretch material across the toe box allows for a natural toe splay.

Arcopédico Alice

Arcopédico’s new Alice style for women is designed to be the essence of casual chic while still being ideal for all-day wear at work. Designed in solid-tone suede, this slide-on loafer features a hand-stitched vamp, cushioned insole for superior comfort, metal-free twin…

Apex Sydney

Apex introduces the Sydney, the newest addition to the company’s Petals line of soft, light, and beautiful shoes for fashion-forward women who need superior support and adjustability.

Anodyne No. 19 Casual Mary Jane

Incredibly lightweight, the No. 19 Casual Mary Jane from Anodyne weighs in at just 5.6 oz. This A5500-reviewed style also features a full-grain leather upper, an anti­microbial-treated…

Alicia Slide from Spenco

New from Spenco for fall 2016 is the Alicia Slide for women, which is detailed with embossed floral leather and synthetic suede trim that can complement a casual or dressier look.