Perhaps one of the most innovative methods of helping to relieve nerve, joint, and muscular pain is through the use of TENS and EMS units. They are a popular method of pain relief, offering safe, effective, and drug-free relief from a variety of musculoskeletal pain. They work by delivering small electrical impulses through electrodes that have adhesive pads to attach them to a person’s skin.These electrical impulses flood the nervous system, reducing its ability to transmit pain signals to the spinal cord and brain.
The same electrical impulses also stimulate the body to produce natural pain relievers called endorphins.
TENS units may help treat the following symptoms:
BenefitsTENS is a noninvasive method for relieving pain. People who experience pain relief from TENS may be able to reduce their intake of pain medications, some of which can be addictive or cause adverse side effects.
TENS units are also convenient because they are small, portable, and relatively discrete. People can carry a TENS unit in their pocket or clip it onto a belt to ensure that they have immediate access to pain relief throughout the day.
Try one this year with your benefits coverage and see if one can help!
Your feet are your foundation. Protect your foundation! A balanced structure at your feet means a reduced chance of injury and increased endurance, balance and alignment. An improvement in your overall structure also improves your gross motor function. Your feet must be able to properly support your body; allow you to stand, walk, run, and jump; and absorb damaging shock that enters your body every time your heel hits the ground. The following are interesting facts about your feet:
What Causes Plantar Fasciitis to Flare Up?
The best way to prevent plantar fasciitis from flaring up is by wearing your custom orthotic insoles regularly and keeping up with your stretching remedies. Take preventative measures like wearing and stretching your feet regularly, and avoid common heel pain triggers:
1. Starting a new fitness activityFinding new ways to get in your daily exercise is a great idea, but new activities may trigger plantar fasciitis. Sometimes it is just a matter of getting used to new movements and easing yourself into a new routine, but other times it may be the activity itself that is causing a real problem.
When you decide to try a new workout, make sure that you warm up thoroughly, learn proper form, and wear supportive footwear. Avoid activities that require that you work out barefoot (like some martial arts and dance classes), and exercises that are particularly jarring to the feet.
2. Changes of intensity in activitiesEven if you walk or run regularly, changing the intensity of your workouts can trigger plantar fasciitis. Sprinting when you normally jog, or power walking when you usually walk at a leisurely pace will put an added strain on your feet that your body isn’t used to. People who spend most of the week working at a more sedentary job and then play hard on the weekends with lots of physical activity are especially vulnerable to plantar fascia injuries and flare-ups.
If you tend to participate in physical activity in spurts, make sure that you take extra preventative measures like icing and stretching your feet before and after the activity. If you’re starting a new workout regimen, ramp up the intensity slowly instead of diving in.
3. Weight gain (even healthy weight gain)Weight gain is a common cause and contributing factor to plantar fasciitis. Whether you are gaining body fat, muscle mass, or healthy weight from pregnancy, the added pounds put extra strain on your feet. This can cause plantar fasciitis for the first time, or trigger a new bout once you have already healed.
If you know that weight gain has triggered your plantar fasciitis, the first solution to consider is losing weight. One study that included 228 patients with plantar fasciitis who lost a significant amount of weight through bariatric surgery showed that an amazing 90% recovered from plantar fasciitis.
If weight loss is not possible (like with pregnancy or different health conditions), try to rest and elevate your feet more, and consider orthotic treatments to take the pressure off your arches.
4. Tight calf musclesThe muscles in the calves (specifically the gastrocnemius and soleus muscles) are directly connected with tendons and ligaments in the foot, including the plantar fascia ligament.
Many podiatrists recommend stretching out the muscles in your calves as a way to improve plantar fasciitis, since improving strength and range of motion in these connected muscles can in turn help stabilize and support your arch. Lisa M. Schoene, DPM, ATC, FACFAS, says, “Calf stretching both with the knee straight and with the knee bent [is] an important part of the treatment protocol [for plantar fasciitis].”
5. New shoesTrying a new style of shoes will sometimes trigger plantar fasciitis if they do not provide the proper support that you need. Shoes that are too flexible may cause added tension to the plantar fascia ligament, and different padding distribution may alter your footstrike as you walk or jog.
To minimize the risk, try to only buy shoes that are immediately comfortable, not that you will need to “break-in”. If you need the added support of arch supports or plantar fascia inserts, it’s usually best to replace them with your new shoes. If you don’t yet have a new pair, swap your old inserts into your new shoes until you are able to replace them to ensure you have proper support at all times.
6. Old shoesWhile new shoes can cause problems for plantar fasciitis, wearing worn-out shoes also poses a risk. If your shoes are showing noticeable wear on the insoles or bottom tread, it’s probably time to toss them out. Check the tread and integrity of your shoes every few months, and replace when needed.
Christopher Corwin, DPM, says, “Wearing appropriate shoes is the first step in alleviating the pain associated with plantar fasciitis.” This is especially important if you spend a lot of time on your feet at work, or if you participate in high impact exercises like jogging or basketball. The more time you spend in a given pair of shoes, the more quickly those shoes will wear out.
7. InjuryMost people intuitively understand that injuries, strains, or trauma to the plantar fascia ligament can cause a flare-up of pain. However, it’s less commonly understood that an injury to the tendons in the leg, ankle, or foot can trigger a flare-up of plantar fasciitis. For example, several studies have documented that tightness or injury to the Achilles tendon is strongly correlated to the function of the plantar fascia.
Injuries to the foot, ankle, or leg can be caused by stepping on uneven surfaces or objects, tripping, playing sports, exercising, or sustaining a blow to the foot. If you sustain an injury, take care of it immediately by icing and elevating it, and visit a doctor if you have any concerns or if the injury is severe.
Tips for Preventing Plantar Fasciitis Flare-UpsIn addition to avoiding these 7 triggers for heel pain, keep the following tips in mind to streamline your healing process!
Follow Your Doctor’s Treatment RecommendationsClosely follow your doctor’s treatment instructions, even if you notice some improvement in your pain levels. Think of your treatment plan like following a course of antibiotics: You wouldn’t stop taking the entire prescription just because you started to feel better! Following your doctor’s recommendations for the full period of time recommended can help prevent relapses caused by reinjury to the fascia.
Stay Consistent with At-Home TreatmentsKeep up with your regular at-home treatments like wearing plantar fasciitis inserts and stretching your feet regularly. Inconsistency won’t give you the results you need as you work to strengthen and support your plantar fascia and surrounding muscles and ligaments. Remember, your plantar fasciitis didn’t develop in a few days but rather consistently over the course of several months or even years. Applying consistent treatment over time will have the opposite effect you’re looking for!
Prevention is the key to avoiding recurring episodes of plantar fasciitis – and that includes following doctor’s orders, consistent treatments, and avoiding common heel pain triggers!
[Courtesy of Heel That Pain]
There are many ways to reduce pain and inflammation caused in the heel by plantar fasciitis. Download this PDF booklet to help with some of the key ways in eliminating the pain alongside custom orthotic intervention. For chronic cases, shockwave therapy treatments are highly effective in eliminating pain, I have included information on it as well if you're considering broadening your treatment options.
Stephan Radoja, M.Sc., C. Ped
Having flat feet is a common condition that involves a flattened or fallen arch on the inside of your foot. This allows the sole of your foot to come into complete contact with the floor when you are standing. While typically painless, flat feet can often contribute to issues with your ankles, knees, hips and back because your body becomes misaligned.
While often hereditary, there are also risk factors that can increase your likelihood of developing flat feet later in life. These can include over-use of the foot or wearing inadequate shoes, obesity, diabetes, aging and even a foot injury.
Common Issues Associated with Flat Feet:
Most people we see will not have any symptoms or issues with their flat feet. However, when left untreated, flat feet can eventually cause:
Best Way to Correct Flat Feet:
Some ways a Pedorthist can help you with your flat feet include:
Schedule an initial consult with Stephan Radoja today! They are free of charge and will help you understand your feet better! If you suspect you have flat feet, meet with him today. He can assess the arches of your feet and recommend a treatment option as well as a good shoe to help provide your feet with the support they need.
Give us a call at 905-467-5557 or request a call back here.
Stephan Radoja, M.Sc., C. Ped
In children, flat feet are a very common condition to observe with their feet. It may impact the way they walk (out-toeing) or "Knocked Knees".
What is a ‘flat foot’?
A flat foot is divided into two types; one that is structural and one that is functional. In the structural flat foot, there is a problem with the arch of the foot collapsing; the functional flat foot is when there is a problem in the biomechanics of the foot and the way we walk. Children with flat feet can often experience pain in their feet, which consequently may affect their posture. When children have flat feet, their feet collapse when they stand, and the knees and hips also become misaligned. This means the muscles that move those joints no longer work as efficiently and takes more energy to perform the same gait mechanics as other children who don’t have this condition.
Are ‘flat feet’ common for children?
When you see the foot sag and arches collapse, it’s noticeable when a child makes a foot movement inward while walking. The arches of the foot develop from birth until until approximately age 6. Flat feet are often hereditary, if the father or mother suffers from fallen arches, there is a good chance that the child may also have the same issue. It is important that the pathological flat foot be identified at an early age and treated efficiently to prevent further issues from occurring later on.
Benefits of Children's Orthotics?
Custom orthotics or exercises can really help. These are options that can help kids to strengthen their muscles and the structure of their foot. Each child is different and so are their feet, as a Pedorthist I often suggest a child-specific orthotic. One softer on the feet and not made from solid plastic, rather EVA materials with excellent shock absorption and rebound. Often the faster a Pedorthist can intervene (mechanically speaking) the more likely we are able to help with a better aligned growth pattern. Children as young as 18 months could benefit from a preventative standpoint. The principle objective of orthotic treatment -generally is to maintain the foot in a corrected position until ligamentous laxity (hypermobility) disappears, a development stage which can be considerably delayed sometimes. Orthotic treatment is usually continued until the stability of the foot has been restored.
If not identified and corrected early, ossification and hardening of the tarsal bones in the foot can lead to more long term issues and complications in the child's gait. Though a high proportion of feet correct with growth, retrospectively a study carried out on 85 children that early orthotic treatment for feet judged to be “abnormal” produced significant improvement with orthotic wear; whereas late or no orthotic intervention allowed for further deterioration of the structural alignment of the foot. A more current study in 2015 also showed that short-term use of custom-molded foot orthotics improved balancing ability in children with symptomatic flexible flat foot.
 Smith MA. Flat feet in children. BMJ 1990;301:942-3. (27 October.)
 Rose GK, Welton EA, Marshall T. The diagnosis of flat foot in the child. I BoneJ7oint Surg[Br] 1985;67:71-8.
 Hong-Jae Lee, Kil-Byung Lim, JeeHyun Yoo, Sung-Won Yoon, Hyun-Ju Yun, Tae-Ho Jeong. Effect of Custom-Molded Foot Orthoses on Foot Pain and Balance in Children With Symptomatic Flexible Flat Feet. Ann Rehabil Med. 2015 Dec; 39(6): 905–913. Published online 2015 Dec 29
How does a Pedorthist help exactly?
Firstly, we evaluate the biomechanics of the child's foot and walk. We recommend a non-intrusive orthotic, paired with a good shoe (later recommended below) which will best help with growth and development of the foot. We have extensive knowledge of the foot and its mechanics and it is this knowledge that allows us to work in close collaboration with allied health professionals to carry out a full assessment of the child.
Children’s Shoe Recommendations:
Providing your children with appropriate shoes will also help strengthen and straighten their feet and legs, allowing them to walk straighter while improving their posture. The picture below shows a child wearing a pair of unsupportive shoes with no custom orthotic built in. Note how the child’s feet are collapsing and turning inwards, throwing the whole body out of alignment.
The image below shows the same child wearing a pair of supportive shoes. Note how the arch and the heel is supported, preventing the child’s feet from collapsing and tuning inwards.
I recommend focussing on picking the correct shoe style and the correct shoe size, as children grow out of their shoes quickly. Foot and leg pain is not normal, if your child is complaining about foot and leg pain consistently, this might be a sign that your child has a foot condition such as flat feet previously discussed. I always recommend matching a pair of supportive shoes with a supportive orthotic for optimal results.
3 Most Important Features of Children’s Shoes:
A good quality shoe must provide comfort, arch support, and a firm heel counter, which will enable your children to strengthen their muscles and move around with ease and comfort.
2. Firm Heel Counter: The heel cup is the back part of the shoe that provides crucial ankle and heel support. Sometimes children can experience heel or ankle pain from having rolled ankles, in addition to flat feet. Always make sure that the heel counter of your kids’ shoes feels sturdy.
3. Flexible and Lightweight: Ideally, you want the shoes to be supportive, but lightweight and flexible in order to prevent your kids’ feet from easily getting tired. Their shoes should always bend at the ball of the foot but no further. It’s important that the back to school shoes are flexible but not too flexible, otherwise they won’t provide enough support and the foot will have to do more work than it should.
The Best Shoes for Kids with Flat Feet:
The New Balance 990 shoes are excellent and can be purchased in the below links.
Shoe 1 here
Shoe 2 here
Shoe 3 here
Stride Rite Ian
Stride Rite Artin
Stride Rite Cannan
New Balance KV790
New Balance KA680
Pediped Dakota Mary Jane
Keen Oakridge Low
Keen Newport Sandal
In order to allow for ample growing room, I recommend parents order shoes half a size larger than the size of their children’s foot length. The shoes recommended above all come with shoelaces, as they provide better support and stability than velcro or no strap.
New Balance shoes are specifically manufactured to provide support and stability to the foot as they provide a substantially thick outsole, as well as a high and well-padded heel which helps minimize the impact on their feet when they hit the ground. All of these shoes are also capable of accommodating an orthotic inside the shoe very comfortably, as they have removable insoles. Ideally any shoe you pick to wear a custom orthotic in should have a removable insole.
Investing in a pair of good supportive shoes will end up saving you a lot of time and money in the future. With the correct type of orthotics, they can help children walk and run straighter, by aligning their feet and legs and reducing the stress that they are putting to their feet. I recommend children’s orthotics for the following reasons:
Excessive foot pain: Orthotics help provide cushion and support to your kids’ feet to help reduce the pressure on the affected part.
Flat feet: Orthotics help prevent your kids’ feet from collapsing and allow your child to walk and run straighter.
Active Kids: Orthotics are recommended for kids that are very active in sports or high intense activities that induce pressure on the foot. They will help relieve some of the stress your kids are putting on their feet when they are running or playing at high intense levels.
Don’t forget to remind your children to stretch regularly, since that will help relieve some of the pain that they might be experiencing. The problem of foot pain is how it is much harder to diagnose in kids as they may not necessarily know how to express the pain they are feeling. It is left to the parents to recognize discomfort in their kids and detect what is the cause of the pain.
- Stephan Radoja, M.Sc, C.Ped
Unfortunately, if you have wide feet, there aren’t as many options up here in Canada as our southern neighbours. Fitting orthotics in narrow footwear can also be problematic for fit and comfort. Thankfully, there are still some excellent options that will give you the stability, structure and comfort out there.
WHAT MAKES WIDER SHOES DIFFERENT THAN OTHER SHOES?
Perhaps the biggest difference between a “wider" size shoe is that it has a larger toe box. Your toes aren’t cramped, while the rest of the shoe provides a good, snug fit in which your feet don’t move around too loosely inside.
Things to Consider before Choosing a Wide Shoe:
Whether you’re shopping for running or casual walking shoes, a few basic rules and considerations apply.
SIZING IS IMPORTANT. The difference between a good fit and a not-so-good fit cannot be understated. When it comes to overall comfort of your running/walking shoes first check the fit of your running shoe in regular size. Finding a running shoe to accommodate your extra foot width doesn’t necessarily mean going up a size with your new orthotics. Many shoes have removable insoles loosely taped or glued onto the bottom of the shoe. Gently remove it from the shoe from toe to heel.
MAKE SURE THE SHOE PROVIDES GOOD STABILITY
Finding a shoe with proper stability is important, no matter what type of feet you have. With wide feet, however, you also may have flat feet, and flat feet can lead to overpronation (when your feet bend inward with each stride).
Also, make sure the stability of your running shoe matches the type of terrain upon which you regularly run. A shoe that’s stable enough for running on paved paths and roads may not be stable enough for running on more rugged terrain, such as unpaved trails.
MAKE SURE THERE’S ENOUGH ROOM IN THE TOE BOX
I have already mentioned the importance of finding a shoe with a roomy toe box if you have wide feet. That doesn’t mean buying a shoe that has a toe box the size of the clown's boot, but there should be about a thumb’s width of room between your longest toe and the front of the shoe.
LOOK FOR SHOES WITH REMOVABLE INSOLES AND LININGS
Being able to take insoles and linings out of the shoe is helpful for any runner with wide feet, and doing so can make extra room for orthotics that help alleviate foot problems related to foot width.
How do we make your custom foot orthotics?
When you book an appointment with the Pedorthist he will provide a musculoskeletal assessment including a gait analysis and biomechanical exam. With Social Distancing precautions still in place, you may schedule a virtual exam to avoid coming into the clinic. In addition, he takes a 3D scan of your foot in both a weight bearing and non-weight bearing position! Both scans are used when designing your custom orthotic and comparing your natural arch shape to the transformation of your foot when all your body weight is on top of it.
New German Scanning Technology now allows the Pedorthist to scan the inside of all the different shoes you wear, to ensure a cross-compatible fit. A common issue with custom orthotics is they don't fit in the shoe properly, creating potential pain and discomfort. The 3D scans create an exact likeness of your foot in its corrected position. The scanner measures the 3D scan to an accuracy of 0.1 mm, currently the most accurate 3D Scanner on the market. If any software adjustments are necessary, such as adding a heel raise for a short leg, your certified pedorthist will build any accommodations into your custom insoles. The scans are then made in his orthotic laboratory here in Toronto, custom designed with 3D CAD software, CNC Milled and hand-grinded for the perfect fit.
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