Shoe Retail Thursday: Today we have a client in some shoes that appear to be a good match, until you look more closely.  See if you can see it.

“ Just because the shoe fits, doesn’t mean you should wear it ! ”

- The Gait Guys

First of all, we apologize for the crummy video. But we were scouring through some old stuff while working on our long awaited “Shoe Fit” program and this video just had to be shown. This is a short video, you might get some  vertigo from the nasty camera work. Sorry about that. 

Initially this client looks great from behind. The rear foot looks neutral, no valgus heel collapse into rearfoot pronation and no over burdening of the lateral crash zone (lateral/outside tipping of the shoe into supination).  If anything could be said, they look like there could be a subtle rearfoot supination from the initial shot before they start to walk. 

We are also not sure what shoe this is, we do however know it is a New Balance stability shoe from the video.  This client had purchased these shoes 1-2 weeks prior in a trusted high end specialty running store.  As the client walks away from us everything looks pretty good. We could point out some subtleties but those are not the point of our talk today.  It is not until they come walking back that something is clearly wrong.  Did you see it ?  The LEFT foot is drastically supinating displaying a lateral weight bearing shift all the way through toe off.

Now, on the surface this is a simple case.  (We just shot a concept video last night to take this blog post today to the next level. We will present it next week once we get it edited.) But the points we need you to understand today are :

  1. Just because someone has a flat foot standing in front of you does not mean they need a stability shoe.  We see plenty of folks who are serious walkers, runners all the way up to professional athletes who have flatter, or flattened, medial longitudinal arches but still have very strong competent feet.  There are ethnic groupings that have flat feet.  So just because a foot looks flat does not mean one should reach for a stability shoe or an orthotic or additional foot bed insert.  This client had flatter arches but had competent feet.  They also had some issues of tibial torsion that negated some of the challenges of flatter feet.  So, our point here is what you see is not always what you get, nor what you should fix either for that matter. 
  2. What should happen in a shoe does not always truly happen.  This means you have missed some calculations or you simply do not have enough experiential wisdom to predict the oddities in certain situations or with the given anatomy of a given athlete.  This comes in time, with experience.
  3. Sometimes supination is not really supination. This client has a flatter foot. Flatter feet do not supinate well. Ok, better put they run out of time to supinate the foot because they have spent too much time into the pronation phase. However, they also could have weakness in the supinatory mechanisms to drive it adequately. Remember, some clients will fall into their weaknesses and some will strategize to avoid the weaknesses if they have enough body awareness and strength to do so.  They just do not seem to have the skills to find the more appropriate pattern to correct the underlying issues. But there is certainly something positive to be said to knowing you have a problem and that you are cheating around it rather than being oblivious.

This case was possibly, maybe even likely, one of several problems:

  1. wrong shoe for the foot type
  2. possibly a faulty shoe fabrication
  3. poor strategy to make for a rigid foot structure

This case also draws clinical inquiry into:

  • whether there is weakness of the ankle and forefoot everting muscles namely the peronei and extensor digitorum longus and brevis. * This the topic of the video we are producing because these muscles have huge implications in the cross over gait (which we have senselessly beat you all with in previous blog posts) at the lower end of the limb.

Who are we ? The Gait Guys…… Shawn and Ivo.  The dynamic duo of all things gait.