Yep, these shoes stink for this gal...

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Look at the left shoe and compare it to the right. See how the upper is canted on the outsole? This “varus cant” can create lots of problems or could actually be beneficial, believe it or not, depending upon the pathology.

In this particular persons story, it was NOT a good thing. They have an anatomical short leg on the left-hand side. If you remember from following us here in the past, generally speaking, the shorter leg tide tends to be more supinated and the forefoot tends to be in more varus. This means more of a “reach” with that foot during the contact phase of gait, Whether that’s running or walking. This generally means that the forefoot will pronate more on the long leg side.

This shoe “defect“ may actually be benefit for someone who has too much rear or mid foot pronation as it would “delay” pronation by starting to rearfoot in an inverted position at heel strike.

The Fix?

You could grind the sole into varus an equal amount to equal the varus cant. In our opinion, not a good idea.

You could return the shoe (that’s what this person is doing) and get another one

In addition, you could…

Give the person a 3 mm sole lift to correct for the leg length discrepancy

Make sure they have adequate range of motion in the first ray on the short leg side to be be able to plantar flex the 1st ray and reach the ground

Make sure they have adequate control of the core musculature as well as foot intrinsic musculature during stance phase.

Dr Ivo Waerlop, one of The Gait Guys

#badshoes #theshoeistheproblem #forefootvarus #leglengthdifference
#gaitproblem

Shoe causing knee pain? You decide… 

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This gentleman presented with left-sided knee pain at the medial collateral ligament. His left foot was planted when he rotated to the left. Take a close look at the shoes in the picture. If you look closely, you will notice the right shoe is tilted on its axis due to a rear foot to forefoot deformity (forefoot supinatus)and the left shoe upper was assembled canted on its axis, Most likely in manufacturing defect. Can you see the subtle valgus in the left shoe rearfoot?

Think of the implications of a shoe with this orientation. Putting the rearfoot in valgus “prepronates“ the foot, causing medial rotation of the tibia and femur and increase valgus stress on the knee, stressing the medial collateral ligament and stabilizing complex. This will most likely manifest itself as anterior rotation of the ilium on the left-hand side with relative posterior rotation on the right and a clockwise Pelvic distortion pattern. With the foot planted on the left side and it being pre-pronated, can you see how the rotation to the left leaves a greater amount of external rotation that must occur to just get the foot to neutral, never mind supination for stability and pushoff?
What about the popliteus having to work on time to assist and extra rotation and the appropriate femoral/tibial rotation ratios to spare the medial meniscus?

These are the kind of things to keep us awake at night…

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Take a  look at these dogs

Take a good look at these shoes. Notice the wear at the heel counter. Did you notice the varus cant  of the rear foot. Good! Did you carefully inspect where the upper was attached to the midsole? Now did you notice that upper is canted in varus as well? This person DID NOT have a rear (or forefoot) varus.

Hmmm. Maybe the varus canting of the upper caused the wear on the outsole? We doubt it; most likely it was the other way around.

What sort of  symptoms so you think they had?

Do you think medial or lateral knee pain?

 Could be either.

  • Lateral; knee pain from stretch on the lateral side of the knee at the lateral collateral ligament or
  • medial from compression of the medial condle of the femur and medial tiibial plateau.

Anything else?

How about pain on the outside of the hip? Canting the foot laterally has a tendency to externally rotate the lower leg and thigh. This may cause shortening of the gluteals (max and post fibers of the min); difficulty accessing the gluteus minimus (its a medial rotator), shortening of the deep 6 external rotators, difficulty accessing the vastus medialis (external rotator when foot is on the ground), and the list goes on.

What’s the fix?

New shoes. Pay attention when you buy shoes. Put them up on a counter at eye level and inspet them closely. We can’t tell you how many defects we see on a daily basis; too many to count. One time at a shop, we needed to go through 10 pair before we had a good right and left.

The Gait Guys. Bald. Good looking. Smart. Increasing your “Shoe IQ” every day.

 Want to  know more? Take our National Shoe Fit Certification Program. It’s the only one of its type and the only one certified by the International Footwear and Gait Education Council. Drop us an email at: thegaitguys@gmail.com for more details or go to our payloadz store  (click here) and download it today.

All material copyright 2013 The Gait Guys/ The Homunculus Group.