National Shoe Fit Certification Course

A quote made by a loyal follower on social media:

“someone asked for the best certification/certificate programs out there, and I posted this with a link to your YouTube promo video, even though I haven’t even went through it, yet. Hopefully this drives a handful of coaches your way. There are over 6k coaches in the group. “National Shoe Fit Program. The most unknown program out there. 2 overwhelmingly smart biomechanical clinicians put together a program to teach people how to integrate foot and shoe anatomy, then apply that to the various foot types to get people standing, walking, running and moving as correctly as they can on a basic level. Good luck trying to correct most of the squatting, deadlifting and Olympic lifting compensations without addressing how the foot interacts with the ground. Good luck trying to improve fitness without addressing gait. Good luck addressing gait without addressing foot types and shoes.”

thanks Michael !  

we blush

Shoe lacing problems, things you need to know (that you don't).

How you lace your shoes does truly matter (according to this study).
We have talked about shoe lacing on more than one occasion. Everyone has played around with different laces and lacing strategies at one time or another. And, every shoe seems to lace just a little differently. Some shoes lace far into the forefoot, some have the potential to lace high up into the ankle.  But just because there are eyelets there, doesn’t mean  you have to thread a lace through the hole. It is about fit the majority of the time.  Some of our runners will use “skip” lacing to avoid pressure over the dorsum of the foot, especially if they have a saddle exostosis or hot tendon in that area, much of the time this works to alleviate the pain and pressure there. Just remember, impaired ankle rocker often via weakness of the anterior compartment muscles (toe extensors, tibialis anterior, peroneus tertius) will force dorsiflexion moments into the midfoot and can cause some joint-related compressive pressure on the dorsal foot which can seemingly (and mistakenly) come from shoes tied too tight across the top of the foot. Be sure to consider this fact before you “skip lace” your shoes, it is a big player, one we see all of the time.
In today’s journal article found below, we discover some other factors in a controlled study.  Here they look into the effects of lacing on biomechanics in running, specifically rearfoot runners. The results of the study showed reduced loading rates and pronation velocities as well as lowest peak pressures under the heel and lateral midfoot in the tightest and highest laced shoes. Whereas, the lower laced shoes resulted in lower impacts and lower peak pressures under the 3rd and 4th metatarsal heads (they proposed that this was from forward foot slide in the shoe because of this lacing). The study authors concluded 

 A firm foot-to-shoe coupling with higher lacing leads to a more effective use of running shoe features and is likely to reduce the risk of lower limb injury.

Remember, this is just data for you to cogitate over. It can help you work through some possible issues with your feet and your sport, however it does not translate to everyone as a standard protocol. Remember this, we have been known to say, “your problem is not often the shoe, it is the thing in the shoe (you and your faulty biomechanics)”. However, blaming your problems on you is not good shoe manufacturer advertising, so many shoe companies will offer a plethora of shoes choices for you to accommodate to your variables. This does not necessarily mean the problem is solved, rather it is often managed by a “better” shoe choice that seems to work for your variables. This is a good thing most of the time, if you understand shoes, shoe anatomy, and human anatomy (foot types) so that you can pair them up for a best outcome. The problem may lie in the fact that your shoe fitter is not likely to have all of the necessary pieces to put your perfectly matched picture together, including understanding your total body biomechanics and possibly understanding why a weak glute is impairing hip extension and thus limiting ankle rocker motion, causing premature heel rise, and thus forcing too much dorsiflexion into the arch of the foot and premature forefoot loading causing what seems to be too tightly tied shoes.  
What we truly need an e-Harmony for matching shoes and feet ! But since that perfect scenario doesn’t often exist at the shoe store level or gait analysis level, here at The Gait Guys we have put together the next best thing, The National Shoe Fit Certification Program if you care to take this all to the next level. 
Shoe fitting is an art, and lacing is just another paint brush you can  use to get the job done. You just have to know what brush to use for each given piece of art (ie. the athlete). 
Shawn and Ivo, The gait guys
J Sports Sci. 2009 Feb 1;27(3):267-75. doi: 10.1080/02640410802482425.

Effects of different shoe-lacing patterns on the biomechanics of running shoes.

 

Another IFGEC Certified Doc!
Here is what Dr Brad Hochstein has to say about the National Shoe Fit Certification Program.
“Taking the National Shoe Fit Certification course has introduced me to many things that I didn’t take into consideration…

Another IFGEC Certified Doc!

Here is what Dr Brad Hochstein has to say about the National Shoe Fit Certification Program.

“Taking the National Shoe Fit Certification course has introduced me to many things that I didn’t take into consideration when working with my patients. The depth of information introduced is very helpful and presented more clearly than other courses I have taken in the past. I have studied a lot of the concepts that are introduced through the program in the past but struggled to put everything together. This certification did just that for me. It has helped me to link things together and look “outside the box” more than I had in the past.


I am a chiropractor with an extensive functional/biomechanics background and this has added another level of depth to my practice assessment and treatment. I am excited to incorporate the knowledge I have gained through this certification into my practice to give my patients an even better experience!”

Is it time to up your knowledge base and separate yourself from other clinicians, coaches, trainers, therapists and retailers?

Want to know more? Email us at : thegaitguys@gmail.com

Podcast 61: Sweating, Ankle Rocker and Free Radicals & Exercise

A. Link to our server:

Direct Download: 

http://traffic.libsyn.com/thegaitguys/pod_61final.mp3

Permalink: 

http://thegaitguys.libsyn.com/podcast-61-sweating-ankle-rocker

B. iTunes link:

https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138

C. Gait Guys online /download store (National Shoe Fit Certification and more !) :

http://store.payloadz.com/results/results.aspx?m=80204

D. other web based Gait Guys lectures:

www.onlinece.com   type in Dr. Waerlop or Dr. Allen,  ”Biomechanics”

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Today’s Show notes:

1. Free Radicals, Exercise and Nutritional Supplements
Free Radic Biol Med. 2011 Jul 15;51(2):327-36. doi: 10.1016/j.freeradbiomed.2011.05.010. Epub 2011 May 14.

Extending life span by increasing oxidative stress.

 
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3. we thank Will, one of our faithful followers for sending this article
 
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4. Jack rabbit sports running shoe company in New York !
 
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Gabe 11:03am Apr 21

5. Hello Gait Guys,
My name is Gabriel and I am a former patient of Dr. Ivo. I am also a quasi gait geek in the sense that I have read about 90% of your posts and listened to about 80% of your podcasts. I am messaging you today because I am now employed in the REI shoe Department and I would like to get shoe fit certified. If you could explain the shoe fit certification in more detail to me and testing locations, I would greatly appreciate it.
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The neurologist with a right short leg from a lower leg reconstruction , barely 90° right ankle dorsiflexion and severe LEFT OA hip
 
Gave him a right to millimeter sole liftft. He doubled the sole lift without telling me. Came in with a raging hot extensor digitorum dorsal foot pain.
 
6. New Balance fresh foam shoes:
weighs 9.1oz

25mm in heel; 21mm in forefoot w/ 4mm drop

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How well do your boots fit your ride?

Whether you ski, ride, nordic or tele, having the right boot fit can make the difference between a good day and a great day. It can accelerate your learning curve, prevent injuries, keep you warm and make you more comfortable. Not all feet are made the same and neither are ski boots. Good fit requires time and patience (lots of both). Here are a few tips for better fit.  

What kind of a skier/rider are you?  Recreational, competitive, racing, extreme?  How you’ll use the boot will often determine the type of boot that is appropriate for you.  In my opinion, you should get a boot that is a little above your ability (unless you are not interested in improving your skiing and/or riding), so that you will improve and “grow into” the boot.  This will ensure that you’ll continue to improve in your snowriding abilities.  Boots are very high tech these days and a subtle change in stiffness or angles can make a drastic difference in your skiing/riding.

The first thing you need to do is look at your feet.  Are they feet to the same from side to side (ie. same size and shape)?  These are the platform for the rest of your body.  What happens down there will affect everything else. Take a good look at your feet while you are standing. Are there bunions, calluses, hammertoes (toes curled under), or a Morton’s toe (2nd toe longer than your big toe)?  Do you pronate excessively while standing or walking (this will look like your arches are collapsing)? What is the relationship of the forefoot (front of your foot) to the rear foot (is the ankle sideways when viewed from behind? It should be neutral without your heel turning in (inversion) or turning out (eversion). The forefoot (front of your foot) should be flat on the ground. Does your ankle bend back as far as it should (this is called dorsiflexion). This will have an effect on the forward lean of the boot. Are you bowlegged or knock-kneed? This will cause you to ride on the outside or inside edge of your ski/ snowboard.

If you pronate excessively, have increased or decreased flexibility in the forefoot, rearfoot or big toe, have bunions or hammertoes, or are excessively bowlegged or knock kneed, proper fit and comfort while skiing will probably require a full contact orthotic or footbed. Hard deformities, such as bunions, may require liner and or boot shell modification.

Good socks are next on the list.  Wool or wool blend socks are best. The intertwining fibers of wool create air pockets, which make it both insulating and breathable. Wool absorbs sweat in its vapor state, before it liquefies, keeping you dry. It utilizes your own body heat to evaporate the moisture. This also helps to eliminate odor. No cotton socks, as they hold moisture, often creating blisters and providing a breeding ground for bacteria that cause odor; no multiple pairs, as they make feet cold. Remember, thin is in… let the liner do its job.

Have your foot measured utilizing a Brannocks device in a standing position.  Remember that your arch will flatten as you put weight on it. Remembering that the foot elongates with weight on it, will be useful for the next step.

Next you need to have the right sized ski/snowboard boot shell. This is as important for hard boots as soft boots Take the liner out of the boot and put your foot inside the shell so that your toes are just touching the front of the shell.  There should be approximately ½ - ⅝ of an inch (two crossed fingers thickness) behind the ankle to the back of the shell.  More than ¾ of an inch will cause too much heel rise once the shells are “packed out”.  There should be ¼ - ⅜ of an inch space between the feet and the side shell of the ski boot.

Now comes the liner. The liner should fit snugly.  Very snugly.  There should be no pressure spots anywhere on your foot.  Put in your foot bed or custom orthotic if available, before sizing the shell.  Remember that you’ll gain between ⅛ and ¼ of an inch of space with break-in when the liners “pack out”.

Buckle the boots loosely and flex the boot forward.  This will help to “seat the heel”.  Remember that if the you cannot flex the boot at room temperature, you will not be able to when the plastic is very cold. Now that the heel is seated, buckle the boot more firmly.  They should not be on the last buckle.

Now simulate some ski/ride movements.   If the boot is relatively comfortable, proceed to the next step otherwise repeat with different shell/liner size.

The cant of the boot (cuff alignment) needs to be adjusted next. This needs to be done by someone other than yourself (because you are standing in the boot). A plumb line dropped from the knee should pass between your second and third toe.  This ensures an even transfer of weight from edge to edge. Most boots are built with about 4 degrees of varus (lateral cant).  If you are not able to adequately align the foot, consider orthotics or having the boot shimmed. Remember that boots with higher cuffs will have more of an effect on your stance.  

Most boots provide between 12-16 degrees of forward lean.  If there is less than 12 degrees, consider a heel lift to place your body weight forward.  Remember to consider how much ankle dorsiflexion you have.

Once these adjustments are made, simulate skiing/riding movements in the shop for at least an hour.  Remember that ski/snowboard boots are made for snowriding, not walking. Now remove the boots and socks and look for “hot spots” on the feet that will show up as red marks.  These may represent areas in the boot liner or shell that need to be stretched and/or fitted better.

Well. There you have it. Now you know lots more than you knew when you began this article. As you can see, it is a very time consuming and labor intensive ordeal. Often times, people need professional help with the whole process and often require a foot bed or full arch contact orthotic. Become familiar with your own feet and then become familiar with the people or shops that do good boot fitting (ask around) and consider enlisting their help on your journey to the perfect boot.

The Gait Guys. Making it real…here….on the blog…with every post…

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So, what kind of shoes do I put this guy in?


The answer is, well…it depends.

This gentleman has a large Q angle (need to know more about Q angles? click here). The second photo is taken from above looking down at his knee.


If he has medial (inside) knee pain (possibly from shear forces), you would want to unload the medial knee, so a more flexible shoe that would allow more pronation of the foot and INCREASE the amount of valgus would open the medial joint space and probably be more appropriate.

If he had lateral (outside) knee pain (possibly from compressive forces), then a shoe with more support (like a motion control shoe) would help to unload the lateral knee and create more space may be appropriate. And that just covers the local knee issue. What if he has a pes planus and needs more than a “more stable” shoe ? And, what if that pes planus is rigid and won’t accept a more rigid arch supporting device ? What are you gonna do then ?

The caveat?

There are no hard and fast rules AND there is no substitute for examining the person and asking LOTS of questions BEFORE putting them in a shoe. You must approach each case on a case-by-case basis with all factors brought into the fold to make the best clinical decision.  Simply watching them walk, as you have heard it over and over again here on The Gait Guys, will lead you into wrong assumptions much of the time. Sometimes the obvious fix is not possible or won’t be tolerated by the person’s foot, knee, hip or body.  So, sometimes you have to settle with something in-between. 

Need to, or dying to, know more? Take our 3 part National Shoe Fit Program and be a shoe guru!

Email us at thegaitguys@gmail.com for details.