You create your own gait problems.

Just a simple reminder. Most shoes have EVA foam between the hard outsole rubber. EVA foam compresses but it also has memory. If you have a running form issue or a foot type that drives abnormal biomechanics into the shoe then over time the shoe’s EVA foam will break down into that pattern. Not only does this then support the problem, but it enables you to engrain the pattern (which means you are not engraining a cleaner pattern) meaining that every other joint and muscle then assumes that this is the norm and begins to alter their function based on the premise. A sign issue can drive many issues and many other complaints.  This client had a rigid rear foot varus , obviously as you can see by the wear pattern (yes, we gently and lovingly flogged this running for wearing the shoes this long into this pattern) but it was made worse by letting the shoe entrench this pattern so deeply. You see, their rear foot varus was no where nearly as bad as the wear into this shoe. But they continued to wear it and the foam continued to break down further and deeper into this varus wedged pattern. They came into see us for lateral knee pain and a tight IT band that was not responding to foam rolling (we immediately began to whimper and then proceeded to thump our forehead into our desk, repeatedly).  Some things should be obvious, but even we are far from perfect or wise at times.  

Key point, you have heard this here over and over again from us, have 2 or 3 pairs of shoes. Introduce the new shoe into your running repertoire at the 200 mile mark. At that point start rotating your shoes so that you are only a day away from a newer shoe that his not broken down into a faulty pattern and thus deformed EVA foam.  Even by the time the one shoe is dead and done, you have not been in it every run.  You should never kill a shoe to the 500 mile mark and then buy a new shoe. The pattern you have worn into your shoe will suddenly disappear when you put on the new shoe. Injuries occur from repeated events or sudden changes. Reduce your risk and rotated at least 2 pairs of shoes, one newer and one older.  

We talk about alot of these issues, and so much more, in the National Shoe Fit Certification Program. Email us if you think you might be interested.   thegaitguys@gmail.com

And ……when it comes to your feet and shoes, use your head.

Shawn and Ivo, The Gait Guys

Excessive Supination in a marathoner: Shoe Photos !

Simple visual case today.

Look at the right shoe, can you see how it is canted laterally? Can you see the inversion of the rear foot ?  Without a foot in that shoe it means that “the last”, the heel counter and the EVA foam are all destroyed and deformed into this great runner’s compensation pattern. 

They did not have pain however can you determine the problem here from the photos ? We hope your answer is no.  We did a teleseminar last night on www.onlineCE.com on pedograph foot mappings and we talked long and hard about the possible limitations of determining foot problems from foot pressure mappings from things like pedographs and pedobarographs.  Do you use foot scanners ? If so, user beware !  They gather vital and valuable information that you absolutely need but you need the critical clinical information from the client examination to bring the foot issue info full circle.

In this case there was a significant limitation in hip rotation. Which one ? Can you theorize ?  If you said internal rotation you are right. There was a notable loss of internal right hip rotation in his marathoner.  And it is represented in his shoe photo above. Someone who has a loss of internal hip rotation will often (but not always) have difficulties achieving the normal foot pronation required for clean foot mechanics, they will be stuck in a supination tendancy.  If loss of internal rotation can mean loss of pronation then in this case ample external rotation meant excessive supination (or at the very least rear foot inversion). Hence the shoe presentation described at the beginning of this post. (Note: this is what we would refer to as a “Flexible” Rear foot Varus posturing).

So, is this the wrong shoe prescription for this runner ? No, the shoes were prescribed correctly. This is a biomechanical breakdown of a shoe because of a hip functional problem.

Solution: Dump the shoes for a new pair and quickly restore hip function. Keeping these shoes in the mix will promote the bad pattern.  In this case, functional movement and muscle tested assessments revealed specific weakness of the right lower transverse abdominus, right internal abdominal oblique, right TFL, right vastus lateralis and coccygeal division of the g. max.   Yes, all INTERNAL HIP ROTATORS  or stabilizers or synergists of internal hip rotation.  Immediate post treatment remedy revealed near full internal hip rotation and homework was prescribed to ramp those said muscles up further to support the new movement. 

If he had remained in this shoe, the breakdown in the shoe would continue to promote the biomechanical deviations into the previously engrained faulty motor compensatory pattern. 

Shoes, sometimes they are the problem, sometimes the solution and sometimes caught somewhere in between.

Need to get better at this stuff ? Just follow us daily here on The Gait Guys or consider adding the National Shoe Fit Program to your repertoire !  Email us if you are interested or need some help with your interesting cases !

Shawn and Ivo, The Gait Guys

There are 2 photos here (move your cursor over to the little triangle on the right to highlight the bar to toggle between photos)

Can you believe that an experienced runner would let a pair of shoes get this far on both sides.  This person does a few marathons a year and has been a patient of our for years…..he tends to milk out every last step in a pair of shoes but we had to hog-tie him and flog him repeatedly for going overboard this time. I bet there had to be 2000 miles on these puppies !  And get this…..he had no foot or knee pain ! (his response was, i saw the wear but i was not having any issues).

Can you imagine how far out side the contact line the knees had to be ? This has the old Nike Cesium beat by a long shot (they were rear foot posted varus by about 3degrees). Heck, this could be 20-25degrees varus !  There is no question that he is avoiding and rear or mid foot pronation……the dude is fixed in supination. 

OF clinical note, he has a fixed right hallux limtus (turf toe) so this likely helps him to avoid medial toe off and forcing dorsiflexion through the big toe joint……however, there are better strategies than this to avoid a hearty toe off !

It is amazing what the body can endure !  Take this as a lesson of what NOT TO DO !  keep the miles between 400-500 miles gang……there are only so many compression cycles in EVA foam before deformation occurs.  In this case there was both deformation and just pure and simple friction wear !

PS: this was an easy pick up clinically……he sat in the waiting room with the 55 gallon barrel set beside him ….the one that he had been carrying around between his knees to force this much rear foot varus !