Dr. Jenny Sanders Shoe Blog

This is a beautiful and well designed shoe. Unfortunately, you won’t be able to find it anywhere online, as I just checked. It does however have some great features which are worthwhile to search for when buying a pair of high heels.

1. The ribbon tie is adjustable accommodating different foot depths.
2. The toe box is wide and rectangular which won’t pinch the toes.
3. The heel comes straight down from the back of the shoe vs. offset, i.e. kitten style.
4. The heel is 3″ which will work for most women.

The reason I don’t do many reviews on women’s shoes is because, whenever someone brings in a blog worthy pair, by the time they get to me the style has been discontinued. I therefore try and show you the design of shoes and what to look for.

This shoe has a lot of mesh in the forefoot upper, which can help if you have hammertoes and /or bunions. The back of this shoe has a firm heel counter, which helps guide heel strike if you pronate excessively. This shoe also has firm EVA (ethyl vinyl acetate) in the midsole extending from the arch to the back of the shoe which makes it very stable.

A general rule of thumb is the darker (more grey) the outsole, the more firm or less flexible the shoe will be. This design feature helps those feet who need lots of support, especially at the rearfoot. The difference between the Ultimate and the Moderate version is the Ultimate has EVA which wraps around to the heel wheras the Moderate just has EVA in the instep.

The mens and womens version of this shoe come in medium and wide but not extra-wide and the toe-box is not too deep which can help fit considerably if your foot is wide and shallow.

Version 7 has just been released and from what I can see on Zappos.com, it looks to be essentially the same as version 6, but I’ll keep you posted if that changes. The other good news is, because version 6 is being upgraded, you can probably find this shoe on sale. At Sports Basement in San Francisco, this shoe is marked down from $100 to $64. Quite a deal for a well made shoe!

D.M. came in today with his barely worn Nike Air Pegasus Trail shoes. He was recovering from a fractured sesamoid bone (small bone under the big toe joint) and wanted me to evaluate his shoes before he resumed running.

He had purchased the running shoes prior to his injury and spent over two hours in a specialty running shoe store, trying on every shoe in the store, because of his difficult to fit narrow foot. Finally, with the help of the sales staff, he found this Nike Air Pegasus Trail shoe. It was apparently rated highly by a runners magazine, which helped to close the sale.

The above image shows the shoe which on first glance appears moderately deep and wide, but I was keeping my fingers crossed, at least until I saw D.M. stand in the shoes.

Normally, the back area of the shoe (heel counter) should be perpendicular to the standing surface. As this image shows, the heels are turned out, which is not good for healing sesamoids, knees or alignment in general. No wonder he wasn’t getting better.

Moral of the story. Just because someone says shoe xy or z is the best shoe ever, make sure the shoe works for your foot and not someone elses. It could me the difference between healing and continued pain.

Finding a wide shoe for soccer is no simple task. Most soccer shoes fit painfully snug, so if your foot is outside of the bell shaped curve, trouble may loom ahead. I found this shoe for someone having serious ingrown nails, because of the narrow toebox fit. Luckily I found the Adidas 7406 which have a couple of great features and fit him perfectly.

• The eyelets extend beyond the ball of the foot, closer to the toes. This allows for width adjustability. Many soccer cleats don’t lace down this far and if your foot is wide, this can really help.

• The arch width doesn’t hourglass in like most soccer cleats, given the arch full support as seen below.

And the overall width is slightly wider than most other soccer shoes and has a removable sock line which will accommodate an orthotic if you need one.

Saucony Grid Stabil has incorporated lock lacing into their design. It requires longer laces and if you don’t know how to cinch up the excess laces using this method, you could just trip and fall. 

When you look at the eyelets from the side, lace through all of them just like this image shows.

Now, instead of making the bow on the inside, take the end of each lace and thread through the loop on the opposite side. 

Finally, cinch tight pulling the laces horizontally from side to side. This method of lacing will stay tight until otherwise loosened. The only down side… it takes more time to tie and untie and if you don’t have a problem with heel slippage, then you have excess lace length for no reason at all.

Saucony Grid Stabil is one of my favorite shoes and I recommend it at least once a day for the narrow (rectangular) foot. Surprisingly it works for shallow (flat) and deep (high arched) feet, because it comes in both medium and wide widths. For a refresher on foot width determination, refer to my blog posting http://drshoe.wordpress.com/2008/01/14/narrow-vs-wide-feet/.

As for the construction, this is one of the few running shoes which is proportional, meaning the heel to ball and heel to toe measurements are true to size (http://drshoe.wordpress.com/2007/12/05/size-matters-heel-to-ball-vs-heel-to-toe/). It’s also deep enough to accommodate a sport orthotic once you remove the sock liner.

It has a non-collapsible heel counter which helps guide heel strike and it has a firm inside mid-sole (grey above) which helps with pronation or foot collapse. Lastly the toe box is shallow meaning it will pass the pinch test (http://drshoe.wordpress.com/2008/01/15/pinch-test-shoe-toebox/), providing a secure fit, if your foot is lower volume than most.

Thanks to surgical resident Rachel for forwarding the American Podiatric Medical Association’s (APMA) “Ten Tips To Foil A Flip-Flop Fiasco”. My comments follow in italics.

Flip-Flop Do’s:

• Do look for a flip-flop that is made of high-quality, soft leather. This material, unlike plastic or foam, will minimize the potential for blisters and other kinds of irritation. I don’t agree with this one, as there are lots of high quality flip flops that are not leather. Also, leather can stretch, causing the flip-flop to become loose over time.
• Do look for flip-flops that hold APMA’s Seal of Acceptance, such as Chaco’ Flip Collection and Wolky’s Serenity, part of their Zen Collection. Evaluated by a committee of APMA podiatric physicians, these products are shown to allow for the most normal foot function and promote quality foot health. I think Chaco’s and Wolky’s are well made sandals, but they won’t work for every foot. Here’s my blog posting with my thoughts on running shoe lists. http://drshoe.wordpress.com/2007/12/14/running-shoe-lists-aarghhh/. I also think there are a lot more sandals than just Chaco’s or Wolky’s which allow for normal foot function.
• Do gently bend the flip-flop from end to end, ensuring that it bends naturally at the ball of the foot. Shoes should never fold in half. Wise advice indeed.
• Do wear a sturdy pair of flip-flops when walking around a public pool, at the beach, in hotel rooms in locker room areas. Walking barefoot can expose foot soles to plantar warts and athlete’s foot. If your flip flops are rubber, it’s a good idea to occasionally mist the wearing surface with Lysol Disinfectant Spray, to kill any harmful organisms which might hover on the top of the shoe.
• Do ensure that your foot doesn’t hang off of the edge of the flip-flop.

Flip-Flop Dont’s:

• Don’t re-wear flip-flops year after year. Thoroughly inspect older flip-flops for wear. If they show signs of severe wear in the soles, it’s time to discard them. Set them on a table to evaluate the heels. If flip-flop flops to one side, they need to be replaced.
  
• Don’t ignore irritation between toes, where the to thong fits - this can lead to blisters and even worse irritation. Ditto for where the side straps insert into the flip-flops. If callous forms here or anywhere else on your foot because of the flip-flops, then it’s time to say goodbye to the flip-flops and get a new pair.
• Don’t wear flip-flops while walking long distances. Even the sturdiest flip-flop offers little in terms of shock absorption and arch support. Gotta love common sense!
• Don’t do yard work while wearing flip-flips. Always wear a shoe that fully protects the foot when doing outside activities like mowing the lawn or using a weed-eater. According to the Annuls of Emergency Medicine - Researchers analyzed emergency room and hospital records from 1996 to 2004 and found that nearly 663,400 people went to the emergency room and almost 12,000 people were hospitalized in lawn mower accidents during that period. Yikes
• Don’t ever play sports in flip-flops. You can easily twist your foot or ankle, leading to sprains or breaks. More good advice.
  

Pikolinos is a Spanish company which has been around since 1984. Because they are imported, their price is higher than a lot of US brands, but Pikolinos are well made using quality materials which helps.

Someone came in today having a bunion, wearing the above shoe. Notice how the flowers on the upper are actually cut-outs? This is a great design and many Pikolinos have similar styling. This open weave eases tightness over protruding bunions or hammertoes, making it a very foot friendly fit. The only problem with this particular style is it won’t fit a really wide foot. 

Other styles can be found at Pikolinos website http://www.pikolinos.com/

Many women who wear shoes that are too short develop hammertoes. This is a condition where the toes draw up, producing a buckling of the joints on the top of the toes.

Hammertoes typically occur more often in women having high arched feet as opposed to flat feet. Before you rush off to the surgeon though, have your feet measured and make sure your high heels are of proper length. Your toes will thank you.

I wasn’t a fan of the Gel Cumulus 9 because of it’s flexibility and disproportional fit. I am a fan of the Gel Cumulus 10, especially if your foot is wide and you have a bunion. The Cumulus 10 has expanded the mesh in the area of the bump, which allows for less pressure in this area.

The cumulus 10 also has less flexibility in the forefoot than the 9 which can help alleviate ball of the foot pain.

The only downside of the Cumulus is the outsole, which is made of soft EVA which will tend to wear more quickly than a shoe with firm EVA. Both will accommodate a sport orthotic easily.

If you have a wide foot that’s either deep or shallow then Chaco sandals (http://chacousa.com/) may be just right for you. They have a thick sole with a built in arch, which is great for flat or collapsing feet.

My favorite part of the shoe though, is how easily it adjusts by sliding the straps to increase or decrease depth. This makes for a better customized fit, then if you just had width adjustability alone.

Another added bonus is their repair program, which includes all parts of the sandal from strapsto soles. At around $100 for the sandal and $30 for the repairs, Chaco sandals can last years. And don’t your feet deserve that?

A marathon runner came into the office asking about the new Newton Running shoes. He had seen their booth at his last Marathon event and wanted to try them, so he purchased a pair online and brought them in.

I was disappointed when I saw them, not only because of the expensive price tag ($150+) but because they were unstructured and flexible, reminding of Nike Free. Most discouraging of all though, was watching JR run in them on the treadmill. The upper was moving from side to side to the point that I was worried about rearfoot injury and the potential for knee pain with continued use.

Needless to say, he looked much better in his Saucony Grid Stabil’s which held him in proper alignment. If you are interested in running in a Newton, make sure you have a sports medicine specialist evaluate them on you including running.

Arthur Beren in San Francisco http://www.berenshoes.com/ is the place to go if you are stylish and don’t mind spending $400 (or more) on a pair of shoes, including Thierry Rabotin. Previously a designer for Taryn Rose, he now has his own line which many of the well heeled wear. Butter soft leather uppers and insoles the color of Tiffany box blue. Genius marketing…if only I’d though of it!

Today someone brought in two pair of Thierry Rabotin shoes which perfectly fit her wide (bunion), shallow, hard-to-fit feet. This pair is “Grace”, a ballerina flat with an elasticized vamp insets which help with the fit. Stylish and fun. If you can afford the sticker shock, Thierry Rabotin is a great designer shoe line.

Asics 2130 is one of my favorite shoes and I recommend it daily. Today however, someone brought in a pair of the new 2130’s in the storm/lightening/hot pink color. Her previous pair were the white/gold/python color and much to my dismay, the shoes were not the same width.

The new 2130’s (right) were 5mm narrower than the old 2130’s (left), which makes the fit more like the old 2120’s which have been discontinued.

If this is your running shoe, make sure you check the width as subtle changes can make a big difference. If the new 2130 seems too tight, switch to the D width which will probably work.

Reader Joey asks “I need professional, non-biased opinions on the MBT’s”.

I reviewed MBT’s, on my 12/22/08 posting. Here’s the link: http://drshoe.wordpress.com/2007/12/22/cnettv-me-on-masai-barefoot-technology/

As an additional summary, I’m not a huge fan of MBT’s because they are heavy and expensive and don’t work at all for narrow or shallow feet.

Research the company cites to validate their findings were done on healthy college students, having little or no pathology. Not surprisingly, there have only been three studies, all sponsored by the company and none within the past several years.

Typically when someone comes into the office wearing MBT’s, I work with them to transition out of the MBT’s into a more normal type of shoe and I have never recommended MBT’s as a first line of treatment.

Ebony brought in this great platform wedge sandal today, purchased from Gap.

Platform style sandals are a great way to add height without increasing ball of the foot pain. This sandal has the added bonus of buckles at the ankle and over the top of the foot for even better fit. All in all this shoe rates an A for summer style and wear.

Okay, I’m not going to really review all the different NikeiD styles because there are so many of them. Instead, what I wanted you to know, is how much fun the NikeiD process is.

Basically, you pick the shoe design, the colors and some of the materials which make up the shoes. For example - upper color, logo color, insole color and shoelaces.

The above image shows a pair brought in today ($110), which are fun and original. This is the Nike Dunk Low iD Men’s Shoe and it’s surprisingly stable compared to similiar shoes like Vans.

Dear Readers,

In the next week I’ll be doing an interview, which will air in July, for Body Language, a new public radio show featuring contemporary attitudes towards health and wellness. http://www.onthepathproductions.com/

Part of what I’ll be doing is talking about the blog, including common shoe misconceptions as well as what it takes to keep your feet healthy and happy for years to come.

In preparation of the interview, I thought your input would be helpful, so I’d like to have you answer the following questions on the blog. If you would prefer to keep you’re answers anonymous, just let me know and I won’t post them.

1. What’s the worst shoe advice you ever got?
2. Are you a slave to comfort or fashion. Can you have both?
3. How much money have you spent on shoes you can’t wear?

Thanks and if there is anything else shoe wise that you would like me to blog about, let me know, I love hearing from you!

Dr. Sanders

Reader and Medical Student Tony asks “What do you think about the FitFlop?”.

I think FitFlops are great. They have nice wide straps and a thick, contoured soles. I have used them successfully with narrow, shallow feet (Wiley’s Felt Remedy required) and wide, deep feet. I don’t however believe the company’s claims about muscle work-outs, toning and trimming of the legs so don’t buy them for this reason.

If you’re looking for a fun, comfy, well designed, well made and well fitting flip flops, then FitFlops may just be for you.

Reader Andrea asks “Could you please review the New Balance 767? I have a relatively narrow foot and wear orthotics for my high and collapsing arch.”

I’m not familiar with the NB 767 model, but I am familiar with the 768 which is the next version. My problem with the 768 is it has a very deep toe box even in the narrow width.

On the plus side - it will work with an orthotic and it won’t strangulate your high arch. Just make sure it doesn’t fail the pinch test: http://drshoe.wordpress.com/2008/01/15/pinch-test-shoe-toebox/

If it does, then you might want to try Asics 2130 in medium, since this has a shallower toe box, fits the narrow foot with a high arch nicely and will work with an orthotic.