Dr. Jenny Sanders Shoe Blog

Sesamoiditis

drshoe — Wed, 25 Jan 2012 15:53:59 +0000

I have had several runners and one roller derby player come to the office recently having sesamoiditis. The sesamoids are two small bones which are embedded in the tendon directly underneath the big toe joint. They act as a stabilizer of the big toe, keeping the toe moving up and down as opposed to side to side.

Sesamoids can occasionally fracture or be bipartate. Bipartate means that an individual sesamoid which normally starts out as two pieces and fuses together doesn’t fuse, leaving the two pieces separate, which the image below shows.

High-arched feet have a greater tendency to develop sesamoiditis than flat feet. Excessively worn, poor fitting or improperly designed shoes can also cause sesamoiditis.

Medical treatment depends on the severity of pain include icing, anti-inflammatory medications (Advil/Aleve), cortisone injections into the joint, immobilization and orthotics.

Shoe treatments include wearing a shoe that doesn’t flex at the forefoot or have a thin, non-shock absorptive sole. In a running shoe, this means no flex groove directly under the big toe joint where the sesamoid is inflammed.

Going barefoot is also not a good idea until the area heals.

Since the sesamoids bear weight with every step, this condition can take several weeks to months to improve. If however, the pain remains unchanged in spite of the treatment, then MRI should be used to make sure there’s no fracture. Fractured sesamoids require non-weight bearing immobilization with cast and crutches and occasionally surgical removal of the sesamoid.

If you have pain under the big toe joint that doesn’t improve with reduced activity and rest then you may have a fracture. Whether or not you have big toe discomfort of pain, it’s important to see a podiatrist for evaluation. Waiting to seek treatment can make this condition worse.

Flex Grooves and Forefoot Pain

drshoe — Mon, 23 Jan 2012 18:31:27 +0000

Horizontal grooves in the forefoot of running shoe outsoles are called flex grooves. As the name implies, flex grooves are designed to promote forefoot flexion across the ball of the foot.

In many cases of forefoot pain, however, this is exactly where you don’t want the shoe to bend. You actually want the shoe to be as inflexible as possible in this area if you have the following forefoot conditions: hallux limitus, sesamoiditis and metatarsalgia.

If you have forefoot pain, deep flex grooves located directly beneath the affected joint will cause an increase in forefoot flexion as well as reduced shock absorption due to a lack of an overlying outsole in the area of a groove.

The shoe on the left side of the image has flex grooves adjacent to where the forefoot bends, which can alleviate forefoot pain. The shoe on the right side of the image has a flex groove where the forefoot bends, leading to more pressure in this area.

If you experience pain in the forefoot, check the flex groove placement in your shoes. Flex grooves in the wrong place can contribute to forefoot pain.

Blood Blisters Under Toenails

drshoe — Tue, 17 Jan 2012 16:55:01 +0000

DG came in today with subungual hematoma, or blood blisters, underneath the toenails from playing soccer in shoes that were too short.

Soccer cleats are designed to be worn snugly, but if they are too short, pressure will build up against the nail, causing a subungual hematoma to form. In this case DG had been wearing size 10 1/2, but measured size 12 1/2 heel to ball and 11 1/2 heel to toe. Additionally, his current soccer cleats were too shallow in the toe box, as well as too short as this image shows.

If you routinely lose toenails from playing sports, you will probably need to go into a bigger size shoe. The best place to have your foot professionally measured is at a specialty running shoe store and then use that information to size your cleats accordingly.

If you experience a subungual hematoma, you will want to visit a podiatrist and have your nails trimmed and thinned down.

Here’s an additional post on runners thickened toenails http://drshoe.wordpress.com/2008/08/18/runners-toenails/

January Poll – How Do You Choose An Athletic Shoe?

drshoe — Sun, 01 Jan 2012 14:38:43 +0000

Starting this month I’ll be posting a monthly poll. If you have a few seconds, I would appreciate your vote. I’ll use the answers to guide future posts. Happy New Year and thanks for reading my blog.
-Dr. Jenny Sanders
Take Our Poll

Shoe Review – Brooks Adrenaline 12 vs. 11

drshoe — Sun, 01 Jan 2012 01:48:47 +0000

Brooks recently released Adrenaline 12. Although this is still a great shoe for the narrow, shallow foot http://drshoe.wordpress.com/2011/11/17/determining-proper-shoe-fit-width-and-depth/. There are some changes to the lower part of the shoe which warrants mention. My video below identifies the changes.

Associated posts include:
http://drshoe.wordpress.com/2009/11/05/shoe-review-brooks-adrenaline-gts-10/
http://drshoe.wordpress.com/2009/02/04/shoe-review-brooks-adrenaline-gts-8-vs-gts-9/
http://drshoe.wordpress.com/2008/01/03/shoe-review-brooks-adrenaline/
http://drshoe.wordpress.com/2008/09/17/footbed-design/

Shoe Review – Adidas AdiPower Predator TRX FG Soccer Cleats

drshoe — Wed, 28 Dec 2011 05:30:18 +0000

Just had my first look at these sleek, well-made and expensive cleats.

All I can say is Adidas, what did you do? The concept is great (lightweight, yet rigid), the style is great (cool colors, streamlined look) but the back cleats are manufactured to sit uneven which will be a major problem for a lot of Soccer players out there.

The above image shows a new-out-of-the-box pair placed on a flat surface. New cleats should NEVER do this. In fact when cleats wear this way, they should be immediately replaced. Adidas Product Defect Department assured me that their cleats are designed level, however a trip to the Adidas Sport Performance Store in San Francisco, confirmed that every new pair of AdiPower Predator’s was manufactured in this way.

Here’s an image of a pair of Adidas F50 AdiZero TRX FG which rest level on a flat surface. This is what you want to look for when shopping for shoes.

If you are excessively pronated or experience problems due to pronation (instep pain, arch pain or inner knee pain) then you will want to steer clear of AdiPower Predator TRX FG . For this reason, I can’t endorse this soccer shoe.

Neuroma Pain

drshoe — Tue, 13 Dec 2011 20:01:07 +0000

Reader Doug writes “I have been having trouble maintaining a level of consistency in my training due a Morton’s Neuroma in my left foot. Over the past two years, I have had 2 cortisone shots, switched shoes multiple times to different sizes, widths, and makes. The first time I had a neuroma, I was running in the Brooks Adrenaline GTS 8 in a size 9 regular width. Then I switched to the Asics GT-2150 size 8.5 2E width.”

Doug is not alone in his frustration of not being able to solve his neuroma pain by changing his shoes. Unfortunately, even with shoe changes or orthotics, neuroma pain can continue to worsen.

A neuroma is an inflamed nerve in the forefoot. Symptoms include burning and tingling in the toes, or feelings of walking on a bunched-up sock. For some people, the discomfort is more noticeable while wearing shoes, for others the discomfort is more pronounced when barefoot. For everyone, however, the more frequent and the longer the symptoms persist, the worse the prognosis.

When this happens, treatment recommendations include cortisone injections and medical grade alcohol, or sclerosing injections infiltrated into and around the nerve.

When a neuroma doesn’t respond to cortisone or sclerosing injections, surgery is the next likely step. To locate a qualified foot and ankle surgeon see http://www.acfas.org/

If The Custom Orthotic Isn’t Perfect, The Shoe Doesn’t Matter

drshoe — Mon, 12 Dec 2011 14:06:33 +0000

My area of expertise, aside from shoes of course, is biomechanics. I received specialized training in podiatric orthopedics and in orthotic evaluation and treatment. If you are considering custom orthotics, or if they have been recommended to you, you will want to make sure a thorough evaluation is done.

This video, although longer than my earlier videos, provides comprehensive information about how the custom orthotic process works in my sports medicine clinic. Understanding this process will make you a more informed consumer, and hopefully guide you to someone who is equally qualified to do this most important rehabilitation step.

Although many specialists make orthotics (chiropractors, physical therapists, and pedorthists, to name a few) they just don’t have the knowledge or training to be able to do this as well as a qualified sports medicine podiatrist – see www.aapsm.org for more. So it’s worth your time to not only find the best shoes, but to also to find the best provider of custom orthotics if they are prescribed for you.

Shoe Review – Asics Gel-Kayano 17

drshoe — Wed, 07 Dec 2011 14:25:07 +0000

Here’s my latest video shoe review on Asics Gel-Kayano 17. Unfortunately, the current Gel-Kayano is a shoe I just can’t endorse. Hopefully, Gel-Kayano 18 will make me a believer again.

Here are links to my other Gel-Kayano shoe review posts:

http://drshoe.wordpress.com/2010/01/31/shoe-review-gel-kayano-15-vs-16/

http://drshoe.wordpress.com/2009/01/15/shoe-review-gel-kayano-15-vs-14/

http://drshoe.wordpress.com/2008/02/11/shoe-review-asics-gel-kayano/

Shoe Review – Asics GT-2160

drshoe — Mon, 05 Dec 2011 14:09:43 +0000

Asics GT-2160 is the perfect shoe for a narrow, shallow foot http://drshoe.wordpress.com/2008/01/14/narrow-vs-wide-feet/. It also works for the medium foot, easily accepts an orthotic and provides lots of support. Here’s my video review on this great shoe.