Foot And Shoe Assessment

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Foot and Shoe Assessment - By Riaan Knoetze The foot is an incredibly complex mechanism, This introduction to the anatomy of the foot will not be exhaustive, but rather try and highlight the structures that will be of significant importance when making a choice in shoes.

1. Foot Physiology 101 The Forefoot contains the five Metatarsal bones and the Phalanges (The toes). The first Metatarsal bone bears the most weight and plays the most important role in propulsion. It is the shortest, thickest and provides anchorage for several tendons. The second, third, and fourth Metatarsal bones are the most stable of the Metatarsals.

Near the head of the first metatarsal, on the plantar surface of the foot, are two sesamoid bones (a small, oval shaped bone that develops inside a tendon, where the tendon passes over a bony prominence). They are held in place by their tendons and are supported by ligaments.

The midfoot includes five of the seven tarsal bones (the Navicular, Cuboid, and three cuneiform). The distal row contains the three Cuneiform and the Cuboid. The Midfoot meets the Forefoot at the five Tarsometatarsal (TMT) joints within the Midfoot itself.

The Talus and the Calcaneus make up the Hindfoot. The Calcaneus is the largest Tarsal bone and forms the heel itself. The Talus rests on top of it and forms the pivot of the ankle.

2. Criteria for Good Shoes Before one can buy a shoe, one has to know what criteria have to be met before a can be deemed as valuable. The following is fundamental criteria that every athletic orientated shoe should have: • Stability - Shoes should be constructed in such a way as to prevent excessive or abnormal motion of the foot and leg.

• Durability - Because certain shoes are extremely stable when new, they rapidly break down and lose their ability to resist abnormal forces. Therefore, shoes should be able to handle extended periods of strenuous exercise without visible deterioration.

• Availability - The desired shoe has to be readily available, having various distributors countrywide.

• Price Point - A tradeoff should be reached between quality and pricing. Always remember that Pricing does not necessarily reflect superiority.

• Quality Control - Certain shoes are extremely consistent in their manufacture and the performance of that shoe is therefore predictable when recommended. In this regard, experience and word of mouth plays a big role. Please note that both are very subjective and therefore very arguable.

• Orthotic Compatibility - Since most utilize functional orthoses as part of our lower extremity injury plan, the recommendation of a shoe that is compatible with the use of a functional orthoses is critical.

• Special Features - While the aforementioned criteria are applicable to virtually every shoe, other shoe requirements might be vital; such as an amphibious shoe that is quick drying and provides excellent grip on slippery surfaces.

3. Shoe Definitions The following terminology is used exclusively in the shoe industry: • Last - The template or model upon which the shoe is built. Different manufacturers use different lasts.

• Outer-Sole - The outermost part of the sole that is treaded. On running shoes, the tread is designed for straight-ahead motion. Court shoes and cross trainers have their tread optimized for lateral or side-to-side stability.

• Upper - This part of the shoe encompasses the foot and contains the laces • Midsole - The portion between the upper and the outer-sole. This is the area where the major contribution to the shoe is shock absorption. It is also usually quite important that the Midsole should be stable from the heel to the distal third of the shoe where, in turn, It should be flexible in order for the foot to bend.

• Sockliner - The liner inside the shoe that has a bit of an arch and usually some shock absorbing material incorporated into it.

• Counter - A rigid piece of material surrounding the heel in order to provide some stability.

4. Trying and Evaluating Different Shoes If you have been having no problems in running or racing, it would be hard recommend a change in shoe. It is difficult, if not impossible to improve upon a situation in which all is doing great. However, if injuries resulted due to uneducated decisions or just dissatisfaction in general with a particular shoe, here is a list to go about making an informed decision: Old Shoes Revisited Examine the soles of your old shoes, note where wear has occurred. Most people seem to be amazed that their shoes wear at the rear outer corner. Most rearfoot strikers will wear at this part of the shoe. This is due to the fact that for most heel strikers it is the point of first contact of the shoe with the ground. Most people walk and run with the feet slightly rotated from the centre. Runners, however, also have what is called a narrow base of gait. This narrow base of gait means that the feet make contact with the ground relative to the midline of the body. This, in turn, creates additional varus (tilting in) of the limb. This results, for the rearfoot striker, that the outer corner is the first point hitting the ground and thus the likeliest point to experience wear.

Forefoot wear may point to an individual who is a sprinter, runs fast, contacts the ground with the forefoot first, or all of the above. Uneven forefoot wear may show where one Metatarsal bone is plantarflexed relative to the others or where one Metatarsal bone may be abnormally long. In forefoot wear, one is at risk of serious stress fractures.

Next, put your shoes on the table and look from the back of the shoe to the heel. If your shoe is tilted or bulging over to the inner part of the shoe, you might be one who is excessively pronating (Feet that roll too far inwards when they hit the ground, especially found in flat feet). Should this be the case, look for a shoe that provides more stability or replace your shoes a bit sooner.

If, however, your shoe tilts to the outside, you may have a high arched foot. In some cases, this can lead to ankle sprains as well as increased transmission of forces to the leg and back. Sometimes individuals with this type of foot may experience lateral knee pain, lower back pain and outer leg pain. For a high arched foot, considerable shock absorption and less controlling shoe is crucial.

Types of Manufactured Shoes Nearly all running shoe and trail-shoe manufacturers make shoes that are specifically designed for these three foot types. They are generally labelled as follows: • Cushion (For high arches): These shoes come with extra cushioning in the Midsole to help feet absorb shocks. Their soles have a curved and semi-curved shape that promotes a natural running motion.

• Motion control (For flat feet): With a straight shape and a more rigid Midsole than other running shoes, these keep your feet properly aligned.

• Stability (For normal feet): These shoes also have a semi-curved shape, but the less rigid Midsole's allow your feet to strike the ground naturally.

How to Make Sure Shoes Fit Properly When deciding to buy a shoe for adventure racing, or running for that matter, a reputable store with a knowledgeable staff should be visited as far as possible. Unfortunately, in South Africa, a regular bloke with no 'shoe education' is used to help you fit a shoe - much less provide an expert opinion and help in making an informed decision. The following list can either be used to test the impeccable knowledge of the sales staff or be used a guide on deciding which shoe to buy: • Never focus on numerical sizes, since they vary a lot from brand to brand and from running shoe to dress shoes.

• Look for a snugly fitting heel; if it slips up and down when you run, you'll end up with blisters.

• The front of the shoe needs to be roomy. You should be able to wiggle your toes. Too tight shoes might result in "black toe-nails" and "bunions" • Make sure the part of the shoe that supports your arch is snug but not tight.

• If you use Orthotic's (customized shoe inserts), take them with you and make sure the desired shoe is compatible with them.

• Take along the socks in which you will be racing.

• Shop around for shoes after you have completed the days running seeing that your foot will then be slightly more swollen that usual.

It is generally considered that the average lifespan for a running shoe is 600 kilometres. However, the type of shoe, the type of runner as well as the type of terrain covered will influence this statistic considerably.

5. If All Else Fails … Get the Experts Alternatively, if you find the whole shopping-for-shoe expedition much too daunting, a second -more advisable- approach is available. The Sports Science Institute of South Africa can be contacted for a foot and shoe assessment. The once-off amount of R70-00 is well worth it. Another addition to this assessment is that they will make a recommendation as to which shoe will be best for your feet. Along with this, they will also keep your records, thus, if you are looking for another shoe in ten years time, you can just phone them and ask for a current shoe that will fit your profile. Here are the details: Sports Science Institute of South Africa (021) 659 6968 Boundry Rd. Newlands (Next to Newlands Rugby Stadium)