Welcome to the Podiatry Blog of Dr Richard Blake of San Francisco. I hope that the information here will help you in some way. Please feel free to leave a comment on the blog, or email me questions at firstname.lastname@example.org. If the blog helps you, consider a $5 donation to keep the blog growing. Any money donated to this blog in September will be given to the Red Cross for Hurricane Harvey relief. $10 donated in September so far. Thanks. Dr Rich Blake
Pay Pal Donation
Please consider a donation if you feel the blog has helped you. A $5 donation will help me pay for the blog artwork, guest writers, etc. I am very honored and grateful. Dr Rich Blake
Dr Blake's Book
Tuesday, June 29, 2010
Supinators: Help with Lateral Shoe Wedging
There is really no great shoe for people whom overly supinate (roll their feet to the outside like spraining their ankles). One way that podiatrists, pedorthists, and shoe repair people handle this problem is with lateral (or valgus) shoe wedging. The wedging can be placed on the outersole or into the midsole as demonstrated by these photos. With excessive supination (aka lateral instability) accounting for 17 known symptoms, including ilio-tibial band strain, low back pain, ankle sprains or strains, cuboid syndrome, etc., this common wedging process can greatly diminish symptoms caused by this motion.
The photo above demonstrates the initial cut with an eleven or ten blade half way up the midfoot and half way through the shoe from lateral to medial. The cut goes from the ball of the foot to the back of the heel.
Once the scalpel has made the cut, barge cement is applied to the inside of the shoe.
Depending on the size of the wedge needed, grinding rubber (I purchase from JMS Plastics) is beveled and then both sides are glued and left standing to dry. Here 1/4" wedges are being made for multiple shoes. The front end of the wedge (placed into the front part of the shoe) is slightly rounded before skiving to ease in the shoe placement.
Here is a closer view of the shoe wedge with the beveled part that will be placed into the shoe first (go in the deepest) and the rounded front part.
Here is the wedge being shoved (yes, shoved!!) not so gently into the shoe as deep as possible.
Here is the shoe wedge from the side view after initial sanding to make presentable.
Here is the finish product of a 1/4" valgus or lateral midsole wedge to fight excessive supination tendencies. Super Glue or one of its knockoffs is normally used here to seal any gaps. It takes time working with the Barge Cement to know how long to wait before applying the wedge. The patient should never feel that the shoe now overly pronates them. If so, there is too much wedge. Normally when this happens, this wedge is removed and a new one one half that thickness is then applied.