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Friday, September 9, 2011

Posterior Tibial Tendon Dysfunction: Pronation and the Shoe Store Recommendations

Hi Dr. Blake!

First, let me say that I love the fact that you've put so many informational videos online. It's been incredibly helpful in my attempts to understand my own Posterior Tibial Tendinitis/tendinosis.

I was prescribed orthotics by my podiatrist back in January, yet my condition has not fully healed. I recently bought a new pair of shoes, hoping this would help. My previous pair of shoes was designed for those who, like me, overpronate. However, the shoe salesman suggested that I get a pair of neutral shoes so that the structure of the shoes wouldn't interfere with my orthotics.

Do you think that would be the smart thing to do?

Again, thanks a hundred times over.


Basil, Thank you for the email and the kind words. There are 3 common misconceptions that shoe salespeople have that greatly effect my patients. These are:
  1. If you have orthotics, you do not need motion control or stability shoes (70% of the time wrong!)
  2. If you have a high arch foot, you need cushion not stability. (50% of the time wrong!)
  3. Pronation is the big problem to reduce, so if you produce supination with a stability or motion control shoe, no big deal. (100%  of the time wrong!)
Your question Basil has to do with number #1. If you have severe pronation and posterior tibial tendon dysfunction, you have a 5% chance that a neutral shoe is acceptable, 25% chance that a stability shoe is acceptable, and 70% that motion control is what is needed along with your orthotic devices, and power lacing, and perhaps varus midsole wedging. I hope this helps. Rich

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.