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Wednesday, October 12, 2016

Lecture on Shoes and Socks at California School of Podiatric Medicine

Shoes and Socks Lecture
October 12th, 2016
Samuel Merritt University
California School of Podiatric Medicine
My partner Dr Jane Denton examining shoes

This lecture is mainly for self study, since the blog posts and videos can take a long while to study. Yet, Dr Blake would like to spend the next 2 hours giving the students a glance at the ever-changing topic. Dr Blake will skip some of the videos during class time for time concerns. 

What are the objectives?
  1. Introduce the anatomy of an athletic and dress shoe (what is a vamp, etc.?)
  2. Explain the 3 types of socks used in a podiatry practice (athletic, compression, speciality).
  3. Explain how to modify shoes for fit and stability (What is skip lacing, or power lacing, or dancer's padding, etc.?)
  4. Introduce podiatry students to various shoes specific for certain sports (what are the 3 traditional types of running shoes?)

1.   Introduction---Shoes and socks are some of the great Podiatry tools that are used in helping patients. The individualization of these factors can greatly benefit your patients. To start out, let us look at a video of the anatomy of the running shoe. Some of the red questions will be used in developing your midterm quizzes. Some of the links are for self study alone.

                      What can go wrong with flex grooves in the wrong place?
               What is more dense--outer-sole or mid-sole?

And now, even more on the anatomy of the shoe.

                                   What popular shoe company has a narrow last?
                        What part of the shoe is the Vamp?
                        Where is the saddle of the shoe?
                         How many irons equal one inch?
                         What is a toe spring?  
                         What are 3 common tests done to shoes?

I think another crucial TEAM effort is the marriage of podiatry and the shoe store. In San Francisco, I am lucky to have the extraordinary help in fitting from 3 stores: Shoes and Feet, Fleet Feet, and On The Run. I have also heard wonderful recommendations on A Runner's Mind and See Jane Run. However, it can get a little too easy just recommending a store, when the doctor should also be giving some direction. 

2.   Socks---A) athletic (know about Merino Wool and NuWool)

     There has been an explosion in the world of socks and shoes. Podiatrists need to have several recommendations for their patients since they get incredible benefit from this knowledge.
                        What socks advertised have Merino wool?
                 What socks have left and right requirements?
                  What socks have embedded arch support (name 3)?
                  What socks from Heat Holders are 7x warmer than                           most?
                  What socks have silver embedded (for anti-bacterial)?
                             What are the two best wools for Hiking?
                    What is the sock with the 5 separate toes?

                    B) compression  (look into 110% and Juzo)

I love Juzo for the thigh high and open toe. Juzo comes 12-20 mmHg pressure in OTC, but also medical grade (20-30 and 30-40).

This following video talks about putting on support hose.

             What is the pressure in typical medical grade support hose?
What is the Juzo slippee used for?

Athletes are using compression socks to their advantage. Check out 110%.

Why are compression and ice used together in controlling swelling?

                    C) particular purpose---arch support

                                                           heel or metatarsal cushion 

(BeyondSock from Thorlo)
See the nice video attached.
                                                           plantar fasciitis
What is the name of 4 plantar fasciitis socks?

3. General Shoe Modifications in Podiatry

What are 2 ways to stop heel slippage?
What eyelet is skipped in power lacing?
Why is Sole easier to work with then Superfeet?
What can you do to make a full length lift more flexible?
When designing lifts, why does Dr Blake prefer full length over heel lifts?
4. General Rule on Shoes---Always Think Bio-mechanics 
                                             Always Think Injury (or history of injuries)

     A) Stable (everybody, pronators, supinators)
     B) Cushion  (where??)
     C) Flexibility
     D) Rocker
     E) Stiffness (usually talking about forefoot)

     F) Width
     G) Toe Box Room (can there be too much?)
     H) Durability?
     I)   Price?
     H) What do we put into Shoes?
     I)   How much do people's feet grow?
            What is the length change from 20 to 70 yo?
     J)   Power Lacing (another name is "Runner's Lacing")
What are two other names for Power Lacing from the video?

     K)   General Shoe Buying Rules
            Buy within 2 hours of the store closing
            Thumb width longer than longest toe
            Fit for the longer foot
            Go to a Speciality store whenever possible for fitting
            If the shoe is uncomfortable in the store, then it probably                          will never break in
            Buy with the socks you will be wearing.
            You should feel low in the shoe.
            If you wear orthotic devices, bring them to try.
            The shoe should always fit snug around the midfoot

5. Types of Shoes  (that have a removable shoe bed)
     A)   Running

What are the 3 general types of running shoes?
What has a straighter last--cushion or stability shoes?
     B)   Court
What are the 3 crucial components of the good basketball shoe mentioned in this video?

What is the phrase "feeling low in the shoe"?
     C)   Ballet
What are 3 ballet shoe companies?

     D)    Dress
As Podiatrists, we are interested in dress shoes with removable inserts to remove and put our orthotic devices. 

     E)   Walking (I love to have patients walk in running shoes)--more cushion and stability than walking shoes
     F)   Hiking
What are the 2 parts of a hiking shoe that helps in stability?
     G)     Soccer
What would have the longest cleats: Indoor or soft ground?
     H)     Ski Boots

What boot line is for narrow feet?

What is the best time to fit a ski boot?
When putting on a ski boot, what is buckled first?

And finally, the last word on what is in!!

What shoe line has the distinctive yellow stitching?
What shoe line started mainly as a skate boarding shoe?
What shoe line had the "Pump Shoe"?


  1. Hi Richard, enjoyed reading your post, thought you might like an extra resource for later:

    1. Thank you Jeremy, I will have fun reviewing all the posts. Thanks Rich


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.