Reading Inserts: These are from the Top of Some Custom Made Orthotics

I love the art of reading inserts from shoes or from the top of an orthotic device. Here if you look at the medial rear foot, you can tell that there is more pronation force on the right side. As the weight moves forward on the insert, it is too far on the lateral side especially on the left. The weight distribution on the metatarsals is quite even on the right and slightly more lateral on the left. However, the Hallux pressure shows good push off both sides. 

I am happy that there was not blockage of first ray plantar flexion with pressure showing up at the distal medial aspect of the orthotic device. The pronation at heel contact has been blocked, the foot re-supinates and gets weight forward and slightly lateral, so that the first metatarsal phalangeal Joint can have an active push off. 

My Shoes Must be Short: The Tips of my Toes Hurt

This is a patient who complained about pain at the tip of her second toe. She had bought one pair of half size bigger shoes, which even felt too big, yet her second toe remained sore. She brought in 3 pairs of shoes at her visit and, after removing the shoe insert, I could definitely tell her that the 2nd toe had plenty of room. She had a hammertoe on the 2nd toe and a large callus at the end of the second toe. I felt the 2nd toe was not painful for running into the end of the shoe, but gripping the floor. I fit her for a small right toe crest to lift the tip of the toes off the ground and she felt instantaneously better.

Monday's Image of the Week: When One Foot Being Longer can cause Chronic Symptoms

I am hoping one of these 3 photos clearly captures the longer left foot. These inserts were removed from the shoe to check why the left second toe was continually being irritated. He was sent home to check other shoes to see if this was a consistent pattern. This will help in my recommendations on shoe buying. With some situations, patients with this problem need to buy 2 pairs of  different shoe sizes and chose one from one pair and the other from the second pair.