Monthly Archives: December 2007

When Heel and Ball of the Foot Pads Don’t Work

Whenever high heels walk into my office with the insides padded to the 9’s it’s almost guaranteed, that the shoe isn’t fitting properly. Possible causes:

  1. Shoe heel height is too steep and you’re sliding forward, losing arch support and contact.
  2. Shoe is too short and all of your body weight is crashing down onto the ball.
  3. Shoe is too deep in the toebox and you’re sliding forward
  4. Sides of shoe are too gappy and you’re not being held secure.
  5. You have a high arch and the instep of the shoe is below your arch’s instep.


This problem with this shoe was #5. In this case, heel and forefoot padding were insufficient to keep her foot in the shoe.


Squeaky Orthotics

If you have squeaky orthotics here’s an easy solution. Place cloth or duct tape on the underside of the orthotic as shown here.


The squeak occurs when the orthotic material springs on the shoe’s insole. Occasionally you will need to place the tape further back, but usually application as shown is sufficient to stop the squeak.

Heel Slippage: Foot Width, Foot Depth

Heel slippage generally happens when a shoe is too wide or too deep or both. Rarely do people think about depth when buying shoes. You can have a wide foot without much depth (flat foot), or you can have a wide foot with a lot of depth (high arch). Even if both feet are the same size and width, they wouldn’t be able to wear the same shoe.

Here’s an example of different depth shoes. The shoe on the left is shallow and the one on the right is deep, even though they are the same size and style.


If you experience heel slippage, then you probably need to look at shoes from the side as well as the top. Shallow feet need shallow uppers or they will slip in the heel.

Heel Slippage: Orthotics & Tennis Shoes

Whenever I dispense orthotics for the first time, I always re-lace a person’s tennis shoes. Without orthotics, your arch height is flatter than it is with orthotics.

By increasing the support undeneath your arch with an orthotic, you’re effectively raising your arch height, which in turn lowers the front part of your foot. If your shoe lacing doesn’t take into account this new foot shape, then you foot will act like a teeter-totter, popping your heel in and out of the shoe with each step.

Also, the best way to ensure proper fit is to completely cinch snug the laces closest to your toes and not the laces securing your foot to ankle. The more form fitting the shoe, the better the fit.

CNetTV & Me on Masai Barefoot Technology

I oftentimes am asked to comment on new shoe technology. Kara Tsuboi of CNet TV did a story on Masai Barefoot Technology (MBT’s) and interviewed me. Here’s a link to her video, where opinions, fact and fiction are explored.


My Masai Barefoot Technology review – MBT’s are heavy, wobbly, expensive and don’t work for every foot type (especially narrow) And, if you’re younger than 30, I doubt you would find them suitably fashionable to wear on your feet.

Arch Blisters – Flat Feet with Orthotics

If you have flat feet, wear orthotics and plan to do a lot of hiking (Grand Canyon), or downhill walking (Stairmaster), it’s important that your shoe be as supportive as possible in the instep.

This pair of hiking boots and running shoes were brought in for me to evaluate today, because they created blisters in the arch and JA didn’t know why.


A quick walk up and down the hall, and I had to turn my eyes away because of his extreme foot collapse. There was no support to hold up the arch at all.

Flimsy cloth or mesh on the inside of a shoe will always allow the foot to pronate (collapse). Mix in orthotics, a steep downhill or two and the skin friction produced against the orthotic because of excessive pronation, can hobble even the toughest of feet.

Pinch Callous Running Shoe Modifications

A pinch callous forms when there is friction against skin – usually the side of the big toe or or under the little toes. This is a patient’s healed pinch callous that formed during a marathon which I mostly shaved off.


This is the shoe which was used during the marathon. Notice the distinct red color, corresponding to the pinch callous bleeding into this runner’s sock and shoe? In this case the problem was the trim on the shoe, gouging into the pinch callous with each running step.


The cure?…a little surgery to excise the offending trim and voila! No more pressure, no more bleeding. The hole was made by this person’s foot, but cutting into the mesh would be fine too.