Category Archives: Sport Specific Shoes

Cycling Shoes And Sesamoid Pain

Sesamoiditis is inflammation of the bones beneath the big toe joint.

Cycling can exacerbate sesamoiditis, especially when using clipless pedals (this is because your forefoot is locked in). This system provides a more efficient stroke for bikers, but if the cleat is in the wrong place or the last (shape) of the cycling shoe is different than the riders foot, then repetitive injury can occur

Sesamoiditis

This was the case with Lisa. She had been happily riding in the same version of a particular cycling shoe for years, and a change in shoe brought about symptoms of sesamoiditis.

Evaluation of her new shoe revealed that the cleat was positioned too medial (toward the midline). Note the difference between her old shoe (on the left), and her new shoe (on the right).

Image

I also discovered that the shape of her new cycling shoe was curve-lasted, whereas the shape of her old cycling shoe was straight-lasted. (And the straight-lasted design was far more compatible with her foot shape.)

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This combination of medial cleat placement and change in shoe last from straight to curved contributed to her painful symptoms of sesamoiditis.

If you are a cyclist who has recently experienced injury, it would be beneficial for you to evaluate your cycling shoes and cleat placement. This is especially true if new symptoms arise soon after wearing new cycling shoes, or after increasing your training frequency, duration, or intensity.

Sesamoiditis can be a challenging problem to resolve, so it’s important to seek immediate medical attention at the first sign of injury or symptoms.

The physicians and surgeons at San Francisco’s Financial District Foot & Ankle Center are experts in treating sesamoiditis, and in treating lower extremity cycling injuries in general. If you have cycling pain, give us a call today at (415) 956-2884.

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Cycling Shoes and Bunions

Clipless cycling shoes are notoriously tight. This is great for fit, and not so great if you have a wide forefoot or bunions. If you are a cyclist and suffer from bunions or have a wide forefoot, the following shoe-fitting recommendations should help.

Cycling_Bunion

  1. If possible, try and find shoes that don’t have a strap that tightens over the bump as seen above. Ideally, you will want to wear shoes that have either 3 straps or an offset strap away from the bump as this image shows.

Cycling_3_Straps

  1. If you already have a shoe that secures and tightens directly over the bump, simply undo the strap and avoid using it entirely as the following image shows.

Cycling_Bunions_Unsecured_Strap

Hiking Boots & Bunions

Hiking boots are designed to resist side-to-side motion. This is typically accomplished by using a stiff upper and reinforcing the shoe both laterally and medially. Although this is great for support, it can make the shoe feel like a vice grip for those hikers having bunions or needing extra forefoot width. If you have bunions, then you will want to make sure your shoe doesn’t have additional trim over the bony prominence.

Hiker with Tailor's Bunion with hiking boot trim removed over painful area.

Hiker with Tailor’s Bunion with hiking boot trim removed over painful area.

If it does, then removing the trim can mean the difference between comfort and pain. The following image is a hiker having a Tailor’s bunion. As the image above shows, it was easy to remove the trim, making the boot more forgiving in those otherwise tight areas.

You can also modify the lacing as the last tutorial in the following video shows.

When Zero Drop Doesn’t Work

Zero drop minimalist shoes are all the rage right now. Unfortunately, just because a shoe has zero height differential — between the ball of the foot and heel — doesn’t mean it will work for you.

Case in point: One patient I saw today is an ultrarunner who switched from a structured shoe to a zero drop minimalist style two years ago to reduce unilateral infrapatellar pain. Fortunately, the pain resolved, but within the last several months he started to experience increasingly painful peroneal (outer foot) pain and medial (inner) meniscal knee pain. He did not have either pain prior to training in the zero drop shoes.

A quick evaluation of his zero drop shoes, identified an hourglass-shaped midsole/outsole.

Minimalist_Medial

The arrow shows the narrow midsole width and the rectangle shows how much of his midfoot was only being supported by the upper (25%). This significant lack of support mid-arch caused his arch to negatively drop below the plane of the heel and forefoot, altering his knee and foot mechanics enough to produce compensatory pain in other areas.

The following image shows the top view of his foot in the shoe. As you can see the grey midsole disappears from the entire arch — and this is where support is needed the most.

Minimalist_Hourglass_Medial

If you’re running in minimalist or zero drop shoes, you will still want to match the shoe to your foot type — otherwise new injuries can occur.

Basketball Shoe Review – Ektio Breakaway

If you’re a basketball player, then you know how difficult it is to find supportive, well-designed basketball shoes.  The Nike Kobe VII has been a favorite of mine — and now I have  Ektio to add to the list.

Ektio is a unique new brand of basketball shoe that offers unparalleled ankle support. Ektio was kind enough to send me a pair to evaluate — and FDFAC staff member (and former WNBA and professional basketball player) Brooke Smith gave the shoes a rigorous court workout. The Result: Ektio passed with flying colors.

FDFAC Brooke Smith

This shoe is designed to support the ankle and prevent inversion sprains, which it accomplishes by utilizing the following features.

  • High Top Design — Supports and stabilizes excessive ankle motion

Ektio_Medial

  • Two Strap System — Secures and cinches to the ankle to provide leverage against lateral inversion motion

Ektio_Ankle_Straps

  • Lateral Forefoot Flare and Graphite Outsole — Makes the shoe torsionally stable and less prone to twist

Ektio_Top

Overall, this is a terrific shoe — especially if you have a history of ankle sprains, or if you routinely wear an ankle brace for added support. You can also wear orthotics with this shoe, making this shoe my new favorite. Best of all, this shoe is reasonably priced at $129.95.

If you play basketball and haven’t tried Ektio, you will want to check them out!

Cycling Shoe Brand Review – DZR

JC came in with a pair of DZR shoes today to be worn with his new custom orthotics, and I’ve got to say I’m impressed. Designed as an Urban Cycling Shoe, DZR is hip enough to wear even if you don’t cycle.

DZR_Top

DZR has the style of a skater shoe, without added forefoot flexibility — which is great for hallux limitus, sesamoiditis and metatarsalgia. For cycling, the outsole can be modified to accept Shimano SPD cleats for a clipless pedal ride, as the following video shows. Ingenious.

DZR_Bottom

Tennis and Bunions — Nike Zoom Vapor 9

Finding a tennis/court shoe to accommodate a wide foot with a bunion, is no easy task. Fortunately, Nike Zoom Vapor 9, is just that shoe. Although sized for the male foot, it will work for women, size 7 and beyond.  If you are a woman with a size 7 foot, order size 6 men’s which is the equivalent size. Now, on to the features that make this such an outstanding shoe.

  • Mesh near the bump — Most tennis-specific shoes have an entirely leather upper with reinforced trim and/or stitching over the bunion area. Zoom Vapor 9 has mesh, which allows for a wide forefoot and expansion over the bunion area.

Vapor_Tennis_Medial

  • Not only does this feature help to decrease pressure along the bunion, it also helps for those players having hammertoes. Beyond that, mesh makes this shoe lightweight and more responsive for being on your toes.

Vapor_Tennis_Dorsal2

  • Wide waist — Tennis players with a wide forefoot, arch collapse and excessive pronation need support, especially mid-arch. Zoom Vapor 9 doesn’t hourglass in at the waist — and that provides stability and maximum support.

Vapor_Tennis_Plantar

  • Torsional stability — Tennis is a sport with lots of side-to-side motion, primarily on the forefoot. Because of this, the shoe needs to be stable lengthwise, which Zoom Vapor 9 is.

All in all, this is a terrific shoe. If you have a wide foot — with or without a bunion and/or hammertoes — then you will want to check this model out.