Category Archives: Uncategorized

Help Texas! Donate your Shoes Today!!

This just in from our friends at Fleet Feet…


As part of a coordinated relief effort, Fleet Feet Sports stores across the country are now accepting donations of new or gently-used running shoes and new socks to send to our stores in Texas. Fleet Feet Sports of Greater Houston and Fleet Feet Sports San Antonio will work to get these shoes and socks to organizations and people in need. Our thoughts remain with the people, communities, and businesses affected by Hurricane Harvey and the flooding taking place in its aftermath. #shoesforhouston

If you live anywhere near one of the countries 170 Fleet Feet stores, run, don’t walk and get your shoe and sock donations to one of their stores today.

Post the above on Facebook, Twitter and your Instagram feeds. The more people who know about this, the more people in dire need can be helped.

With deep gratitude.

Dr. Jenny Sanders



Help Keep the 50km Race Walk in the Olympics

Patient and competitive race walker Paul DeMeester has been rigorously training to qualify for the 50km Race Walk Olympic Team Trials.


On 4/12/17 the IAAF will be meeting to vote on whether or not to abolish the men’s 50km race walk at the Olympic Games and IAAF World Championships and the 20km race walk moving to a half-marathon distance (21.1km). As supporters of these events, we should not, and cannot let this happen.

Please join us and sign your name on the attached petition to join the fight to save these historic, Olympic events.

Warmest regards,

Dr. Jenny Sanders

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 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.


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.


  • 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.


  • 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.


  • 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.

Altra ZeroDrop Responds to Instinct Shoe Review

I previously posted a review on Altra Instinct and was contacted by AltraZeroDrop as follows:

“Interesting review. A couple of things as I consider what is being said here. First, The Instinct is a neutral shoe and is sold as such. The Brooks Adrenaline is a motion control shoe. To compare the two with a pronator is not a fair comparison. To look at an Altra shoe that offers some pronation support please check out The Provision. This runner obviously needs some medial support and thus The Instinct may not be the best option right off the bat. As they strengthen their feet over time maybe.”

My reviews are based on the shoes that runners wear in, and the Instinct is the only shoe I’ve seen from Altra. In this runner’s case, he purchased the Instinct based on it’s “wider,” more supportive appearance, only to develop forefoot pain.

Altra’s website promotes Altra zero-drop footwear as “reducing forefoot pain, excessive pronation, IT Band pain, runners knee and shin-splints.” These claims are made independent of Altra model or style, but are instead specific to the zero-drop platform. So, based on these general design claims, this particular shoe should have worked for this particular runner.

My primary goal for doing shoe reviews is to reduce injury by educating runners about their foot type and alignment, and teaching them how to apply this to their shoe purchases. I agree that runners need to match their foot type (pronated, wide, etc.) to their shoes and I’m pleased that Altra offers a stability model.

I have asked Altra to send me a pair for review. I’ll keep you posted.


How To Tell When Your Athletic Shoes Are Worn Out

At least once a day, I’m asked “how do I know when my athletic shoes are worn out?”. If you go to a running shoe store, you will be told a pair of running shoes will last 300-500 miles. This is a terrible recommendation. What if you only work out at the gym on the Elliptical Machine or StairMaster? How long will your shoes last then? What if you walk or hike and don’t run at all?

A better way to determine wear is to check your own shoes – regularly. Below is a video I created which takes you step by step through the process of evaluating athletic shoes for excessive wear. Learning how to do this will save, time, money and potential injury. Tutorial

I have been using for several years now and I recommend all of my patients use this site when shoe shopping. The interface is intuitive and easy to navigate and you can’t beat the free shipping option.

This video highlights a few of the features I especially like.

Shoe Review – Nike Zoom Kobe VI Basketball

Basketball shoes can be a challenge because they typically don’t come in widths other than medium and tend to run wide, making it all but impossible to fit a narrow foot. Nike Zoom Kobe VI is an unexpected exception. In addition to a narrower last than most basketball shoes, it’s also extremely stable.

Another plus is the insole waist of the Kobe VI doesn’t hourglass providing a more supportive foundation for a pronated foot.

With an inflexible forefoot sole, torsional stability and a firm heel counter, this court shoe rivals some of the most stable running shoes available, which truly is an exception to the rule.

My only minor reservation with this shoe is that it’s a mid-top style and not a “true” high-top which may exacerbate ankle instability. This is easily remedied however, by wearing an ankle brace during play. If you remove the sock liner, there will be more than enough room to accommodate any additional tightness an ankle brace or custom orthotic might cause.

Boot Trees

Thanks to ED for showing me an ingenious, inexpensive way to make boot trees. Instead of plunking $50+ to purchase a single pair of boot trees, she showed me how to make your own. Just grab a handful of paper grocery bags, fold them together lengthwise, insert into boot and voila, a perfectly upright boot which will proudly sit in your closet without falling down. This boot would have stood even taller with 3 bags instead of 2. Ingenious, don’t you think?

Barefoot Running Shoes

During the past several months, more and more runners and readers have asked for my opinion regarding the increasingly popular barefoot running styles of shoes. What follows are my responses to an interview I recently did with Podiatry Today

Have you seen an increased demand for shoes that simulate barefoot running?

Yes. Questions about barefoot running seem to parallel the introduction of new barefoot running shoes into the marketplace. The most common I’ve seen in my practice include NikeFree, Vibram Five Fingers and Newton Running.

NikeFree was the first introduced in 2004. At the time, Nike who was sponsoring Stanford’s track team discovered that some of their training had been done barefoot. Stanford’s coach at the time, Vin Lananna felt that barefoot training reduced injuries and improved foot and ankle strength. Seizing an opportunity, NikeFree was developed. Basically it has a soft, non-supportive cloth upper with a wide, cushioned midsole having deep grooves to enhance flexibility.

A little slower to catch on has been Vibram Five Fingers, which were introduced in 2005. Vibram originally designed these to be worn while yachting and was surprised initially that anyone would want to run in them. Once they discovered this however, this shoe with individual toes became mainstream.

Newton Running was developed in 2007 and is similar to NikeFree in appearance but provides more forefoot cushion. It was designed by Runners and is heavily endorsed by runners. The shoes are expensive and cost between $150-$200.

Other than the debut of a new barefoot running type shoes, Christopher McDougall’s recently released book entitled Born to Run, has re-ignited the barefoot running controversy.

Chris is an ultrarunner and writer for Men’s Health. His book is a page turning, entertaining read about his own personal journey of barefoot ultrarunning, which started, with the simple question of “why does my foot hurt?”

It chronicles Chris’s introduction, training and subsequent 50-mile treacherous run with the Tarahumara Indians of Mexico’s Copper Canyon. The Tarahumara are a legendary tribe known to run hundreds of miles at a time while only wearing sandals. In it he vilifies running shoe companies, podiatrists, sports medicine specialists and orthotics as the cause of running injuries. Looking below the surface however, I was able to appreciate the book for it’s historical accounting of barefoot running, ultrarunning and Chris’s analysis of running form. I also think it will stimulate conversation and better scientific research into the question is there an optimal running form and is it the same for everyone and every foot type?

In regard to shoes that simulate barefoot running, what in your clinical opinion are the biomechanical strengths and weaknesses of these shoes in comparison to conventional running shoes?

Barefoot running shoes are designed to promote forefoot contact over heel contact. This does two things. One, it reduces the impact of heel strike, improving shock absorption throughout the midfoot and forefoot.  Two, it alters the center of gravity forward with the feet being better centered below the hip, which is a much more stable alignment.

My problem with barefoot running shoes isn’t with the biomechanics of the design but rather the concern that runners will see this as the newest fad and train without proper conditioning or assessment. It doesn’t matter whether you are wearing NikeFree 5.0 or Nike Zoom Structure Triax +12. If the running shoe isn’t a match to your foot type and running biomechanics, injuries will occur.

I also think in addition to shoes, too many runners have not been adequately coached in proper form. The best running shoe design in the world coupled with poor running form has little chance of benefiting a runner. ChiRunning, Pose Tech Training and Evolution running are all running methods which simulate barefoot running form and are often helpful in reducing or eliminating injury.

Are there other considerations Podiatrists should keep in mind when asked for recommendations of these shoes by patients? Are there certain foot types that would prohibit use of these shoes?

When asked by patients about barefoot running I say it may have a place in an overall training strategy, but based on most of the patient’s pathology I see coming through the door, few would benefit from this as a primary treatment. In fact I have taken quite a few runners out of these styles of shoes because they caused injury. It amazes me that so many experienced runners (triathletes, marathoners, ultrarunners) who presumably know everything about their running are oftentimes clueless when it comes to their shoes. They are sponsored by a particular shoe company consequently have to wear that company’s shoe and no one has really ever analyzed whether it’s right for them or not. Or, they have run in the same shoe for the past 10 years but never realized that the shoe design has changed so dramatically during a version change, that in spite of the name being the same it’s not the same shoe.

In your experience in treating athletes, are there particular brands of these shoes that simulate barefoot running that you have found to be effective?

The few patients I have who use these types of shoes as well as readers of my blog find that Vibram Five Fingers are really the only shoe that simulate the true feel and biomechanics of barefoot running. NikeFree and Newton Running seem to be losing ground in the battle of barefoot running shoes. However, I’m sure as time goes on, more and more shoe companies will jump on the barefoot running bandwagon and incorporate even more designs and styles into their manufacturing lines.

Brooks Introduces New Colors – Beast and Ariel

Brooks is staying cutting edge by not changing the shoe, but giving you more color choices instead. They just released two new colors in the Beast model and one new color in the Ariel model. I am a fan of both of these shoes and have blogged about both before: FYI as of today, Brooks does not have all the colors available on their site, so is a good place to go instead.



Shoes On the Brain – Team FDFAC

As Bette Midler sings “You gotta have friends”. In my case, this blog would not be possible without the contribution of my friend and Financial District Foot & Ankle Center ( colleague – Samantha Gibson, BSc (Hons). In addition to being a podiatrist, Sam acts as my sounding board, assistant problem solver and Shoes on the Brain expert extraordinaire. She not only makes patient care fun, but shoe sleuthing as well. Thanks Sam. Your help is greatly appreciated.


Buyer Beware – Midsole Construction

Here is another example of Buyer Beware. CF came in today with a new pair of Asics Gel Evolution 4. She had worn them for an initial 2 mile run and started to experience left forefoot pain. This was discouraging especially since her last shoes caused arch pain, which I’ve also blogged about

Upon close inspection, I discovered that the grey EVA midsole were of different lengths in the right versus the left shoe.


In this case the amount of EVA in the left shoe extends less forward than the EVA in the right shoe. This results in vastly different flex points in the forefoot as the grey EVA is much firmer than the white EVA as this image shows.


As most of you know if you’ve read my blog, I am a huge fan of many Asics shoes, so I’m not being dispariging to their brand. This is simply a manufacturing error and one more instance where buyer needs to beware.

Buyer Beware – Heel Positioning

JH came in today with this brand spankin’ new pair of handsome Allen Edmonds dress shoes. When I turned the shoes over however, I was shocked and dismayed to discover the heel of the right shoe was cadywompus and twisted to the left at a funny angle. This was obviously missed by quality control and easily overlooked in the store.


The purpose of this post is not to slam Allen Edmonds, but rather to show you how all shoes need to be thoroughly checked before taking them out of the store for a spin. With millions of shoes being inspected each day, there are bound to be a few which should not have passed quality control and do.

Great Shoe Site –

For those of you who love the ease of ordering from, you may want to check out their other site, which features the same multi-view shoes as, only at deeply discounted prices. The shipping policy is not as liberal (free outbound only with orders over $100) and their return policy is shorter (30 days as opposed to 365), but given the deals to be had, this site is well worth it.

Squeaky Orthotics – Part 2

I addressed squeaky orthotics in a prior post which illustrates how to apply tape on the underside of an orthotic to stop squeak.

Reader Sarah read this and asks “I have tried this many times, and the tape always comes off. Hockey tape gets all gooey and comes off in a lump, as well as leaving your shoe quite sticky. Masking tape just wears off. What tape works well?”

When tape works to eliminate squeak but won’t stay put, the best thing to do is have your podiatrist permanently glue a piece of leather or vinyl to the underside of the orthotic in the same place where the tape was. Typically Barge (shoemakers waterproof glue) is used. If your podiatrist doesn’t have the necessary materials then your local shoe repair store will. 


Footbed Design

A lot of people aren’t aware that the footbed of a shoe can go a long way to impart stability or cushioning. If your shoe has a removable sock liner, the footbed is the structure below the sock liner.

Typically there are 3 main types of footbeds.

1. Slip lasted – No additional stiffener added to shoe. Identified by a stitched seam either around the sides or down the middle of the insole. This method allows for the most cushioning and flexibility.

2. Strobel lasted – Same as above with a thin, soft full length insole. This allows for a more stable (anti-pronation) shoe.

3. Combination lasted – A 1/2 and 1/2 mixture of the above. Forefoot – slip lasted, heel area – Strobel or (card) board lasted. This provides rearfoot stability with a cushioned forefoot.

When considering the overall structure, the footbed is only one component of stability, you also need to take into account the outsole composition. You can have a firm footbed and a soft midsole and the shoe will overall be soft. Conversely, you can have a soft footbed and a firm midsole and the shoe will overall be firm.

The goal is to start getting you familiar with shoe construction, so that you will eventually be able to match the construction to your particular foot.

Shoe Review – Nike Air Equalon +2

Nike Air Equalon +2 is a great shoe if you have bunions. Notice the mesh over the widest part of the foot? It also has a firm heel counter and firm EVA for stability. It’s shallow, but not narrow, so if you have a narrow foot, this shoe may not work for you. For everyone else, it’s a great shoe.

Heel Taps – Spend A Little Save A Lot

Here’s an example of a heel tap on a shoe.

Commonly made out of plastic or rubber, heel taps help prolong the life of your heeled shoes. Normal heel wear is on the outside so the taps should be placed here. Considering a pair of taps cost less than $10 and re-soling a pair of heels can run as much as $50, taps are a good value and easily applied. The plastic taps aren’t as durable as the rubber ones, so if your shoe repair person carries rubber taps, you’ll be better off.

Ten Tips To Foil A Flip-Flop Fiasco – American Podiatric Medical Association

Thanks to surgical resident Rachel for forwarding the American Podiatric Medical Association’s (APMA) “Ten Tips To Foil A Flip-Flop Fiasco”. My comments follow in italics.

Flip-Flop Do’s:

  • Do look for a flip-flop that is made of high-quality, soft leather. This material, unlike plastic or foam, will minimize the potential for blisters and other kinds of irritation. I don’t agree with this one, as there are lots of high quality flip flops that are not leather. Also, leather can stretch, causing the flip-flop to become loose over time.
  • Do look for flip-flops that hold APMA’s Seal of Acceptance, such as Chaco’ Flip Collection and Wolky’s Serenity, part of their Zen Collection. Evaluated by a committee of APMA podiatric physicians, these products are shown to allow for the most normal foot function and promote quality foot health. I think Chaco’s and Wolky’s are well made sandals, but they won’t work for every foot. Here’s my blog posting with my thoughts on running shoe lists. I also think there are a lot more sandals than just Chaco’s or Wolky’s which allow for normal foot function.
  • Do gently bend the flip-flop from end to end, ensuring that it bends naturally at the ball of the foot. Shoes should never fold in half. Wise advice indeed.
  • Do wear a sturdy pair of flip-flops when walking around a public pool, at the beach, in hotel rooms in locker room areas. Walking barefoot can expose foot soles to plantar warts and athlete’s foot. If your flip flops are rubber, it’s a good idea to occasionally mist the wearing surface with Lysol Disinfectant Spray, to kill any harmful organisms which might hover on the top of the shoe.
  • Do ensure that your foot doesn’t hang off of the edge of the flip-flop.

Flip-Flop Dont’s:

  • Don’t re-wear flip-flops year after year. Thoroughly inspect older flip-flops for wear. If they show signs of severe wear in the soles, it’s time to discard them. Set them on a table to evaluate the heels. If flip-flop flops to one side, they need to be replaced.
  • Don’t ignore irritation between toes, where the to thong fits – this can lead to blisters and even worse irritation. Ditto for where the side straps insert into the flip-flops. If callous forms here or anywhere else on your foot because of the flip-flops, then it’s time to say goodbye to the flip-flops and get a new pair.
  • Don’t wear flip-flops while walking long distances. Even the sturdiest flip-flop offers little in terms of shock absorption and arch support. Gotta love common sense!
  • Don’t do yard work while wearing flip-flips. Always wear a shoe that fully protects the foot when doing outside activities like mowing the lawn or using a weed-eater. According to the Annuls of Emergency Medicine – Researchers analyzed emergency room and hospital records from 1996 to 2004 and found that nearly 663,400 people went to the emergency room and almost 12,000 people were hospitalized in lawn mower accidents during that period. Yikes
  • Don’t ever play sports in flip-flops. You can easily twist your foot or ankle, leading to sprains or breaks. More good advice.