Foot Facts

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Bunions and Bunionettes

Sole Comfort carries an extensive selection of shoes to accommodate bunions and bunionettes. Beside our vast inventory, we have the skills and expertise to customize footwear, whether bought at our facility or elsewhere, to relieve painful bunions and bunionettes.

Bunion and Bunionette

Illustration of Bunion and Bunionette

Bunions refer to a bony prominence or enlargement at the dorsal or medial head of the first metatarsal phalangeal joint (mpj). Bunionettes are acquired bony enlargement or prominence of the fifth metatarsophalangeal head. Often called a “Tailor’s bunion” because tailors setting cross-legged causing abnormal pressure on their outer feet while measuring clients, causing these deformities of the fifth metatarsophalangeal joints.

Bunion Deformity is a subluxation of the first metatarsal and the phalange or great toe joint. Hallux Valgus is a deviation of the great toe towards the second and is accompanied by enlargement of the medial first metatarsal head. Hereditary and anatomical predisposition combined with repeated minor injury from wearing footwear more narrow than the feet are generally thought to be the primary reason for bunions. Concern for heel fit is one of the primary reasons for wearing footwear too small for forefoot freedom of movement and functioning. Our heel bone, or calcaneus, is the largest bone in the foot and it will not deform from loose fit. Blisters are caused from friction of tight shoes. BUT the smaller bones of the forefoot can be deformed from tight shoes, i.e., shoes that are more narrow or short for our feet to function normally. 90% of Americans wear their shoes too small for their feet according to the study by the American Foot and Ankle Society.

Tailor’s bunion or bunionette is a prominence that may start as irritated, swollen tissue that is consistently rubbed by the shoe. With time, this constant pressure may cause the bone to thicken, creating an even larger bump to rub. The body may form a bursa to help protect the area.

Sole Comfort”s Solutions for Bunions and Bunionettes:

  • Anatomical shaped toe box that respects the foot
  • Orthotics to stabilize the foot, often adding forefoot varus wedging for intervention, controlling -pronation
  • Stretch Shoes to increase width of forefoot of footwear
  • Adjustable straps in walking sandals such as Wolky, Taos, Birkenstock and many other styles and ds
  • Medial Heel Wedging
  • Custom Molded Footwear for the more severe deformities.
  • Referral to physicians if unresponsive to conservative measures
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Amputations

Some of the most common reasons for amputations are:

  • Diabetic and Idiopathic neuropathy
  • Trauma
  • Gross Deformity
  • Ulceration causing osteomyelitis (bone infection)
  • Gangrene (poor circulation)

Sole Comfort focuses on safely supporting the remainder of the foot and limb to promote ambulation. Orthotic toe fillers can be molded directly to the foot and used in extra depth shoes. For severely deformed feet, custom footwear is available at Sole Comfort.

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Charcot Foot

Sole Comfort is expert at assisting physicians and their patients in maintaining healed Charcot deformities.

Charcot Foot

Charcot Foot refers to the damage of the joints that occur in a neuropathic foot. Diabetics are prone to this condition due to autonomic neuropathy and hypervascularity. The result is a weakened bone (osseous) structure. An undetected injury such as a stress fracture, rupture of a ligament or sprain can result in chronic swelling and damage to the supporting foot structures. The foot may collapse with weight bearing of normal walking since the neuropathy causes LOPS or Loss of Protective Sensation. The architecture of the foot is rearranged so that the arch may become inverted, causing a rocker bottom foot. Rocker bottom deformities do not match the shape of any standard shoes so breakdown of the tissue will occur creating an open wound. The danger is that an open wound is susceptible to bacteria that can lead to infection, dangerous since blood supply may be compromised for healing.

NOTE: If foot lacks sensation and is hot, swollen, and/or red, see a physician immediately. Often early detection and treatment by podiatric physicians with serial casting will result in a more normal shaped foot. Time is important!

The “Gold Standard treatment” with many practitioners is total contact serial casting for open ulcers and Charcot foot. This aggressive approach assists patients to realize the seriousness of the situation so they will reduce activates, elevating limb appropriately and heal before resuming normal activities.

Charcot foot disease can affect the forefoot or rearfoot. Osteomyelitis, arthritis, and soft tissue infections are conditions which can be confused with Charcot Foot Disease.

Sole Comfort’s Solutions for closed ulcers:

  • Properly Fit Footwear with increased width and depth
  • Direct molded accommodative type orthotics.
  • Rocker Soles to reduce movement of the foot joints to protect from stress fractures and overuse
  • Carbon fiber or full steel shanks to prevent over extension or to mimic forefoot in the case of amputations
  • Custom molded shoes if deformities cannot be appropriately managed with standard extra depth shoes

Sole Comfort’s Solutions for open ulcers:

  • Closed cell and washable orthotic material on total contact custom orthotics with elevated areas to reduce pressure at ulcer site
  • Custom Healing Sandals
  • Custom Molded Footwear,
  • Rocker soles with full steel shanks for rigidity to reduce joint movement a
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Diabetic Foot Care Guidelines

Diabetes can be dangerous to your feet – even a small cut could have serious consequences. Diabetes may cause nerve damage that takes away the feeling in your feet. Diabetes may also reduce blood flow to the feet, making it harder to heal an injury or resist infection. Because of these problems, you might not notice a pebble in your shoe – so you could develop a blister, then a sore, then a stubborn infection that might cause amputation of your foot or leg.

To avoid serious foot problems that could result in losing a toe, foot, or leg, be sure to follow these guidelines:

  • Inspect your feet daily. Check for cuts, blisters, redness, swelling, or nail problems, Use a magnifying hand mirror to look at the bottom of your feet. Call your doctor if you notice any of these concerns.
  • Wash your feet in lukewarm (not hot!) water. Keep your feet clean by washing them daily. The temperature should be the same that would be used on a newborn baby.
  • Be gentle when bathing your feet. Wash them using a soft washcloth or sponge. Dry by blotting or patting – and make sure to carefully dry between the toes.
  • Moisturize your feet – but do not allow excess lotion/cream to accumulate between your toes. Use a lotion/cream daily to keep dry skin from itching or cracking.
  • Cut nails carefully and straight across. Also, file the edges. Don’t cut them too short, since this could lead to problems.
  • Never trim corns or calluses. No bathroom surgery and do not use over-the-counter corn removals with acid ingredients. Let your podiatric physician do the job.
  • Wear clean, dry socks. Change them daily.
  • Avoid the wrong type of socks. Make sure your socks do not bind your toes or above your ankles where the elastic may be too tight.
  • Wear socks to bed if your feet get cold at night. NEVER use a heating pad or hot water bottle.
  • Shake out your shoes and inspect the inside before wearing. Remember, you may not feel a foreign object or pebble – so always shake out your shoes before putting them on.
  • Keep your feet warm and dry. Don’t get your feet wet in snow or rain. Wear warm socks and shoes in winter.
  • Never walk barefoot. Not even at home on the carpet! You could step on something that you do not feel and cut the skin on your feet.
  • Take care of your diabetes. Keep your blood sugar levels under control.
  • Exercise regularly in the appropriate shoes and socks.
  • Don’t smoke. Smoking restricts blood flow in your feet.
  • Get annual Comprehensive Foot Exams by your podiatric physician to prevent the foot complications of diabetes.
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Flat Feet

The Flat Foot Problems

Flat feet, (other names include: Pes plano valgus; Fallen arches; acquired flat feet; pronation of feet) is one of the most common foot problems and people continue to suffer because this condition is complex.

Flat feet

After heel strike the arch normally flattens in midstance and then weight is transferred to the inside of the forefoot. In a flat foot, the resupination action or the transference of weight to the great toe does not happen as it should. The heel and medial long arch remains rolled inward straining the ligaments of the foot, ankle, and knee.

The Flat Foot Solutions

The solution is to support the medial aspect of the foot and bring the ground to the foot in heel off so strain of the ligaments is reduced. Just providing medial arch support is not enough since at heel off, the foot is not supported and will over-pronate. The types of arch supports and orthotics available at Sole Comfort offer support to balance the multiple arches of the foot appropriately.