https://www.youtube.com/watch?v=P1NMYIaR3Ws&t=34s 

Livestream version of Blog

In today's live stream recap, we will be going over an E22 foot type situation. A foot typing can be found through the quadrastep system. See the quadrastep system chart below. ⬇️ Try to see what you might consider your foot to be! We also recommend stopping by our store to fully assess your foot typing and how Chiappetta Shoes can solve your foot problem needs. Now let's dive into solving some foot pain!

Today, the situation is a type E22 foot, medium to low arch, hallux limitus, and a bunionectomy. That sure is a mouthful. How about we at least explain a little bit about these situations...

First, is a hallux limitus. A hallux limitus is a stiff big toe joint. It is a condition that is characterized by a decreased range of motion and pain at the big toe joint (first metatarsophalangeal joint). Over time, the limited range of motion can result in arthritis of the big toe joint. The other situation is a bunionectomy.

A bunionectomy (Chevon Bunionectomy) is performed to correct a deformity of the big toe joint, known as a bunion. One of the most common and effective bunion removal procedures is an osteotomy, which removes a portion of the bone from the big toe.

Now that you're caught up with the terminology, let's assess the situation.

This customer bought a pair of custom orthotics around two months ago. The orthotic was comprised of the typical four layers of material. The materials being a cork base, crepe mid-sole, nylon, and poron.

With an E22 foot type, there's not a lot of medial contour to the insert. The orthotic did help but by about 25%. This can happen sometimes when an orthotic is made, but adjustments are the key to success. Chia Shoes always does a 3-month check-up to make potential alterations to the insert to perfectly fit and support the foot.

The main issue was a ""pressurization"" to the foot. It's similar to the ""taking a bra off at the end of the day"" type of feeling. The support is there, but it also feels good to take the shoe off too. Chiappetta Shoes wants to make sure that the pain relief is at all times while wearing an orthotic because you should NEVER be walking barefoot!

The walls of the orthotic were originally built at a medium-high height. The adjustment to the insert will be to shift the weight off of the medial aspect of the foot. Oftentimes, you're going to have a compensation factor where you get a pulling sensation along the lateral aspect mainly in the dorsal area of the foot, into the anterior part of the lower leg.

In this instance, we did not experience that situation. This is a great example of knowing all options to explore as a pedorthist because everyone's foot issues are unique to the individual.

So the direction to go with this situation is to lower the wall height of the orthotic. The next step is to add a combo pad, which is a small metatarsal, plus an arch bar support. The goal is to not overload the medial area of the arch and allow more stability from heel to toe.

The combo pad used is made up of cushion cork to allow a little bounce. The material works well for modifications that don't wrap around the sides of the orthotic. You will only see this material used on the bottom of the orthotic.

Pressurization in your foot should not happen all that much because the foot has a natural amount of pronation and you would be over supporting it. The over support usually comes from the medial aspect of the arch. These situations lead to a compensatory movement where you are supinating too much. To supinate means to turn or hold (a hand, foot, or limb) so that the palm or sole is facing upward or outward. This would lead to a shin splint pain-type sensation. The pain may also stay in the foot too.

It's important to buy a good pair of shoes, but not everyone's feet are made to step into a high arch-supporting insert like a Birkenstock. That's where custom orthotics come into play.

The final step of the process for today's video is to taper the combo pad to the insert. The customer with the E22 foot type should feel a whole lot more relief with the adjustments made in today's workshop.

AND THAT is how we solve foot pain!

Check out the entire live stream in the link below. You can catch all live streams on Youtube, Facebook, and Twitch!