pedorthics pe•dor•thics (pi-dôr'thiks) n. The art concerned with the design, manufacture, fit, and modification of foot appliances as prescribed for relief of painful or disabling conditions of the foot.

The Certified Pedorthist is responsible for carefully evaluating footwear along with a known or diagnosed problem and then dispensing proper fitting and functional shoes and orthoses to relieve or accommodate foot conditions, temporary or chronic. Proper footwear in function and fit is essential to pedorthic solutions to foot problems.

A Pedorthist earns professional credentials through a stringent and demanding educational process that includes practice and patient management. Pre-certification studies cover a range of topics, including anatomy, physiology, biomechanics, gait analysis, and pathologies (understanding the diseases and ailments that affect the foot and ankle.) Pedorthists are likewise educated in the construction and fit of footwear, the principles and intricacies of foot orthoses design and fabrication, as well as material properties for foot orthoses and shoe modifications.

1. What causes heel pain and what can be done about it? Heel pain is usually caused by irritation of a ligament that runs from the heel to the ball of the foot. People usually experience pain when taking the first step in the morning or when getting up after prolonged periods of rest. Heel pain can be treated conservatively with ice, stretching, physical therapy, night splints, orthotics, and properly fitted shoes. Generally, increased arch support and shock absorbing properties will lengthen the stressed ligament and cushion the heel strike impact, leading to fewer instances of discomfort and eventual recovery.

2. What is a bunion? Can they be caused by shoes? A bunion is a painful mal-alignment or enlargement of the bone at the base of the big toe. They certainly can be caused by poor fitting shoes; however, in approximately 40% of the population they are hereditary. Slightly increasing the length of a shoe, as well as the width and depth, can result in immediate relief. Likewise, reducing unnecessary forefoot motion by use of a shoe with a rigid rocker toe sole is, in most cases, successful.

3. Why do I have pain and numbness is the ball of my foot? Pain and numbness in the ball of the foot can often be contributed to a neuroma or an enlargement of a nerve that runs between the ends of the long bones (metatarsals) of the forefoot. The most common location for this discomfort is between the second and third or third and fourth metatarsals. Slightly increasing the length of a shoe, as well as the width and depth, can result in immediate relief. Likewise, reducing unnecessary forefoot motion by use of a shoe with a rigid rocker toe sole is, in most cases, successful. In extreme cases, a negative heel shoe may be necessary.

4. What is a hammertoe and how are they caused? A hammertoe is a deformity where the joints of the toe become contracted and the toe begins to curl as a result. It can be either flexible or rigid and is caused by a dynamic imbalance of the muscle that attach to the toes. This is also a progressive condition and may require surgery to correct. The use of a toe straightening splint in an extra depth shoe with a rocker toe can result in immediate relief.

5. What are corns and callouses and how do I get them? Callouses are areas of hard, thick, dead skin usually found on the bottom of the foot, heel or ball of the foot. Usually, callouses are caused by excessive friction or pressure from shoes. Corns are likewise areas of hard, thick, dead skin usually found on top of the foot, covering areas of bone protrusion, or between toes where an excessive bony protrusion can be found on the side of the toe. Corns, like callouses are caused by poorly fitted shoes and can be prevented by wearing extra depth footwear with a wide toe box. Moisture wicking socks can also reduce friction between any shoe surface and the foot by keeping the skin surface dry.

6. I have just spent a lot of money on either custom orthotics or over-the-counter arch supports to help my foot condition. Why do I need special shoes if the inserts are supposed to fix my problem? Even the most expensive and technologically advanced orthoses can fail if they are not supported or contained properly in footwear. For instance, if you have a very low arch (flat foot) and have purchased an arch support to lift your mid-foot, you need to be sure that the shoe itself is not going to allow the arch support to drop or flatten when you bear weight. Or, you have pain in the ball of your foot and have purchased an insole with metatarsal support to lift and separate the metatarsal heads and relieve pressure, but if you do not increase the size, width, and depth of your footwear, you may actually increase pain by overcrowding the ball of the foot and toes.

7. What makes a therapeutic shoe different from shoes I could buy off of the rack at any shoe store? By definition, a therapeutic shoe has an extra quarter inch of material in girth around the toe box area and has some form of closure. However, shoe shape is also a very important factor. If a shoe is not the appropriate shape for the patient’s foot, it can be more of a hindrance than a help. Shoes can have round, square, or pointed toes, can be wide or narrow, curve-lasted, straight-lasted, reverse-lasted, have rocker heels or toes, or both, etc. The most important thing is that the shape of the shoe matches the shape of the foot, providing a proper fit.

8. How do I know what shoe shape, function, or feature is correct for my feet? You don’t have to know, you just have to trust that there are Certified Pedorthists whose sole purpose is to be sure that you receive the product that will suit your needs best.

9. Will proper fitting shoes and inserts solve all of my foot problems? Not always. Remember, your Certified Pedorthist is part of a team that includes your physician, podiatrist, orthopedic surgeon, physical therapist, chiropractor, and most importantly you. All members of the team working together toward a common goal, your foot health, generally yield good results.

10. Do my feet stop growing in my teens or twenties? Not always. There are known cases where a person’s foot will grow several sizes after they are well into retirement. There are several factors, including medication and other medical anomalies that can result in growth. Regardless of when your feet stop growing, they never stop changing. Changes in length, width, and girth can be due to weight gain or loss, injury, disease, deformities, routine change, workout change, or an increase/decrease in daily activity. You should have your feet measured every time you buy shoes.

Do you have a prescription? We can fill it. No prescription? We can help. Never hesitate to stop in for the following, and more:

1. Gait Analysis: how your foot reacts to ground pressures in motion.

2. Static Analysis: how your foot reacts to ground pressures standing still.

3. Custom Shoe Fitting: measurement of the foot, heel to toe and heel to ball, and recommendation for proper shoe shape according to the foot shape and size, as well as the customer’s needs.

4. Over the Counter Orthosis Fitting: measurement of the foot, heel to toe and heel to ball, gait analysis, static analysis, and recommendation for proper support and relief without custom modifications needed.

5. Custom Orthosis Fitting: measurement of the foot, heel to toe and heel to ball, gait analysis, static analysis, casting in a foam box to create a positive mould, and custom construction of support to meet the customer’s specific needs.

6. Over the Counter Foot Appliances: splints, tubes, moisture wicking socks, seamless socks, compression socks, heel cushions, metatarsal pads, tongue pads, etc.

7. Diabetic Shoes and Inserts: upon prescription, complete foot health examination, measurement of the foot, heel to toe and heel to ball, and recommendation for the proper Approved Diabetic Footwear and inserts.

Note: For patients who have Medicare as their primary form of medical insurance coverage and who are not enrolled in a secondary HMO, we are able to dispense shoes according to the Medicare Therapeutic Shoe Bill, which, if qualified, requires little expense to the patient. Call any of our locations during normal business hours for more information.

8. General Questions: we are always here to answer general questions you may have concerning you foot health and will take time and care in doing so.

Dear Jen at New Balance,
You bring special magic to an ordinary day with your charming smile and delightful caring way… And so, this come with many thanks for everything you did and with hopes that all things wonderful will come two-fold to you!
Thanks again, can’t thank you enough for finally being able to walk.
Gratefully,
C Archuleta

Dear Lucky Shoes,
Recently my husband came to your store to purchase some shoes. He was very fortunate to have Josh assist him. Josh was very helpful and informative as to the type of shoes my husband needed. (style, make, the sole, insole) Josh has a very pleasant personality, nice manners and did not hurry us into making a decision. You are so lucky to have and employee of his caliber. Josh is a real asset to your company!
Mrs. Schwab

Dear Lucky Shoes,
Just a note to tell you that I had the pleasure of meeting Eric at your Lucky’s store in Strongsville. I must tell you that you have a real gem here. Eric knows more than any shoe salesman that I have ever met and I know where to go for shoes now!! Thank you Eric!
Sincerely,
B Carter

To John Luck,
I have been buying shoes at New Balance for at least 5 years because of a foot condition I have. My foot condition is fairly severe and yet I’ve always been able to find adequate shoes to help “keep my going” at work and home. Thank you for your store. I would like to compliment Elias. Over the past years with my difficulty he has been patient to show me his products and is very knowledgeable about the products. Elias takes an interest in the customers needs and I appreciate his help so much and I always make sure to have him help me. So thank you Mr. Luck for your store, your fine products, but most of all for your Great Employee Elias!
Sincerely, a very satisfied customer
R Stutzman

Dear Mr. Tom Luck,
On behalf of the Achievement Centers for Children and especially the children and families we serve, I would like to thank you for your generous donation of the planting and mulching services (not to mention everything else) for Camp Cheerful. With support from individuals and the community, the today's and tomorrows of children with disabilities become brighter and have promise. Your support of the Achievement Centers for Children and Camp Cheerful helps bring joy and happiness closer to the hundreds of children we serve.
Thank you again, Patricia Nobili & Tim Fox

The Institute for Preventive Foot Health (IPFH) exists to promote awareness of, and the need for, preventive foot health as a key to long-term quality of human life, and also to promote research and education dedicated to preventive foot health practices, products and procedures that contribute to the general well being of the human foot.

Preventive Foot Health (PFH) is defined as the practice of taking proactive measures to protect and care for the feet to reduce the probability of incurring serious problems as the feet age over the course of a person's lifetime. Preventive foot health is necessary in all sports and activities as well as in daily work and home routines. It is a vital and critically important practice in persons with chronic health problems such as diabetes, arthritis, and circulatory disease where small problems can be magnified into both limb and life threatening conditions.

The IPFH has prepared a 24 page brochure that will help you take complete care of your feet.