• The most fashionable but comfy shoes for teachers

    Orthofeet Team  /  August 18, 2023
    Being a teacher is not easy. Teachers have a great responsibility of educating, role modeling, and even instilling habits and behaviors in children to some extent. And all this is done standing on their feet all day! Teaching can be exhausting and take a toll on the feet and body, which can lead to pain, injuries or the development of certain conditions.  Research found that standing long hours has been linked to musculoskeletal disorders (MSDs), injuries that affect the body’s movement by impacting the muscles, tendons, ligaments, nerves, discs and blood vessels.  These disorders can produce conditions like tendonitis, lower back pain, plantar fasciitis and ball of the foot pain, to name a few. That said, studies have shown that wearing comfortable and appropriate footwear can help prevent and treat MSDs. Since we admire teachers and want to make your lives easier and healthier, we have ranked our best and most comfortable shoes for teachers. But most importantly, educator heroes can now enjoy special back to school prices on all Orthofeet’s innovative footwear. Our way of saying thank you for your dedication and hard work. Click To Learn More About Our Special Prices For Teachers Best shoes for teachers with plantar fasciitis Women’s Palma [product-tile data-url="/products/palma-stretchable-gray"][/product-tile] Why you’ll love it Accommodates any foot shape Extra heel cushioning   Specs Sizes: women 5-12 Widths: Standard (B) - Extra Wide (2E) Upper materials: stretch knit   Palma are the best plantar fasciitis shoes and are perfect for teachers wanting a modern look without sacrificing comfort.  Palma’s best plantar fasciitis feature is its premium insole that helps maintain a good posture throughout the day by propping up the arch, controlling over pronation and allowing the feet to remain in a neutral position. This anatomical arch support feature keeps the overworked plantar fascia in a neutral position, reducing or eliminating the stress and pain experienced.  Its unique technology incorporates air pockets within the sole and extra heel cushioning to absorb shock forces and make you feel as though you are walking on air.  Designed with 4-way stretch fabric, it is the ideal shoe for teachers who run around all day and might experience swelling as a result of prolonged standing. Furthermore, if you happen to have a bunion, hammertoe or wide feet, the upper will stretch over any shape, offering a relaxed and pressure free fit.  This shoe is designed with a soft, padded fabric interior with no overlays that eliminates irritation and provides superior protection for sensitive feet.  This lace up style is available in black and gray that can be easily paired with any formal and non formal school dress code. Shop Palma   Men’s Tabor Why you’ll love it Perfectly balances style and comfort Significantly minimizes plantar fasciitis pain   Specs Sizes: 7-14 Widths: Standard (D) - Extra Wide (4E) Upper materials:  stretch knit and soft leather    The Tabor shoes are an excellent choice for teachers with plantar fasciitis who are seeking a comfortable and stylish casual option. Unlike many other orthopedic shoes, these shoes strike a perfect balance between style and comfort. Designed with superior support and cushioning in mind, the Tabor shoes feature contoured orthotic plantar fasciitis insoles, ergonomic sole, and cushioned collar and tongue. These elements work together to ensure your feet, and especially your plantar fascia, remain well supported and at ease throughout the day. You can expect to experience less to no plantar fasciitis pain or discomfort.  Crafted with high quality materials, these shoes are not only durable but also breathable, keeping your feet cool and dry even during long hours. The stretch knit design provides both breathability and a customized fit that embraces your feet, catering to various foot shapes, including those with protrusions. Another feature that sets these shoes apart is their wide toe box, offering ample room for your toes to move freely and avoid unnecessary pressure throughout your busy day. Shop Tabor   Best casual shoes for teachers Women’s Sanibel   Why you’ll love it Stylish and feminine Multiple adjustability options   Specs Sizes: women 5-12 Widths: Narrow (A) - Extra Extra Wide (4E) Upper materials: soft leather and stretch knit   For a more feminine style and of course healthy feet, Sanibel will be your go to shoe.  This adorable mary jane will meet all your needs throughout your day, minimizing foot, leg and back pain, and bringing back spring to your step. Sanibel is uniquely designed with several features that allow you to create a custom fit based on your specific needs.  To start, it is designed with a padded instep strap that is gentle on the skin and won’t cause any irritation across the bone. The next feature, an adjustable heel strap, can be tightened or loosened around any heel shape and size to prevent slippage. If you have a wide or a narrow heel, these shoes will fit the bill.  The upper material is made from soft leather, as well as mesh fabric that promotes airflow and keeps your feet cool and dry.   Anatomical arch support, 5 layers of cushioning, a wide toe box, extra depth and a seam free interior create the optimal environment for feet that work long hours each day. Shop Sanibel   Men’s Leo Why you’ll love it Looks great, feels great Wide toe box for natural toe splay   Specs Sizes: 7-14 Widths: Standard (D) - Extra Wide (4E) Upper materials: soft leather   The casual Leo shoes are a perfect match for teachers, offering both style and practicality without compromising on comfort. These dress shoes come with built in anatomical, removable arch support, ensuring they not only look great but also align your feet with your body for proper posture.  No more discomfort caused by ill fitting shoes! The soft leather uppers provide a comfortable fit that won't squeeze your feet. The wide toe box allows your toes to spread naturally, reducing pressure and potential foot damage. The mild rocker design of these shoes is a game changer, especially for those dealing with foot pain or conditions. By reducing the impact on your feet and joints with every step, the rocker design ensures a more efficient and less fatiguing walking experience. The rubber outsole of the Leo shoes provides stability, security and steadfast support for your everyday activities. Whether you're in the classroom or on the move, the Leo shoes will keep you stable at all times. Shop Leo   Best sneakers for teachers     Women’s Kita | Men’s Yari Why you’ll love it No hands needed to slip in and out of them Water repellent uppers that are easily cleaned   Specs Sizes: women 5-12 | men 7-14 Widths: Standard (B) - Extra Wide (2E) | men Standard (D) - Extra Wide (4E) Upper materials: stretch knit   The women’s Kita and men’s Yari sneakers are an ideal choice for teachers seeking comfort and relief throughout their busy days, and are two of the best shoes for standing all day. Designed with features to alleviate foot and leg pain, these sneakers prioritize your wellbeing. The breathable, water repellent mesh uppers keep your feet cool and dry, and are extremely easy to clean, no matter how wild your day (or the kids) gets. The uppers are also stretchy, which means it will conform to your foot shape and is a must buy for anyone with bunions, hammertoes and swollen feet.  The innovative back construction is a time saver thanks to a special spring incorporated in the design. This allows you to effortlessly slip your foot into the sneakers without bending down or fussing with laces. In other words: the perfect shoes for days on the run (which is basically every day, right?). The contoured orthotic insole offers excellent arch support, evenly distributing pressure across the foot to reduce stress on your legs and back. In addition, the cushioned sole absorbs shock, lessening the impact with each step. The expertly cushioned insoles with anatomical arch support take care of your feet and legs as you walk and stand, while the mild rocker design enhances ease of movement. With the Kita and Yari sneakers you'll find walking requires less effort, minimizing muscle fatigue in your feet and legs.  Shop Kita Shop Yari   Best fashionable shoes for teachers Women’s Emma Why you’ll love it As comfortable as a sneaker Ergonomically shaped 2-inch heel puts no pressure on the forefoot   Specs Sizes: 5-12 Widths: Standard (B) - Wide (D) Upper materials: soft leather   The Emma booties offer a unique blend of orthopedic comfort and stylish design, making them an excellent choice for teachers seeking both functionality and fashion in their footwear. One of the standout features of these boots is their inconspicuous orthopedic design. You wouldn't be able to tell just by looking at them that they provide orthopedic support, making them perfect for professionals who want to look stylish without sacrificing comfort. Crafted with care, the Emma booties boast several elements that ensure comfort throughout the day. Despite having a 2-inch heel, they are engineered to be as comfortable as sneakers. The ergonomically shaped heel evenly distributes weight, alleviating pressure on the forefoot and allowing you to walk without experiencing foot pain. The wide toe box is a welcome addition, providing ample space for your toes to spread out, preventing foot pain and potential foot conditions. Accompanied by a cushioned insole, these boots offer support and comfort, reducing overall fatigue and discomfort. Shop Emma   Men’s Zodiac   Why you’ll love it Comfortable slip on design Non-binding fit   Specs Sizes: 7-14 Widths: Standard (D) - Extra Wide (4E) Upper materials: soft leather    With their slip on design, the Leo shoes are incredibly easy to put on and take off, making them ideal for those who are looking for a quick and effortless shoe wearing experience, as well as individuals with limited mobility. There’s also no need to tie laces or fasten any buckles - the adjustable strap across the instep allows for a customized fit without the hassle. Beyond their trendy appearance, the Leo shoes prioritize comfort. Crafted with premium quality materials, including soft, non-binding leather, these shoes ensure a plush and cozy feel all day long.  The anatomical orthotic insole provides excellent arch support and cushioning, enhancing overall foot comfort. The ergonomic design helps alleviate pressure points, reducing discomfort and fatigue during extended wear. The Leo shoes are engineered with a wide toe box, allowing room for toe movement and preventing cramped toes. With excellent arch support, they promote proper foot alignment and reduce the risk of foot conditions, such as plantar fasciitis or bunions.  Finally, the lightweight, ergonomic sole absorbs shock, minimizing impact on joints and enhancing overall foot stability. Shop Zodiac FAQ What kind of shoes should a teacher wear? Teachers should look for shoes with specific design features that can support their feet throughout the day.  Orthotic support is crucial, providing arch support and heel cradling to keep feet aligned with the rest of the body.  Shoes with superior cushioning made from unique materials offer optimal shock absorption and comfort, with foam insoles conforming to foot shape for a customized fit.  Adequate cushioning in the heel and around the metatarsal heads is essential to avoid pain and discomfort.  Stretchy or non binding upper materials accommodate foot swelling, which naturally happens during the day, and relieve pressure.  Soles with a minimal heel-to-toe drop and mild rocker design prevent forefoot pressure, and facilitates walking.  Adjustable features, like hook and loop straps, laces, bungee cords and zippers, allow for a comfortable, secure fit tailored to individual needs.  Wide widths cater to various foot shapes and help prevent swelling.   Shoes with these features provide the comfort, support and stability teachers need for long hours on their feet. Can you wear sneakers as a teacher? The answer depends on the school, but most schools do not allow teachers to wear flip flops or open toed shoes. Typically, closed toed options, such as sneakers or dress flats, are acceptable.  How important is comfort versus style in shoes for teachers? Comfort is paramount when it comes to shoes for teachers. Given the demanding nature of their daily responsibilities, being on their feet throughout the day, requires shoes that prioritize comfort and support. A comfortable pair of shoes can help teachers navigate long days with less fatigue and discomfort, allowing them to focus on their students and tasks without distractions. While style can be appealing, it should not come at the expense of comfort. Fortunately, there are plenty of shoe options that strike a balance between comfort and style. Shoes designed with supportive features, cushioned insoles and breathable materials can provide the necessary comfort without compromising on style. How often should teachers replace their work shoes? The frequency with which you should replace your work shoes can vary depending on several factors, including the quality of the shoes, how often they are worn, the type of activities performed and individual wear patterns. As a general guideline, it is recommended to replace your shoes every 6 to 12 months, especially if they are worn daily. If you notice signs of significant wear and tear, loss of support, or visible damage, it may be time to replace the shoes sooner. Regularly inspecting work shoes for signs of wear, checking the soles for excessive wear, and evaluating the support and cushioning can help determine if they need replacement. Paying attention to any discomfort or changes in comfort can also be an indicator that it's time for new shoes. Remember that investing in high quality, supportive shoes can prolong their lifespan and provide better foot health.  And here’s a tip: having multiple pairs of work shoes and rotating them can help extend their life and provide continued support to your feet.
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  • Best Running Shoes for Shin Splints

    Josh White DPM  /  April 11, 2023
    Before we list our recommended shoes, first let’s get the definition out of the way.  Shin splints is a general term that refers to pain and inflammation in the lower leg, specifically along the shinbone (tibia). It is a common overuse injury that can occur in runners, dancers and other athletes who engage in activities that involve repetitive impact on the legs. The exact cause of shin splints is not fully understood, but it is thought to be related to repetitive stress on the muscles and bones in the lower leg. This can lead to micro-tears in the muscles and inflammation of the connective tissue that attaches the muscles to the bone. If you have shin splints, the following shoes can help support your healing process, but even if you don’t, these running shoes can also help prevent shin splints to begin with. Best running shoes for shin splints for men Sprint Why you’ll love it Tie-less lacing Fasten and unfasten on both sides of the shoes Specifications Sizes: 7-14 Widths: D-6E Upper materials: soft fabric and microfiber   These shoes are designed with extra cushioning and support to help alleviate the pain and discomfort associated with shin splints, which means they are also the best walking shoes for men. They have a wide toe box to accommodate foot swelling and provide a comfortable fit.  The Sprint also features a non-binding upper and an ergonomic sole to reduce pressure on the foot, and a roomy toe box that allows for natural toe splay, which can help to improve balance and stability while reducing the risk of foot and leg injuries. As an added bonus, the Sprint sneakers have no less than three adjustable straps - two on either side of the shoe and one at the back - that allow you to fully customize the fit, eliminate the need to tie and untie laces, and enables fastening and unfastening on both sides of the shoe. Shop Sprint   Sorrento Why you’ll love it Pressure free fit Increased durability Specifications Sizes: 7-14 Widths: D-4E Upper materials: soft leather and fabric   The Sorrento sneakers are designed with an anatomical arch support that helps to reduce stress on the shin muscles and prevent over pronation, which is a common cause of shin splints. A thick layer of cushioning in the insole absorbs shock and reduces impact on the feet, helping to prevent the jarring and pounding that can lead to shin splints. With a lightweight and flexible design, the Sorrento allows for natural foot movement and reduces the risk of muscle strain and fatigue in the feet and legs. The width of the sole, coupled with the firmness of the heel counter, further enhances stability, as does the unique tread design that provides exceptional grip and provides an assured feeling of steadiness with every step. Shop Sorrento   Yari Why you’ll love it Hands free foot insertion Water repellent uppers Specifications Sizes: 7-14 Widths: D-4E Upper materials: stretch knit   Thanks to a unique hidden spring in the back of the shoe, you can put the Yari on without using your hands. By eliminating the need to bend down to put on or take off the shoes, these shoes can help reduce the strain on the muscles in the feet and legs, including the shins. This can potentially alleviate some of the symptoms of shin splints, such as pain and discomfort in the lower legs. Support is one of the most important features when it comes to finding shoes for shin splints, and Yari offers plenty of it. The cushioned insoles reduce impact on the feet and legs; the added arch support provides better stability and support, keeping over pronation at bay; and the cushioning outsole with a mild rocker design helps you walk with greater ease. The lightweight design allows you to walk with less effort, minimizing muscle fatigue in the feet and legs, and the upper’s breathable mesh material keeps the feet cool and dry.  Shop Yari   Best running shoes for shin splints for women Talya Why you’ll love it Slip resistant Water repellent uppers Specifications Sizes: 5-12 Widths: B-2E Upper materials: soft synthetic leather   The Talya sneakers are made with professionals in mind and are designed with pain relief technology that’s perfect for people who spend long hours on their feet.  The uppers are made from soft, high-quality, water and stain repellent faux leather that’s also flexible to provide a non-binding fit.  The sole is slip resistant, so you can walk safely on any type of surface without losing your balance, which reduces the risk of slipping and falling. This is helpful if you have shin splints, as this condition is often caused by overuse of stress on the muscles and tendons in the shin area, and slipping or losing your balance can exacerbate the problem. In addition, by improving your grip and stability, slip-resistant shoes can help reduce the stress and strain on your lower leg muscles and tendons, which can alleviate the symptoms of shin splints. Shop Talya   Coral  Why you’ll love it Breathable, aerated uppers Fully cushioned, yet lightweight Specifications Sizes: 5-12 Widths: B-2E Upper materials: stretch knit   With multi-layered cushioning in the insole of the Coral sneakers, impacts on your feet and lower legs are significantly reduced and excessive pronation is prevented, helping to alleviate pain associated with shin splints.   The Coral sneakers have a wide and deep toe box, which can provide extra room and reduce pressure on the toes and forefoot, improving overall foot comfort and reducing the risk of exacerbating shin splints due to cramped and tight shoes. In addition, the lightweight and flexible design can help promote a more natural and comfortable walking motion. This can reduce the strain and impact on the lower legs, minimizing the symptoms of shin splints. What all this means is that the Coral is not only great for running, but also the best walking shoes for women. Shop Coral   Kita  Why you’ll love it Easy on-off without bending Easy to clean, water-repellent uppers Specifications Sizes: 5-12 Widths: B-2E Upper materials: stretch knit   The Kita sneakers are constructed with a number of features that can help alleviate pain associated with shin splints.  The contoured orthotic insole provides arch support, which can help to distribute pressure evenly across the foot and reduce stress on the lower leg. The shoes also have a cushioned sole that can absorb shock and reduce the impact of each step, which can also help to reduce the pressure on the lower leg muscles. The innovative construction of the back of the shoe allows you to insert your foot without using your hands or even bending down, helping to minimize pressure and ease pain caused by shin splints in the lower legs.  The insoles are expertly cushioned, including an anatomical arch support, and help to absorb shocks on the feet and legs as you walk. In addition, the mild rocker design improves the ease of walking. With the Kita sneakers on your feet, you can walk with less effort and minimize muscle fatigue in the feet and legs, while the uppers are made from a breathable mesh material that keeps the feet cool and dry. Shop Kita   FAQ Can running shoes help with shin splints? Running shoes can certainly help with shin splints.  Shin splints are a common overuse injury that can be caused by a variety of factors, including improper footwear, but also over pronation, flat feet and weak lower leg muscles. Proper running shoes can provide adequate support and cushioning to reduce the impact of each stride, which can help alleviate the pain of shin splints.  Shoes with a stable sole and a good arch support can help prevent over pronation, which can also contribute to shin splints. However, it's important to note that it's also important to gradually increase your running mileage, stretch properly before and after your workouts, and incorporate strength training exercises for your lower leg muscles. Rest and ice may also be necessary to allow your body to heal. Can my shoes cause shin splints? Yes, your shoes can contribute to the development of shin splints.  Wearing shoes that don't provide adequate support or cushioning can increase the impact of each stride, leading to overuse and strain on the muscles and tendons in the lower legs. This can result in pain and inflammation in the shin area, which is known as shin splints. In particular, shoes that are worn out, don't fit properly, or lack sufficient arch support can increase the risk of shin splints. Shoes with a high heel-to-toe drop or too much cushioning can also lead to poor running form and over pronation, which can further exacerbate the problem. Therefore, it's important to invest in a good pair of running shoes that provide adequate support and cushioning and fit well. You should replace your shoes every 300 to 500 miles, or when you notice signs of wear and tear. Will more cushioned shoes help shin splints? If you are experiencing shin splints, shoes with additional cushioning can help reduce the impact of each stride and provide extra shock absorption, which can alleviate the pain of shin splints.  However, it's important to remember that overly cushioned shoes can also cause issues if they are not right for your individual foot and gait. In addition to cushioning, other factors to consider when selecting running shoes for shin splints include stability, support and fit. A shoe with a stable sole and good arch support can help prevent over pronation and contribute to better running form, which can reduce the risk of shin splints. Overall, it's important to find a shoe that is comfortable and supportive for your individual needs. Is walking or running better for shin splints? If you have shin splints, it's generally better to avoid running and other high-impact activities until your symptoms have improved.  In the early stages of shin splints, it may be best to rest and allow your body to heal before returning to exercise. However, once your symptoms have subsided, you can gradually return to activity. Both walking and running can be effective forms of exercise, but it's important to take proper precautions to prevent the recurrence of shin splints. When returning to exercise, start slowly and gradually increase your intensity and duration over time. This can help reduce the risk of overuse injuries like shin splints. Additionally, incorporating strength training exercises for your lower leg muscles can help improve your overall leg strength and reduce the risk of future injuries. Exercises such as calf raises, toe raises and ankle circles can be effective for building strength in the lower leg muscles.  
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  • Tarsal Tunnel Syndrome - Finding the Right Shoes

    Steven Gershman DPM  /  January 26, 2023
    Shoes for tarsal tunnel syndrome should have good arch support, cushioning, sturdy heel counter, extra depth and firm midsole and outer sole. Before I explain why, let’s jump straight into my list of the best shoes for tarsal tunnel. If you want to learn about the syndrome and how to treat and prevent it, simply scroll down or continue reading. The 6 Best Shoes for tarsal tunnel syndrome Sneakers: Women’s Coral | Men’s Edgewater These stylish and extremely comfortable sneakers are designed with extra depth and anatomical orthotic insoles with superior arch support, which help minimize over pronation, alleviate tarsal tunnel pain and align the foot with the rest of the body. The outer sole is firm, yet flexible enough at the toes to allow natural foot movement and reduce motion while walking. Another feature that makes these sneakers great for tarsal tunnel is the stretchable upper materials that conform to your foot shape and size, providing a customized fit.  Edgewater is available in black, gray and blue, while the blue and gray styles are constructed with a rubber outsole that provides advanced grip on any surface. Coral is available in black, gray, turquoise, silver, lavender, blue, white, wool gray and black with black sole. Shop Coral Shop Edgewater Boots: Women’s Florence | Men’s Ryder These boots feature orthotic insoles that make them extremely comfortable and provide unparalleled support. The lightweight, yet firm and cushioning soles alleviate stress on the joints and facilitate proper foot motion, helping minimize tarsal tunnel pain and deterioration.  On the inside, the anatomical orthotic insoles support the arches and feet at all times and on the outside, the non-binding uppers are firm enough to prevent the feet from collapsing when you walk. Both boots are also designed with features that make it super easy to slip in and out of them. The Florence boots open up widely, allowing the tongue to fall forward, thanks to two hook and loop straps across the instep, while the Ryder boots have two zippers at the heel to offer a wide opening, allowing you to effortlessly insert your foot. The Florence shoes are available in black and camel, and there’s two waterproof versions in black and brown. Ryder is available in black and brown. Shop Florence Shop Ryder Walking: Women’s Delta Black | Men’s Hunter Black  Walking in these shoes feels like you’re stepping on a soft pillow while being fully supported. With a firm and cushioned heel counter, these hiking shoes wrap around the heel to keep it from rocking from side to side and putting pressure on the tarsal tunnel.  Both boots are designed with durable, waterproof leather and are sealed at the seams, so that no liquids seep through, while the rubber outsole with its unique grooves channels liquids away.  Here, too, the premium orthotic insoles offer excellent arch support to help prevent over pronation and the mild rocker sole design allows you to walk with less effort. Both boots are also available in brown, but these styles are not waterproof. Shop Delta Shop Hunter What is tarsal tunnel syndrome? While many people have never heard of tarsal tunnel syndrome, most have heard of or actually have been diagnosed with carpal tunnel syndrome.  Carpal tunnel syndrome affects the arms, wrists, and hands. It is basically a nerve entrapment causing pain, electrical like sensations, numbness and weakness.  Tarsal tunnel syndrome (sometimes referred to as carpal tunnel syndrome in feet) is a similar problem that affects the feet, ankles and sometimes the lower leg. The word carpal is a Latin term meaning hand, while tarsal is a Latin term for feet. The tarsal tunnel is a canal on the inside or medial side of the foot, just below and aside the inner ankle, specifically where the medial malleolus is located.  Inside the canal is a large nerve, almost as thick as a pencil, called the posterior tibial nerve, and its three main branches. Also in the canal are blood vessels and three tendons going from the leg to the foot. In effect, they are bundled together in the canal under a roof of ligament. What are the causes of tarsal tunnel syndrome and its symptoms? True tarsal tunnel syndrome occurs when the nerve is entrapped in the canal by several possible factors, including swelling from inflammation, thickening of the tendons adjacent to the nerve due to overuse of the tendons, or scar tissue on the nerve coating as a result of chronic irritation.  Any of these can produce pressure on the nerve in the enclosed canal, which then causes the symptoms. Symptoms of tarsal tunnel syndrome can include: Pain directly over the canal Shooting electrical sensations into the bottom of the foot as the nerve innervates the bottom of the foot Pain or electrical sensations going back up the lower leg on the inside of the leg Numbness or complete lack of feeling on the bottom of the foot in severe cases In general, the most common cause of this syndrome is hypermobility or simply put, too much motion in the foot.  Hypermobility causes increased torque forces on the leg, ankle and foot, stressing the ligaments that hold the bones together. By itself, hypermobility causes irritation to the tissue and can lead to inflammation, swelling and scar tissue, which are potential factors in tarsal tunnel syndrome.  However, it doesn’t end there. As the body senses hypermobility, it tries to compensate to protect itself. The three tendons in the tarsal tunnel have several functions, but a major one is stabilization of the foot. With hypermobile feet, the tendons overwork.  WOLFS law basically states that as a body part is stressed (such as a muscle that enlarges when weightlifting is performed) it will grow larger in proportion to that stress. The tendons become thicker, taking up more room in the tarsal tunnel and can become inflamed from the overuse and swell.  This can cause tendonitis, which adds to the pain and scarring. Either way, the nerve is entrapped in the limited space of the canal. There can be other causes of nerve entrapment, such as space occupying lesions, tumors or bone spurs, deformities of the canal, nerves or tendons, metabolic syndromes that affect the nerve directly, vein problems causing swelling, or injuries directly impacting the canal.  However, the most common cause in my practice is hypermobility, especially with flat feet or post pregnancy, which weakens the ligaments with soft, worn out shoes.  Too much pronation, which in general terms means rolling-in of the foot with associated arch drop, also causes hypermobility. Do orthotics help tarsal tunnel syndrome? Treatment of tarsal tunnel syndrome begins with diagnosing the underlying cause. Once you have been diagnosed with the possible cause, there are a few simple steps you can take to treat your painful symptoms and yes, orthotics are definitely on this list. Orthotics Wearing orthotics is even more effective than just wearing the best shoes for tarsal tunnel syndrome.  The shoes and orthotics work as a synergistic pair and both need to be of superior quality and function for each patient.  Good orthotics should have a prominent arch to support the foot and prevent it from over pronating, as well as shock absorption features to cushion and help relieve pain. Shoes With the most common cause of hypermobility, the first step is to wear shoes that are appropriate for tarsal tunnel syndrome. That begins with the age of the shoe.  As shoes age, the leather stretches and warps as does the midsole material that acts as a stabilizer. This leads to the outsole irregularly wearing out. All these factors cause increased motion, which is counterproductive to tarsal tunnel treatment.  In general, shoes that are worn regularly should be replaced at least once per year and more often if under heavy use. In many cases of foot pain, new and more appropriate shoes have been the only treatment to solve the issue. What are the best shoes for tarsal tunnel syndrome? New or nearly new shoes of the correct size, both in length and width, are advisable. If the shoes don't fit correctly, they can allow either too much motion or warp, which leads to damaging abnormal motion.  The best shoes for tarsal tunnel syndrome will have most or all the features below. A good tarsal tunnel shoe will be a motion control shoe with extra depth.  Motion control shoes have a sturdy firm heel counter, which is the back of the shoe that wraps around the heel. This area of the shoe is critical in keeping the heel from wobbling, which torques on the tarsal tunnel.  In addition, the shoe needs a solid and firm midsole and outer sole so it doesn't bend easily in the middle, but allows some bend near the toes.  Shoes with a sturdier midsole material are beneficial on the inside or tarsal tunnel side from the heel to the midfoot. This rigid material resists the foot from collapsing when it pronates or rolls in. A low heel close to the ground is generally useful in reducing motion. Extra depth shoes are important as they allow better control of the foot motion, because the deeper the shoe the more material resists the motion. In addition, extra depth shoes can accommodate custom orthotics or specialty insoles, which are a major component in treatment. Good arch support built into the shoes aligns the feet and helps keep them in the neutral position, minimizing pronation. The correct arch height will also help transfer pressure off your tarsal tunnel and relieve pain. Shoes with removable insoles to accommodate custom orthotics, or braces (AFOs).   In shoe brace In severe cases of tarsal tunnel syndrome, an in-shoe brace, such as a so-called gauntlet AFO, is used. This delivers maximum control of the motion problem.  This type of device usually requires a special shoe, preferably one that is stretchable, so that it can accommodate the brace. You will need shoes that are designed with a deep and wide shape, including a wide toe box, to ensure a comfortable fit for the brace.  In addition, the built-in insole should be removable to free up even more space and accommodate custom orthotics.    Non-surgical treatment  There are several treatment options for non-surgical care for tarsal tunnel syndrome.  After exhausting motion control options such as shoes and orthotics, medication, injections, cold laser, and sometimes complete immobilization in a cast or boot for several weeks, may be required.  Physical therapy modalities can be useful, but in general I haven't seen much improvement from tarsal tunnel exercises or tarsal tunnel stretches, as they can further irritate the tissue. Bottom line, the best treatment for tarsal tunnel syndrome is prevention.  It all starts with proper, well made and non worn out shoes. So many foot problems could be prevented by following this simple rule.
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  • Best Shoes for Multiple Sclerosis (MS) Patients

    Josh White DPM  /  December 04, 2022
    Being able to walk and maintaining stability can be very challenging when you have MS, but the right shoes can help. That’s why we’ve prepared a list of some of the best shoes for people with MS.  If you want to learn more about the disease, how it affects your feet and which footwear features you should look for if you have MS, simply scroll down or continue reading.  What are the best shoes for MS patients? All the footwear that made our list are orthotic shoes that were biomechanically engineered with unique comfort features, providing an extremely advanced solution for a long list of foot conditions, including those caused by MS. Best MS shoes for women            1. Joelle The highly flexible and aerated stretch fabric upper of the Joelle shoes provides a pressure free fit, and keeps your feet dry throughout the day to prevent the build up of bacteria and fungi. This is especially beneficial if your MS symptoms include numbness in the foot. The stretch fabric also forms to the specific shape of your foot, providing a comfortable customized fit. Furthermore, the no-tie elastic lace offers a relaxed fit that gently follows every curve of your foot. The adjustable strap across the instep makes these shoes easy to get on, and the elastic laces will stretch over your feet, where needed. The premium orthotic insoles offer anatomical arch support that realigns the foot and the body posture, making it easier to walk and maintain stability.  Shop Joelle          2. Francis With its stretchable uppers and soft protective interior, the Francis no-tie sneakers offer a 4 way stretch that will expand or contract on your feet, depending on your foot size and shape.  The uppers are also breathable, promoting air flow to keep your feet dry and healthy.  Thanks to the bungee toggle, tying laces becomes a thing of the past and on-off wear is super quick and easy.  And there’s more. The rubber outsole gives you excellent stability and advanced grip; the premium orthotic insoles with anatomical arch support help realign the feet, legs and body posture; the cushioning system cradles and supports your feet as you walk; and the foam padded forefoot and padded collar at the heel constantly protect the most vulnerable areas of your feet. Shop Francis         3. Siena If you’re looking for lightweight boots that support your feet, the Siena boots could be perfect for you. The mild rocker design helps propel the foot forward as you walk, with minimal joint motion and effort, while the cushioning soles absorb impact as you walk.   The boots are designed with a side zip and adjustable strap, making it easy to put them on and take them off, and allowing for adjustments in fit. The soft fabric protective interior that’s padded with foam eliminates friction and offers superior protection. At the same time, the soft, waterproof and flexible leather upper eliminates pressure on the foot and keeps it dry at all times and in all weather conditions.  Last but certainly not least, the slip-resistant soles provide advanced grip and stability on various surfaces. Shop Siena          4. Florence Waterproof boots that are as stylish as they are cozy. The gusseted tongue and the sealed seams prevent water from seeping in, while two hook and loop straps allow an extremely wide opening, making it very convenient to put them on and take them off, and allowing you to adjust the fit to your individual foot shape, ensuring your feet don’t slide around.  The special rubber of the sole, as well as the sole’s unique tread design that channels liquids away from the shoe, allow extra traction and grip while you walk on any type of surface. There’s also a shock dispersing insole and antimicrobial top cover that keep your feet healthy and provide relief.  Finally, the front shape of the boot is generous, promoting biomechanical movement and providing plenty of space for the toes to move, without being squeezed.  Shop Florence Best MS shoes for men         1. Sprint While these sneakers look like regular lace shoes, they are designed with innovative tieless laces that have a hidden strap. This allows you to effortlessly put the shoes on and easily take them off.  You only need to tie the laces once, and from that point on you can use the strap. What’s more, these straps are on both sides of the shoe, providing greater adjustment as well as easier access.  And that’s not the only customization feature that makes sure these sneakers are just the right fit. With the heel strap, the back of the shoe can be made more roomy or snug to fit the foot shape, even if you have braces.  In addition, the thick cushioning insole and the shock dispersing sole make sure your feet and body are fully supported as you walk, and the breathable upper material provides a truly non-binding fit.  Shop Sprint         2. Zodiac Thanks to their classic design, the Zodiac shoes are a great choice for a wide variety of occasions.  These casual men’s shoes are constructed with a rubber outsole that provides advanced grip on every surface, while the soft leather upper and wide toe box eliminate pressure on the feet.  With the hook and loop strap, closure is both easy and adjustable, making on-off wear a breeze.  With the Zodiac shoes, your feet will always be protected and supported, thanks to the removable anatomically designed insole and mild rocker.  Shop Zodiac         3. Alamo The Alamo sneakers are made with full grain leather uppers that are both highly durable and soft enough to provide a pressure free fit.  The two straps allow a highly customized adjustability and make it super convenient to take them off or put them on. Like all the other shoes on our list, the tread design of the rubber outsole of the Alamo sneakers provides advanced grip and allows you to walk with advanced stability, and the anatomical orthotic insoles offer superior support and cushioning all day long.  Shop Alamo         4. Ryder  Although you can’t tell just by looking at them, these innovative boots are perfect for those who need quick and convenient on-off wear. Yes, they have laces, but there are also two hidden zippers at the heel, so you only need to tie the laces once and never again!  By pulling down the zippers in the back, you create a wide opening that allows you to effortlessly slide your foot in.  The built-in advanced orthotics support the foot and control its rolling inwards to maintain an aligned body, while the mild rocker design allows proper foot motion and improves walking. The seam free and padded interior creates a protective environment for the feet, and the wide and round toe box gives the toes enough room to naturally move around.  Shop Ryder   What is MS?   Multiple sclerosis (MS) is a chronic, often disabling disease of the brain, spinal cord and the optic nerves - all of which make up the nervous system that basically controls everything we do. “MS is an autoimmune disease in which the body’s immune system attacks and destroys myelin, the covering of nerve fibers, which is critical for their function. This interferes with the transmission of electrical signals between the brain, the spinal cord and other parts of the body,” explains podiatrist, Dr. Josh White. “The cause of MS is unknown.” This disruption can cause a variety of unpredictable symptoms, such as paralysis, numbness, tingling, pain, blindness and more. Over time, the disease can cause permanent nerve damage. The effects of MS on your feet and legs   “As a result of the body attacking the myelin sheath, plaque and lesions start hitting the nervous system,” says Dr. White. “At this point, people may start feeling pain in their feet, legs and the rest of the body.”  Unlike other conditions that cause pain in the legs and feet, such as neuropathy caused by diabetes, the nerve damage from MS is not only painful, but also makes walking very difficult, leading to gait (your walking pattern) related foot problems.  Seeing as MS also causes vision problems, people with MS may not notice foot problems at the early stages, when they are easiest to treat, which can lead to complications. Another possible and common effect of MS is foot drop (or drop foot) - an MS symptom caused by weakness in the ankles or a disruption in the leg-to-brain nerve pathway.  Foot drop makes it more difficult to lift the front part of the foot to the angle needed for walking, causing the foot to hang and the toes to drag on the ground and making it very difficult to maintain stability. Stairs, uneven surfaces and curbs can become a real challenge when you walk with foot drop. Many MS patients lift their legs higher to compensate for the foot drop and avoid dragging their feet on the ground, which can be very tiring.  Further down the line, foot drop could lead to other problems, such as lower back pain and poor balance.  The good news is that quality, light weight and well fitting shoes can support the foot and allow it to be held in a more natural walking position.  In addition, there are some treatments available to people with foot drop, such as physiotherapy that strengthens the foot and ankle muscles, and FES (functional electrical stimulation) that helps position the leg in a more natural walking angle.   Can people with MS wear high heels?   Although the right heel height can vary from person to person, it’s best to avoid heels higher than 2 inches. Shoes with higher heels might make it difficult for you to walk and cause you pain.  In addition, high heels can add to the balance issues that are a common MS symptom. “If high heels are very important to you, it’s best to discuss your options with your MS neurologist,” says Dr. White.    The design features to look for in your MS footwear   Here are some tips that will help you shop for the best shoes for MS. A good fit. People with MS need to find shoes that fit them well and right away, instead of buying shoes that don’t fit properly in the hopes that they will gradually break them in. Well fitting footwear will provide support to your feet and legs, helping with balance issues, pain and foot drop. If the shoes are too small, they might restrict blood flow to the feet and if they are too large, you won’t be stable.  Shoe depth. Extra depth shoes are higher, which means they provide better support, fit better and leave enough room for custom orthotics and braces.  Tread design. The tread is the pattern of the outsole that can help prevent slipping and falls. Naturally, since MS affects your balance, it’s best to look for shoes that offer better traction. Shoe weight and flexible materials. If you have MS related muscle weakness, look for a light-weight shoe made from flexible materials, because it requires less energy and effort to lift the legs when you walk, thus reducing the risk of falling.  Heel counter. Look for shoes with a firm heel counter. Mules, slip-ons, flip-flops and similar backless shoes can slip off the heels, as they require toe strength and a good sensory feedback that many MS patients lack.  Secure fastening. If your MS makes it harder for you to tie your shoes, opt for styles that offer velcro fasteners or no-tie elastic laces. This can also allow you to adjust the fit to your specific foot contour and size.
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  • Edema: Causes, Symptoms, and Treatment

    Steven Gershman DPM  /  September 13, 2022
    What is edema?               There are many types of Edema, but they are all characterized by buildup of fluid in the tissues of the body causing swelling. It is commonly called "fluid retention" and is often seen in the extremities and as such it is known as "peripheral edema". Edema can also be seen in the face, lungs, and abdomen. This blog mainly will deal with peripheral edema in the lower extremities, i.e., the lower legs, ankles, and feet. Generally, edema in the peripheral tissue is categorized as either pitting or non-pitting. Pitting edema is diagnosed by pushing on the area of swelling and seeing if there is an indentation or pit in the tissue. It usually lasts for a few seconds. With non-pitting edema, which is more severe edema, the tissue is so firm it doesn't indent when pushed on. It is like a water balloon filled fully. The fluid is body water or natural/isotonic saline, not blood. Edema causes In the legs the veins have valves that operate as "check valves" to prevent blood from going down to the feet due to gravity. Heart pumping action pushes blood through arteries down to the feet. The blood needs to return to the heart for re-circulation through veins. However, there is no true pump pushing the blood up the legs. Blood pressure through the system and the leg muscles contracting pushes the blood up the leg veins while the valves prevent backflow down against gravity. Incompetence of the valves allows blood to pool in the legs and feet eventually leading to edema and swelling. When blood stagnates or pools in an area, water leaches out of the blood into the surrounding tissue. Valve incompetence can occur due to the following reasons: As we age Standing in one place for many hours Sitting with the feet down on the floor for many hours Varicose veins which in many cases is a genetic weakness in the valves Regardless of the cause, as the valves in the legs become incompetent, the blood pools and causes swelling which puts pressure on the veins dilating them and further hindering the valves from working efficiently leading to more swelling. It is a vicious cycle. Besides vein issues, edema can be caused by a variety of other problems that can affect both legs. Heart disease: is a major cause, specifically congestive heart failure or CHF. As the heart begins failing as a pump, fluid will stagnate in areas like the legs and lungs and cause swelling/edema. Also, there is less blood going to major organs like the kidneys causing fluid retention. Kidney disease: causes fluid retention and edema as the kidneys can't eliminate enough fluid. Liver disease: causes edema in the legs and abdomen especially if there is cirrhosis. Specific medications: calcium channel blockers and beta blockers can have peripheral edema as a side effect and is seen often in the ankles and lower legs. Sodium: salt in the diet is another culprit in edema. Salt causes fluid retention which manifests as edema. Alcohol: causes dilation of the veins which leads to edema. Susceptible people will have widespread vaso-dilation of the face, arms and legs when consuming alcohol. Eventually the veins stay dilated with chronic edema resulting. Another type of edema is lymphedema. It is often quite severe with large swollen legs or arms. Usually it is single limb. Lymphedema is often a genetic issue but can also be caused by cancer treatment and surgery. The lymph system which is part of the immune system is compromised causing swelling. Symptoms of edema   Swelling is the big symptom of edema. In this blog I will specifically discuss leg swelling, ankle swelling, and foot swelling. But other symptoms ay also present themselves, such as the ones below. Discoloration to the skin: In the lower legs and ankles when the edema is caused by incompetent veins, changes occur to the skin. Chronic edema often leads to a brownish or reddish discoloration of the skin on the front of the shins and down to the ankles. This discoloration is due to hemosiderin deposits. Hemosiderin is a pigment from the iron/hemoglobin in the blood that leaches out of the blood into the tissue and skin. It permanently stains the skin. I tell my patients it is "rust deposits" from the iron in their blood. With edema there is fluid pressure in the tissue that builds up forcing the iron into the tissue and skin especially as the blood stagnates or pools. Hemosiderin is a good indicator that the edema is affecting the skin and problems are going to occur if not dealt with and stasis dermatitis can then occur. Skin inflammation: Stasis dermatitis is an inflammation of the skin causing a rash which itches, burns, and can be painful. In severe cases, stasis dermatitis can cause breakdown of the skin resulting in open wounds or ulcers that are painful and can become infected with resulting in cellulitis. Skin thickening: Chronic edema can also cause thickening of the skin in the lower legs from the inflammation. This is permanent. The skin becomes thick, irregular, rough and almost elephant like in texture. It often drains fluid or weeps chronically and can blister. Neurological disorders : Another issue with edema is neurological. Edema causes pressure in an enclosed space where the nerves run down to the feet from the legs. The nerves become compressed causing pain and or numbness in the feet. It is similar to diabetic neuropathy. Swelling: Swelling of the feet from edema makes it difficult to wear shoes as the feet are simply too large to fit shoes. Many of my patients with edema come into the office wearing worn stretched out slippers or shoes way too large and stretched out. How to treat and prevent edema   Treatment of Edema will depend on what triggers it. Some treatments are simple and can be done on your own at home while others will require medical intervention. Elevation of the feet and legs: As gravity is one of the main culprits with edema, elevation of the legs/feet is a mainstay in treatment. Sitting for long periods with the feet down on the floor can cause or add to edema. Many older patients sit a lot at home with their feet on the floor. I recommend a recliner to them. Basically, elevation of the legs higher than the waist, as in a recliner, works. With the feet higher than the waist, gravity works to pull the fluid back toward the heart. Elevating even higher where the feet are higher than the heart is better BUT often uncomfortable and not practical.   Compression Stockings: This is the real treatment for edema. By putting pressure up the legs, the fluid is pushed back from the lower areas up to the upper legs and midsection where it is pumped back to the heart. Pressure needs to be graded so it is highest down near the ankles and gradually lessens going up the legs. Support hose up to the knee at least are the mainstay in treatment. There are several strengths of hose starting from mild compression over the counter type all the way up to prescription higher pressure stockings. Prescription stockings need to be custom fitted carefully by a trained professional. These need to be applied when first getting up in the morning before getting out of bed and worn until bedtime. People who stand a lot in one place at work and have the tendency toward edema or varicose veins should consider wearing support hose to reduce the chances of severe edema with its permanent damage. Compression Wraps: In severe cases of edema such as in stasis dermatitis, or when ulcers occur or with lymphedema it is often required to wrap the legs in heavy compressive dressings. This is done first by a medical professional and can be followed at home by a nurse or the patient. Often several layers of wrap are used, and it is cumbersome. However, in many cases this is the only way to control the fluid and the damage. Prevention is still the best treatment here as once the edema reaches this point it often becomes a chronic issue of wrapping the legs.  Avoiding Salt: Reducing salt in the diet can help reduce fluid problems and edema. I have had patients with leg edema who ate pizza daily and swelled up. Reducing the pizza in the diet in those cases reduced the swelling. Limiting Alcohol: Reducing alcohol also makes a big difference. I have seen remarkable changes in the edema in patients who took my advice in this area. For the other issues causing edema, patients should work with their medical professional to best manage the condition. In many cases the edema will improve as the medical issue is stabilized. If medication side effects are causing edema, talk to your prescriber about it and how to manage the side effects. Shoes for Edema   As written about earlier, shoes can become an issue with edema resulting in swollen feet and ankles. Shoes for people with swollen feet and ankles can help prevent further swelling and pressure and enable people to function normally. Edema shoes should have the following features: Stretchable to accommodate the increased size and the constant changes in size that can occur from day to day and during the day. Usually fabric uppers that incorporate stretch are able to do this best. This type of shoe conforms to your unique foot shape and size and creates a pressure free environment for the feet. Orthofeet manufactures stretchable shoes that serve this purpose well. I have recommended these shoes often for edema and many diabetics.  Multiple adjustability features are important as they allow you to customize the fit to your particular foot shape. Straps, laces and bungee cords in various locations, such as the heel, instep and forefoot can be loosened to accommodate a swollen foot. The more adjustability the shoe has the better it will fit your feet and accommodate the swelling.  Wide widths are especially helpful with edema. Most brands only design shoes in medium width (B) which is way too narrow and constricting for a swollen foot. Not only will your foot not be able to fit into them, but if they do, it will further exacerbate the condition. Many orthopedic brands such as Orthofeet offer extended widths that go up to 6E! Extra depth from the heel to toe area provides more space for the expanded foot and makes a comfortable foot space.  Shoes designed with a round and wide toe box are always recommended since they allow the toes to flex and extend properly. The generous space prevents the formation of bunions and hammertoes and offers a pressure free environment for swollen toes. This will eliminate or reduce friction and rubbing between the toes which can lead to calluses, blisters or other serious problems. Orthotics built directly in the shoes can provide added benefits for edema in the feet. Swelling in the ankles may impact your gait. Orthotics are designed to support the arch and align the body from the ground up.  Many patients with swollen feet prefer to wear slippers as their design is usually less constructing and structured and are fairly stretchable. However, most slippers often lack the support and protection of well-made orthopedic shoes. If opting for a slipper, a quality one that not only stretches but has some support is critical. Poorly made slippers can lead to falls and often severe injury and don't protect the feet from objects on the ground or furniture. As mentioned above, I recommended Orthofeet shoes to many of my patents and wear them myself. It is an orthopedic footwear company that specializes in designing shoes for swollen feet. All the shoes, including the edema slippers, are designed with built in orthotic insoles, extra depth, a round toe box and are available in wide widths. The edema styles are made with stretch uppers and several adjustability features to achieve a perfect fit. Socks for Edema   Have you ever experienced rings around your ankles and legs after removing your socks? Wearing the right type of socks for edema can also be critical in managing symptoms. Edema socks are uniquely designed with a non-binding and non-constricting shape and yarns to eliminate pressure. Orthofeet also offers socks for swollen feet that are made of viscose rayon fabric and are super soft against the skin. Finally, edema as in all medical issues, is best managed early. If you start noticing swelling near your ankles or pitting skin or marks such as rings around the lower legs when you remove socks, it is time to start thinking of edema and how to control it. Many of the changes that can occur with edema later are permanent. So, prevention is so critical. When in doubt, talk to your medical provider about it.
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