Foot Care Tips!

• Except at the beach, avoid going barefoot, even in your own home.
• If you have foot problems, inspect your feet every day or have someone do this for you. If you notice any redness, swelling, cracks in the skin, or sores, consult your physician
• Trim or file your toenails straight across. If you have foot problems, inspect your feet every day or have someone do this for you. If you notice any redness, swelling, cracks in the skin, or sores, consult your physician.
• Bathe your feet daily in lukewarm (not hot) water, using a mild soap, preferably one containing a moisturizer, or use a moisturizer afterward.
• Panty hose or stockings should be of the correct size and preferably free of seams.
• A shoe with a firm sole and soft upper is best for daily activities.

My shoes wear badly…

I am looking for a product to help with a problem I am having with my shoes, despite the doctor-prescribed orthotics (dress and casual) that I have. My shoes wear badly down on one side: the left side on the left and the outside right on my right side. Do you have any product that might address that?

It is not abnormal to wear down your shoes slightly on the outside of your heels. Most people strike the ground normally on the outside of the heel. We call this motion supination. It is the first phase in the gait cycle. However, an abnormal strike pattern can lead to increased wear of the shoe. The job of the functional foot orthotic is to help control the mechanical forces in the foot. This can help reduce the wear in the shoe. But when the shoes show significant wear it is probably time to be fitted with new footwear. Shoes will wear and compress depending on the frequency of usage and do need to be replaced. The other consideration is that the orthotic prescription may need to be reevaluated. If the orthotic is not adequately controlling the mechanical forces in your feet, then this can lead to problems as well. It is hear that you should consult with you physician.

- Dr. Charles A. Mutschler, Podiatric Consultant for Footcare Express

I have been diagnosed with a Neuroma…

I am a weight trainer and 56 years young. I have been diagnosed with a Neuroma in my left foot and also developing in my right foot. I have been given orthotics. Will the orthotics cure this problem without surgery? Do you specialize in problems such as this? This condition is getting worse for me.

Typically, a Neuroma may be caused by a mechanical problem or an abnormality in the gait cycle. I am not certain whether a functional foot orthotic will cure a Neuroma in your foot. However, a functional foot orthotic can provide relief or drastically reduce or eliminate the pain caused from such a problem. Surgery may be the last resort or even a necessary option when the problem has become such that it is warranted. Even though surgery is often used to remove a painful Neuroma, a functional foot orthotic is often prescribed to create the proper mechanics of the foot and to prevent any future developments or reoccurrences.

- Dr. Harold R. Reinhartz, Podiatric Consultant for Footcare Express

Footcare Express: The Nations First One-Stop Footshop

Jose Menuto, 45, an Argentinian real estate contractor and property manager now living in Miami, injured his left leg six years ago while running a 26-mile marathon. “I tried chiropractors, massage therapists, and everything else I could think of, but whenever I ran or felt stressed, my left leg tightened up.” Because Menuto favored his right leg when he ran or walked, he began having problems in his right knee as well.

Then, Menuto saw an advertisement for Footcare Express, the nation’s first “one-stop footshop.” After a thorough high-tech examination by a podiatrist who diagnosed him with shin splints, an inflammation of the muscles where they attach to the bone, Menuto was fitted for a pair of functional foot orthotics in less thanan hour. “Within two days I was running entirely differently,” Menuto says. “My muscles and ligaments have relaxed in my left leg. I have much more energy, and I now plan to build back up to running 50 miles a week.”

To help athletes, growing children, diabetics, arthritis sufferers and many people with back, leg or hip or knee problems — Footcare Express, a Miami retail store, uses the services of experienced podiatrists to examine a person’s feet, sophisticated video-motion analysis and computerized scanning to identify problem areas, licensed pedorthists to design and fit prescription foot orthotics and modify shoes, and an in-store laboratory to make the devices — all in about an hour.

“Just as the one-hour optical laboratory made it cheaper and much more convenient for people to order eyeglasses, Footcare Express is re-inventing the process of prescribing and making customized foot orthotics,” says Jarett Reinhartz, managing director and co-founder of Footcare Express. “Nobody else in the country has our equipment, our prescription service and our array of athletic and dress shoes, compression hose, support socks, and skin creams and lotions. That’s why we call Footcare Express the nation’s first one-stop footshop.

What’s an Orthotic

Functional foot orthotics are customized rigid or semi- rigid devices inserted into shoes that place the foot in a more functional position and allow it to strike the ground more efficiently, while adding more stability. Foot orthotics relieve pressure points, support the foot more effectively and assure proper alignment of the feet, ankles, knees and legs. In addition to enhancing performance and increasing energy, foot orthotics reduce the risk of injuries.

Footcare Express serves a broad market, ranging from children who need orthotics to correct a gait or walking problem, adults with foot, leg, hip or back pain caused by biomechanical problems or foot disorders, diabetics who need extra foot protection, patients with rheumatoid arthritis, and athletes who put heavy stresses on their feet. A runner, for example, puts as much as three times the normal amount of force from the body’s weight on the feet.

While only a small percentage of the public wears orthotic devices, many more would benefit from wearing them, says Reinhartz. “If you have chronic back pain, knee problems, high arches or flat feet, changing your gait could remedy the pain.”

Don Bailey, Jr., vice president of Don Bailey Carpets in Miami, began wearing orthotics as a professional football player with the Tampa Bay Bucs and the Indianapolis Colts. “When it was time for a new pair, I went to Footcare Express,” says Bailey, who also broadcasts pregame and sideline radio shows for the University of Miami Hurricanes. “They did a wonderful job, with personal treatment and individualized attention. My wife is a marthon runner who was having problems with her heel and hip, and orthotics helped her, too.”

Traditionally, a patient who needed foot orthotics might wait three to six weeks from an initial visit to a physician to receiving the orthotic device, manufactured from a plaster cast at a lab in another city or state. The cost would be $300 to $1,000, plus professional fees.

An hour-long process
In contrast, Footcare Express completes the process in about an hour, using sophisticated laser scanners and CAD-CAM technology to make the prescribed orthotics at a total cost of $200 to $450. “It’s a different mindset than going to a doctor’s office,” says Reinhartz. “Our store has it all.” Footcare Express has won praise from foot care professionals, as well as its clients. “I am very pleased with the foot orthotics they produce,” says James Losito, D.P.M., professor at the School of Podiatric Medicine at Barry University. “They keep physicians involved in their business, and I approve of their techniques. Their prices are very fair and their products have met with excellent patient compliance.”

Reinhartz projects first year sales of $350,000 with a staff of three. “Our Miami store is an excellent prototype for the foot orthotics store of the future,” he says. “We hope to expand this concept and open similar stores in other markets in Florida and the rest of the United States.”

The idea of Footcare Express originated with Jarett Reinhartz’ father — Harold Reinhartz, D.P.M., a podiatrist with 29 years experience who dreamed about opening a store for most footcare needs. In 1996, Harold and Jarett Reinhartz, began creating a business plan and exploring the industry.

After researching different markets, it became clear that South Florida would be the best fit for Footcare Express. “Miami’s demographics were exactly what we were looking for — a large marketplace with sports teams, college students and senior citizens,” says Jarett Reinhartz.

A high-tech approach
One of Footcare Express’ distinguishing characteristics is its high-tech approach to correcting foot problems. After a physical examination of the foot, a computerized gait analysis is performed using the new F-Scan equipment. Paper-thin, disposable sensors placed in a person’s shoes feed information into a computer, which generates a three-dimensional image of the reactive forces between the foot and footwear as they occur. Next, a video motion analysis is used to study the person’s gait while walking or lightly jogging on a treadmill.

Finally, a laser scanner generates a three-dimensional computerized image of the feet showing any pressure points or potential problem areas. That computerized file is transmitted to the store’s own orthotics mill, which manufactures the device, according to specifications from a licensed physician, who dispenses custom-designed orthotics and modifies over-the-counter footwear to meet an individual’s needs.

“I enjoy helping people with diabetes, arthritis and other foot problems, as well as the many athletes, children, teenagers and other adults who can benefit from wearing correctly designed footwear,” says Dr. Reinhartz. “When someone is in pain, it’s important to bring them relief as quickly as possible.”

In addition to custom-made functional foot orthodics, Footcare Express offers high-end athletic and comfort shoes such as Saucony, Asics, New Balance, P.W.Minor and Softspots, as well as other foot- related products. The store itself, at 7756 SW 88th Street, was designed by Sandy Samole, president of the Interior Design Association of Florida.

“It’s an ongoing process to keep your feet healthy and working properly,” says Reinhartz. “We’re here to help keep you going strong.”

Preventing Injury and Increasing Your Performance

Athletes often neglect their number one supporter: their feet. Many of us rarely give them a second thought until they cause us pain. We force them into shoes that don’t fit, pound them into the ground and neglect to care for them properly. Yet, a small abnormality in foot function can have a large impact on the entire body causing pain, discomfort and interrupting an athlete’s game. With the strenuous activity athletes’ bodies endure, it is important to understand how to treat sports injuries, maintain treatment and ensure the feet receive the extra T.L.C. they deserve.

Athletes must not only be aware of sports related injuries but more importantly, how to prevent them before they occur. As proper biomechanics begins to gain more popularity and importance in the sports world, trainers and athletes are beginning to think more pro-actively about how to care for the feet. Yet, many are unaware that the symmetrical alignment of their feet affects their entire body. Any deviation can create a deleterious effect on their performance. Because no one person shares the same foot structure, the ultimate solution to preventing injuries, treating existing problems and increasing athletic performance is with precise custom-made functional foot orthotics.

Functional orthotic devices are fabricated by using a neutrally balanced and stable position captured impression of the foot. They are designed by a physician, experienced and trained in the field of Clinical Biomechanics. Medically prescribed, their purpose is to limit excessive motion and align the rear foot to forefoot. It is important that custom-made, functional foot orthotics are not confused with arch-support devices sold at pharmacies or shoe and sporting goods stores. Over-the-counter arch supports are a one-size-fits-all version that provides support to a patient’s arch based on average foot shape and function.

In our practice, we use the latest diagnostic technology to perform my biomechanical evaluations. A thorough study incorporates a medical and family history, video gait analysis, muscle strength testing and range of motion study. The combination of this information helps to determine the best method to increase performance, prevent and/or address injuries.

Some of the most common athletic ailments that we have encountered that could have possibly been prevented with the use of functional foot orthotics are:

Heel Pain

The most frequent cause of heel pain is plantar fasciitis. Plantar Fasciitis can be caused by an abnormal motion of the foot called excessive pronation. If your heel is rotating outwards too much and your arch is lowering too much then you have excessive pronation. It is this extra stretch in the arch that causes the partial pulling, straining or tearing of the plantar fascia and the possibility of spur formation.

Plantar Fasciitis can be controlled with a combination of treatments. Strapping of the feet with the foot held in a neutral position combined with a physical therapy program and an anti-inflammatory medication will usually improve the symptoms. A custom made orthotic will control the excessive pronation and also support the arch taking the tension off the plantar fascia.

If the patient continues to have pain, a physician could conduct injection therapy, the injection of a small amount of cortisone to decrease the inflammation. The patient could receive several injections while still performing the conservative treatment for several weeks or months. For the remaining small percentage of patients who fail to be relieved of the pain, the patient may choose to have Extra-Corporeal Shock Wave Therapy (ESWT). This innovative, non-surgical treatment involves the delivery of sound energy or shock waves to affected areas of the body triggering the body’s own natural repair mechanisms and stimulating healing. ESWT can be done in the office (low energy) and without the need for an anesthetic. Surgical correction is the last choice of treatment. Surgical corrections consist of releasing the part of the plantar fascia from the attachment to the heel bone.

Shin Splints

Medial Tibial Stress Syndrome (MTSS) is commonly known as Shin Splints. The people who are at the greatest risk for developing MTSS are beginning runners, people who over-train and people with a poor selection of shoe gear.

The usual mechanical factors that lead to MTSS are an imbalance between the posterior and anterior muscle groups. The posterior muscles may be both too tight and too strong. The effect of the tight musculature has an impact on the gait cycle at two points, just before and after heel contact and when the foot is leaving the ground at toe off. These stresses cause a repetitive inflammation in the muscle or at the attachment of the muscle to the bone. Other factors that may cause MTSS are continual running on a hard surface and a biomechanical abnormality in the foot such as excessive pronation.

The initial treatment for MTSS is decreasing the amount of training, adequate stretching exercises before and after running and proper shoe gear with shock absorption. Running on hard surfaces should be avoided. Icing immediately after exercise should also be done to control inflammation.

A physician should conduct a thorough evaluation of the training schedule, training surface, shoe gear being used and the biomechanics of the foot and ankle. If a biomechanical fault is found in the lower extremity a custom foot orthotic could help eliminate the fault and reduce the pain.

Leg Length Discrepancy

Another common problem that has been encountered are leg length discrepancies. During our evaluation, we can determine whether this is a functional or structural problem or combination of both. With a length discrepancy an athlete could experience pain in the knees, hips, lower back and neck. These difficulties and biomechanical faults can easily be accommodated with custom-made orthotics.

Turf Toe

Turf Toe is an injury that can occur in all types of athletics. The injury occurs when there is excessive motion behind the big toe which causes the tendon and ligaments of the first metatarsal phalangeal joint to become disrupted. If this injury is not addressed it can lead to a severe limitation of motion, fractures and early arthritis. This also can be treated with a functional foot orthotic with long term excellent results.

Other Injuries

Back and knee pain, ankle sprains, strains, instability and metatarsal issues can also be treated with foot orthotic therapy.

Case Study

In February 2007, Drew Stanton, a quarterback from Michigan State, was referred to Footcare Express to seek treatment for a persistent foot problem. A thorough examination was performed and functional foot orthotics were created to control his foot and accommodate his pain. With the orthotics in place Stanton was able to achieve the fastest time for a quarterback in the 40-meter dash at the 2007 NFL Combine. Stanton was later drafted to the Detroit Lions in the 2007 NFL Draft.

No matter your status on the playing field, it is important that you take care of your feet and not neglect clinical biomechanical problems. It is especially important that the coaches and parents of youth athletes understand the symptoms of sports related injuries.

As athletes improve performance and maximize efficiency, they rely on sports medicine to surpass their performance thresholds. Custom foot orthoses are increasingly making their way onto professional and recreational playing fields as sports medicine is focusing more on biomechanics and kinesthetic awareness to prevent and treat lower extremity injuries. When properly prescribed, foot orthoses can enable the body to work to its potential. Once an athlete’s entire system is in balance, he or she should notice improved performance and enjoy lower risk of injury.

Helping Diabetics Manage Their Foot Care Needs

Preventing foot problems is essential for both children and adult diabetics, according to Harold Reinhartz. D.P.M, a podiatrist with 29 years experience. Regular examinations, proper foot care, and properly fitted shoes are fundamental needs for diabetics to reduce the risk of bleeding sores, ulcers and hard-to-treat infections.

Diabetes is a chronic disease that will cause more than 178,000 deaths in the United States this year, according to the American Diabetes Association.

“Diabetes accounts for 50 percent of all non-traumatic amputations of the lower extremities,” says Louis Chaykin, M.D., a leading Miami endocrinologist and former president of the American Diabetes Association/Florida Affiliate. “At least half of the 50,000 amputations that occur annually as a result of diabetes complications could be prevented by appropriate footware.”

While physicians expect the current 16 million diabetics in the United States to double in the next 30 years, researchers have made relatively little progress in treating the disease since 1921, when insulin injections first began.

That makes preventive care even more important, says Dr. Reinhartz, who is a co-founder of Footcare Express, a Miami store specializing in prescription foot orthotics, custom shoes and foot care products. “Diabetics are apt to have serious problems with their feet, especially when blood circulation or nerves are impaired,” he says. “When blood circulation is poor, the tissue in the foot is less able to fight infection and to regrow skin over a wound. If the nerves to the foot are impaired, an injury can occur without pain and may go unnoticed.”

Dr. Reinhartz said a recent survey of diabetic patients at a Veterans Affairs hospital found that 50 percent had circulation and nerve damage, plus some type of foot deformity.

Charles Adler, D.P.M., a board-certified podiatrist who is chief of podiatry at Columbia Aventura Hospital and Medical Center and president of the Dade County Podiatric Association, says it’s very important for diabetics to wear the right shoes and orthotic devices. “Young and healthy diabetics with good circulation can use functional orthotics to prevent future problems. Older diabetics, especially those with calluses, corns or hammertoes, should use soft orthotics to offload pressure from those areas.”

Footcare Expess the nation’s first “one-stop footshop,” uses a high-tech approach to correcting foot problems in diabetics. After a physical examination of the foot, a computerized gait analysis is performed using the new F-Scan equipment Paper-thin, disposable sensors are placed in a person’s shoes to show the reactive forces between the foot and footwear as they occur. Next, a video motion analysis is used to study the person’s gait while walking or lightly jogging on a treadmill. Finally, a laser scanner generates a three-dimensional computerized image of the feet showing any pressure points or potential problem areas.

Our experienced technicians then design and fabricate foot orthotics to prescribed specifications, using an on-site CAD-CAM laboratory to make custom-fitted devices in about an hour.

Footcare Express also sells compression hosiery, special lotions, special extra-depth shoes, diabetic socks, insoles with magnets to increase circulation and other foot care products for diabetics to prevent chafing and protect the skin. For example, Footcare Express sells special Juzo compression hose for diabetics that provides support from the toes all the way up the leg.

“Diabetics should always check their shoes and socks to make sure nothing is sharp or rubbing,” says Kustra. “It’s a good idea to check the bottom of the feet at the end of each day. Use a mirror if necessary.”

A diabetic can come to FootLabs to identify pressure points on the foot where sores or ulcers might eventually arise, and determine how well the feet are functioning biomechanically. “We can then provide an over-the-counter device or an accommodative orthotic to prevent that person from having problems later on,” says Kustra. An accommodative orthotic is a soft and flexible cushion that supports and protects the foot.

The federal Medicare program reimburses diabetics for one special pair of shoes and three sets of inserts per year, says Reinhartz. A prescription and a note from the doctor are necessary. For diabetics covered by private insurance companies, Footcare Express can provide a letter of medical necessity.

Since cuts, scrapes, blisters and puncture wounds are part of childhood, diabetic children should always wear some kind of footwear, says Dr. Reinhartz. If splinters become lodged in the foot, or if an infection or puncture wound occurs, the child should be treated promptly by a professional.

As children grow, the shape and structure of their feet changes. That means a regular evaluation is important to identify and correct potential problem areas.

Poor circulation is a chronic problem in persons with adult- onset or Type II diabetes. Chronically tired or painful feet, along with symptoms such as numb, tingling, cold or blue feet or swelling that will not go down indicate poor circulation. Cramping may occur at night, during rest or while walking a short distance. Smoking, caffeine and stress usually increase the severity of these symptoms.

“Diabetics who suffer from these symptoms may benefit from properly fitted shoes or custom orthotics,” says Dr. Adler. “For example, cramping and fatigue may occur because the bones in the foot are not aligned correctly to propel the body forward when walking. These types of biomechanical problems can be corrected easily.”

Diabetic neuropathy can cause a person to lose the ability to feel pain, heat and cold in the foot. Protective footwear is especially important in these cases, since a small cut, a splinter, or a bruise may not be noticed until a serious infection occurs.

Many diabetics also suffer from dry skin, which may lead to itching, fissures and cracks in the skin’s surface. Moisturizers and lubricating creams may help prevent problems from developing, according to Dr. Reinhartz.

“If you have diabetes, you should have your feet examined at least yearly to determine the level of risk for foot ulcers,” he says. “At Footcare Express, we work closely with physicians to provide the right footwear and assure a high quality of life for diabetics.”

Recommendations for Diabetics

If you are a diabetic, the American Podiatric Medical Association recommends:

• The shoes should always fit properly.
• The widest part of the shoe should match the widest part of your foot.
• The shoe should fit the natural outline of your foot and be snug, but not tight.
• The shoe should have a firm heel counter to keep the foot in place.
• The heel should give a wide base of support.
• The toe area should be round and high to allow space for toe deformities.
• The upper portion of the shoe should be soft and flexible.
• The lining should be smooth and free of ridges, wrinkles or seams.
• New shoes should be worn for short periods of time until they are broken in and comfortable.
• If you have a deformity, you should wear special shoes or have an accommodative orthotic prescribed for your shoes.

Podiatrist Advises Foot Screenings For Growing Children

When Richard, a 10-year-old boy, injured his ankle sliding into second base in a Little League game, he didn’t complain about the pain. But three weeks later, his parents saw that Richard’s foot kept turning inward, and brought him to Harold Reinhartz, D.P.M., a podiatrist with 29 years experience and co-founder of Footcare Experss, a Miami store that specializes in functional foot orthotics, custom shoes and foot care products.

“Richard had stretched his tendon enough to weaken the ankle,” says Dr. Reinhartz. “His ankle was getting weaker and weaker. Left untreated, he would have developed devastating leg, knee, ankle and back changes over the years. But thanks to functional foot orthotics and physical therapy, he’s fine.”

Parents take their children to the dentist to have their teeth checked. Vision and hearing screenings are done in school. But it’s rare for children to have their feet examined, says Dr. Reinhartz.

Yet, a brief screening by an experienced podiatrist using a computerized gait analysis combined with video-motion analysis — the process followed at Footcare Express — can detect problems with the bones of the foot, the surrounding muscles or the way a child is walking — before they become more serious.

“I feel that foot screenings are extremely important for both children and their parents,” says Dr. Reinhartz. “Many children’s gait problems are easily correctable with properly prescribed foot orthotics by a licensed podiatrist.”

The consequences of ignoring a difficulty with the foot vary with the individual and nature of the problem, Dr. Reinhartz says. “An untreated tight Achilles tendon, for example, puts excess pressure on the foot, which eventually can lead to deformities. Other types of foot problems can cause back, hip or knee problems, because the way a person walks affects the whole muscular skeletal system.”

Preventing problems with a functional foot orthotic — a customized device inserted into the shoe to relieve pressure points, support the foot more effectively and assure proper alignment of the feet, ankles, knees and legs — usually lets a child walk, run and play with more energy, while reducing the risk of injuries.

Dr. Reinhartz advises parents to watch for these early warning signs of foot problems:

• Chronic ankle sprains
• Frequent muscle cramps
• An ankle that turns in when walking
• Knees that turn in or out when walking
• Curly toes or deformed toes
• Clumsiness
• Differences in symmetry between the feet and legs
• A child who wants to be carried
• Abnormal sitting positions
• Family history of foot problems
• Child’s history of foot problems
• Heel pain, especially in children age 8 to 12
• Broken-down heel counters
• Inside or out toe walking
• Frequent fatigue during or after walking
• Persistent pain, swelling, redness, blisters or bunions
• Lateness in starting to walk (12 months or longer)

“Most children don’t complain about their feet,” Dr. Reinhartz says. “So as a parent, you have to be alert for other symptoms and observe whether or not the child exhibits a limp. And if a child starts complaining, you know there’s a problem that requires attention.”

Boston Red Sox Sports Orthotics

Mike Reinold
Boston Red Sox
Director of Rehabilitation/
Assistant Athletic Trainer

“I have enjoyed working with Jarett and Footcare Express for all my orthotic needs. They offer an exceptional product, but more importantly stand behind the quality of their orthotics and strive to exceed my expectations.”

Read More Testimonials about Footcare Express Services, Custom Foot Orthotics and Foot Care Products

Sports Orthotics for Boston Celtics

John Hester, DPM
Team Podiatrist for the Boston Celtics

“It is important for me to able to communicate with a custom foot orthotic laboratory that can understand my patient needs and be able to provide the type of devices that can deliver positive clinical outcomes. I have been impressed with Footcare Express’s quality products and excellent customer service”

Read More Testimonials about Footcare Express Services, Custom Foot Orthotics and Foot Care Products

Drew Stanton NFL Quarterback

Drew Stanton
NFL Quarterback, Detroit Lions

“To Footcare Express…Thanks for getting me back up to speed so fast”

Read More Testimonials about Footcare Express Services, Custom Foot Orthotics and Foot Care Products

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