Arch Support Question

Question:
Hello Dr. Mutschler,

I have very wide, flat feet and have been diagnosed with plantar fascitis in both feet. I was told to purchase a quality arch support and came across your website. I’m very interested in purchasing a pair of arch supports from your on line store but was hoping for a recommendation on the type I should buy. I like to hike and was wondering which type (running, basketball, soccer etc…) of Athletic Custom Arch support you would suggest best meets my needs or would I be better off buying the Express Correct Custom Arch support? I’m 5 foot 9 and weigh 205 lbs and I’m a 44 year old male. Thank you so much for your help! – B

Answer:

B,

Thank you for your interest in Footcare Express.

Our $99 product is considered a semi-custom device. At Footcare Express, we have a library of engineered shells that are used to match the length, width and arch height of your foam cast impression. The $199 product is a completely custom-made arch support designed and fabricated from your foam cast impression. These custom arch supports are manufactured using a variety of different materials based on discomforts, activity, use, etc. (Cast Foam Impressions are provided once purchase is made)

In either case, the materials are durable. The life expectancies for any of our products really depend upon the amount and type of usage. We have had customers and patients replace their custom devices yearly, while others have gotten much longer “life”. Softer materials can wear and will wear out quicker. In most cases, each of these products can simply be refurbished without having to fabricate an entirely new product. Refurbish fees may vary.

I hope you find this information useful. Should you require any further assistance, please do not hesitate to contact us again.

Sincerely,

Charles A. Mutschler, DPM

Medical Director
Sincerely,
Customer Service Team

Foot Orthotics Comparison

Question: I’m interested in full length custom orthotics to put in hiking boots for hiking in the mountains.  I have plantar fasciitis in one foot.  What is the difference between your $99 model and $199 model?  What are the life expectancies?  Thanks.  – Mark

Answer: Our $99 product is considered a semi-custom device. At Footcare Express, we have a library of engineered shells that are used to match the length, width and arch height of your foam cast impression. The $199 product is a completely custom-made arch support designed and fabricated from your foam cast impression. These custom arch supports are manufactured using a variety of different materials based on discomforts, activity, use, etc. (Cast Foam Impressions are provided once purchase is made)

In either case, the materials are durable. The life expectancies for any of our products really depend on the amount and type of usage. We have had customers and patients replace their custom devices yearly, while others have gotten much longer “life”. Softer materials can wear and will out quicker. In most cases, each of these products can simply be refurbished without having to fabricate an entirely new product. Refurbish fees may vary.

I hope you find this information useful. Should you require any further assistance, please do not hesitate to contact us again.

Sincerely,
Customer Service Team

Extracorporeal Shock Wave Therapy in Miami Florida

Extracorporeal Shock Wave Therapy (ESWT) or Extra Corporeal Activation Technique (EPAT) in Miami Florida

Footcare Express of Miami, Florida, provides to its patients a breakthrough solution to alleviate pain in the feet.  This non-invasive procedure in which shock waves are used is known as Extra-Corporeal Shock Wave Therapy (ESWT) or also known as Extra Corporeal Activation Technique (EPAT).

This procedure has been used to treat over 2.5 million patients. This 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.

This treatment is performed when a therapeutic flow of energy is transferred directly to the ailing area through a handheld applicator used by the physicians at Footcare Express. This highly effective treatment may yield complete results after 3-4 sessions, each lasting less than 5-10 minutes and scheduled 7-10 days apart.

At Footcare Express, our goal is to help you conquer pain as we have done for professional athletes all over the country. We understand how frustrating it is when you have tried everything from multiple steroid injections to medications, splints, braces, strapping, taping with little to no relief. Extracorporeal Shock Wave Therapy (ESWT) or Extra Corporeal Activation Technique (EPAT) is the non-invasive solution for conditions not helped by anti-inflammatory or immobilization devices.

What are the benefits of ESWT or EPAT for you?

No surgical risks, no downtime, no time and money wasted on treatments that don’t work. Extracorporeal Shock Wave Therapy or Extra Corporeal Activation Technique (EPAT) is proven, effective pain relief and the healthcare professionals at Footcare Express are here to help you with your pain or injury.

ESWT or EPAT offers PAIN RELIEF & RESTORATION of MOBILITY in:
•    TENDON Injuries
•    LIGAMENT Injuries
•    MUSCLE Pain
•    Delayed BONE Healing / Stress Fractures
•    JOINT disease such as Osteoarthritis

Contact us to schedule an appointment or learn more about ESWT or EPAT therapy NOW! Phone: 877.687.3338

Platelet Rich Plasma Therapy

Footcare Express Integrates Platelet Rich Plasma Therapy

The medical staff at FootCare Express is pleased to announce the integration of Platelet Rich Plasma therapy to promote faster healing of soft tissue injuries.

PRP received a lot of Publicity after Pittsburgh Steeler star Hines Ward used the therapy to recover from a nagging knee injury in time to help the Steelers win last year’s Super Bowl. This was not the first use of Platelet Rich Plasma therapy but it certainly created quite a buzz.

The medical community has begun widely using PRP as an alternative to surgery to help in many conditions. The theory is this a patients own blood is used and the platelets are separated in a centrifuge. Once the blood components are separated, the patients own plasma with a high concentrations of platelets is injected into the injured area. It is believed the Platelet Rich Plasma Injection will stimulate healing in conditions such as arthritis, plantar fasciitis, tennis elbow, knee problems, and the strengthening of damaged tendons.

In a nut shell, Platelet Rich Plasma Injections of one’s own platelets have characteristics which encourage the natural healing process. When high concentrations are placed into a specific area, the healing process shows extraordinary results.

A major advantage of this therapy is the low incidence of rejection because the platelets belong to the patient being treated. The reason this is done by direct injection is because most injuries the therapy targets are located in areas with little blood flow, or at least not enough to carry the concentrated platelets to the points they are most beneficial. So their has been minor irritation reported at the injection sites but the results of PRP therapy for outweigh the mild discomfort which may be experienced.

For a detailed discussion of Platelet Rich Plasma Therapy watch the video below, or Call Footcare Express to discuss your treatment options with our medical staff.

IMPACT GEL INSOLES – Billy Mays Pitchmen and IMPACT GEL INSOLES

IMPACT GEL INSOLES – Billy Mays Pitchmen and IMPACT GEL INSOLE
ARCH SUPPORTS

So now that we have all seen Pitchmen on The Discovery Channel and watched Billy Mays and the impact guys smash and squash the impact gel insoles with a hammer and an automobile, what’s your take on Pitchmen?

We were quite sure the impact gel insole material would hold up to any test the Pitchmen carnival barkers could throw at it, but we don’t want anyone out there to think that just because a couple of stooges like the Pitchmen put impact gel insoles on an info-reality show means the product is not legitimate.

The impact gel insoles were featured on Pitchmen because they needed a great product that people would want to buy and our medical professionals are here to tell you exactly why the impact gel insoles are worth every penny.

The Impact Gel material is also utilized by our medical experts when prescribing and designing custom functional and accommodative foot orthotics for their own patients.

The Impact Gel material’s amazing ability to redistribute energy is perfect for incorporating the material into areas of the custom device whereby the foot requires specific and /or additional accommodation.  This can include padding for problems such as Plantar Fasciitis, Heel Spurs, AchillesTendoniitis, Shin Splints or Metatarsal relief.

Impact Gel Insoles can also be used to help reduce the shock at heel strike that may cause knee, hip, and backpain.  The outcomes have been extremely positive.

Foot Care is the most important thing to us here but Television runs a close second. Well that’s not really true. We are fitness buffs, but when a hot new show like PitchMen is premiering on the Discovery Channel and one of our products is featured, we suddenly become interested.

So make sure you tune to PicthMen Sunday morning at 11am and watch Billy Mays put our Impact Gel Insoles to the test. He actually loves the product and has taken his act to the Tonight Show with Jay Leno and was literally a smash.

PitchMen is a show that promises to put all the claims of “As Seen on TV” products to the test and most won’t fare to well. However, Impact Gel Insoles are a great product used by the leading Podiatrists and Podorthists around the world. In fact, at FootcareExpress we are one of the few companies that feature the same material in our custom foot orthotics as well having a full range of the Inpact Gel Insoles you will in action on The Discovery Channel Tonight.

It’s not our fault that Television has discovered how great Impact Gel Insoles are, and please believe us when we tell you that this is no Inside The Egg Scrambler.

Choosing the Right Orthotic

How to Choose the Right Prefabricated Orthotic

There are many different types prefabricated arch supports and inserts to choose from in today’s marketplace. Each of these over-the-counter products promises to be “band-aids” and relieve pain and discomfort for foot, knee, leg, hip and back pain. The balancing act here is the middle of the road individual who requires cushioning but some support. In these instances, fit and feel is always the best litmus test. This is the trial and error of the prefabricated arch supports and insoles. A person must know how they feel the most accommodated, whether it is a high arch they need or a low arch or whether they feel more comfortable with lots of cushion or hardly any at all. And then there are the multiple combinations of all of the above that are commonly found in stores and available to consumers.

Therefore, it is important to know your foot type when choosing the correct prefabricated arch support or insert. Some of these products are firm or rigid where others are soft or flexible. Individuals who have flat and flexible type feet are generally more comfortable with products that provide some type of arch support. Flat feet normally tend to be due to overpronation, which may be a case where the foot is absorbing too much shock and lacking support. The pronated foot is one in which the heel bone angles inward and the arch tends to collapse. A “knock-kneed” person has overly pronated feet. This flattens the arch as the foot strikes the ground in order to absorb shock when the heel hits the ground, and to assist in balance during mid-stance. If habits develop, this action can lead to foot pain as well as knee pain, shin splints, achilles tendinitis, posterior tibial tendinitis, and plantar fasciitis. Prefabricated arch supports and insoles for these types of persons are usually designed with some firmness in the arch area of the foot to provide some support and stability in the arch area of the foot.

In contrast, Individuals who have high arch and inflexible feet are more comfortable with products that provide mostly cushion. These types of feet are generally more rigid and tend to be more supinated. Supination (or underpronation) is the insufficient inward roll of the foot after landing. This places extra stress on the foot and can result in iliotibial band syndrome of the knee, Achilles tendinitis, plantar fasciitis. Usually, a person who has a very high arch foot lacks that ability to absorb shock, therefore, they are more comfortable with products that are much softer and provide more cushioning.

The above should be used as a guide. Prefabricated arch supports and insole use with different footwear can also be a factor. It is always best to consult with an expert for the most appropriate product for the best results.

PitchMen Premiers on Discovery Channel With Impact Gel Insoles

PitchMen on Discovery Channel

Foot Care is the most important thing to us here but Television runs a close second.  Well that’s not really true.  We are fitness buffs, but when a hot new show like PitchMen is premiering on the Discovery Channel and one of our products is featured, we suddenly become interested.

So make sure you tune to PicthMen tonight and watch Billy Mays put our Inpact Gel Insoles to the test.  He actually loves the product and has taken his act to the Tonight Show with Jay Leno and was literally a smash.

PitchMen is a show that promises to put all the claims of “As Seen on TV” products to the test and most won’t fare to well.  However, Impact Gel Insoles are a great product used by the leading Podiatrists and Podorthists around the world.  In fact, at FootcareExpress we are one of the few companies that feature the same material in our custom foot orthotics as well having a full range of the Inpact Gel Insoles you will in action on The Discovery Channel Tonight.

It’s not our fault that Television has discovered how great Impact Gel Insoles are, and please believe us when we tell you that this is no Inside The Egg Scrambler.

Our First Steps – Flat Feet

I often hear people tell me that they have the “flattest feet” or their feet are “flat as a board”. In truth, the only people that truly have normal “flatfeet” are infants.

Flatfoot may be defined as an absence of the arch upon standing or walking. It is often associated with excessive inward “rolling” of the foot known as pronation. It is well accepted that children under the age of 7-10 years normally do not possess a significant arch or one that resembles the average adult foot. James Losito, D.P.M., Professor of Biomechanics at Barry University and a team physician for the Miami Heat, University of Miami and Barry University Intercollegiate Athletic Programs and Medical Director for Pro-Tech Sports Medicine, has had lots of experience with care of common pediatric pathologies. ” It is for this reason, that pain and function be emphasized rather than the cosmetic appearance of the foot when determining if a child’s foot is abnormally flat,” says Dr. Losito.

Dr. Losito states that a history of fatigue, cramping, pain, excessive shoewear or “sloppy” gait are the most reliable indicators that an abnormality is present. Several different causes of flatfoot exist including, ligamentous laxity, tightness of the Achilles tendon (equinus), muscular weakness or spasticity, and pigeon-toed gait. In the adult, excessive pronation (flattening of the arch) may produce many problems including tendinitis, fascitis, shin splints and stress fractures. Therefore, treatment of a symptomatic pediatric flatfoot should not be ignored. In some cases, treatment such as muscular strengthening or stretching is the key to improving the flatfoot condition. However, in many instances a functional orthotic device may be used in conjunction with exercises or used alone.

For example, children who walk pigeon-toed (intoed) or slew-foot (out-toed) suffer from severe pronation (flattening of the arch) as compensation during gait. A functional foot orthosis helps prevent the excessive pronation, which can lead to a structural flatfoot. In those children who trip, stumble or are clumsy, the orthotic can be fabricated to reduce the degree and severity of the abnormal gait pattern.

Children who suffer from equinus, defined as a tight Achilles tendon almost always suffer from excessive pronation and a flatfoot. This requires rigorous stretching exercises or surgery to eliminate the abnormal force creating the flatfoot. Functional foot orthosis are useful in eliminating any residual pronation and supporting the foot if any permanent structural changes have occurred.

Shoes and functional foot orthosis are not necessary for normal development of the child’s foot. However, when the aforementioned symptoms are present, functional foot orthotic devices are a proven and successful option that families can benefit from to help correct and prevent future problems.

Neuroma Pain: A Common Problem

Neuroma pain is typically described as a burning, tingling pain of the forefoot and toes.  It can also be felt as an aching or shooting pain in the forefoot.  Patients with this problem commonly state that it feels like they are walking on a pebble under their forefoot.  The patients usually state that removing their shoes and massaging the forefoot relieve the discomfort.   The pain that is present is usually present following a long period of standing, walking, or running.

A neuroma is formed by an enlargement of the sheath surrounding a nerve that runs between the metatarsal bones in the forefoot (just behind the toes).  The most common location that this occurs is between the third and fourth metatarsals.  Neuromas may also occur between the other metatarsal bones also.  The reason that the neuroma is located in this area is that the nerve running between the bones divides here and has two branches one going to each of the toes in front of the metatarsals. It is a chronic inflammatory process that causes the enlargement of the nerve sheath.

A common cause of a neuroma is wearing shoe gear that is too tight.  Another common cause of neuromas can be pronation (turning out of the heels) of the foot.  The pronation causes a rotation of the metatarsal bones, which can cause pinching of he nerve between the adjacent bones.  It is this chronic pinching by either tight shoes or rotation of the bones that causes the enlargement of the nerve sheath.  And as the nerve sheath continues to enlarge the pain continues to get worse for the patient.

Prior to seeing a podiatrist a patient may try some of the following to relieve their pain.  A patient should first evaluate their shoes.  If the shoes are tight, then the patient should replace those shoes with a wider shoe that does not squeeze the foot.  A patient may also check the laces on the shoes to make sure they are not tied to tight.  A patient may also try to get more supportive shoes that may stop some of the pronation that may be present and adding to the problem.  A patient may also choose to try some over the counter pain medication.

Upon seeing a podiatrist the patient should expect a thorough medical and biomechanical evaluation.  After the evaluation the podiatrist can treat the neuroma several different ways.  Conservative treatments consist of placing pads under the forefoot to take the pressure off of the areas as well as to try and spread the metatarsal bones.  These pads can be placed in shoes by themselves or incorporated into a custom orthoitc.  The custom orthotic is also designed to control the pronation that may be present.   A podiatrist may also want to inject the neuroma.  A steroid injection is sometimes utilized to try and stop the inflammatory process that is occurring and causing the pain.  Another option is that the podiatrist may try sclerosing the nerve with an alcohol injection.  The goal of the sclerosing is to shrink the enlarged nerve sheath.  It may a series of several injections prior to seeing any improvement.  Finally if all the above treatments have not relieved the patient’s pain the podiatrist may choose to surgically remove the neuroma.

Neuromas are a problem that effect many patients.  It is a problem that usually responds to conservative treatment, but in some situations surgical removal is necessary.

What is a Functional Foot Orthoses?

What is a functional foot orthoses? By definition, a functional foot orthotic is a device that is contoured to the entire foot and used to reduce abnormal motion or abnormal position of the foot. A functional foot orthoses is also used to control the abnormal motion or abnormal position of the lower extremity that is affected by the position and/or motion of the foot.

Custom functional foot orthotics are essentially shoe inserts that may be prescribed by a Podiatrist, Orthopedist, Chiropractor, or any other health professional with a background in biomechanics. They are specifically designed devices that are worn inside the shoe to control abnormal foot function and/or accommodate painful areas of the foot. They can provide stability for the foot and correct injury-causing imbalances. This may result in a dramatic improvement in foot symptoms and efficiency. Other arch supports and insoles may be considered foot orthotic devices, however, they do not have the same corrective properties as a functional foot orthotic. For a professional to prescribe a functional foot orthotic, they must take a medical evaluation and perform a comprehensive biomechanical examination. It is important for the doctor to take angles of measurement, including structural and functional discrepancies in leg length, ranges of joint motion and evaluation of muscle activity. FootLabs goes one step further with the ability for the prescribing physician to analyze gait through video and computerized gait analysis.

A functional foot orthotic helps to control the movements of the foot known as pronation or supination. Pronation occurs when the heel bone angles inward and the arch collapses, while supination is the opposite. Supination and pronation are a normal part of the gait cycle. They allow the foot to absorb shock and adapt to uneven surfaces. However, too much of these motions may cause injury. Many problems with the feet, legs, knees and hips are caused by excessive pronation or supination. Orthotics may prevent injury or deformity from occurring or halt the progression of existing problems and allow healing to occur. If you suffer from sore hips, knees, shins, arches or metatarsal bones, you may need orthotics. In fact, most everyone can benefit from some type of orthotic. They are very useful in optimizing performance and enhancing comfort for athletes.

Functional foot orthotics can be made from an impression of your foot that capture the contour and alignment of the foot. A mold is generated from the impression and is modified to compensate for angular differences between the forefoot and heel, which can lead to excessive foot motion. A thermoplastic material is either milled or molded to the shape of the corrected impression and this becomes the orthotic. Once the orthotic is formed, various materials can be formed to the form to fabricate an orthotic device that is created according to certain specifications.

Foot orthotics are prescribed for many people including children up to the elderly for various pains and symptoms resulting from a biomechanical foot fault. From the sound of this, one might conclude that these types of foot orthotic devices are a medial necessity, considering the fact that no one has a perfect gait or walk. At Footcare Express, we strive to educate people as to the importance of a proper biomechanical examination and foot care. Our facility is accredited by the PFOLA (Prescription Foot Orthotic Laboratory Association). The PFOLA is the highest recognized certifying body for evaluating orthotic laboratories that produce functional foot orthotics. Footcare Express has been active with other larger wholesale accredited laboratories in the country, to come up with a set of criteria that can assist various insurance companies, physicians, and health organizations in recognizing the need for such medically necessary devices.

It is an educational process. Anyone who wears a functional foot orthotic can attest to their importance and how they have helped them become better and more efficient.

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