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Welcome to Foot Talk Fridays!

So, Tri-Step is a system for flat feet.

The foot has three arches and what we want to do is squeeze the transverse arch back up again and raise the arch and the lateral arch so that we can get the arch engaged. First of all, we want to get the forefoot contracted first, so we are going to use a couple of tapes on the feet (four pieces to be precise).

This is to get the fore to the mid foot corrected. We start by putting these neuromuscular tapes on to the foot. They adhere to the skin with hypoallergenic glue and the glue also does not cover the tape completely to allow the foot to breathe. When we squeeze the foot we’re making the foot stronger and tighter, bringing the transverse arch together. And then we can anchor it in place like this.

This tape can be used on the toe if there is a bunion, or it can be used underneath the ball of the foot to help pull the fat pad back down underneath the bones. This is particularly good when somebody has pain underneath the ball of their foot here. Now, that is the forefoot held in place so that the metatarsals through here can come together.

Now what we want to do though, is to engage the medial arch and the middle of the foot arch here. So, how do we do that?  We’re going to use one of these shaped pads called ‘Foot Arch Formation.’ First of all, we are going to apply it by peeling back the paper on to just the forefoot. Over the top of these pads here right up under the toes. Then we’re going to remove the rest of the paper and we ask the patient to point their toes down like this. Then, we stick it to the outside of the foot and bring each tab up the back of the foot like this. 

Now, we have the arch pointed at its highest position and the last thing we do is really lift and pull. As you can this person has a fantastic transverse arch, excellent lateral arch and magnificent medial arch when before the foot was flat. So this holds the foot in the place to help the ligaments contract.

The next step we would do when the patients wearing this every day for 2-6 weeks, is they would also wear an orthotic or insole that helps to lift the foot, keep the arch up, and keep the transverse arch up as well to give structural support and this addresses the bones, this addresses the ligaments. 

I’ll just show you one more time on the other angle of the foot. We anchor it to the first metatarsal, squeeze the foot laterally like this to make the transverse arch pick up, and then we’re going to use the other twin pad on to the side of the foot and squeeze the foot to hold it together. Then, we’re going to use the anchor tape to help those two like this on to the side of the foot – this engages the transverse arch which is really important, especially for cyclists. And now we’re going to use another anchor pad to bring that fat pad back down to where we want it to be. There we go, perfect! Now what we’re going to do is just use the next pad as I showed you before, up underneath here to engage the medial and middle arch as well. So one more time we peel the paper away and stick it underneath the toes like this. Then we can take the rest of the paper away. We stick it to the outside first like this and then we bring all the other tapes around the back of the foot. And then from the top here you can see the arch now is already beginning to form and now we’re really going to pull this arch right up like this. So, this flat foot has quite an incredibly high arch now and is very powerful when it is all held together. They would wear this all day every day from morning until evening. At night time, remove it so that they have no sweat buildup on the foot and let the fresh air get to the foot. 

To use the EMS devices, we just peel off the backing here and you can put it along the inside of the foot to work the arch or you can put that across the foot here to work this part of the foot. So for now, we’re going to put it across the mid foot, then switch the device on. We can increase the intensity of the electro-muscle stimulator by pressing the plus (+) button. We’re going to keep on increasing it until the foot starts to move. You can see the foot beginning to contract. So, the foot is contracting and pulling downwards because it is making this muscle here contract. That will hold it like this for 20-30 seconds and then it will release then contract again. 

So, you can see that this simple sticky patch is more than strong enough. It is not even at its maximum effect on this area here. If we want to switch the machine off, we press the minus (-) button. Now the machine goes off and the toes goes back to being relaxed. Therefore, no electro-muscle stimulation happening. 

If we want it to use on the inside of the foot, we remove the sticky gel and put it on the inside of the arch muscle here, then switch it on. Now, we’re going to increase the intensity. Here, we have level 9, and we can make it go to 10 to contract the big toe. This really works on the muscles of the feet and send signals to the brain to tell the foot to wake these muscles up as well. You can also help by contracting your foot as well and helping to scrunch the arch muscle to get even more out of this. I am going to switch it off now just to relax the foot again. 

Now, we’re going to move to a stronger machine because some extreme flat feet do not have enough muscle for this level to work on. So, we would use a much stronger electro-muscle stimulator device, but we would check that in the clinic which one you would need, and we stick it on the insides of the foot on the arch. This is to make the arch muscle work. Then, we switch the machine on. We already have it entered at a specific program that we want to use at channel 1, and we’re going to increase the intensity on channel 1 until we see the toe beginning to move.

It’s making the muscle (tick, tick, tick, tick) and move almost like doing sit ups on this muscle here. You can even see the muscle moving along the inside of the skin here as it really contracts the muscle and helps to build arch. This is at level 23, it depends on the level the intensity that the patient needs. Everybody’s different, the weaker the muscle, the higher the intensity needs to be. And you would leave this for 30 minutes to let the muscle stimulation program work. And then we switch it off by pressing that button.

If we want to use it in a different position, we just remove the little bit of gel sticker that’s on the foot and place it on a different area on the foot. This gel sticks well to the foot and can be tickly when we remove it. 

So, say we want to work on the transverse arch across the foot we can use it in this position as well. It is already set to everything that we want it to be, and we’re going to increase and see how fast these muscles will start to contract and work. Now, we see the toes begin to twitch. We increase the intensity and now we’re really beginning to see these two toe twitch. The first one is beginning to twitch as well. So that’s the intensity, now all the muscles are beginning to work and that works the muscles across the foot here. You can increase the intensity depending on what feels comfortable for you and what doesn’t feel comfortable. For this person, this is a nice and strong pulse.

[Showing the Tri-Step System box]. So, the Tri-Step System lifts arches. But just like braces for the teeth and adjusting the braces, we also adjust the height of these orthotics as we go along with it. So we start off minimal, then medium-strong, finally very strong, and then go back to medium-strong again. These are the collection of tapes that are all in here, there’s a full batch in here that last 2 weeks for both feet. And these are the electro-muscle stimulators that I have been talking about. 

For appointments and other queries:
Call: +971 4 3435390
WhatsApp: +971 50 331 4978

 



Subtitles:

Welcome to Foot Talk Fridays!

Today we’re going to be talking about swelling in the feet and how to make it better using things that look like this which is what we call a foot bath shoes.So, I want to show you today how to use foot bath shoes. These are about 10 dirhams from Daiso and these are absolutely fantastic. You don’t wear them like shoes, what you do is you fill them with water and then you have a little bath with your foot. The reason I like these is because they save on water and they save on medication. What I mean by that is, say you have a foot injury or you have swollen feet, or something like that and you want to soak your feet.

When we ask you to use Epsom salts for example, they are absolutely fantastic with warm water to use for your feet, but you would have to use this much water (5 litres). Then you would need to use five hundred grams of Epsom salts which is quite a lot just for one foot bath and that’s a lot of wastage in my opinion. So this is to save your Epsom salts (not that it is expensive – about 40 dirhams for 1 bag of Epsom salts) and conserve all of this water and medicine. These little 10 dirham shoes from Daiso, if you fill them with water (fill to this mark here with 500 milliliters = 1 small bottle of water). Also, you would only need to use this much Epsom salts instead of this much Epsom salts.

So, if you have a foot injury such as a bruise to your foot or swelling or something like that, you would put warm water in to these and you would use your Epsom salts.

Now, if you only have one foot with the foot injury you would fill up one of these with the warm water with Epsom salts, and you would soak your foot in it for 30 seconds. After 30 seconds you would remove your foot from the warm water and then you would put your foot in to cold water for 30 seconds. The warm water brings oxygenated blood from your heart and lungs straight down to your feet. The cold water then shrinks the blood away from your feet.

Then, we want to bring it back again. Now you’re going to put it back into the warm water with the Epsom salts for 30 seconds and again back into the cold. So you’re going to repeat the cycle (warm-cold, warm-cold, warm-cold, warm-cold). You are going to repeat it 30 seconds for each time for five repeats. And that really helps foot injuries to get better faster and is relatively cheap to do – just take some water, some Epsom salts, (only use the Epsom salts in the warm water, you don’t need to use it for the cold water).

So, that’s a great way to help your foot repair from any swelling, damage, trauma or ankle sprains, in your own house. If  you did it every evening and (it only takes 5 minutes to do it 30 seconds twice) that can really take the swelling down and help injuries in the foot repair. Obviously, if you have a cut, laceration or open wound, you can’t do this. You can only do this on skin that is intact, so that’s something to do at home yourself and one of the best ways to help injuries repair faster.

Enjoy your Friday!

For appointments and other queries:
Call: +971 4 3435390
WhatsApp: +971 50 331 4978


Subtitles:

Welcome to Foot Talk Fridays!

Today we’re going to talk about hard skin on feet and why you get to it, especially if you’re quite active and you exercise.

So, most of the time you get hard skin along the side of your toe (along this area) and around the heel area here. The reason why you get that is because imagine weight lifting calluses if you’re always weight lifting and you get hard skin on your hands, that is in reaction to friction. The reason that you get calluses along these areas (these are the areas that push off) when you’re really exerting yourself. The more active you are, the more hard skin you have around your foot. If you have it in unusual areas like in the middle of your foot or just off to the inside here, that has to do with this arch collapsing, that’s a

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different type of hard skin. If you ever have painful hard skin, that’s not good news but hard skin is an advantage, it’s your body working properly.

So if you have good sensation – then your body with friction feels a slight burn or twist of the skin and it will grow up thicker skin here and around the edge here to protect your skin. If  you have no sensation to your feet (neuropathy), that’s why we say where memory soled shoes, because with memory soled shoes it absorbs the foot. The reason for that is when you have no sensation and you have high pressure you can get an ulcer into the foot because the body doesn’t know how to defend itself with hard skin. So, whenever you have hard skin I always say to everybody “why are we removing? It will literally grow back tomorrow or the next day because it’s there for a good reason”. It’s there as you push-off on your foot. So (just like cleaning your teeth) you can file your foot slightly just a little bit to take off the excess, but we always want that stronger layer.

Now, there are times when we are not that active, for example, if you go on a summer holiday and you are not fitting in your exercise regime like you would normally do, you might end up with softer feet because you’re not doing as much activity. Or, it could be that you are doing more activity in summer, so you end up with thicker, harder skin during the summer holidays. It just depends when you’re active – expect to get hard skin. Don’t be disappointed if you go for a pedicure and it literally comes back the next day or so, that’s good, it’s an advantage – it is supposed to be like that.

Also, for example, if you’re not very active at all and you have hard skin. If you’re overweight, the extra pressure and exertion of your foot will cause hard skin around the ball of the foot and hard skin around the heel just because you’re heavier. So, if you’re not active and have hard skin, look at your weight, if your weight is on the high side you will get hard skin with that as well. I hope this was all useful.

Enjoy you Friday!

For appointments and other queries:
Call: +971 4 3435390
WhatsApp: +971 50 331 4978



  Subtitles: Welcome to Foot Talk Fridays! Today we will be discussing Plantar Fasciitis which is a very painful heel condition.  So, with plantar fasciitis the heel bone becomes inflamed and it’s because it’s a strong band of fascia that attaches from the heel to the forefoot. It keeps the integrity of the arch of the foot up, but if your arch is relaxing or dropping or your foot is beginning to lean in a little bit, then the plantar fascia will engage and pull taut. Where it engages into the heel bone becomes inflamed and it is actually the heel bone outer casing that becomes very painful, especially if you are sleeping or sitting for a long time you go to stand up then the heel bone is at its’ most painful. Then when you walk for maybe twenty steps it begins to feel a lot better. Unfortunately, during the walking and standing that you’re doing (while it feels better) the plantar fascia band is pulling on that part of the injured heel bone and it inflames it so that when you rest or sleep for a while the inflammation shows up. So, what we do to reduce plantar fasciitis is we lift the arch back up again and we tilt the foot a little bit until the ankle straight so the plantar fascia can go back to being relaxed and only engage when there’s an emergency (e.g. if you jump off of a wall, or jump off and landed with your feet quite strongly) the plantar fascia engages in those instances and soon engages all the time. All we do is put it back to its’ rested position so that the bones that attaches into gets better. Enjoy your Friday! For appointments and other queries: Call: +971 4 3435390 WhatsApp: +971 50 331 4978


Subtitle: Welcome to Foot Talk Fridays! Today we’re going to be talking about the Metatarsal area (pain in the ball of the foot, the forefoot). Metatarsalgia of the feet happens in the forefoot or the ball of the foot and metatarsalgia means anything that gives you pain along this metatarsal region. So, in the hand we have metacarpals that are quite short, and in the foot we have metatarsals which are quite long.  Now, these metatarsals are supposed to be arch-shaped in this kind of position here. The second, third and fourth should be raised a bit like a little rainbow, but commonly they fall forward. When they fall forward the peak of the arch can also drop, and this is what we call Metatarsalgia – it’s an umbrella term for pain anywhere in this area. So, it can give problems with heel pain if the metatarsal has dropped down, it can cause problems with any of these muscles which can be stretched. It can also cause problems with the metatarsal arch here. Like I said these bones should be in that position up and raised, they shouldn’t be flat like this, or dropped down negatively. If that does happen, in my opinion, (there are three metatarsal arches: the transverse metatarsal arch, the longitudinal arch and the lateral arch) this arch here is the most important that runs across from left to right behind the toes. If this arch drops it makes up this peak of this arch all the way underneath, so for me I always look for this arch to save the foot from any structural damage later on, so it is better to address this arch soon as soon as we see it dropping, or as soon as you get pain in the ball of your foot. If that happens, firstly, we can take a gypsy cast of your foot. This area here (if you look at the side profile) looks like a little half an egg, and it depends how much your arches are dropped to see how much we lift that part of the arch of your foot so it can be small like this one, or it can be quite large. If it’s larger we can push it further back to lift the dome of your foot as well. Also, sometimes we need to do some structural binding of the foot and that’s what we have all of these neuromuscular tapes or K-tape. These all have different strengths and different sizes and these are placed, for example, across the foot in a web position and that lifts and compresses the forefoot and lifts the middle portion up here, so that the metatarsals can all be aligned. Also, something interesting with the nerves. The nerves  have a double branch between the third and fourth toe, and this double branch of nerve can sometimes form a neuroma, or if all the metatarsals dropped down flat it can create neuritis which is inflammation of the nerves. Inflammation of the nerves is what we call Morton’s Neuritis and if you have a bundle of nerves (it is quite rare but it can happen) it is called Morton’s Neuroma and sometimes people called the Neuritis the Neuroma, but the Neuroma is quite rare. What we would do for that is we would try and open up the space in between the bones by lifting this area (where I’m pointing to) and that opens up the space to give the nerves more space to talk to the toes, otherwise these toes can go numb. So that’s what we do for Morton’s Neuroma, Morton’s Neuritis, collapsed transverse arch, Metatarsalgia. We use orthotics, foot binding and taping to constrict the foot as well, there’s also electro muscle stimulation that you can do to tighten these intrinsic muscles to keep the metatarsals in place also. Enjoy your Friday! For appointments and other queries: Call: +971 4 3435390 WhatsApp: +971 50 331 4978


Subtitles: Most of the patients that come to see us at Dubai Podiatry Centre complain about having a flat feet and in fact their feet are not flat in most cases even though when you stand and show and exhibit a flatfoot. Most of the reason the foot appears flat here is actually because the ankle joint here leans in and when the ankle joints leans in, it depresses and flattens these arch here. You can test this yourself by raising your foot off the ground and crossing your legs and if an arch forms you don’t have flat feet. But how can we help your foot to stay straight like this when you stand without the arch from dropping and what we have to do engineering wise is control this joint here. There is a bone in here called the talus bone, when the talus bone leans in and when it leans in causes the arch to collapse.Traditionally orthotics and insoles have been used to try and raise the arch of the foot. But now we know that in most cases the origin of the problem doesn’t come from here, it comes from the ankle so we make something exactly the shape of the foot and this is called a gyps cast, so we take a gyps cast to get the exact the shape of your foot so it should be extremely comfortable. But even if we make a fantastic insole or orthotic exactly the shape of your foot and you stand on it the foot will still lean in because the problem comes from your ankle joints. So what we have to do is we have to measure how many degrees your foot leans in. When we measure precisely how many degrees your foot leans in we count your balance that to tilt your feet straight. When we tilt the foot straight, the ankle joint from above also become straight. The ankle joints, ligaments on the medial and lateral sites start to tighten just like you do when you get braces for the teeth. And we measure this depending on your activity levels and what age you are and align your foot 5 degrees every time. So that’s why it’s important to come in and see us so that we can measure your arch and the position of your foot leaning in. So what we can do is we make an orthotic exactly the shape of your foot and we add a medial wedge to tilt you. So if you’re 30 degrees were going to tilt you 30 degrees straight and then what we ask you to do is get a very firm sole shoe. It’s very important when you put an orthotic inside your shoes, the shoes is correct. If you use a very soft sole shoe, the foot might still be able to lean in because the foundation of the shoes is too soft . But in this case the shoe is perfect because the foundation the shoe is very very strong.So as the foot leans in and or tries to lean in, you have an arch support that tries to stop that but more importantly you have a medial wedge so your can foot cannot lean at all and to make sure that you get a true results you should have a very firm sole shoe as well that we ask you to wear and when you put inside your shoes, you remove the sponge liner that comes with your shoes because even if you put your orthotic on top of it you can lose a few degrees so we make sure that the outcome is going to be as true and successful as we can possibly get it in collaboration with our patients.
For appointments and other queries: Call: +971 4 3435390 WhatsApp: +971 50 331 4978


Subtitles:

Welcome to Foot Talk Fridays!

Today we’re going to talk about some people that have an embarrassing problem called sweaty, smelly feet.

With sweaty, smelly feet it is normal for your feet to sweat, but if the sweat is contained inside socks and shoes for a bit too long the normal fungus that’s on your foot can start to grow and that’s what gives a musty smell to the feet.

Not only do we have fungus on our feet, we also have bacteria. We have good bacteria and good fungus, but if you give this warm and damp conditions the bacteria and the fungus can thrive and that’s what can give a very strange odour to the feet which some people find offensive and embarrassing to their self. To explain the

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skin on the foot, there’s a reason why a lot of foot odour sprays don’t work to alleviate the symptoms. We’ve all had cases of smelly feet, you know if you’ve been stressed or something there is some hormone that is released in the body and it can make the body smell in an unusual way but as soon as you have a shower it washes off.

There are other times where the bacteria and the fungus actually take hold and penetrate the deeper layers of skin. I have a little example of layers of the skin.

In the foot, there are five layers of skin and it takes 28 days for the baby skin layer here to grow up to become the top player that you would normally see on the outside of your skin (ignoring hard skin).

If you get a fungal infection and a bacterial infection, they creep into the deeper layers of skin so any foot odours spray or salt bath that you used for your feet or perfumes that you use only address the top layer (and maybe if you’re lucky the second layer). But the third and other layers here still have a bacterial and a fungal infection and that’s what gives the strong odour.

So, when you come and see a podiatrist we will normally use a strong medicated treatment to get through all the layers of the skin. That takes a course of six weeks and normally we will use a strong gel or cream to penetrate all the way through the five layers of the skin, not just the top two.

To get rid of foot odour it normally takes six weeks to clear the foot odour from all of these layers of the skin.

If you have smelly feet or extra sweaty feet, come and see us. If you don’t have bad foot odour but they just sweat a lot, there is something that we can do for the feet that closes the sweat pores so that the feet don’t sweat too much (but we do want the feet to sweat little bit – it’s a self-cooling regulatory system that the body has).

So, if you think you’re sweating too much, come in and see us and there’s something that we can do for you to close the sweat pores. Or if you have bad smelling feet according to you then come and see us also there are some anti-fungus and antibacterial gels that we can use that penetrate through all five layers of the skin. Then those five layers of skin can grow out over six weeks to reveal the fresh, healthy, new skin without a bacterial or fungal infection.

Enjoy your Friday!

For appointments and other queries:
Call: +971 4 3435390
WhatsApp: +971 50 331 4978



  Subtitles: Welcome to Foot Talk Friday! Over summertime we’ve got so many travellers going to nice destinations and doing a lot of walking in shoes that they normally wouldn’t wear so much, like walking shoes with socks, and maybe they are used to wearing sandals here in the Middle East. So, when your skin is very baby soft around the edges you can get blisters, calluses and corns. What we recommend is something that is really light and it fits in your bag (even your purse or wallet), it takes up no space. We have ones like this, we call these toe pads or bunny pads (actually we call this a bunny nose because it’s so soft – but no bunnies were harmed in making of these!).  And you put it on your fifth toe like this so if you’re wearing strappy sandals, or you’re wearing high-heel shoes, or you’re wearing a business shoe, or sports shoes that might feel like it’s rubbing on the toe from the London heat and sweat right now. That’s why I would recommend putting bunny pads – keep them for the whole family so if somebody complains about a hot spot on their foot you can put that on.  You can also put them on the second toe or the third toe, a lot of people come back after summertime with bursas on their toes – they sometimes look like little swellings on the top of the toes and they sometimes think that they’re corns. So, if you use this when your toes are gripping a little bit and rubbing on the top of the shoe it prevents from bursa and discoloration of the skin. Then these ones if you’re wearing shoes you’re not used to (like the heel on one of the shoe because there’s always one bigger foot and one smaller foot for almost all human beings) is that one of the bigger foot can rub and press on the back of the heel a little bit, so this would go in the back of the shoe on the heel area and that instantly stops hot spots and stops a blister from forming. You can also use them behind the big toe – most people get hard skin behind the big toe and along the side of the foot. So, you can use the long pads (we call it bunny ears) behind the big toe where you get calluses and burning as well. Then finally we have the bunny face. You can put this under the ball of your foot so if you’re wearing high heel shoes or your sandals gets sweaty and you’re slipping or something like that, you can just put this behind your toes under the ball of your foot like this. So, if you’re wearing high heel shoes or doing a lot of walking it cushions the ball of your foot. You can also use it on your heel for extra cushioning (it’s a perfect size for your heel). But there is another handy trick to this pad and it’s where you can actually put it up underneath the arch of your foot. For example, your arch is hurting from doing a lot of standing and walking and normally people get one arch that hurts them because we all have a pelvic tilt because we have a leg length discrepancy (it is totally normal). Say for example the arch of your foot is here, if you stick this pad underneath your arch and you pull it up it helps to lift your arch and to keep it up. So, there’s a lot of handy different ways that all of these little pads can help your feet. These pads have been taken to the top of Everest, from one side of the pole to the other side of the pole, they have come in handy with a lot of adventures! The weight is hardly even anything, but if you’re going to go hiking, go on forest walks, or you are going to do lots of walking in cities like Rome, London or Paris that you’re not normally used to doing – definitely take them in a little pouch in your bag and anybody in the family that complains about a hot spot then they are absolutely perfect to use. Enjoy your Friday! For appointments and other queries: Call: +971 4 3435390 WhatsApp: +971 50 331 4978


Subtitles:
Welcome to Foot Talk Fridays! Today we’re going to talk about children’s school shoes.  So, the time is coming where you’re trying to leave it as close as possible to the start of this school term so that the child’s feet is accurately fitted to the school shoes for the school term.  For example, when buying shoes, we want a shoe that’s quite sturdy and strong. These are Adidas and I really like it because they have velcro straps so it makes it very easy to take on and off.  Older children (over the age of eight and on wards) we encourage them by that age that they should be tying their own laces for school. But for very young children it makes it easier for moms and dads to have velcro straps.  The reason that we also like Adidas, like this type for the school shoes (it comes in black for school and white for sports) is they have nice insoles that are fitted. Now the good thing about Adidas and Eco school shoes do it, also – do you see this grid pattern here? This shows where the child’s foot should be fitted when they’re in the shop (that first line). Then these diagonal lines here show where the child should be able to have growth during the school terms. That last line is where the children should get a new pair of shoes when their toes get to the end there. This is really helpful as well if you’re not sure about the shoe fitting in the shop, you can always take this easily out of the shoe (you saw how easily this one came out of the shoe). Ask your child not to sit but to stand on this, I don’t want them to be sitting when they place their feet on it, I want them to stand on it. Just get the heel matching up to this back line and the big toe and small toes should not be beyond that first line here. Then that’s the perfect size for them.  Getting onto girl school shoes, so for example your child does wear an orthotic for flat feet or something like that, the insole comes out of this shoe and quite a large orthotic (this is a child that leans in almost 45 degrees) will fit into a shoe like this.  The reason that we like this is that it has this extra velcro strap on the top which acts like a seat belt, so that when the child is running or if they have a strong orthotic inside there, the seat belt strap keeps the foot and their heel down inside the shoe.  Now another reason for this is so that you can get quite a generous sized shoe for the child to allow them to grow. If you buy your child ballerina style shoes without this Mary Jane style strap, you will have to get a tight-fitting shoe and we see so many young girls with corns and calluses on the outside of their toes because they had to get tight fitting shoes so it doesn’t slip off with their heel. So that you can do the same thing that is allowed for other types of shoes in children, you want this extra space to grow. You’ll be able to do that in a Mary Jane style shoe, they will have the extra space to grow without the heel slipping out the shoe because they have the seat belt strap. So please, please, please for children, please don’t buy the ballerina style of shoes. I see there’s not much cushioning normally underneath so they feel heel pain and there’s not much support at the side of the ballerina pump so the arches become quite soft and strained, it can cause a lot of arch pain. And then of course they have to be tight-fitting style school shoes to keep the shoe on, so please don’t buy ballerina styles -please buy the Mary Jane’s styles with the strap on the top. I hope that help with finding shoes for children for the upcoming school term.  Enjoy your Friday! For appointments and other queries: Call: +971 4 3435390 WhatsApp: +971 50 331 4978


Subtitles:

Welcome to Foot Talk Fridays!

We’re going to discuss ‘knock knees’ and that’s when the child’s knees lean in together, called ‘Gene Valgum.’ When the child’s knees go away from each other it’s called ‘Genuverous’. 

Gene Valgum is quite common especially if the feet lean in. If the feet lean in, the knees can internally rotate and the knees can begin to bend together causing an X appearance. Some children might have a straight leg and one knee that bends in and that’s what we call a ‘K leg’ because it looks like a letter K.

So what we want to do initially is we want to find out where the Gene Valgum comes from – is it coming from the hip? Is it coming from the knee? Is it coming from

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the foot? Is it coming from the ankle? Once we discover where it’s coming from that will change the treatment plan.

Say for example, we need to get the knee to point out wards and the space to open, we’ll put something underneath the foot that tilts the foot to get the knee to externally rotate again, because normally with the feet straight we want the knees to point at eleven and one o’clock.

The perfect position of the knees is eleven and one o’clock, we don’t want straight ahead knees either, we also don’t want the knees to point to ten and two o’clock or nine and three o’clock, we just want eleven and one o’ clock with the feet straight.

The reason for that is when the feet are straight and the ankles are straight, the hips are set wider, so the knee does have to get 50% of a different angle from the ankle to the hip ratio, so eleven and one o’clock is perfect alignment.

We also have to look at leg length because ‘leg length discrepancy’ is normal with growing children. When one leg grows longer than the other the pelvis will tilt, and one knee will point to a different direction compared to the other.

We have to understand that’s normal for children, but if you notice your child has knees that are leaning in or bending in it’s very important to take them to the podiatrist, or the orthopaedic, of course your general practitioner, or your paediatrician just to get a full scope of assessment done.

But most commonly we use something underneath the feet to tilt the feet to get the knees to change direction which is why if your child has ‘Gene Valgum’ or ‘Genuverous’ you’ll be asked to come and see a podiatrist to get the foot and ankle sorted to help with that.

So, what we do with Gene Valgum is we would put something underneath the foot, and we would tilt the foot (and that’s what this tilt is). Depending on the severity of the Gene Valgum, it depends on how high this wedge is so it can be anything from five degrees up to forty-five degrees in the most severe cases.

Again, say for example it’s a child, we would put a tilted orthotic with how many degrees (this child has a twenty-seven-degree tilt on to theirs) for their Gene Valgum inside school shoes and it fits easily inside the school shoe, of course we always like it with a strap on the top. For boy’s school shoes’ most of the time it’s very easy because they look like sports shoes.

Going back to Gene Valgum, normally if the ankle leans in you can imagine the leg will come up like this and then bend up to the top as well. That’s why we put something underneath the foot that will tilt the foot straight.

I will show you what we mean, say the foot leans inward like this, we would put something tilted so that when a child stands on it they are tilted straight and that’s how we correct Gene Valgum in most cases.

Enjoy your Friday!

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