Twas the Night Before Christmas!!

Santa has been wearing his new custom orthotics for 2 weeks now. Santa tells Dr. Vail that his bilateral heel pain (Plantar Fascitis) is much better with the new custom orthotics in his Santa Boots. Santa is also doing his stretching exercises with his feet everyday - has been wearing his night splints on his feet to stretch out the ligaments and tendons. Santa has been practicing at the North Pole with the elves coming down chimneys and has had no problems. Santa has even used a bag full of presents and toys when practicing coming down the chimney. Dr. Vail has given Santa the clearance to go ahead with delivery of presents and toys on Christmas Eve night. Dr. Vail advised Santa to be careful, stretch daily, and continue night splints for bilateral heels if they feel tight or start to hurt again. Ice is abundantly available at the North Pole to use on the bilateral heels for pain also. Santa was very pleased with all the information that Dr. Vail gave to him on his condition and the treatment has been very successful. Santa left Dr. Vail's office on his way back to the North Pole to get last minute presents and toys ready for Christmas Eve! Santa wished Dr. Vail , staff, and patients a "Very Merry Christmas!" as he left.

Twas the night before Christmas, when all through the house

Not a creature was stirring, not even a mouse.

The stockings were hung by the chimney with care,In hopes that St Nicholas soon would be there.

The children were nestled all snug in their beds,

While visions of sugar-plums danced in their heads.

And mamma in her ‘kerchief, and I in my cap,Had just settled our brains for a long winter’s nap.

When out on the lawn there arose such a clatter,I sprang from the bed to see what was the matter.

Away to the window I flew like a flash,Tore open the shutters and threw up the sash.

The moon on the breast of the new-fallen snow

Gave the lustre of mid-day to objects below.

When, what to my wondering eyes should appear,

But a miniature sleigh, and eight tinny reindeer.

With a little old driver, so lively and quick,I knew in a moment it must be St Nick.

More rapid than eagles his coursers they came,

And he whistled, and shouted, and called them by name!"Now Dasher! now, Dancer! now, Prancer and Vixen!On, Comet! On, Cupid! on, on Donner and Blitzen!

To the top of the porch! to the top of the wall!Now dash away! Dash away! Dash away all!"

As dry leaves that before the wild hurricane fly,

When they meet with an obstacle, mount to the sky.

So up to the house-top the coursers they flew,

With the sleigh full of Toys, and St Nicholas too.

And then, in a twinkling, I heard on the roof

The prancing and pawing of each little hoof.

As I drew in my head, and was turning around,

Down the chimney St Nicholas came with a bound.

He was dressed all in fur, from his head to his foot,

And his clothes were all tarnished with ashes and soot.

A bundle of Toys he had flung on his back,

And he looked like a peddler, just opening his pack.

His eyes-how they twinkled! his dimples how merry!

His cheeks were like roses, his nose like a cherry!

His droll little mouth was drawn up like a bow,

And the beard of his chin was as white as the snow.

The stump of a pipe he held tight in his teeth,

And the smoke it encircled his head like a wreath.

He had a broad face and a little round belly,

That shook when he laughed, like a bowlful of jelly!

He was chubby and plump, a right jolly old elf,

And I laughed when I saw him, in spite of myself!

A wink of his eye and a twist of his head,

Soon gave me to know I had nothing to dread.

He spoke not a word, but went straight to his work,

And filled all the stockings, then turned with a jerk.

And laying his finger aside of his nose,

And giving a nod, up the chimney he rose!

He sprang to his sleigh, to his team gave a whistle,

And away they all flew like the down of a thistle.

But I heard him exclaim, ‘ere he drove out of sight,

"Happy Christmas to all, and to all a good-night!"

Clement Clarke Moore (1779 - 1863) wrote the poem Twas the night before Christmas also called “A Visit from St. Nicholas" in 1822.

Santa's New Custom Orthotics

Santa's new custom orthotics that Dr. Vail ordered for him arrived and Santa came down in a flash to try them on. Santa was very impressed with the way his heel pain has improved with the night splint , stretching exercises , and theraband roller - still some pain but not as much with the heels know as Plantar Fasciitis.

When Santa tried on the new custom orthotics his heels felt very well cushioned and arches very well supported. Dr. Vail's staff directed Santa on how to break in the new custom orthotics and advised he purchase a new pair of Santa Boots back at the North Pole.

Congratulations Santa! You have just received your new orthotics. This represents the most advanced, scientific concept in functional foot care. They have been custom-made for you and your individual foot problems.
Your new pair of Custom orthotics will support your foot in the "Neutral Position." This position allows for controlled pronation (necessary for shock absorption), but prevents excessive flattening of the arch and rolling of the heel, which can lead to overuse injury.
The body must adjust to this new support. Because foot orthotics change the movement of your foot, you may experience an adjustment period of 1 to 6 weeks. You may feel some discomfort during this time frame such as foot or leg cramping, skin irritation, or joint pain; but this should pass. It is important that the orthotics are NOT worn all day at first. If you have removable insoles in your shoes, and they create a fitting problem remove them to wear your orthotics. Your orthotic must rest on a flat surface to function properly. We recommend the following break-in schedule:
DAY 1: Wear the orthotics for 2 hours (including sitting time), then remove them from shoes. DO NOT use the orthotics for a sports activity until they are fully broken in.
DAY 2: Wear the orthotics for 4 hours (including sitting time).
DAY 3: Wear the orthotics for 6 hours (including sitting time).
DAY 4: Wear the orthotics for 8 hours (including sitting time). You should be able to wear them all day long from now on. If not, continue to gradually increase the hours of wearing until you can wear them all day.
If you develop ankle, knee, or hip pain while breaking in the orthotics, remove them from your shoes immediately. Do not wear orthotics for one or two days, until the pain subsides. You may take aspirin if necessary. Begin wearing the orthotics at a duration equal to one or two hours less than the amount of time you wore them on the day the pain began. Continue with the break-in as described above.

DAY 10-14: Follow-up in the office for evaluation and possible adjustment of the orthotics. This is important in that there is a specific time frame that we can send the orthotics back to the Lab where they are fabricated at no charge to you and the Doctor will take measurements of your orthotics for future reference. Additional follow up exams are 3 months, then every 6 months after that.
Wear some type of sock or stocking during the break-in period to avoid skin irritation.If your orthotics squeak in your shoes, sprinkle a small amount of powder in your shoes prior to inserting your orthotics. We recommend Zeasorb-AF which can be purchased at our clinic. Your orthotics can be wiped with mild soap on a warm washcloth. Do not immerse them in water. do not use hot water as it may cause damage or distortion to your orthotic materials. Use the warm air flow of a blow dryer to "fluff up" padded top covers that may have compressed over time.

Your custom orthotics should last years depending, of course, on how often they are used and activity level. The top covers (especially soft cushion materials) and posts (additions to the bottom of the orthotics) may need to be replaced sooner however, depending again on your activity level. Repairs and recovering of orthotics are not covered by insurance. To help the longevity of your Orthotics please remove them nightly from your shoes to increase air circulation around the orthotic. You may also wear your orthotics in different shoes as long as their is enough depth to accommodate the insert.

Remember, your feet are the foundation for your entire body. They do a tremendous amount of work each day. Even the slightest misalignment of the bones and muscles can cause a lot of discomfort. Consistently wearing your prescription orthotics can be the best investment you can make to your overall well-being. Periodic orthotic checks by Dr. Vail are essential to ensure that this investment is still working properly and supporting your body in the correct manner.

Santa was scheduled an apppointment with Dr. Vail on 12/22/10 just before the Big Night!

Christmas is coming!

It's the week after Thanksgiving and Santa Claus is busy at the North Pole! He's making his lists and checking them twice! Santa is working with the elves to get things ready for the BIG NIGHT! Santa has been practicing to come down a chimney with care when he has noticed when landing his feet and heels are hurting more each time.

Santa decided it is time to have his feet checked out before things get busier at the North Pole - He makes a call to Advanced Foot Care Clinic in Findlay, Ohio. He remembers Dr. Thomas F. Vail when he was a little boy and delivered Christmas presents under his tree on Christmas Eve. An appointment Santa did make - Dr. Vail examined Santa's feet with diagnostic digital x-rays and bilateral heel spurs were found - Dr. Vail explained to Santa Claus that Plantar Fasciitis was his diagnosis.

Plantar Fasciitis (heel-spur syndrome) is a common problem among people who are active in sports, particularly runners, and coming down chimneys with care. It all starts with a dull intermittent pain in the heel which may progress to a sharp persistent pain. Classically, it is worse in the morning with the first few steps, after sitting for a period of time and then standing or walking, and at the beginning of sporting activity. The plantar fascia is composed of a thick, fibrous material on the bottom of the foot. It is attached to the heel bone (calcaneus), fans forward toward the toes, and acts like a bowstring to maintain the arch of the foot.

A problem may occur when part of this inflexible fascia is repeatedly placed under tension as in running, or up and down chimneys on Christmas Eve carrying heaving gifts in a large red sack. Tension causes an overload that produces an inflammation usually at the point where the fascia is attached to the heel bone. The result is PAIN!

Plantar fascia injury may also occur at the mid sole or near the toes. Since it is difficult to rest the foot, the problem gradually becomes worse because the condition is aggravated with every step. In severe cases, the heel is visibly swollen. The problem may progress rapidly and treatment must be started as soon as possible.

The Inflammatory reaction at the heel bone may produce spike like projections of new bone called heel spurs. These sometimes show on X-rays, as Santa's did. They do not cause the initial pain , nor do they cause the initial problem: they are the result of the problem. But later, having to walk on spurs may cause sharp pain and in Santa's case up and down chimineys and in and out of the sleigh on Christmas Eve will cause PAIN!

Contributing Factors: Flat(Pronated) Feet / High arched, rigid feet / Poor shoe support / Toe running, hill running / Soft terrain (i.e. , running on sand or snow) / Increasing age / Sudden weight increase / Sudden increase in activity level / Family tendency

Improvement may take longer than expected, especially if the condition has existed for a long time. During recovery, loss of excess weight, good shoes &or Santa Boots, and sedentary activities all help the injury to heal. You should return to full activity gradually.

Dr. Vail directed Santa to rest his feet and heels as much as he could during this busy time - Use pain as your guide. If your feet are too painful, then rest

Ice - Use our Theraband roller that comes in our Heel pain kit when your are checking those little boys and girls lists to see who is naughty or nice - roll the Theraband roller under your heels for at least 15 minutes a few times a day to reduce inflammation - make sure to put in your freezer or snow bank to get frozen again

Dr. Vail also prescribed Santa an Anti Inflammatory for the inflammation and pain in bilateral heels - this prescription was Escribed to the pharmacy at the North Pole so Santa could just pick up on his way home

Dr. Vail has recommended to Santa that he has custom orthotics for his Santa Boots to help control his feet and cushion the heels especially for the BIG NIGHT with all those Chiminey drops / Dr. Vail had one of his back staff digitally scan Santa's feet on the Tom Cat 3 D Scanner for his custom orthotics that will fit into his Santa Boots.

Dr. Vail and his staff advised Santa to take it easy for the next couple of weeks - his custom orthotics arrive by RUSH order so that he has time to get used to them before the BIG NIGHT!

Vail Foot Orthotics

What is Orthotics? (follow our link to view more information)

Orthotics are designed to fit your feet efficiently. They are more adequate than the over the counter arch supports, that balances the biomechanical inadequacies of your feet or legs.

The most common reasons that people might use foot orthotics are:

- Limiting the pain in your heel. 

- Knee Pain- such as Iliotibial Band Syndrome. 

Why Buy Orthotics?

Orthotics can help people to get relieve and prevent the following:

- Achilles Tendonitis

- Shin Splints

- Heel or Arch Pain

- Iliotibial Band Syndrome

How much does Orthotics Cost?

The ones at the pharmacy are less exspensive ($8 - $15), but the more well rounded comforting pair ranges from ($200 - $500), and these are your custom-made orthotics.

Who Needs Orthotics?

Some people are born with an inherited foot structure that develops bunions, corns and hammertoes. If you have a family history of these problems or are developing them, early recognition and use of orthotics may lessen their impact.

Custom Orthotics

Custom orthotics is made to help correct any misalignments in the foot, improve a person's posture, or alleviate any pain in the foot and leg. They are either inserted in a shoe or can be integrated into your shoes design so that they become a part of the shoes sole. Custom orthotics differs from inserts that you can buy at any store, because here in our office they are made to specifically conform to the unique shape of an indivdual's foot. They are usually made out of rubber materials that are quite stable. Some have added padding, depending on the persons weight.

- A different pair of shoes may help.

- A person who weighs a lot and has a low arch, may need a more stable, motion controlled shoe.

- A person with a high arch may need a shoe with more cushioning.

- Alternate shoes.

- Rotate a slightly worn shoe with a new pair.

Try wearing different shoes for different types of surfaces.

- Consult a physical therapist or a massage therapist.

- Your pain may be a result of tight or weak muscles instead of structural problems.

To view our Powerstep ProTech Orthotic (click here)

Orthotic Supports, & Comfort Insoles

Today I will explain 3 products we highly recommend here in the office that relieves heel & arch conditions.

Heel Pain is one of the most common symptoms we see in our office. There are multiple causes of heel pain, but most are equally uncomfortable. Your initial response to heel pain at home should be to follow the RICE treatment method (Rest, Ice, Compression, Elevation) Stay off your feet and elevate them. Rotate ice on for 20 minutes and off for 20 minutes at a time. Do not use ice while sleeping, and keep a towel between the ice and your skin. The ice will help to relieve both your pain and swelling. Use a compression wrap to help reduce the swelling in your foot and ankle.

Here are the 3 products I will explain today:

1. The "Powerstep ProTech Classic" - This is the Podiatrist's Prescription for Pain Relief! This will relieve your heel and arch pain. This product includes:

- Medical-grade arch support

- Stabilizing heel cradle

- Encased in full-length double-layered.

- Thin full-length profile to fit many shoes.

This product is Therapy for: Plantar Fasciitis, Heel Spurs, and other foot conditions! This will support your Foot, Ankle, Knee, & Even your Lower Back.

Powerstep ProTech Classic is a unique podiatric support system specifically intended to relieve heel and arch pain, and prevent foot strain from injury. Unlike leading insoles or arch support, ProTech Classic's unique 4-phase design is optimized to provide complete foot support and comfort, and correct foot posture and mechanics.

Wait! There is a GUARANTEE--30 day money back gurantee for any reason. Lifetime gurantee against breakage of plastic arch supports when used under normal conditions.

2. The "Spenco RX Comfort Insoles" - This is a clinically designed & doctor recommended product! With this one-year unconditional gurantee you get:

 -Cushions that comfort and heel the toe.

An Ultra-Fresh Silpure- Exceptional odor control through advanced silver-based antimicrobial
- Absorbs shock
- Reduces friction
- Comfortable and lightweight
- Durable and washable

-Spenco has 40 years of Footcare Solutions under there belt, and this 4-way Stretch Fabric with Ultra-Fresh Silpure- Helps prevent blisters, along with controlling odor. This Spenco material has an exclusive cushioning layer, and provides maximum comfort.




3. Finally, "The Aetrex Lynco Orthotics" - Aetrex is your #1 choice in Foot Orthotics. For this specific product I will tell you why this is one of our top choices:
- This specific product assures you feel great during high impact activities.
- Improves balance and body alignment
- Reduces stress at the Ball-of-the-Foot

The Lynco L400 Sports Orthotic is designed specifically to provide comfort, balance, and support in athletic, walking and comfort footwear. This product features a Pro-Shox top cover for superior cushioning and shock absorption. Pro-Shox's high tech polyester fibers wick moisture away from the foot and provide a cool, friction free surface to prevent blisters and other foot problems.
The L400 is light-weight, resilient and provides unmatched cushioning and support. These unique orthotics are designed with a cupped heel for balance, stability, and pressure reduction. This product is recommended for medium and high arch feet.

We highly recommend either of these three products. If you would like more information about our products visit our online store to view products like the PowerStep, or stop in at 1725 Western Ave., Ste. C Findlay, OH 44883.  

How Does an Orthotic Work?

Make a Foot Mold

An orthotic can be custom made (by having a mold made of the foot), or bought ready made in drugstores. Either way, the orthotic is inserted in one or both shoes (as needed) to correct a normal walking pattern that causes pain in any area of the foot, leg or even the back. The orthotic changes the way the foot hits the ground and softens or completely eliminates pain felt when walking.

Soft Orthotic 

A soft orthotic is more prevalently used and helps to change a normal walking pattern that causes pain when walking. Since this change in body movements will take time to get used to, a new orthotic should be broken into over the course of a few days.

Rigid Orthotic
The rigid orthotic is usually made of hard plastic, and while it is less comfortable than the "soft orthotic," it is used for a different purpose. It helps those that need more support to either hold or control the function of the foot to avoid pain either in their upper legs, back, or foot. Using the rigid orthotic will enable you to have complete control of your foot and be able to walk almost or completely pain free.

Keep in Mind
Molded to fit orthotics are not inexspensive. The expense just might be worth the cost if it helps relieve pain felt when walking. Store bought orthotics will certainly cost less, but they might not correct a specific foot or walking problem found by having the foot molded and formed to the actual site of the problem.

To learn more about how an Orthotic works visit our website, and make sure to watch our educational video as well.

Custom Orthotics can help you!

Custom orthotics can help you avoid some common foot problems!

Corns and calluses are thick, hard layers of skin that develop from pressure when foot bones push together or against footwear. Corns appear on or between toes and calluses are usually found on the balls of the feet and on the heels.

Blisters are bubble-like pockets that develop when skin rubs continuously against another surface. this friction causes a tear inside the upper layers of the skin (the epidermis), which forms a space between these layers and fills it with fluid. Help prevent corns, calluses and blisters by wearing properly fitting shoes and by using cushions and/or custom orthotics that protect areas highly prone to such problems

A Bunion is an enlargement of the big toe's joint. It often develops when the big toe bends inward toward the other toes, a condition called "Hallux Valgus". These problems are often created by frequently wearing tight shoes that squeeze toes together. Hereditary factors can also be a cause.

If you have a bunion, you can relieve pain from footwear by placing a cushion over the tender area. Custom Orthotics can also slow down the progression of the bunion. Severe cases may require surgery, however wearing a splint or a toe spacer may help slow down the progression of the condition also and postpone the surgery.

The Ball-of-Foot area is part of the forefoot, located between the base of the toes and the foot's arch. "Metatarsalgia" is a general term used to describe pain in that area. "Morton's Neuroma" is a condition associated with pain, swelling, and/or a burning sensation in the ball-of-foot's nerve, most commonly between the 3rd and 4th toes. these ailments can occur after the forefoot experiences long periods of excessive pressure, such as when wearing high-heeled shoes or participating in high-impact activities. Also, the ball-of-foot's natural fat pad thins out with age and makes the area more susceptible to problems . To protect and relieve feet, add cushion to shoes to comfort the sensitive areas. Custom orthotics can also be made to fit your foot to protect these areas.

The Arch is the curved part of the middle of the foot. It's shape is maintained by the "Plantar Fascia", a connective tissue band which runs from the heel to the forefoot. Excessive stretching of the plantar fascia, usually due to over-pronation ("flat feet") causes "Plantar Fasciitis", a condition that can create pain and strain in the arch and the heel. If left untreated, bony protrusions ("heel spurs") may develop on the heel. If you suffer from arch problems - wearing supportive custom orthotics can provide relief

What type of foot arch do you have?

Feet have three basis arch types: Normal, High and Flat.

Normal Arches: Normal arches are medium arches. while walking, these feet naturally land on the outside of their heels and then roll inward slightly, or "Pronate", to absorb shock.

High Arches: High arches can be flexible or rigid. flexible high arches over-pronate, which means the foot rolls inward too much while walking. Rigid high arches under-pronate and do not absorb shock effectively.

Flat Arches: Flat arches, also known as "FLAT FEET", are low and overly flexible. They flatten and roll inward too much.

The arch is the curved part of the middle of the foot. It's shape is maintained by the "Plantar Fascia", a connective tissue band which runs from the heel to the forefoot. Excessive stretching of the plantar fascia, usually due to over-pronation ("Flat Feet") causes "Plantar Fasciitis", a condition that can create pain and strain in the arch and the heel. If left untreated, bony protrusion ("Heel Spurs") may develop on the heel.

Help Your Arches!!

Arches that are not normal will not pronate properly. Flexible arches - High and Flat - can be comforted by custom foot supports. Custom orthotics prescribed by your podiatrist not only cradle the arches, soothe plantar fasciitis, absorb shock, and well as pain in the legs and lower back.

ORTHOTICS - A NATURAL CURE

It is estimated that greater than 75% of the population suffer from EXCESS PRONATION due to the Tibial Varum Factor and the unnatural, hard flat surfaces that we walk on daily. EXCESS PRONATION often disrupts normal nee function and hip alignment and increases forces on the lower back muscles. These bio mechanical deficiencies are common in all types of patients from children to the elderly, from top athletes to people with a sedentary lifestyle. By realigning the lower limb to its natural angle custom orthotics ensure correct foot function and help relieve common bio mechanical complaints. In combination with the Podiatrist's regular treatment regime, custom orthotics are usually successful in alleviating chronic pains. The human foot was originally designedto walk on natural, soft surfaces like the earth and sand. Instead, we now spend most of the day on unnatural, hard, flat surfaces like pavements and floors that force our feet to flatten and twist. The "LOSS OF OUR FOOTPRINT" has resulted in a new modern variety of pan and injuries. The normal lower limb has a 3-4 degrees Tibial Varum (mild blow-legged) angle when approaching the ground. When the feet strike natural surfaces like earth and sand, these surfaces give way to accommodate to the foot's strike angle. However, when the feet strike hard flat surfaces like pavements and floors the feet flatten and pronate excessively upon contact. Excess pronation at the SUBTALAR JOINT commonly exhibits: CALCANEAL EVERSION - INTERNAL TIBIAL ROTATION - MEDIAL PLANTAR DISPLACEMENT OF THE TALUS UPON THE CALCANEUS - LOWERING AND ELONGATION OF THE ARCH STRUCTURE - EXCESS WEIGHT BEARING OVER THE 1ST METATRSOPHANGEAL JOINT - EXCESS MEDIAL LOWER LIMB STRAIN - EXCESS LATERAL UPPER LIMB COMPENSATION. Remember your footprints when you last walked on the beach? You will notice that the sand gave way under the lateral strike of your heel forming a natural wedge. Thus preventing excess subtalar joint pronation from occurring. This is what custom orthotics will do for you and your feet.

LIVING WITH ORTHOTICS!

The success of your orthotic treatment depends greatly on you and your expectations. If you maintain your orthotics in good condition, you can expect them to last for years. But as your age or face new physical demands, the needs of your feet may change. Follow-up visits with you podiatrist may help control new foot problems before symptoms develop. Realistic Expectations: Your foot problem took time to develop, so don't expect your symptoms to go away overnight. But if you wear your orthotics as instructed, your symptoms can lessen over time. Also keep in mind that your orthotics can help you move more comfortably, but they won't change the structure of adult feet. Your orthotics will work only if your remember to wear them. Orthotic Care: Your orthotics must be in good condition to do their job. By replacing a torn or badly worn covering, you can extend the lift of your orthotics. Lost posts or additions should be replaced to avoid new foot movement problems. If your orthotics crack, begin to lose their shape, or start rocking in you shoes, they may need replacing. Follow-up Visits: Once you're wearing your orthotics full-time, regular podiatric checkups can help you maintain the health of your feet. As with contact lenses, your orthotic prescription may change over time, and your podiatrist may recommend new orthotics. Children, athletes, and people with health concerns affecting their feet may require special care. Your podiatrist will recommend a foll-up schedule to meet your individual needs. Moving with support: Your feet no longer have to ache with every step. By controlling foot movement, your orthotics can make it easier to get on with your life and the activities you enjoy. Help yourself keep this symptom-free pace by wearing your orthotics daily and visiting your podiatrist regularly.

CUSTOM ORTHOTICS

TRYING OUT YOUR NEW CUSTOM ORTHOTICS: After your orthotics arrive from the lab, your podiatrist will make sure they fit and correct your movement problem. You may be asked to walk with your orthotics in your shoes to check for sharp edges or rubbing. Minor adjustments may be made by your podiatrist, but extensive changes may require returning your orthotics to the lab. BREAKING IN YOUR ORTHOTICS: Getting used to your orthotics takes time. They may feel strange, even uncomfortable at first. But if your build up your daily wearing time as your podiatrist instructs, you can get used to the feel of your orthotics. You'll probably be wearing them full time by the end of 2 or 3 weeks. SELECTING SHOES FOR YOUR ORTHOTICS: Orthotics usually work best in shoes with a closed toe and low heel. you may be able to your pair in similar types of shoes. But if your wear different shoe styles or enjoy a sport that makes special demands on your feet, you may need more than once pair of orthotics. When you're shoe shopping, remember to wear your orthotics. Your want to be sure they fit and don't slip in the shoes you want to buy.

FITTING YOUR CUSTOMIZED ORTHOTICS

To meed your unique needs, your orthotics can be custom built from different methods of casting the feet. Our office uses a TomCat Scanner - this is a 3-D scanner - we make a 3-D image of your feet to reproduce images to be used to create your custom orthotics. We also have biofoam impression where we evenly compress your feet into the biofoam for the impression. Another way is using casting supplies with plaster or casting socks where we use water and hands to form the plaster or casting socks to your foot. Which ever casting device is used - the scan or cast is sent to an orthotics lab where a trained technician with then craft your custom orthotics to meet your specific prescription and fit the model of your foot. Your can expect to receive your new custom orthotics anywhere from 2-4 weeks.

Different Types of Custom Orthotics

Rigid Orthotics: Rigid orthotics are made from study materials such as steel, graphite, or special plastics. They offer the greatest control of foot movement. In young, growing children, rigid orthotics may improve the way the bones of their feet develop. Rigid orthotics may relieve bunion pain by controlling over pronation and the pull of tendons on our big toe joint. Semi -Rigid Orthotics: Semi-Rigid orthotics control foot movement and increase shock absorption. They are often made of flexible plastic, and may help reduce strain on soft tissue overused during strenuous activities. Semi Rigid orthotics may relieve inflammation of the plantar fascia caused by over pronation. Soft Orthotics: Soft orthotics cushion your feet when they're on the ground, but offer only limited control of foot movement. Made of spongy plastic or foam, soft orthotics are lightweight but slightly bulkier than the more rigid varieties. Soft orthotics can redistribute weight away from a callus on the bottom of your foot. Accommodative Orthotics: Accommodating orthotics protect your feet from the stress of weight bearing. Made of cork, foam, or leather, these orthotics may have indentations or raised areas to take pressure off tender parts of your foot. If a medical problem places your feet at risk, accommodating orthotics may protect your feet from sores and infection.

AN ORTHOTIC FOR EVERY NEED

Orthotics come in a variety of materials, ranging from rigid plastic to soft foam. All of these materials can be shaped to fit your individual foot. The rigid orthotics offer the most control of movement, while the softer one's provid better cushioning and protection. When prescribing your orthotics, your podiatrist makes the best match between your needs and the qualities of the materials. Customized Support: Unlike shoe inserts bought in a store,m prescription orthotics are built to meet the unique needs of your feet. Ask your podiatrist about constructing orthotics to fit the special shoes you wear often. Orthotics can be made for dress shoes, athletic shoes - even ski boots. The Post of Orthotics: The post allows only the amount of the heel motion that your podiatrist prescribes. The Plate: The plant controls flattening of the foot and holds your arch in place. The Covering: The covering is placed over the plate to reduce any friction between your foot and the orthotic. Additions: Additions may be added to extend the orthotic out to your toes. Accommodations: Accommodations are indentations or raised areas that may be added to the plate to protect tender parts of your foot.

YOUR PODIATRIC EVALUATION

To determine your best treatment, your podiatrist looks for the cause of your symptoms. A medical history and a foot exam help diagnose your problem. Your podiatrist may also test the range of motion in your joint, from hips to toes. If necessary, you may be scheduled for imaging or lab test to help confirm the diagnosis. Your Medical History : Does foot pain interfere with your job or keep you from a sport you enjoy? To learn if orthoses may treat your problem, your podiatrist asks about your symptoms and how they limit your activities. You may also be asked about medical conditions affecting your overall health. Imaging and Lab Tests: Your podiatrist may order x-rays to study the bones of your feet. sometimes special imaging tests, like CTs, are ordered to assess damage to soft tissue. Routine lab test, such a blood analysis, may help evaluate your general health. Your Foot Exam: During this hands-on examination, your podiatrist looks for the problem causing your symptoms. He may feel for displaced bones or swollen soft tissue. Your feet may also be examined for sores and/or other skin changes. To evaluate blood circulation, your podiatrist may check the pulse, skin color, and temperature of your feet. The strength, reflexes, and sensation in your feet may be tested, too. Testing Your Range of Motion: To help diagnose your problem, your podiatrist may test how far and how smoothly your joints move. Depending on your symptoms, range of motion may be tested in the joints all the way from your hips to your toes. Your podiatrist may also watch how your lower body moves when you walk or run. Your podiatrist may use a tractographto measure the range of motion in your subtalar joint. Your Treatment Plan: After making a diagnosis, your podiatrist may recommend orthoses as the best treatment for your. Before prescribing your particular orthoses, your podiatrist may make a 3-D scanner image of your feet. this 3-D scanner image will help your podiatrist determine which type orthoses will be effective to help you with your foot pain and problems. This will also help your podiatrist to decide with Physical Therapy and/or surgery will be necessary.

WHY DO FEET FALL ASLEEP?

Sometimes if we sit on our foot funny, it falls asleep. What causes that? When your foot falls asleep, it is not blood but nerves. Nerves carry feeling from your body to your brain. When you stay in one position too long, sometimes you squash your nerves and lose feeling. After you move around, and the nerves are no longer compressed, the feeling in that part of your body comes back. So don't worry when this happens. Everyone has something fall asleep once in awhile. Just make use it is not your brain especially while you're at school or work!

PROBLEMS WITH LEGS AND FEET

Where would you be without your legs and feet? They do a lot to get you where your need to go. But sometimes, kids have problems with these important body parts. Their legs and feet might look different of might not work exactly the way they should. The good news is that these problems usually aren't serious. They either go away on their own or the kid learns to handle them by using stuff like special shoe inserts. PIGEON TOES - Pigeon toes, or inwardly turning toes, is a common foot condition in kids. It occurs when the front of the foot is turned inward, facing the other foot. Boys and girls both experience pigeon toes. Most kids' feet straighten naturally without any medical treatment. BOWLEGS - When someone stands with the feet and ankles together but the knees widely apart, we call that being bowlegged. Many babies are born bowlegged because their legs were folded tightly across their bellies while they were growing inside their mom. Bowlegs usually straighten once babies with this condition start to walk and their legs bear weight. By the age of 3, most kids grow out of this condition. KNOCK-KNEES - A condition where the legs curve in at the knees so much that the ankles are separated. Lots of kids become knock-kneed between the ages of 3 and 5. But around age 6, the body begins to straighten naturally, and within a few years most kids can stand with their knees and ankles touching at the same time. FLATFEET - Stand sideways in front of a mirror, rise up on your toes - can you see the arch (curve) in the bottom of your feet? Most of us have some sort of arch on the bottom of our feet between our toes and heel. Someone who doesn't have this curve might have flexible flatfeet. That means more of the person's foot surface is in contact with the ground. In a typical foot, that arch part wouldn't touch the ground. Most babies are born with almost no arch in their feet. Within 2-3 years , after kids have been walking for a while, the arch develops. Wearing the right kind of shoes - ones that are flexible, not stiff - helps kids feet develop the way they should. About 1 in 7 kids never develop a full arch. Very rarely, this requires surgery. Some kids might wear arch supports is their feet hurt. But most of the time, flatfeet do not cause pain or problems.

SMALL STEPS FOR YOUR HEALTH

SMALL STEPS FOR YOUR HEALTH! There are many things the "Experts" tell us to doe to prevent diabetes complications or type 2 diabetes - Choose health foods - make healthy meals - be active 30 minutes a day. But where should you start? It's not easy to do all of this every day living in today's fast paced fast food world. It can be even harder if you have a lot of changes you want to make! * ONE STEP AT A TIME! - It's easier to make lifestyle changes over months and years - Think of each small step as one piece of your effort to change your habits. ** BAD HABITS? - Accept that you have bad habits you need to change - If you believe you have a problem, you will probably succeed in making some changes. *** READY, WILLING AND ABLE! - To succeed at making lifestyle changes the change must be important to you - For example, maybe you want to live long enough to see your grandchildren grow up - You must have more reasons to change than reasons not to change. **** PICK AND CHOOSE! - Take what you want to do and break it down into small steps - Then think about the few things you are ready, willing , and able to change - Leave other habits that you don't feel ready to change for another time. ***** TAKE A LOOK! - Think about your current habits - How active are you? - Pick some changes that you want to do the most and that will make the biggest impact - For example, take 15 minute break from the TV and go for a walk. ******SETTING GOALS! - For each goal think about 4 things: How long will you try to reach this goal? Keep it short - How often will you do this? - Is it easy to do in your regular daily like? Keep it realistic - Is it limited in scope? Be specific - Set 1-2 goals at a time - For example for the next month (how long). 4 days each week (how often) I will take a 15 minute walk after lunch 3 days a week (realists and specific) - Write them down - Put them in a place where you will see them often - on the refrigerator - your bathroom or bedroom mirror, or in your purse of wallet. ******* HOW DID YOU DO? - Once the time you set is over, look at the goals you set - Did you succeed? Did you set your sights too high? Did something happen in your life to keep you from being successful? If you were successful, give yourself a BIG pat on the back (or maybe a trip to the movies!) ********WAIT!! YOU ARE NOT DONE!!! - Making a change for 2 weeks or a month does not mean that it will stick for life - It is so easy to slip back to your old ways - Practice the new habits faithfully - It will take months before they become your way of life - If you weren't successful, try again - Revise your goals or choose easier ones - Make sure they contain the four parts of setting a goal that's within reach - Make sure you want to make changes in this area and that you believe you can!

Ways to Heat Up Date Night!!

8 Ways to Heat Up Date Night!

Get your heart really pumping on your next date night and sneak in some exercise! With a sense of adventure ( and perhaps a sense of humor ), you could be on your way to burning enough calories for DESSERT!

1. Dance the night away! Salsa, Tango, or foxtrot with your special someone - Ballroom dancing can burn a whopping 240-260 calories in just one hour session!

2. Wander about winter! Take advantage of all winter has to offer- Start a snow ball fight - Build a snowman - Go ice skating or cross country skiing!

3. Walk the dog! Take a leisurely walk with your sweetie and the pooch! Some restaurants and cafes now allow canines in outdoor seating areas - Pack a picnic and head towards the park!

4. Window Shopping! A 30 minute stroll before and after a meal can burn 90 - 130 calories! - You can also break it up into two 15-minute sessions!

5. Rent a Movie! Cue up a fitness video from the library - video store - DVR - or online. Trying a new type of exercise, such as yoga or aerobics, at home allow you the freedom to make mistakes and laugh at yourself (or your partner)!

6. Do some good! Volunteering at a hospital, youth program, school, or park can keep you moving and provide you and your loved one with some special bonding time.

7. Go bowling! Not only is bowling a fun activity to do as a couple or with a group of friends, it is also a great way to strengthen muscles and improve flexibility.

8. Quick and Easy! Don't forget the simple ways to burn calories, whether you are on date night or just out and about. Take the stairs - Park at the far end of parking lot - Avoid automatic doors and open the door for your date yourself!

TOP 10 BENEFITS OF BEING ACTIVE!

1. Improve blood glucose management - Activity makes your body more sensitive to the insulin you make. Activity also burns glucose (calories). Both actions lower blood glucose!



2. Lower blood pressure - Activity helps your heart pump stronger and slower!



3. Improve blood fats - Exercise can raise good cholesterol (HDL) and lower bad cholesterol (LDL) and triglycerides. These changes are heart healthy!



4. Take less insulin or diabetes pills - Activity can lower blood glucose and weight. Both of these may lower how much insulin or diabetes pills you need to take!



5. Lose weight and keep it off - Activity burns calories. If you burn enough calories, you'll trim a few pounds. Stay active and you will keep the weight off!



6. Lower risk for other health problems - Reduce your risk of a heart attack or stroke, some cancers, and bone loss!



7. Gain more energy and sleep better - You'll get better sleep in less time and have more energy, too!



8. Relieve Stress - Work out or walk off daily stress!



9. Build stronger bones and muscles - Weight-bearing activities, such as walking, make bones stronger. Strength-training activities, such as lifting light weights (or even cans of beans), make muscles strong!



10. Be more flexible - Move easier when you are active!

Walk Away a Winner!!!

Good Health has its Rewards: Walk Away a Winner!!

Walking is a great way to get and be fit. Walking improves Circulation and mobility - Promotes weight lass - even helps reduce stress! There is no time better than now to begin a walking routine.

If you are not used to being active, star with 10 minutes each day and build as your energy increases. When you begin, find a comfortable pace and try to add about 3 to 5 minutes to your walking time each week. A good goal to shoot for is to walk 30 to 45 minutes, 5 days a week.

You can use a pedometer to track how many steps you take each day. Experts suggest you build up to 10,000 steps a day = 5 miles. First, check how many steps you do now - Wear the pedometer of 1 week or 2 - find out the average steps you take each day - once you know your starting pint, try to up your daily average by 500 steps every couple of weeks - Before you know it, you will hit 10,000 steps.

Quick tips to put an extra SPRING in your step:

* Stretch for 5-10 minutes before and after every walk.

* Keep a good posture - Gaze forward not down at the ground with your chin level and head up.

* Stay hydrated - drink 8 ounces of water before you begin your walk.

* Wear shoes designed for walking for greater comfort and injury prevention.

* Your walks don't have to be long and strenuous to be beneficial.

If you are a Diabetic:

* Wear your diabetes ID

* Check blood glucose before exercise - under 80 eat a piece of fruit-crackers-glass of milk.

* Check blood glucose after exercise - this will tell you how your glucose react to exercise.

* Carry a snack to eat if you'll be active for a few hours.

By Walking an extra 5 minutes a day - you can burn an additional 24 calories per workout! that may not seem like much, but over the course of 1 year that totals up to 8,760 additional calories burned!!

So get out there and start walking!

Findlay's Day of Dance

The Advanced Footcare Clinic will be at the Day of Dance for Health event sponsored by Blanchard Valley Health Systems! The event is to raise awareness for women's health issues, as well as enjoy a day to enjoy different dance styles, watch dance performance groups, take in music, eat good food, sign up for give-a-ways, receive health screenings and even win door prizes. Our office will have a booth at this event to share valuable health information about your feet. When you are exercising or dancing regularly you can really improve your over-all health. But nothing will hinder your ability to do so quicker than sore feet. So we want to give you tips on how to avoid this type of pain, as well as making you aware that we are available when you do experience foot problems. We will also have special offers and products from our office. Our display will include examples of our new therapeutic shoes. We want our patients to see that our shoes are not what they traditionally think of as therapeutic shoes, but they have been updated to offer great style as well as great footcare. And these shoes are available to all our patients, not just diabetics. We will also have an offer on a free pair of Dr. Comfort brand slippers for anyone who makes an appointment to see the podiatrist. And lastly, we will be offering free giveaways on some of our most recommended moisturizers, creams, scrubs, soaks, and other products.

The event will be held on Saturday, February 27th from 10:00am to 2:00pm. It will be in the University of Findlay's Koehler Center and the admission fee is a toothbrush and/or tube of tooth paste for charity. There is no preregistration required. Any questions can be directed to 419-423-5551. We look forward to seeing you that Saturday to enjoy yourself and learn all about women's health needs.

CUSTOM ORTHOTICS

INCORRECT MOVEMENT STRAINS YOUR FOOT:

When your foot flattens too much, some bones and soft tissue are forced to support too much body weight. Muscles may pull harder on these areas, making it difficult for your ligaments to hold the joints and bones in place. Over time, the strain on the soft tissue and joints may cause foot problems.

Example: When walking - At contact, the inner part of your heel hits the ground instead of the outer edge. During mid stance, the ankle and heel are misaligned and your foot has no arch.

ORTHOSES CONTROL MOVEMENT, STOP STRAIN:

By limiting the swing of your heel, orthoses control the amount your foot flattens. The stress of weight bearing is better distributed throughout your foot, reducing strain on soft tissue and joints. Existing bone or soft tissue changes may not disappear, but orthoses can help reduce of eliminate your foot pain.. If your hips or knees also hurt, orthoses may relieve this symptom, too.

Example: When walking - At heel contact, orthoses limit the swing of your heel so your heel strikes the ground correctly. During mid stance, your orthoses support your foot so it can regain its arch, allowing the ankle and the heel to align.

CUSTOM ORTHOTICS

WHY YOU MAY NEED ORTHOTIC SUPPORT!

Bone and Soft Tissue Changes: Changes in the shape of your foot may be caused or aggravated by over pronation. Some shoe types, such as high heels, or strenuous sports activities, like running, may also stress bones and soft tissue. This irritation may speed up changes or increase pain.

Bunion: The big toe joints shift position, creating a bony bump

Flat foot: Arch of the foot is unstable or weak, resulting in a foot that looks flat.

Plantar Fascitis: The plantar fascia running along the bottom of the foot (heel) becomes inflamed.

Callus: Skin builds up where bone presses against the bottom of the foot

Variations in Body Structure: Your foot may over pronate because of a hip or leg problem. too much flattening of the foot may be your body's way of offsetting faulty limb development. This incorrect foot movement sometimes makes your hips or knees hurt along with your feet.

In - or Out- Toeing: A child's legs, knees, or feet may develop in a way that forces the foot to turn in or out.


Joint Problems: Too much or too little motion is allowed by the joints in the hips, knees, ankles, or feet.

Limb Length: Corresponding bones on the right and left sides of the body are a different lengths.

Medical Problems: Some diseases damage the nerves in your feet, making you unable to feel a cut or a sore. Other illnesses may limit your body's healing ability. Under these conditions, a minor skin break on your foot can lead to serious infections, threatening your overall health.

Diabetes: This health disorder may cause loss of feeling in the feet and may also slow healing.

Arthritis: This disease may cause inflammation or even destroy the joints in the feet.

CUSTOM ORTHOTICS

Understanding Your Feet!

Your feet work hard! They support your weight. They absorb the shock of your body pounding against the ground and they adjust to the many different surfaces you walk and run on. Each foot contains 26 bones, 33 joints, and may types of soft tissue including muscles, tendons, and ligaments.

Bones Form The Framework!

Bones give shape to your foot. The bony structure of the arch also helps your foot support your weight and protect your body from jarring shocks. The joints allow you to bend and move your foot and toes.

Soft Tissue Links Parts!

Your muscles are connect to your bones by tendons. As the muscles of your legs and feet tighten, your foot bones move at their joints. Ligaments connect bone to bone at the joint.

Your Feet On The Move!

As you walk, your heel swings from side to side very slightly, like the pendulum on a clock. When you foot hits the ground, the contact stops the swing of your heels, and your arch begins to flatten. The flattening is called pronation. The opposite movement, supination, happens as your heel lifts off the ground and your foot regains its arch.

When you heel touches the ground, the soft tissue connected to the bones and joints relaxes. Your foot is now able to flatten, adapt to uneven surfaces, and absorb the shock of striking the ground.

During mid stance, your heel reaches the midpoint of its side-to-side swing. Now your heel is below your ankle bone, and the front and back of your foot are aligned. Your foot now bears your full weight.

As your heel lifts, soft tissue connected to bones and joints tightens. Your foot regains its arch. This allows your toes to push your weight off the ground, with your bit toe exerting the most force.

WHY YOU MAY NEED ORTHOTIC SUPPORT

If your heel swings too far when you walk, your foot may be overpronating or flattening too much. this incorrect movement stress and weakens parts of your foot. Over time, you may develop symptoms in your feet, ranging from a change in shape to pain when you walk. If a medical problem places your feet at risk, you may need help protecting their tender area.

Custom Orthotics

Custom Orthotics - Controlling Foot Movement Through Podiatric Care!

Out of sight, out of mind, healthy feet are easily forgotten. But if you feet aren't moving right or you're working them too hard, foot pain may invade you life. Tired aching feet are hard to ignore. Controlling your discomfort can be made by prescription custom orthotics made especially for your feet.

When you feet hurt you can't get far! When it hurts to walk or even just to stand, your feet may slow down your whole life. Swelling changes the way your feet looks, sharp pain when you stand, aching that will not stop! These are just a few common symptoms of foot troubles. Your symptoms may be caused by the way your feet move or by the way your legs are developed. Or you may have a medical condition - Diabetes - that puts your feet at risk for sores, infection, or other health problems.

Custom Orthotics can help!

With years of medial training in foot care, Dr. Thomas F. Vail is an expert in treating foot problems with custom orthotics. Just like contact lenses can improve vision, custom orthotics improve foot movement. The custom orthotic shoe inserts may relieve your symptoms by controlling the way your feet move. Custom orthotics may also help compensate for a problem in your hips or knees that causes incorrect foot movement. Custom orthotics may protect tender areas of your feet from the constant wear and tear from use. Even if your foot problem is best treated by surgery, custom orthotics may delay the need for surgery and help maintain your surgical correction afterwards.

Custom orthotics come in a variety of materials, ranging from rigid plastic to soft foam. All of these materials can be shaped to fit your individual foot needs. The rigid custom orthotics offer the most control of movement, while the softer custom orthotics provide better cushioning and protection. When prescribing your custom orthotics, Dr. Thomas F. Vail will make the best match between your needs and the qualities of the materials.

Custom Orthotics

Custom foot orthotics are designed for you based on the degree of mechanical control you require, your activity leve, your physical status and the type of footwear in which you will wear your orthotics. Wearing custom orthotics can help decrease or eliminate pain from corns, calluses, and leg/joint/muscle fatigue. Professionally fitted custom orthotics can improve posture - correct overall anatomical misalignment that cause stress and pain in the other parts of your body. When used of Athletic activities, custom orthotics can reduce muscle fatigue and enhance performance.

Breaking in your new custom orthotics - for best results it is critical that you break in the new custom orthotics gradually. This can take 2-3 weeks. It takes time to correct a problem you have acquired over many years. Your new custom orthotics will help teach you body to move in a healthier way. It is not unusual to be conscious of your feet and "FEEL" the new custom orthotics while your body is learning to walk in a better way.

Normal things you will feel during the breaking in period &/or the adjustment period can be:

A feeling of pressure &/or firmness in the heel.
A Mild -Moderate feeling of pressure &/or support in the arch area
You may fee a mild awareness of the outer border & heel seats of the new custom orthotics

It's a good idea to purchase a new pair of shoes with plenty of room for your new custom orthotics. Should this not be possible, make sure that the heels and soles of the shoes are not excessively worn. Before you place your new custom orthotics in either new or old shoes, it is important to take out the removable insoles from inside the shoes.

You should initially wear your new custom orthotics over a gradually increasing period of time until you can wear them comfortably all day:

First day 2 hours including sitting time.
Second day 4 hours including sitting time
Third Day 6 hours including sitting time
Fourth Day 8 hours including sitting time

Any time during this break-in period should you develop uncomfortable feelings in your feet, ankles, hips, knees, or low back - you should remove the new custom orthotics from your shoes and go without them for a day possibly 2 days. You make take your choice of OTC pain relief medication. After pain has subsided then you may put the new custom orthotics back in your shoes and begin wearing at the time frame that the pain started - Say Second Day 4 hours when pain began - pick up with the instructions for Second Day. You should continue this pattern until you can wear your new custom orthotics all day.

Helpful Hints to assure your satisfaction with new custom orthotics:

Always bring your orthotics when buying shoes - Remember, shoes with deeper heel seats (depth in the back of the shoe) and higher heel counters ( the outer part of the shoe that supports the back of your foot) will enhance the success of your new custom orthotics

Women's Shoes/ Low Cut - Your heel may possibly slip out of the shoes, especially if they are the step-in shoes. Should this happen, try other shoe styles with the new custom orthotics

Cleaning - Wipe the vinyl surface with a damp, not wet cloth. Never soak your new custom orthotics in water!

Take new custom orthotics out of your shoes overnight - "Airing" will enhance both the life of your new custom orthotics and the life of your shoes.

Squeaking - sometimes your new custom orthotics will "Squeak" in your shoes. Should this happen, sprinkle some baby powder in your shoes before putting the new custom orthotics inside. Sometimes soap or wax to the edges of the new custom orthotics also works.

Professional Evaluation for your new custom orthotics - Make sure you see your foot care specialist at least once a year. Make an appointment sooner if you experience wight gain, become pregnant, injured, or uncomfortable in your new custom orthotics. Make sure to bring your custom orthotics and your shoes in which you wear them to each appointment for evaluation.

Custom Orthotics

Women tend to bring into our office with them a bag full of dress shoes, whether they be casual, flats, dress pumps or dress heels . Men and Women alike need to realize that a custom orthotics if not a shoe issue, custom orthotics are to be made for their feet. We must treat the pathology of the foot not the shoe. Let's face it women have alot more pairs of shoes then men do. Women do like their shoes, I know I do. We have to take into account the variety of function and fashionable shoes, evaluate the bio mechanics of the foot, and what specific material and unique orthotic materials and modifications are necessary for the patient. A dress shoe can be labeled from the most functional/ stable shoe to the least stable shoe. Choosing a custom orthotics for the dress shoe is very much the same as choosing for an athletic shoe. Dress shoes that have a stiff heel that holds the heel in a stable position and also allows a functional custom orthotics to increase the stability of the rear foot. To test your dress shoes or any other shoe for a stiff heel - squeeze the heel counter ( back of the heel ) together and make sure it is firm. Stability in the mid shoe for the mid-foot - hold the shoe with one hand on the toe box and the other hand on the heel box - try to twist the shoe from side to side and bend in the middle - a good shoe will not flex much / You want the shoe to not bend like a pretzel - this will prove to be a stable shoe. Shoes that have a removable original insole will allow for more room in the shoes for a custom orthotics. A loafer or dress flat shoe is the best representative of the most stable shoe- stiff heel counter and stiff upper. Women need to understand that the custom orthotics and the proper shoe will provide the best bio-mechanics control for your feet.