If you read The OMPT Daily or any or my previous Quick Links, you'll know I am a fan of The Gait Guys. Occasionally in their posts, I get a bit lost due to shoe fit terminology, and the methods of shoe fit pertaining
to running injuries or general LQ issues.
For that reason, I decided to pony up and take their Shoe Fit course, which can be found here. This is parts 1-3 and is considered their "medical" series and is about 3 hours and 15 minutes of great material.
"pronation makes the foot a flexible adaptor, supination a rigid lever"
Parts 1 and 2 are broken down into foot/ankle and some hip/knee anatomy and biomechanics. Gait was reviewed as well in additional to some functional and palpation/visual testing needed to assess which shoe may be right for your patient/client. It was a great review and as much as we all want symmetry, sometimes genetics just plays you a hand you may not be able to ignore.
Since joint/tissue mobilization do not affect bony position and only movement, sometimes there is only so much we can do with the hand that is dealt us!
|ordered one shortly after starting the course|
“there are no Swiss army knives in shoes”
Part 3 is the meat I was looking for more information on and it did not disappoint, except that I felt at 1 hour and 15 minutes that it was too short! You learn about using a Brannock Device to measure for foot and arch length - which is important because it tells you where the first ray should bend in a toe box. You also learn about the anatomy of a shoe - for example, do you know what the vamp, last, or crash zone are? You should, especially if you treat people who have feet and wear shoes. Some of this information already helped a current case of a marathoner with intermittent left lateral knee pain. I will write that case up later this week.
The Gait Guys Runner's Problem's List
Most Runners Problems
- wrong shoes, poorly fit shoes
- too much mileage on shoes
- bad technique
- different foot types may not tolerate different running styles
- poor anatomy - genes (alignment)
- bad orthotics or no orthotics (usually bad)
- the thigh is in control of the hip
If you look at what they list first, you can change the first with you current training - go buy a new shoe. However, what if the shoe isn't properly fit for your patient? What if the involved foot is larger or smaller than the uninvolved foot? What if the shoe has a defect? - 3-5% of all manufactured shoes. All your manual therapies, form coaching, stability training and corrective exercises may not be enough!
What's the verdict?
Highly recommended! If you are serious about treating patients with lower quarter issues, especially runners or anyone with hips, knees, spines, and feet, you should think about Shoe Fit and how it may impact them. Since most of us as clinicians have no formal training in the importance of measuring feet, knees, and hips for functional Shoe Fit, it's a worthwhile course that is immediately applicable to your practice.
Keeping it Eclectic...