___________________ Foot Pathology Trainer’s Guide Reproduced in part from Bill Meanwell’s Certified Pedorthist Course

*Note: Foot Pathology is used to understand and better assist Good Feet customers. We DON’T play doctor. NEVER diagnose customers’ ailments, or prescribe products to heal them NEVER discuss the name, causes or cures of a pathology with a customer unless you’re reviewing information they received from their doctor Customers with severe foot pathologies should be referred to their physicians

The Three Arch Types High Arch “Normal” Arch Flat Foot The Look: In a High Arch, the heel bone is angled directly toward the ground. The Look: In a “Normal” Arch, the heel bone is at a 45-degree angle with the ground The Look: In a Flat Foot, the heel bone is almost directly parallel to the ground The Feel: The foot tends to be rigid The Feel: The foot tends to be semi-rigid, semi-flexible The Feel: The foot tends to be more flexible

Type I: High Arches “Pes Cavus” in Latin High arches are less common than flat feet and more susceptible to orthopedic and neurological conditions such as: Hammer toes Plantar fasciitis More likely to be painful than flat feet due to excess pressure on the metatarsals Can be difficult to fit in shoes – the middle of the shoe squeezes the mid-foot, and claw- or hammer toes need more room

Type III: Flat Feet “Pes planus” in Latin More of the foot surface is in contact with the ground than normal Flat feet are the result of a decreased or absent inner longitudinal arch. The majority of flat feet are considered variations of normal.

Plantar Fasciitis Inflammation of the Plantar Fascia Feels like: Dull bruise or stabbing under heel Worse in the morning or after sitting for an extended period Common causes: Excessive weight bearing Frequent contact with hard surfaces Ill-fitting or unsupportive shoes How Can Arch Supports Help? Metatarsal rise supports Metatarsal Arch which decreases pressure on Plantar Fascia ligament Foot maintains a supported position in all shoes and activities Prevents foot from over-pronating /supinating

Fitting the Diabetic Customer Diabetes can lead to “Neuropathy.” Neuropathy means: A loss of sensitivity in the feet or an inability to discern changes in foot function or sensation. Sometimes neuropathy is characterized by oversensitivity. Why Diabetics must take extra care of their feet: Poor-fitting shoes can increase the risk of ulcerations or infections What to know when fitting diabetic customers: The break-in process must be adjusted for sensitive feet

Complications of Diabetes Foot infections can go undetected and untreated Ulcerations can develop Severe bacteria-born infections may occur

Rheumatoid RA NOTE! RA is an inflammatory disease Symptoms include: Pain Swelling Stiffness Loss of function in the joints. NOTE! People with RA can’t break in their arch supports normally. DO NOT encourage customers with RA to wear supports that aren’t immediately comfortable.

Osteoarthritis Caused by inflammation, breakdown, and eventual loss of the cartilage of the joints Repetitive use of the joints over the years irritates and inflames the cartilage, causing joint pain and swelling. Results in limitation of joint mobility. Inflammation of the cartilage can also stimulate the growth of spurs forming around the joints.

Corns How can Good Feet help? Hardened area(s) rooted past the surface layers of skin on the toes. Common Causes: Ill-fitting shoes Constant pressure on the toe joints How can Good Feet help? With arch supports that are designed to stabilize and elevate all four arches, alleviating pressure on toe joints And better-fitting shoes

Calluses Hardened area(s) on the surface layers of the skin Common causes: Ill-fitting shoes Prominent bones Increased pressure or rubbing on a specific area of the foot for an extended period of time How can Good Feet help? With arch supports that are designed to alleviate pressure from afflicted areas and stabilize the foot

Heel Spur A calcification projecting from the back or underside of the heel that often makes walking painful People with heel spurs experience similar symptoms as those with plantar fasciitis How can Good Feet help? With arch supports that are designed to: Take pressure off the heel Provide heel support which alleviates additional stress to the area And provides a cushioning effect during the heel strike phase of gait

Posterior Tibial Tendon Disorder Posterior Tibial Tendon Dysfunction (PTTD): A progressive form of tendonitis that occurs on the inside of the ankle. With increasing deformity of the foot, the joints in the foot get very stiff, and little in or outward movement of the foot is possible.

Hallux Abducto Valgus HAV is Characterized by: Common causes: Deviation of the great toe towards the second enlargement of the medial first metatarsal head. Common causes: Heredity and anatomical predisposition Repeated minor injury from wearing narrow, pointed shoes and high heels, Excessive pronation or added body weight Injury, arthritis, or weakened muscles. How can Good Feet help? With arch supports that support all 4 arches Better-fitting shoes designed to alleviate pressure from afflicted areas and stabilize the foot

Morton’s Neuroma Morton’s Neuroma: A common benign nerve enlargement usually developing between the third and fourth metatarsals and most often found in women resulting in irritation and inflammation Causes: High heels and other narrow / tight / ill-fitting shoes

Metatarsalgia Metatarsalgia: A condition characterized by pain emanating from the metatarsal heads that increases with weight bearing and pressure. Shoes with higher heels that place the majority weight on the forefoot and metatarsals often worsen this condition. Affects the metatarsal bones and joints of the ball of the foot. One or more of the metatarsal joints becomes irritated or inflamed Common Causes: Excessive pressure from high heels / tight / narrow / ill-fitting shoes