ORLANDO, Fla. — Athletic footwear has evolved through the ages, and with it must evolve pedorthic techniques for working with athletes, according to Jeremy Long, BOCPD, who presented at the Pedorthic Footcare Association and American Podiatric Medical Association Combined Meeting, here.
Long is a Pedorthic Footcare Association (PFA) board member who has worked in both the athletic footwear and pedorthic industries for more than 20 years. He currently works as a pedorthist for of Orthotic Holdings.
For most of recorded history, Long said, athletes performed barefoot. Shoes have changed over time to adapt to sports, from the competitive track spike introduced in 1895 to the vulcanized rubber shoe in 1921 and molded rubber outsoles in 1965.
Long became involved in the athletic footwear industry in the 1990s.
“It was really a golden age and a change of athletic performance footwear,” he said. “We started applying lots of different technologies.”
Although technology has evolved, no one shoe is right for everyone; athletes still need pedorthic care because different shoes are best for different sports and foot types. Long said today’s athletes are looking for shoes that are lighter weight, offer more cushioning and aesthetic flare, and offer an advantage over the opponent. Injury prevention is not always a top priority for the young athlete, but it needs to be the top priority for the pedorthist, according to Long.
“You bring up injury prevention and it is not an important characteristic for them. [For] kids who are 20 [years old] or younger, it is almost never a consideration,” he said.
One major challenge to working with athletes is the conflict between their contracts — in particular, any type of deal with a shoe company that requires the athlete to wear that brand while performing — and the pedorthist’s treatment plans.
“We are almost stuck entirely within the realms of whatever they are dealing with contractually,” Long said. “You have to find some way to modify that footwear to keep the athlete healthy and performing.”
According to Long, some common liabilities among current athletic shoes include fit limitations, a lack of width options among top name brands, slender shanks, sole deformities and lateral flaring. These problems can lead to plantar fasciitis, turf toe, Lisfranc tendon strain or fracture, and Achilles tendonitis.
Pedorthists should address these problems by working to stabilize the heel within the counter, reduce excessive midfoot tortion and reduce unwanted longitudinal flexion, according to Long.
“Also, as much as possible, [pedorthists should be] doing what we can to improve the overall fit of the shoes so we are not producing other midfoot and forefoot injury conditions,” he added.
In addition, he said, pedorthists should educate athletes, coaches, parents and anyone else involved in the choice of footwear.
“It bodes upon us to identify and understand what shoes are available to them within their player pool and help guide them into the products that have better injury protection elements to them,” he said.
Athletes not confined by a contract typically try to balance price with injury risk. Long said a good rule of thumb is a $100 price point for midfoot protection.
Most importantly, Long said, pedorthists need to identify the athlete’s specific needs.
“Use your knowledge as an experienced pedorthist to get the right effect for your patients, case by case,” he said. “Athletes want to get back into competition. Use yourself as a team with their athletic trainers, physical therapists and coaches so you can get them back to competition as soon as possible.” – by Amanda Alexander
Long J. Advanced pedorthic techniques for modern athletic footwear. Presented at: Pedorthic Footcare Association and American Podiatric Medical Association Combined Meeting; July 23-25, 2015; Orlando, Fla.
Disclosure: Long reports no relevant financial disclosures.