The Update Spring 2019

FitFirst Ladysport 3713 Kensington Ave 3545 W. 4th Ave Burnaby, B.C. Vancouver, B.C. V5B 0A7 V6R 1N9 www.fitfirst.ca www.ladysport.ca

The Shoe Update - Spring 2019

The Shoe Update Spring 2019

Table of Contents

Commentary

Shoe Construction – Terminology and Definitions

How to Choose the Right Pair of – Putting Fit First

Metatarsalgia: A Footwear Prescription

Heel Slippage – No Simple Solution

The New Age Flip Flop – Improved support with traditional convenience

Shoe Charts - An in-depth, categorized look at what’s new

Key Models – Your categorized model cheat sheet

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca The Shoe Update - Spring 2019

Commentary

Years ago, a medical supply company printed informational brochures describing a variety of sports-related injuries. These brochures included a description of each injury with a basic treatment plan and suggestions for how to return to play; each brochure also listed “predisposing factors” for each injury or pathology. “Footwear” was listed in most—if not all— of their top-ten considerations.

It has taken me a lifetime to appreciate that each patient is likely affected in some way by not one, but all of the listed predisposing factors—in a unique sequence of priority.

For instance, for one patient footwear may be the number-ten influencer, whereas for another individual footwear sits at number two. The genius is in putting the factors in order of significance and attacking the injury appropriately. As part of the healthcare team, we all need to be aware that our area of expertise, our specific tool, should not always be the first one out of the toolbox. As a shoe fitter, I’ve learned to see shoes as just one part of a holistic solution. When called upon, I need to be open to and appreciate all footwear options in order to have success.

There are no simple solutions to complex problems. An educated, experienced, humble, and open mind will allow the healthcare team to be successful and the patient to get back to sport faster.

The shoe update is a guide to the shoe-fitters toolbox. Feel free to drop by the stores and try some on for size, to better understand how we can help you and your team.

Cheers,

Phil, Brett, Evan

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca The Shoe Update - Spring 2019

Shoe Construction Terminology and Definitions

Motion Control To be deemed worthy of the term motion control, the shoe should have at least six of the following ten features: 1. Thermoplastic Heel Counter 2. Medial Midsole Plug 3. Torsional Rigidity 4. Straight Last 5. Motion Control Collar 6. External Arch Support 7. Medial Strapping/Upper 8. Broad Sole Plate 9. Firm Midsole 10. Heel Counter Medial Extension

Numbers (1), (2), and (3) are virtual necessities to classify a shoe as "motion control". The label of motion control is difficult to achieve, and rarely given to any shoe other than a running shoe. The reason is because running shoes are designed to take issue with the biomechanical peculiarities of the heel-toe gait pattern under high impact. Problems resulting from misalignment due to excessive pronation during this gait pattern are well-documented (ex. patello-femoral syndrome, plantar fasciitis, etc). Shoe designers and biomechanists are very conscious of foot type when building these shoes, so motion control is usually front and centre. With cross-trainers, tennis shoes, basketball shoes, and others, sport specific attributes are more important to the designer than are the mechanical or foot specific features. Therefore, true motion control is a rare commodity outside of the running market. More pronation control walkers and running oriented cross-trainers will likely be introduced in the near future as the population ages, and consumers become more cerebral about even the most recreational of purchases: their .

Stability I define stability as a relatively straight lasted shoe that has many of the qualities of a motion control shoe, with torsional rigidity, a strong heel counter and firm midsole. Where it differs is that it is less pronounced in its medial posting. Instead of a plastic plug or post, it has only dense medial foam (eg. Asics Duomax). In other words, a pronation control shoe without

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca The Shoe Update - Spring 2019 the exclamation mark! The designers clearly have the excessive pronator in mind, but are trying to create a nicer ride without too much control. Some feel that the chance for lateral midsole collapse is reduced because the difference in density of the midsole, from medial to lateral, is less than in the classic motion control shoe. Many orthotic providers are reluctant to put their orthotics in shoes with medial posting. The denser medial column may influence the correction of the orthotic, and with extended wear, cause premature collapse of the lateral rear midsole. This fear of lateral collapse may be as much from design influences on the rearfoot, aimed at slowing the rate of pronation as from the medial posting. See the attached article for more on lateral heel design evolution.

Neutral Supportive In this style, the last shape and firmness of the lateral midsole column is similar to that found in most stability shoes. The difference here is there is no dense medial midsole material of any kind. The entire midsole is quite firm, to act as a supportive foundation for an orthotic or the impact of a heavier/harder heel strike. Neutral supportive is the most common referral category for orthotics, as the platform is the same on both sides. One thing to keep in mind is that if the lateral column is soft, then the shoe may collapse to the outside, regardless of the presence of any denser medial posting. Firm lateral columns made of dense EVA or, even better, polyurethane may be the answer. So if the orthotic provider needs a little extra from the shoe some medial posting in the right shoe may prove useful. Just ask that the lateral midsole be appropriately firm to last the life of the shoe.

Neutral Cushion Slightly more curve lasted, but not necessarily more torsionally flexible. The midsole is softer than a neutral supportive shoe and has a more squishy, bouncy ride. An orthotic wearer who has some shock attenuation issues may do better here than in a neutral supportive model.

Cavus Flexible and Ultra Cushioned A forgotten category! It seems that torsional flexibility in the midfoot and marshmallow soft midsoles are a thing of the past, possibly because designers think that torsional flexibility does not necessarily help a rigid cavus foot to pronate. Therefore, they support it into the midfoot and give it lots of shock attenuation. That would mean one should fit that cavus foot in a standard cushion shoe above.

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca The Shoe Update - Spring 2019

Minimalist Running A minimalist running shoe has a combination of features that differentiate it from a traditional runner. 1. The ramp angle, or drop, is less than 10 mm. Drops are usually 4-8 mm, but can be as low as 0 mm. 2. Lightweight – These shoes are lighter weight, much of that due to the reduction in the midsole.

Minimalist (Natural) This minimalist category is defined by its torsional flexibility and lack of supportive upper. The midsole flexes in all planes, and the heel counter is often non-existent.

Minimalist (Traditional) This minimalist category is defined by its traditional torsional rigidity and supportive upper. The midsole doesn’t flex in all planes and the heel counter is firm.

Last Type The last is the mold around which the shoe is made. It influences many things about the shoe including, most importantly, the fit and support. A shoe is designed around a last just like a dress is designed around a pattern. The last is the culmination of all the designer’s wants and needs with respect to the fit of the shoe. Now depending on the materials chosen and the manufacturing process, the end result may or may not reflect the last mandate, but when the same mold is used there is a greater chance of consistency. Straight lasted shoes generally provide superior support for the pes planus, or flatter foot, a common excessive pronator. The curved last is often associated with the cavus, or high rigid arched foot, and can commonly be sculpted or dished away under the long arch, making the shoe torsionally more flexible. Lasts that are neither very straight, nor very curved can be denoted semi-curved (SC), as even the straightest of the straight lasts used in athletic shoes have a curve of approximately 8 degrees.

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca The Shoe Update - Spring 2019

Board Last, Slip Last & Strobel Last When manufacturing a shoe, there are 3 basic ways to laminate the upper to the midsole or foamy base of the shoe: 1. Board lasting is where the sides of the upper of the shoe are tucked under a board and the board is glued to the midsole holding the two together. This board usually stops just before the metatarsals. From here the sides of the upper are joined together, sewn and glued down. The board creates increased torsional rigidity in the rearfoot with maximum flexibility in the forefoot. 2. Slip lasting is what occurred in the forefoot of example (1). The upper is sewn together as one piece from heel to toe; negating the need for a board to bind the sides of the upper. This or slip lasting is used in some shoes from heel to toe to increase flexibility and aid in achieving a snug contoured fit to the foot. 3. Strobel lasting is now the most popular way to construct an upper. It is really a modification of the slip last. It’s like sewing a flat insole around its outer edge to the rest of the upper. The midsole sits on this sole-shaped piece of material. Companies are using midsole materials for this base piece to get enhanced cushioning in the shoe.

Combination Lasting A method of lasting where the forefoot is slip lasted and the rearfoot is board lasted. This allows for flexibility in the forefoot and extra support in the rearfoot. Combination lasting is mostly used to add torsional rigidity in shoes. In the charts we say “board lasting” as a short form for combination pronators.

Midsole The midsole is the area between the upper and the outersole of the shoe. Usually made of EVA pre-compressed foam or polyurethane, this is where all the shock-absorbing bells and whistles are housed. Air bags, hexalite gel, etc., along with the foam, helps to attenuate the shock while its firmness or softness dictates the shoe’s rating for stability, rigidity and often its motion control capabilities. It is also here that densities of material are varied to increase medial control and forefoot flexibility depending on the durometer, or firmness, of the material that is chosen and placed in key areas of the shoe.

Dual Density Midsole A firmer density of EVA located on the medial side of the midsole which guards against premature medial midsole breakdown, common to excessive pronators.

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca The Shoe Update - Spring 2019

Medial Post Lodged into the medial, or inside aspect, side of the midsole are firm plastic or urethane plugs that keep the foams from collapsing under the extra pressure exerted by excessive pronation. In some cases, this plug is an integral part of the heel counter and acts as a restrictive post and a control mechanism for rearfoot pronation. In other cases, the post is simply a firmer, higher density material on the medial aspect of the shoe. Many posts are now incorporated as part of the midfoot shank (see below) and extend into the medial midsole. Posts are rarely found in the forefoot.

Midfoot Shanks Companies have a variety of proprietary names for their midfoot shanks, which separate the forefoot from the rearfoot of the shoe. It allows the designer to cut away part of the midsole, and replace it with a hard, lightweight hytrel plastic, reducing the weight of the shoe, while enhancing torsional rigidity. Asics uses two trusstic plates, with a space between them, so that the midstance and foot sink towards the ground, enhancing the windlass effect of the shoe (See the Asics website for more info on the Space Trusstic System).

Exceptional Heel Counter The formed thermoplastic cup inside the heel portion of the upper of the shoe is the most important structural part of any piece of footwear. All control begins and ends with this feature. Some models have plastic or molded collars added externally to the heel counter that reinforce it and/or hook into the medial posts; these are deemed worthy of the label exceptional! Rarely does a running shoe make it on the wall without this feature. Some are bombproof, but most are very good.

Decoupled Heel One of the early design efforts to slow the rate of pronation was to put a slice through the outsole and a bit of the midsole of a runner at an acute angle to allow the heel to decouple upon heel strike, thus reducing the lever arm at that moment. The outsole and midsole would widen out, creating less lateral collapse of the midsole, and a broader base of support. This was a revolutionary feature which, though it has evolved, is around in some form in all technical running models. has taken the concept the furthest by almost hinging this section so that it truly decouples at heel strike.

Foot Bed This term refers to the insole of the shoe, which, though made with numerous types of materials, essentially acts as a comfortable liner for the shoe. Rarely does it enhance support, LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca The Shoe Update - Spring 2019 and it is often replaced by an off-the-shelf arch support or a custom orthotic. Almost all of the better athletic shoes have this removable insert. Manufacturers should dedicate more time and money to making this a useful, supportive accessory.

Foot Frame/Cupsole In shoes which are designed for court or lateral activity, the midsole is molded up the side of the foot at key stress areas to aid in keeping the foot over the sole plate, decreasing the risk of inversion sprain and lateral breakdown of the shoe. The feature is found in court shoes (when made properly) and in cross-trainers.

Saddle This is the area of the upper that wraps the arch, the portion of the shoe that the eyelets are cut into. Often the company logo is placed here and sewn in such a way to enhance the midfoot support of the shoe. Plastics are sometimes used to add substance to this region, but at the cost of fit. Some are using cables, hooked into the eyelets to gain support as the shoe is laced up.

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca The Shoe Update - Spring 2019

Toe Spring The amount of upward tilt of the toe of the shoe, internally defined by the last used to create that shoe. The greater the toe spring of the shoe, the more the toes are dorsiflexed. The toe spring is often part of the overall rocker profile (see definition below) of the shoe.

Rocker The rocker is defined by the amount of taper in the midsole. Forefoot rocker is made by tapering the midsole at the ball of the foot, thinning it out distally. The apex of the rocker can be set at different points, measured as a percentage of the length of the shoe. A forefoot rocker set at 60% of the length from heel to toe will affect the pressure relief at the metatarsals differently than one set at 80%, or closer to the toe of the shoe. The same principle applies to rear foot rockers in reverse, and effects different biomechanics.

Rocker Profile The rocker profile of a shoe is a combination of rocker tapering and toe spring. This is the usual term used to describe most off-the-shelf running and walking shoes.

Drop The drop of a shoe is the difference in height between the heel and the ball of the foot.

Ramp angle The ramp angle of a shoe is the angle that the shoe pitches forward from heel to toe.

Stack Height The stack height of a shoe is the height from the bottom of the shoe sole to the bottom of the foot in the shoe. That is, the addition of the thickness of the outer sole, midsole, and insole.

Stretchable Uppers Traditional upper materials like leather and synthetic leathers, which have a limited amount of give, are being combined with 4 way stretchable materials, including Lycra and spandex, to help accommodate foot abnormalities (bunions, hammer toes, claw toes, etc.). XSensible footwear combines thin leather or suede skins with a combination of Lycra and spandex to create orthopaedic magic in a dress casual shoe. Athletic suppliers are also using stretchable material insets to accommodate protruding Taylor’s bunions. Some orthopaedic companies like Propet, Pedor, and P.W. Minor are making shoes with completely elastic toe boxes, which are useful for fitting individuals with diabetes or arthritic feet. LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca The Shoe Update - Spring 2019

Rocker Soles The most popular prescription right now is for a stiff rocker soled shoe to help manage many forms of metatarsalgia. Many types of athletic designs increase the “rocker profile” or “toe spring” of the shoe and the toe of the shoe often appears slightly “turned up”. When this “rocker profile” is combined with a lack of flexibility, a rocker sole effect is often achieved. True rocker soles are internally flat and have a rocker that is apexed in the forefoot. Some shoes have a heel/toe rocker whose shape is much like that of a rocking horse. In these shoe designs, the toes sit in a dorsi-flexed position when the foot is bearing weight. This is a very useful strategy for limiting movement at the metatarsals and can act like a splint for the forefoot, while letting the individual ambulate normally.

Hokas and “Maximalism” Developed by a European trail runner, this platform “moonboot” running shoe is winning trail runs all over Europe. Its application here is far more often as an orthopaedic device to manage metatarsalgia in the general population. The stiff rockered thick sole provides an extremely lightweight and cushioned base that is stable and supportive. By splinting the forefoot there is minimal flex at the MT heads and relief for the neuroma, hallux rigidus, and rheumatoid arthritis sufferer. Goofy looking, but it can put a smile on the face of the crankiest foot!

Skeletal Heel Counter In some cases heel counters are being minimalized by removing some of the girth of the counter leaving only a skeletal framework to support the rearfoot. This is done primarily to reduce weight, and promoted as being just as strong as the traditional “bomb proof” heel counters celebrated for their control of rearfoot motion. You be the judge!

Minimalism The barefoot movement created a visceral response by the athletic shoe manufacturers to develop a “new” category of shoes called “minimalist” footwear! Unlike the traditional jogging shoe which has a fairly consistent midsole heel to toe grade of 12mm (eg. 24 mm heel height and 12 mm forefoot height), minimalist shoe grades are anywhere from 0 mm to 8 mm. The shoe heights from the ground are as varied as the number of styles. In some ways the variety of heel heights can be useful as long as one knows what they are putting their feet into. Recommending styles to patients becomes a daunting task with all these different measurements! LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca The Shoe Update - Spring 2019

The idea behind wearing “less shoe” is the conventional running shoe and its progressive pronation control systems are causing more harm than good. Feet were made to move freely and are therefore stronger and more efficient when left unshod. With the minimalist shoe, the gait returns to a more natural midfoot strike and many injuries are avoided. Which injuries, and who exactly are candidates for this strategy is the million dollar question! Most minimalist shoes are recommended as an adjunct to your traditional footwear. You are to introduce it gradually and see if indeed “less” is “more”. So far a lack of education and compliance has been the biggest hurdle, but with a well-designed strategy and the right amount of minimalism… sometimes the most stubborn problem is only a “minimalist “step away! There are two main categories of minimalist shoes, Tradition and Barefoot. 1. Traditional Minimalism: Some shoes have the traditional heel counter support and torsional rigidity; they are just thinner and more “minimal” in that respect. These shoes are a throwback to the old racing & training shoes of the late ‘70s. Running with an athletic midfoot strike has always been the ideal gait pattern for this style of footwear. One should be aware of the reduced heel height and possible extra strain on the Achilles and gastroc/soleus. A good example of a traditional minimalist shoe is the 1400, or the Cortana. 2. Barefoot Minimalism: This type of minimalist shoe is, in the same design way, attempting to create more freedom of movement by minimalizing the amount of support in the shoe. This is usually done by all but eliminating a heel counter and designing the midsole/outsole to be torsionally flexible, thus mimicking a shoeless scenario. The midsole thickness and heel grade can vary significantly, but are usually relatively low profile.

The Nike Free is a barefoot minimalist shoe category developed by Nike which allows maximum foot flexibility in all planes while still offering protection with some cushioning and a -like upper. The idea is to allow the athlete an opportunity to exercise the foot, increase proprioception, and build intrinsic strength. It is suggested to initially use in conjunction with your regular footwear, as a training tool for your feet. There are two main styles of the Free shoes; the 5.0 and the 3.0. The 5.0 is thicker than the 3.0, and is built with a 7 mm grade. The 3.0 is one step closer to being shoeless, with its low profile and narrower midfoot. The Vibram Five Fingers line is another example of barefoot minimalist shoes. The Five Fingers is a foot covering where the toes go into five finger-like sleeves. This shoe line is a staple for the barefoot fundamentalist.

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca The Shoe Update - Spring 2019

3. Minimalism Guidance: For a complete guide to Minimalist shoes and a minimalist shoe rating scale visit …… therunningclinic.com. On the shoe charts in the shoe update we have used their minimalist ratings to help you differentiate one minimalist model from another. At the back of the shoe update you will find a helpful flow chart showing the transition times recommended for those desiring to move to more minimalist footwear from their traditional supportive shoes. Notice the extensive adaptation time required to even have a chance of success. The body needs time to adapt and the runner must understand the requirements for success. Keep in mind that the founders of the runningclinic.com do favor the minimalist approach to running but also realize that many acute foot and ankle pathologies may need more support and cushioning in at least the short term. Sharing philosophies and listening to varied points of view and research is fundamental in having a healthy holistic approach to problem solving!

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca The Shoe Update – Spring 2019

How to Choose the Right Pair of Shoes

These days, with thousands of different models of shoes on the market, it is virtually impossible for consumers to select on their own, the most appropriate brand and model for their individual foot type and function.

Inappropriate, ill-fitting, or worn out shoes can increase the chance of injury. As well, over time shoes lose their stability and capacity to absorb shock which can dramatically increase stress to your feet and legs. These added stresses could lead to blisters and calluses as well as contribute to lower limb overuse injuries causing heel, arch and shin pain. Foot shape is only one factor which determines the type of athletic shoes that is best for you.

FitFirst Footwear strives to stay on top of the latest trends and technologies and are there to assist with fit and recommend the most appropriate running and walking shoe for your foot type. Whether you are training for a certain event, getting ready for summer activities, or working your way back from an injury, our store’s staff is here to help!

Shoes Matter: • Many Studies show that our quality of life is directly related to remaining active, with a long list of benefits from preventing heart disease to improving mental health. Proper fitting and functioning footwear is crucial to maintaining an active lifestyle and preventing exercise related injury.

Fit Matters: • Poor fitting footwear is a primary contributor to foot and ankle injury and can exacerbate many common health conditions. Foot size, forefoot width and arch type are essential measurements in a proper footwear fitting, but there is more to know about ensuring an ideal fit.

• Black toenails and foot cramping are often signs that your shoes are too small or narrow. When running, the more distance you cover during individual runs or walks the longer your shoe needs to be.

• When cross training and moving laterally, look for a sturdy shoe with a snug fit that makes the foot feel as though it is taped within the shoe.

Your Health Matters: • At FitFirst Footwear, we know an annual foot measurement and attention to your changing health needs makes a significant difference in choosing footwear to keep you active and injury free. Whether you wear orthotics, have arthritis, diabetes, or experience changes in your feet during pregnancy, our team will provide you with the knowledge you need and a level of service and customer care that stands above the rest.

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca The Shoe Update – Spring 2019

Metatarsalgia: A Footwear Prescription

As shoe retailers, we often receive footwear prescriptions from podiatrists for patients suffering from metatarsalgia. On many of these prescriptions, the referring doctor makes note of a few footwear features that are expected to help in managing the patient's overall foot discomfort.

These features generally include: • The ability to accommodate a custom orthotic • Provision of a deep roomy toebox

More recently the prescription has also requested: • A stiff-rockered sole to help minimize loading at the ball of the foot.

The purpose of this article is to provide a brief overview of key models and designs that have proven useful in managing patients suffering from metatarsalgia.

Hoka: These stiff-rockered, lightweight, ultra-marathon running shoes offer both a stiffness and rocker profile that is unmatched in athletic footwear. Hokas are also extremely useful for patients transitioning from an unloader walking back into day- to-day footwear. They have produced excellent results for patients recovering from a recent ankle fusion/ replacement or for those suffering from plantar fasciitis.

New Balance Fresh Foam More: New Balance has just officially entered the Maximalist Shoe Market that has been dominated for years by Hoka. The More has a similar rockered profile but is even stiffer than it’s competition. The More is available in medium wide and extra wide fittings, whereas Hoka has only medium and wide options.. In the rearfoot the medial sidewall of the More is extremely deep helping it to offer a significant amount pronation support.

The Shoe Update – Spring 2019

ON Footwear: These new Swiss designed shoes include stiff propulsion plates, making them less flexible from heel to toe.

Hiking and Trail shoes: Many trail running shoes have rock plates lodged into the midsole of the shoe in an effort to limit rock bruising at the ball of the foot. Many hiking and light hiking incorporate stiff shanks as well in an effort to increase torsional rigidity. The resulting stiffness makes them an excellent option for any patient diagnosed with metatarsalgia.

Tennis shoes: A tennis shoe's high density midsole, firm upper, and hard rubber outsole helps create a durable board-like stiffness. This can prove useful for any metatarsalgia sufferer who might benefit from stiffness with little or no need for additional shock absorption.

Dress casual shoes: Most Dansko models, as well as select Naot and Aravon shoes have stiff inflexible soles. Unfortunately the resultant thick bulky profile may not be popular with female patients looking for a more fashionable .

Sandals: Birkenstocks are a good rigid option, but with a lower rocker-profile and permanent insole they can be somewhat limiting. Cambrians on the other hand have a noticeable forefoot rocker as well as a removable cork footbed to accommodate even the deepest custom orthotic! The Wolky Jewel is another key style featuring a stiff sole and removable insole with numerous colour options.

For a comprehensive review of stiff shoe options you can visit www.ladysport.ca and review a live up to date article called “Metatarsalgia and Stiff Shoes”.

The Shoe Update – Spring 2019

Heel Slippage… No Simple Solution

I’ve been fitting shoes now for the better part of 37 years. When I die my tombstone will sport a small button beside a sign that says “these words put this man in his grave.” When you push the button a whiney voice says “my heel slips … my heel slips … my heel slips …”

Most believe that it is caused from an unusually narrow heel (something that those of a certain generation appear to take great pride in). This common foot profiling comes as a result of being fit in a dress shoe store, where the salesperson tells the customer that they have a narrow heel (for example, a 2A forefoot with a 6A heel). This kind of statement is made even though there has never been—to my knowledge—a device designed to measure heel width.

Whether the heel can be measured or not, the use of a combination last can be important when fitting most pump-style shoes. In the case of this style of footwear, there are really only two places the shoe can hold on to the foot: the heel and the toe. The fact that there is no material over the instep leaves only one strategy for keeping the shoe on—i.e. squeeze the foot and hope it doesn’t hurt!

But a good fit and limited heel slippage are far more complicated than just a tight heel and toe fit.

In fact, with most athletic and orthopedic fits, we are trying our best to actually avoid a tight toe box. The resulting roominess up front makes keeping the heel in place even more challenging.

In these cases, a good heel fit is only possible by having a snug and customizable fit over the instep. That is why a lace-up shoe should fit better than Velcro, , or slip-on options.

Here are some ways to improve heel fit while still allowing for ample toe room:

• Snug up the laces over the instep. • Make use of the top eyelet.

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca The Shoe Update – Spring 2019

• Lock or loop-lace the top lace holes. • Adhere a tongue pad to the inside of the tongue—this creates a snugger fit over an otherwise sloppy instep. It can also act as additional padding, so that the laces can be pulled tighter without bruising the dorsal aspect of the foot. • Consider having an additional eyelet punched out in casual shoes, so the shoe can be laced further up, closing the gap around the ankle (this can be done at a shoe cobbler or in our shop while you wait). • Adhere ‘heel grips’ to the inside of the heel counter. Have these contact- cemented in place so that they don’t come off, and use a shoe horn to put the shoe on each time. • If a roomy toe box is not required, then place toe taps or half insoles under the footbed, or full-length orthotics to snug up the forefoot. You can do this on both shoes, or just one if the slippage is unilateral (often this is the case when one foot is shorter than the other). • In the case of a sulcus or ¾-length orthotic, cut the removable insole in half. Using just the forefoot section, drop the orthotic in place. This will ensure a deeper fit in the back along with a snug cushioned feel in the toe box. • In the case of an equinus/tight-calf individual, try adding a small heel lift on each side. You will lose heel depth, but the lift may help to counteract the early heel rise and subsequent heel slippage experienced from having tight heel cords. • Try different types of : thick vs thin, cotton vs synthetic, single vs double layer, etc. • In the case of a very stiff shoe, heel slippage is often inevitable, as the foot is trying to flex during toe off while the stiff shoe lags behind. o If stiffness is a recommended feature, then making sure the shoe has a good toe spring or rocker profile may be the only way to ensure a good heel fit. o If stiffness is not required, try to bend or ‘preflex’ the shoe to make it move better with the foot thus keeping the heel in place.

There are no simple solutions to complex problems, and heel slippage is a complicated issue requiring multiple strategies and a variety of tools—as well as, of course, lots of patience.

Hope this helps!

Cheers!

Phil

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca The New Age Flip Flop

They’re not all the same!

The flip flop, or to some of us elders, the thong, has changed significantly over the last decade or so. The thong strap upper has remained essentially unchanged since its debut in 1500 BC, but the foot platform has undergone a massive overhaul. Three key changes have been responsible for the welcomed evolution of the flip flop.

1. Its new functional design includes a concave contoured heel that cups the calcaneus providing a welcomed degree of heel stability and support. Gone are the days of seeing the rear-foot sitting half off a foam platform that has been completely collapsed on the medial side. 2. A contoured longitudinal arch incorporated into the midsole provides a comfortable level of arch and medial support that has been all but absent in the classic style. The benefits of this kind of support, I am sure, require no explanation. 3. In addition, high tech midsole materials have improved the resilience, durability, and shock absorbing capability of the new age design. Foams and urethanes of different durometers help provide a range of foot platform options including firm supportive ones complete with rockered profiles as well as soft comfortable cushioned styles.

Here are some brand suggestions for the new flip flop:

1. Models with firm support: The Sole brand (unfortunately this brand has limited Canadian inventory until 2019!) as well as Vionic, Spenco, and Olukai all incorporate a firm contoured longitudinal arch support that can vary in both height and placement from style to style. Heel toe offsets also differ between brands which may be an important distinction for some of your patient pathologies.

”Spenco Yumi Women’s Flip Flop”

2. Models with soft cushioning: This category is dominated by the Oofos brand! Though its incredible cushioning is welcomed by some, the inherent instability that comes with a very soft platform may be troublesome to others. With increased compression upon heel strike there may be some additional strain on the calf and achilles. That being said, some individuals who cannot tolerate the firmness of other brands, are right at home with the shock absorbing softness of an Oofos. LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca

3. Brands with a stiff forefoot rocker: Hoka has just introduced a flip flop with both a firm midsole and noticeable forefoot rocker. Though the rocker’s ability to reduce motion at the first MTP may be diluted by the heel to toe action of a flip flop, combining it with an inflexible base may help to splint the forefoot and provide relief to those suffering from many forms of metatarsalgia. As expected, the thick contoured base of the Hoka will bolster an unprecedented level of cushioning and support to the new age flip flop sector.

”Hoka Women’s Ora Recovery Flip Flop”

When it comes to flip flops and patient care we may have to pick our battles. Knowing that many patients will wear flip flops no matter what, it is evident that a little guidance can go a long way in helping them survive a holiday or those warm summer months.

Visit Ladysport.ca for more pictures and a complete guide to footwear in The Shoe Update

Phil Moore BA-BPHE

Owner LadySport/FitFirst

Vancouver/Burnaby BC

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca The Shoe Update - Spring 2019

Chart #1: Motion Control Running Shoes Major medial enhancement for the excessive pronator.

Available Dense Plastic Forefoot Heel Drop/ Torsional Available Width Brand Model Price Stiffness Counter Ladies Men at FitFirst Replaces Description Medial Medial Flexibility Offset Rigidity at Sizing Foam Post Firmness LadySport Footwear Available

Addiction A wide based firm shoe much like the Dyad Brooks Addiction $160 Extensive ü Moderate Very Very 12 mm High ü ü ü ü - 12 but with a long firm medial post

The fit of a contoured neutral shoe with Saucony Redeemer $190 Extensive ü Moderate Very Very 8 mm High ü ü ü ü ü Stabil CS3 best in class medial support.

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca

The Shoe Update - Spring 2019 Chart #2: Stability Running Shoes Guards against some excessive pronation/moderate medial enhancement by way of some dense medial midsole foam.

Dense Plastic Heel Available Width Forefoot Drop/ Torsional Available at Brand Model Price Medial Medial Stiffness Counter Ladies Men at FitFirst Sizing Replaces Description Flexibility Offset Rigidity LadySport Foam Post Firmness Footwear Available

The benchmark shoe in the stability Asics GT 2000 - 7 $170 Slight - Moderate Moderate Very Firm 10 mm High ü ü ü ü ü GT 2000-6 category. Fit has been an issue with this series, so trying it on is key!

Womens: 13 13mm offset is very distinctive. A great Asics Kayano 25 $220 Slight - Flexible Moderate Very Firm mm Mens: 10 High ü ü ü ü ü Kayano 24 blend of cushion and stability. Fit has been mm the main issue with this new model The guide rail medial post is very new and Adrenaline NEW dense Adrenaline Brooks $170 ü Moderate Moderate Very Firm 12 mm Moderate ü ü ü ü ü the more generous fit will be good for the 19 rail 18 more challenging foot Wave A significant change in style, but the medial Mizuno $175 - ü Flexible Very Very Firm 12 mm High ü ü ü ü ü Inspire 14 stability remains effective Inspire 15 The new knitted upper makes it very New accommodative for numerous forefoot fit 860v9 $165 Slight - Moderate Moderate Very Firm 10 mm High ü ü ü ü 860v8 Balance issues… my have to size up as it fits quite shallow The convex midsole shape protects against lateral midsole compression. Particularly Nike Lunarglide 9 $165 Slight - Moderate Moderate Firm 10 mm Moderate ü ü ü - - Lunarglide 8 good for fashion conscious runners who need a good stable platform.

Zoom Structure The better engineered lateral midsole will Nike $165 Extensive ü Flexible Moderate Moderate 10 mm Moderate ü ü ü ü - Structure 22 21 increase the durability

The unibody tongue has not been received Saucony Guide ISO2 $170 Slight ü Moderate Moderate Very Firm 8 mm Moderate ü ü ü ü ü Guide ISO as well as we thought.. hard to get on and off at times Maybe the best high stability shoe for fit as Light – Saucony Omni 16 $175 Slight - Moderate Very Firm 8 mm High ü ü ü - ü Omni 15 it presents as a less ‘clunky’ model than moderate most control shoes

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca

The Shoe Update - Spring 2019

Chart #3: Neutral Supportive Running Shoes Ideal for orthotic providers who want a neutral but firm platform for an orthotic device.

Sole Heel Available Available Width Forefoot Drop/ Torsional Brand Model Price Midsole Stiffness Ladies Men at at FitFirst Sizing Replaces Description Plate Flexibility Counter Offset Rigidity Width Firmness Footwear Available LadySport The newly designed seamless toebox is more accommodative …combine this Brooks Dyad 10 $160 Firm Wide Moderate Moderate Very Firm 10 mm Strong ü ü ü ü ü Dyad 9 with a great heel fit and we have something special

This classic has come back to it’s roots and improved the toebox shape. New 840v4 $170 Moderate Wide Moderate Moderate Moderate 10 mm Strong ü ü ü √ ü ü 840v3 Combined with a seamless toebox it is a Balance great neutral support shoe for orthotic wearers , hammertoes and bunions

Excellent for the heavier runner/patient New 1540v2 $180 Firm Wide Moderate Moderate Very Firm 8 mm Strong ü - ü - ü 1540 who collapses the lateral midsole or has a Balance posteroir tibial dysfunction

Significant fit change from the past Saucony Echelon 7 $160 Firm Wide Moderate Moderate Very Firm 8 mm Strong ü ü ü ü ü Echelon 6 models … but deep and accomodative

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca

The Shoe Update - Spring 2019

Chart #4: Cushion Running Shoes For the neutral to cavus foot that requires exceptional cushioning and a softer ride.

Available

Sole Heel Available Width Forefoot Drop/ Torsional at Brand Model Price Midsole Plate Stiffness Counter Ladies Men at FitFirst Sizing Replaces Description Flexibility Offset Rigidity LadySpor Width Firmness Footwear Available t

Asics Cumulus 20 $160 Soft Medium Moderate Moderate Moderate 10mm Moderate ü ü ü ü ü Cumulus 19 The toebox fit continues to be a hinderance… small and shallow Women: 13 Mod- Moderate Asics Nimbus 21 $200 Soft Wide Stiff Moderate Firm mm Very ü ü ü ü ü Nimbus 20 The fir is getting better with each update … still a Men: 10 mm 13 mm offset which helps the equinus patient Wide heel Brooks Ghost 11 $160 Firm Moderate Moderate Firm 12 mm Moderate ü ü ü ü ü Ghost 10 Narrow heel fit and is deep with a wide seamless and forefoot toebox… keep an eye on this model! This has become a best seller…. a classic with a Brooks Glycerin 17 $200 Soft Medium Stiff Moderate Firm 10 mm Moderate ü ü ü ü ü Glycerin 16 narrow heel and wide seamless forefoot fit The narrow fit was a key… but that is now Mizuno Wave Rider 22 $165 Moderate Moderate Flexible Moderate Firm 10 mm Moderate ü ü ü ü Wave Rider 21 discontinued…. boo… it may resurface in 2020 This shoe is our store’s top seller……comes in New multiple widths, acoomodative toe, seamless 880v9 $165 Soft Medium Moderate Moderate Moderate 10 mm Moderate ü ü ü ü ü 880v8 upper, consistent fit year to year, looks great Balance We will have a size guarantee in store policy this year in 3 widths all sizes men and ladies

New Wide 1080v9 $200 Firm Moderate Very Moderate 8 mm Moderate ü ü ü ü ü 1080v8 Wide base for excellent stability, firm forefoot Balance rearfoot flex and a seamless toebox. This shoe is shaped well for an adducted great toe New Fresh Foam Fresh Foam Zante This where function and fashion come together… $150 Soft Moderate Stiff Very Moderate 6 mm Very ü ü ü ü ü great for midfoot striker and fast short runs as Balance Zante Pursuit v4 well as travel and fashion The improved lateral heel contour makes it Nike Pegasus 35 $155 Soft Moderate Stiff Moderate Weak 10 mm Flexible Pegasus function as a true neutral shoe… relatively stiff ü ü ü ü ü 34 forefoot flex as well A good update with added cushion for the Nike Vomero 14 $190 Soft Medium Moderate Moderate Moderate 10 mm Moderate ü ü ü ü - Vomero 13 Pegasus wearer who wants a bit more protection A new model that has a very soft ride in a lighter On Cloudswift $190 Firm Moderate Moderate Moderate Moderate 7 mm Moderate ü ü ü ü - - full training model… classis great Swiss styling Narrow Fit has been a challenge with the unibody Saucony Triumph ISO5 $195 Firm Stiff Moderate Moderate 8 mm Firm ü ü ü ü - Triumph ISO4 tongue…. but classic Saucony customers still midfoot seem to gravitate to it Medium- Saucony Ride ISO $160 Firm Flexible Moderate Moderate 8 mm Strong ü ü ü ü ü - Ride 10 Common them here with Saucony…. the one wide piece tongue hols it back

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca

The Shoe Update - Spring 2019

Chart #5: Trail Runners Running shoes that are made specifically for off road running.

Available Dense Plastic Heel Drop/ Torsional Available Width Brand Model Price Type Medial Medial Counter Ladies Men at at FitFirst Sizing Replaces Description Offset Rigidity Foam Post Firmness Footwear Available LadySport A shoe with great heritage – it’s neutral and Asics Fuji Trabuco 7 $160 Neutral ü - Very 8 mm Moderate ü ü ü - - Fuji Trabuco 6 very functional on trail and road

Fuji Trabuco 7 Fuji Trabuco 6 Waterproof version of the shoe above and Asics $180 Neutral ü - Very 8 mm Moderate ü ü ü ü - Gore-Tex Gore-Tex has a relatively stiff forefoot flex

The upper is a bit stiff affecting the first feel, Cascadia 13 Cascadia 12 Brooks $175 Neutral - - Firm 10 mm Moderate ü ü ü - but otherwise a firm and durable run/hike Gore-Tex Gore-Tex option

One of the only high top trail running shoes Speedgoat Hoka $200 Neutral - - Firm 4 mm High ü ü ü ü - - on the market….goretex upper and classic Mid WP stiff rockered sole

A slimmer base than the Stinson… it is less suited for the problem fit but great for Hoka Speedgoat 3 $210 Neutral - - Firm 4 mm High ü ü ü ü - - unloading the forefoot of a healthy shaped

foot New Kaymin GTX $150 Neutral - - Firm 10 mm Moderate ü ü ü ü ü - Balance

New Summit A realatively stiff forefoot with width sizing $155 Neutral - - Firm 8 mm High ü - ü - ü 910v4 Balance Q.O.M. for the challenging forefoot fit

New Summit A more square / accommodative toe shape $175 Neutral - - Firm 8 mm High ü - ü ü ü 910v4 GTX Balance Q.O.M. GTX would have been nice

This newest version has a firmer upper and is Cloudventure a bit less accommodative for orthopaedics … On $210 Neutral - - Firm 6 mm High ü ü ü ü - - WP but with the stiff forefoot and great lug outsole it performs on the trail!

I am sounding like a broken record,,,, fix the Saucony Xodus ISO3 $180 Neutral - - Very 4 mm High ü ü ü - ü Xodus ISO2 tongue fit PLEASE!

Not for the pronator…. .it does have a Saucony Peregrine ISO $150 Neutral - - Very 4 mm High ü ü - ü ü Peregrine 8 relatively stiff flex… comes in waterproof as well… very light for the support it offers

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca

The Shoe Update - Spring 2019

Chart #6: Walking Shoes People walk in all kinds of shoes from athletic to casual. These are shoes specifically marketed to the walker. They are chosen for their support and ability to accommodate an orthotic.

Available Stiff Rearfoot Torsional Available Width Brand Model Price Type Midsole Rocker Ladies Men at Replaces Description Outersole Depth Rigidity at FitFirst Sizing LadySport Available Stiff forefoot flex with a minimal rocker New profile. A great country walker/light hiker 1300 $175 Support Neutral Very ü ü Rigid ü ü ü ü ü - Balance option with an extra deep forefoot in the 2E (extra wide) fitting Stiff forefoot flex with a minimal rocker New profile. A great country walker/light hiker 1350 $170 Support Neutral Very ü ü Rigid ü - ü - ü - Balance option with an extra deep forefoot in the 2E (extra wide) fitting Stiff forefoot flex with a minimal rocker New profile. A great mid top country walker/light 1400 $190 Support Neutral Very ü ü Rigid ü - ü - ü - Balance hiker option with an extra deep forefoot in the 2E (extra wide) fitting An inline tweak to the upper was needed to New 928 v3 $170 Support Neutral Very ü ü Rigid ü ü ü ü ü 928 v2 create the roomy midfoot/forefoot fit classic Balance to this iconic series No changes…and don’t change it PLEASE Grid (and definitely never discontinue it). Closest Saucony Integrity ST $130 Neutral Neutral Very Moderate Moderate Moderate ü ü ü ü ü Grid Integrity thing to a runner in 3 colour options (black 2 leather, white leather, and suede tan)

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca

The Shoe Update - Spring 2019 Chart #7: Court, Cross-training and Fitness Shoes Styles work for individuals with or without orthotic devices.

Available Width Sole Forefoot Heel Torsional Available at Brand Model Price Sport Plate Counter Deep Heel Ladies Men at Sizing Replaces Description Flexibility Rigidity FitFirst Width Strength LadySport Available

Consistently a superior fit especially for the Asics Resolution 7 $180 Tennis Moderate Very Stiff Firm - - - Resolution 6 narrow-ish foot and a real players shoe ü ü ü ü Solution Lighter weight version of the Resolution with Asics $160 Tennis Moderate Stiff Firm ü Rigid ü ü ü - - Speed 3 Speed 3 less lateral support and durability

A nice alternative to the Ryka for water Drainmaker aerobics and better for outdoor watersports Columbia $120 Aqua Moderate Flexible Soft ü Flexible ü - ü - - - 4 (kayaking, adventure runs through a stream etc.)

Maximum cushion but limited lateral Hoka Tivra $160 X-Train Wide Stiff Firm ü Rigid ü - ü - - - support…it is a first attempt at crosstraining for them… hope for more next time

A new mid high upper makes it a first choice Lightning Z5 Mizuno $180 Indoor Court Moderate Moderate Firm Moderate Rigid ü - ü - - - for indoor sports where lateral ankle support Mid is key

More support than a Free model usually has… Free TR Nike $165 X-Train Moderate Flexible Soft Moderate Flexible ü - ü ü - - deep cupsoling makes for excellent lateral Flyknit stability with better than average cushion

Same as above les the accommodative Nike Free TR v8 $140 X-Train Moderate Flexible Soft Moderate Flexible - ü - ü - FreeTR v7

knitted upper Lower profile than above model … nice for Nike Metcon 4 $175 X-Train Moderate Stiff Firm Moderate Rigid ü ü ü ü - Metcon 3 plyometrics and Crossfit

A classic minimal cross trainer for the serious Minimus 40 New Balance $140 X-Train Moderate Stiff Firm Moderate Moderate ü ü ü ü - - Gym rat who does squats and wants a feel for TR the ground

A classic leather upper, old school cross New Balance 608 v4 $100 X-Train Moderate Stiff Moderate ü Moderate ü ü ü - ü 622 trainer. Available in multiple widths and has a relatively stiff forefoot flex

The lateral cupsole at the met heads makes New Balance 786 $110 Tennis Wide forefoot Stiff Moderate Moderate ü ü - ü - ü 646 this special for lateral control that the true “player” requires

Moderate - Width sizes are very useful here and it is a New Balance 806 $140 Tennis Wide Firm Moderate Rigid ü ü ü - ü 804

Stiff consistent line to go back to

The unusual mesh upper helps those with Prince T22 Lite $160 Tennis Moderate Moderate Very ü Moderate ü - ü - - - orthopaedic needs (hammer toes, bunions

etc.) Moderate- Midfoot sleeve upper can be VERY annoying. If Wilson Rush Pro 2.5 $180 Tennis Moderate Firm ü Rigid ü ü ü - - Rush Pro 2 Stiff it fits, it delivers better than average stability

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca

The Shoe Update - Spring 2019 Chart #8: Ladies Dress, Casual and Orthopaedic Shoes Styles work for individuals with or without orthotic devices.

Stretch Forefoot Rearfoot Torsional Width Sizing Brand Model Price Type Removable Insole Closure Rocker Description Elastic Flexibility Depth Rigidity Available

Dressy stiff rockered sole; wider forefoot; very Aravon Maya $170 Heel Full Length Mary-Jane - Stiff Good Deep Rigid ü accommodative.

Seamless leather upper; deep; accommodative; Aravon Farren $160 Casual Full Length Lace-up - Flexible None Moderate Moderate ü good fit.

Stiff rocker sole in a slim and younger looking Aravon Kitt Strap $170 Dress Casual Full length Mary-Jane ------

dress shoe Same sole plate as the Mary Jane in a zip boot. Aravon Kitt Boot $190 Casual Full length ------Midfoot fit can be troublesome like any non lace-

up option. The width options are very helpful Moderate Mary Jane style shoe; three-quarter removable Ziera Rhapsody $240 Casual 3/4 Length Mary-Jane - Good Deep Rigid ü Stiff insole with metatarsal pad; stiffer forefoot.

Slides come in both leather and mesh upper.

Merrell Slides ~ $160 Casual Full Length Slip-on - Moderate Moderate N/A Flexible - Excellent for around the house, and take orthotics.

A slip-on version of the Sea… stiff rockered great

Naot Lenok $210 Casual Full length ------look,,, but a slip on is often a slip off! Hard to get a wide fit in the front and keep the heel secure

Naot Brussels $175 Casual Full length ------

A cute shoe with a rigid forefoot, excellent cork Naot Sea $200 Dress Casual Full Length Mary-Jane - Rigid Good Moderate Rigid -

foot bed; very deep.

A very important shoe with seamless, full stretch Stretch Dress

Portofino $200 Full Length Velcro ü Flexible Moderate Deep Rigid - toe box and Velcro closure. Wide base and dressy Leather Casual look!

Cush’n , Neoprene upper, with one large Velcro strap. Propet $90 Full Length Velcro ü Flexible - Moderate Flexible ü Foot Casual Excellent slipper or outdoor shoe.

Extremely important shoe due to super-flexible elastic Lycra toe box; handles the most difficult Propet Bianca $140 Ortho Full Length Velcro ü Flexible - Deep Flexible - arthritic foot very well. Stiff sole available at $229 for summer 2017.

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca

The Shoe Update - Spring 2019

Chart #9: Ladies Most sandals come with removable foot beds to accommodate orthotics or have specific orthopaedic attributes.

Width Sole Plate Forefoot Torsional Brand Model Price Type Removable Insole Closure Rocker Back Strap Sizing Description Width Flexibility Rigidity Available

Excellent walking sandal; multiple widths; large

Aravon Katy $160 Dress Casual Full Length Velcro Moderate Flexible Slight ü Moderate ü removable foot bed; Velcro straps.

A closed heel sandal. It's an excellent option for extremely posted orthotics or use of a heel lift. Moderate Portofino Open Toe $165 Casual Full Length Velcro Moderate None ü Moderate - stiff Also creates better rear foot stability in case of extreme hallux varus, for instance.

Moderate Excellent arch support built off the Sole off the

Sole Flip Flop $80 Casual None Slip-on Wide Good - - - stiff shelf insoles.

Moderate Best for arch support in young looking sandal for Teva Tirra $110 Casual None Velcro Wide Good ü Rigid -

stiff road or beach. Non-removable insole, but comes with excellent Revere Vionic $155 Dress Full Length Velcro Moderate Flexible Slight - Moderate - arch support, unique adjustable straps, that are Miami

accommodating for wider feet. Wolky Jewel $230 Dress Full Length Velcro Wide Rigid Good ü Rigid - The best stiff rockered walking sandal made.

Extremely supportive sandal. Birkenstock look with good heel offset, rigid rocker, and a Cambrian Delphi $200 Dress Full Length Velcro Wide Rigid Good ü Rigid ü removable foot bed. Also a sport sandal with removable foot bed.

The look of a Birkenstock … but… it has a heel strap on the back…. removeable footbed… Great Cambrian Marina $170 Casual Full Length Velcro Moderate Rigid Good ü Rigid - for wide based orthotics and heavier

individuals… widths available

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca

The Shoe Update - Spring 2019

Chart #10: Natural Minimalism This minimalist category is defined by its torsional flexibility, lower heel offset , lower stack height and desire to mimic being barefoot . The midsole flexes in all planes and the heel counter is often non-existent. (Though this is an important category of footwear, we do not carry a deep selection. Please call first as we may be able to help refer you to a store in your area if required)

Heel Available Width Sole Forefoot Drop/ Torsional Available at Brand Model Price Midsole Plate Stiffness Counter Ladies Men at FitFirst Sizing Replaces Description Flexibility Offset Rigidity Width Firmness LadySport Footwear Available This light weight model is excellent for those who Pureflow Brooks $130 Firm Wide Moderate Moderate Firm 4 mm Moderate ü ü ü ü - Pureflow 6 pronate and wear orthotics. It is defined as a 7 neutral fast shoe with a wide platform. The knitted upper makes it very accommodative and may prove useful for the problematic foot for New Zante $150 Firm Moderate Stiff Very Moderate 6 mm Rigid ü ü ü ü - Zante v4 indoor use and for those who need Balance Pursuit accommodation but lighter easier to move in footwear A beefier version of the Free that is more “runnable” for the long distance that a traditional Free Run Free RN Nike $140 Soft Moderate Very None None 8mm Fkexible ü ü ü ü - Free has struggled to perform well. I expect to see 2018 2017 more development in this more protective Free going forward. A more traditional minimalist shoe with a heel On Cloud $160 Firm Moderate Very Slight Moderate 6 mm Flexible ü ü ü ü - - counter and narrow midfoot platform. Wide More minimalist-traditional as it is not terribly Break Saucony $130 Soft heel, Moderate Slight Moderate 4 mm Moderate ü ü ü - - torsionally flexible. Great light road show. Thru 4 ü forefoot Excellent forefoot cushion.

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca

The Shoe Update - Spring 2019

Chart #11: Maximalism and stiff rockered

Available Width Sole Plate Forefoot Heel Counter Drop- Torsional Available Brand Model Price Midsole Rocker Ladies Mens at Sizing Replaces Description Width Flexibility Firmness Offset Rigidity at FitFirst Ladysport Available The new model is the only medially posted Hoka . They have improved Hoka Arahi 3 $180 Firm Medium Very stiff ü Moderate 4mm ü ü ü ü ü ü Arahi 2 on the low heel sensation of the previous model Very stiff, with an extremely wide platform especially in the wide Hoka Bondi 6 $190 Firm Wide Very stiff ü Very 4 mm ü ü ü ü ü ü Bondi 5 fitting. Excellent for plantar fasciitis, Achilles, and calf issues as well as standard forefoot pathologies. Sleeker than Bondi. Trail and road Stinson Stinson Hoka $190 Firm Wide Very stiff ü Very 4mm ü ü - ü - - soles…. a very broad base with 5 ATR 3 classic midsole stiffness Slightly more flex than the Bondi Hoka Clifton 5 $170 Firm Medium Stiff ü Very 5 mm ü ü ü ü ü ü Clifton 4 but a slimmer fit feel and look

Hoka Cavu $160 Firm Medium Stiff - Moderate 4 mm ü ü ü ü ü - -

Coming to stores late March…. the New More $200 Firm Wide Very Stiff ü Moderate 4 mm ü ü ü ü ü ü - x-wide should prove extremely Balance useful!! Uncharacteristically stiff for a low New Zante profilr shoe… excellent for short $150 Firm Moderate Very Stiff ü Moderate 6 mm ü ü ü ü ü - Zante v4 Balance Pursuit hall use and around the house… very stretchy upper The takedown of the 4% sub 2 hour marathon shoe… ot is not for the Zoom Nike $200 Firm Moderate Very Stiff ü Moderate 10 mm ü ü ü ü ü - - pronated foot… but is very stif with Fly a midsole plate and better styling than Hoka… a true stiff speed shoe Cloudac On $250 Firm Moderate Stiff - Very 7 mm ü ü ü ü ü - - e Big toe spring or rocker profile and Cloudsu On $160 Firm Medium Mod. stiff ü Mod. 10mm ü ü ü ü - - - the stretch elastic toe box is useful rfer for bunion fitting. Any trail show with a plate is bound Any Trail Shoes with $140- Generally, Firm Medium Stiff ü 4-10mm ü ü ü ü ü - - to be stiff and splint the forefoot a Rock Plate 200 firm somewhat

LadySport FitFirst Footwear 3545 West 4th Avenue 3713 Kensington Avenue Vancouver, BC Burnaby, BC 604-733-1173 604-299-8851 www.ladysport.ca www.fitfirst.ca

The Shoe Update – Spring 2019

Available at Widths Model Men Women Price Range FitFirst Running Motion Control (wide base, major posting) ü Saucony Redeemer ISO2 ü ü $190 ü Brooks Addiction 13 ü ü $160 Stability (hard foam medially) ü ü Asics GT 2000 v7 ü ü $170 ü ü Asics Kayano 25 ü ü $220 ü ü Brooks Adrenaline 19 ü ü $170 Mizuno Wave Inspire 15 ü $175 ü ü New Balance 860v9 ü ü $165 ü Nike Zoom Structure 22 ü ü $165 ü Saucony Guide ISO 2 ü ü $170 ü Saucony Omni ü $175 Neutral Supportive (firm neutral midsole) ü ü Brooks Dyad 10 ü ü $160 ü ü New Balance 840v4 ü ü $170 ü New Balance 1540v2 ü $200 ü ü Saucony Echelon 7 ü ü $160 Cushion (soft neutral midsole) ü Adidas Ultraboost ü ü $250 ü ü Asics Cumulus 20 ü $160 ü ü Asics Nimbus 21 ü ü $200 ü ü Brooks Ghost 11 ü ü $160 ü ü Brooks Glycerin 17 ü ü $200 ü Mizuno Wave Rider 22 ü ü $165 ü ü New Balance 880v9 ü ü $165 ü ü New Balance 1080v9 ü ü $200 ü ü New Balance Fresh Foam Zante ü ü $150 Pursuit ü Nike Pegasus 35 ü ü $155 ü Nike Vomero 14 ü ü $200 ü On Cloudace ü ü $250 On Cloudsurfer ü ü On Cloudswift ü ü $190 ü Saucony Ride ISO ü ü $160 ü Saucony Triumph ISO 5 ü ü $195 Trail Running Asics Fuji Trabuco 7 ü $160 ü Asics Fuji Trabuco 7 GTX ü ü $180 Brooks Cascadia 13 GTX ü $175 The Shoe Update – Spring 2019

Available at Widths Model Men Women Price Range FitFirst ü Hoka Speedgoat 3 ü ü $210 ü Hoka Speedgoat Mid WP ü ü $200 ü ü New Balance Kaymin GTX ü ü $150 ü New Balance Summit Q.O.M. ü $155 ü ü New Balance Summit Q.O.M. GTX ü $175 ü On Cloudventure WP ü ü $210 ü ü Saucony Peregrine ISO ü ü $150 ü Saucony Xodus ISO 3 ü ü $180 Minimalism ü Adidas Boston Boost 7 ü $ Asics Noosa Trainer FF2 ü $ ü Brooks Pureflow 7 ü ü $130 ü ü New Balance Zante Fresh Foam ü ü $150 Pursuit Nike Free RN 2018 ü $140 ü On Cloud ü ü $160 Maximalism and Stiff Rocker ü ü Hoka Arahi 3 ü ü $180 ü ü Hoka Bondi 6 ü ü $190 ü Hoka Cavu ü ü $160 ü ü Hoka Clifton 5 ü ü $170 Hoka Stinson 5 ü $190 ü ü New Balance More ü ü $200 ü ü New Balance Zante Pursuit ü ü $150 ü Nike Zoom Fly ü ü $200 ü On Cloudace ü ü $250 Walking ü ü New Balance 1300 ü ü $175 ü New Balance 1350 ü $170 ü New Balance 1400 ü $190 ü ü New Balance 928 ü ü $170 ü ü Saucony Grid Integrity ST 2 ü $130 Cross-Training, Court, and Fitness Shoes Cross-Training Hoka Tivra ü $160 ü Nike Metcon 4 ü ü $175 ü Nike Free TR v8 ü ü $140 ü Nike Free TR Flyknit ü $165 ü New Balance Minimus 40 TR ü ü $140

The Shoe Update – Spring 2019

Available at Widths Model Men Women Price Range FitFirst Tennis Asics Resolution 7 ü $180 Asics Solution Speed 3 ü $160 ü New Balance 786 ü $110 ü New Balance 806 ü $140 Prince T22 Lite ü $160 Weldon X ü $150 Wilson Rush Pro 2.5 ü $180 Aquafit Columbia Drainmaker 4 ü $120 ü Ryka Hydrosport ü $100 Ryka Hydrosphere ü $ Volleyball Mizuno Wave Lightning Mid Z5 ü $180 Mizuno Wave Hurricane ü $100 Ladies dress, casual, and orthopedic shoes Orthopedic, elastic ü ü Propet Bianca ü $150 Portofino Stretch Leather ü $200 Orthopedic, dress ü Aravon Farren ü $140 ü Aravon Kitt Boot ü $190 ü Aravon Kitt Strap ü $170 ü Aravon Maya ü $170 Naot Sea ü $210 ü Ziera Rhapsody ü $240 Dress/Casual ü Aravon Revsavor ü $160 Naot Brussels ü $175 Naot Lenok ü $210 Slides Slides (various) ü ~ $160 Sandals ü Aravon Katy ü $160 ü Aravon P3 Strap ü $160 ü Cambrian Delphi ü $200 ü Cambrian Marina ü $180 Vionic Revere Miami ü $155 Wolky Jewel ü $230

The Shoe Update – Spring 2019

Available at Widths Model Men Women Price Range FitFirst Non-Removable Insoles (good arch support) Keen Venice ü $120 ü Oofos Flip Flop ü ü ~ $65 ü Teva Tirra ü $110