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When the Wrong Running Shoe is a Problem

When the Wrong Running Shoe is a Problem

Running shoes

This middle aged gent presented to the clinic after visiting two other podiatrists and yet was still plagued with foot pain.

He is a fit and healthy man with no prior foot or ankle injuries. He has been training for the last 6 months for a local marathon. He developed right lateral foot pain approximately six weeks ago. There was no proceeding injury or ankle sprain. It became progressively sorer the more he continued to train. He sought treatment with a podiatrist who recommended custom orthotics. This made the pain worse. He tried them for several weeks and the pain persisted. The advice from the second therapist was to continue with the orthotics and stop running. He ceased running but the pain returned once he went back to running.

By this point this gent was quite exasperated about the pending race and he was still plagued by foot pain. My examination of his foot revealed very little. There was no pain on palpation of any bone or joint or soft tissue. There was no pain on passive or resisted movement of the foot and ankle. There was no swelling or bruising. Medical history was unremarkable. The patient pointed to the area of the dorsal cuboid area and described the pain as a deep aching pain. He had no pain in the foot during the day at the office.

Upon further questioning it was revealed that he had purchased new shoes two weeks before the pain started. He describes his old pair of shoes as being ‘cheap and old’ department store running shoes and decided to treat himself to better shoes. Looking that the shoes they were evidently a stability or anti-pronatory type shoe. A quick gait assessment showed that this gent has a fairly ‘neutral foot type’ with bilateral lateral ankle instability.

The immediate thought was he was experiencing lateral column overload from the anti-pronatory shoes. He did not bring in his orthotics for assessment but it is not difficult to surmise that these were likely contributing to the lateral foot overload. There was not a significant amount of over-correction present in the shoes but it was enough to be causing pathological loading changes in the foot.

I suggested he go and change his footwear back to a neutral runner with an even medial and lateral sole. I was pleased to have a phone call to say that all his pain had ceased and he was back to training full steam.

It is important to note that sometimes footwear can play a big role in contributing to injury and conversely reducing the risk of injury. If you suspect your shoes are contributing to your pain or need a footwear review we can assist and give advice on what sports shoes you should be looking for in future.

Grishko Pointe Shoes – Elegance and Safety Balanced on Toe Tips

Grishko Pointe Shoes – Elegance and Safety Balanced on Toe Tips

Pointe shoes are an essential tool in a ballet dancer’s life. They allow the dancer to dance ‘en pointe’ or on the tips of their toes. They were initially used so the dancer looked like she was effortlessly gliding across the stage. It is vital to obtain a well-made pointe shoe that fits the foot perfectly to reduce risk of injury and pain.

The Grishko Pointe Shoes

Grishko Pointe Shoes - Ballet ShoesGrishko Pointe Shoes are beautiful, handmade pointe shoes manufactured in Russia. They are completely handmade using natural and environmentally-friendly glue/paste which becomes flexible on exposure to high temperature and humidity, which allows the box to mould perfectly to the shape of the foot. One of the special characteristics of a Grishko shoe is a well flattened sole: this promotes stability when standing flat. Most pointe shoes made by machine cannot achieve this and the sole can be quite thick and uneven. The platform of a Grishko shoe is hammered and smoothed by hand and extra attention is given to the sides of the platform so that it is even and well-defined. The shoes must stand upright by themselves before they leave the factory.

Grishko offers multiple models, and in these various models, the company offers five width fittings plus five different shank strengths ranging from Super Soft to Super Hard. Some models also come in a performance ready shank.

Traditionally made pointe shoes are only designed to last between 6-12 hours of use and require 36 hours to dry out. The shoes will last longer if a dancer has multiple pairs in rotation. Contrary to popular belief, the shank strength has no influence on the longevity of the shoe. The dancer’s strength and size should be taken into consideration when selecting a shank strength. The dancer should feel uplifted and supported, yet at the same time be able to roll through the shoe and get up and over the platform.

In summary, Grishko’s attention to detail includes:

  • Balancing each shoe by hand.Grishko Pointe Shoes Fitting
  • Using cotton drawstrings to protect against tendonitis that over-tightened elastic can cause.
  • Using glues that help the toe box mould beautifully to the foot.
  • Maintaining shank mobility at the heel without sacrificing support.
  • Designing both platforms and soles to be flat and stable for excellent balance on and off pointe.
  • Selecting only the finest satin for a beautiful appearance.

Pointe shoes must be fitted by an experienced trained fitter. A poorly-fitted pointe shoe can lead to injury, pain or even prevent the dancer from getting on to the box. Lauren is a podiatrist with 12 years’ experience, current adult ballet dancer and a trained pointe shoe fitter. She offers professional Grishko Pointe Shoe fittings at the Perth Foot & Ankle Clinic.

The Durability of Grishko ShoesThe Durability of Grishko Shoes

This study performed dynamic testing of the pointe shoes to highlight the fatigue properties (cycles to failure) of the toe box under repetitive loading conditions. Grishko Pointe Shoes lasted three times longer than a Capezio Point Shoe and eight times longer than a Freed Pointe Shoe, making them a durable and thus cost-effective shoe.

Try them out! You’ll like them!

Back To School – Tips for School Shoes

Back To School – Tips for School Shoes

Kids spend a lot of time in their school shoes, so it’s important to get the correct shoe and have it properly fitted. Here are some tips to help you get the best for your child.


  • Back To School - Tips for School ShoesShoes should be fitted correctly. Getting a bigger size so that there is some “growing room” is a bad idea, and in any case will cause the shoe to wear out quicker, as well as being less comfortable.
  • Get both feet measured as sometimes one foot is bigger than the other. If this is the case, get shoes that fit the larger foot.
  • Make sure the feet are measured for width as well as length. A shoe that is too narrow will be uncomfortable and can injure the feet.
  • Get measured for shoes at the end of the day as feet swell slightly during the day, and so will be at their biggest in the afternoon.
  • On average, childrens feet grow about one size per year, and will be at adult size by around 13-14 years of age. This is a guideline only, and kids can have growth spurts at any time.

Design & Fitting

  • Kids School Shoes

    The sole should not twist from side to side.
  • The sole should bend at the ball of the foot to enable walking and running.
  • The area surrounding the heel (the heel counter) should be firm to support the heel.
  • The heel should fit snugly into the back of the shoe, and be held there by straps/laces etc. It should not slip forward in the shoe.
  • There should be a child’s thumb width between the front of the shoe and the longest toe (which may not be the big toe).
  • The shoe should feel stable and with good cushioning.
  • A lighter shoe is better than a heavier one as long as it is of good quality.
  • You shouldn’t need to wear the shoe in. If it is not comfortable (for both feet) in the shop, then do not buy it.
  • Different brands and styles suit different feet. Take advice from your shoe fitter.


  • You do not need to go overboard and spend a fortune on shoes. There are a few well known brands that provide quality for a reasonable price.
  • Sometimes spending a bit more on better quality shoes will save you money in the long term, as they will last longer.

Pain? Problems?

  • It is not normal for children to have regular pain in their feet, legs, knees, hips or back when doing normal activities and sport.
  • If your child reports pain, then get one of our podiatrists to check them out.
  • Untreated foot and leg problems in children can become lifelong problems if left untreated.
Happy shopping!
5 reasons why you should consider the Perth Foot & Ankle Clinic for orthotics

5 reasons why you should consider the Perth Foot & Ankle Clinic for orthotics

Customised orthotics (also known as orthoses) are used to treat a variety of foot and leg problems, as well as being used to optimise function in the athlete. Here are 5 reasons why you should consider The Perth Foot & Ankle Clinic for orthotics.

1. Individualised care

Perth Custom Made Podiatrist OrthoticsCustom orthotics are tailor made to fit your recovery or other goals, so whether you just want to be rid of pain, or are trying to improve in your sport, we can work with your individual needs.

2. Professional assessment

We keep up with developments in the field, and have the best tools and techniques in order to assess your needs.

3. State of the art equipment

Perth Foot OrthoticsWe use the latest equipment, like our Bodytech gait analysis treadmill. We also use optical scanners to obtain accurrate models of your feet. We can assess your gait, muscle function, balance, posture and more.

4. Choice of orthotic design

Orthoses are not one size fits all. We use more than one orthotic laboratory, and this means we can produce a great variety of orthotic designs and materials to get the best solution.

5. Follow up care

We follow up all our orthotic patients in order to make sure everything is going as it should be. Sometimes we tweak them to get better results. Often, orthotic therapy is part of a bigger treatment plan, and we may offer additional, adjunctive treatments to help get the best results. Examples include stretching and exercise regimes, mobilisations, trigger point therapy and laser therapy. Our goal is to fix your current problems and work with you into the future to keep you at your best.

See us today for prompt, professional, customised orthotic care at the Perth Foot & Ankle Clinic.

Pros and Cons of Custom Orthotics versus Off-The-Shelf Orthotics

Pros and Cons of Custom Orthotics versus Off-The-Shelf Orthotics

There are many reasons your podiatrist will recommend extra support for your feet.  A few common reasons include management of foot pain, balancing high-pressure areas, supporting feet that roll excessively inwards (pronating) or outwards (supinating).

Shoes OrthoticsThere are two choices when deciding on the type of orthotic to fit

  • Custom orthotics (prescribed and fitted by your podiatrist)
  • Inserts that are pre-made (also known as off-the-shelf orthotics)

Off-the-shelf orthotics are usually matched to your shoe size and then trimmed to fit. They offer a generic arch profile and offer heel support.  They come in a variety of materials, are relatively low cost and easily available. You can expect them to last around 6-12 months depending on the quality of materials used. They can be beneficial when you have a ‘classic’ foot shape, with symmetry between both feet and no major biomechanical concerns.

Custom orthotics are individualized and made to your feet and shoes. They can incorporate specific support and control features that are not included in off-the-shelf orthotics. Your podiatrist will measure and prescribe your orthotics, which are then made by an orthotic laboratory. Different shoes can require a unique fitting, such as boots, dress shoes, sneakers, football boots, heels and even ice skates! With a variety of material choices your individual needs and biomechanical factors can be addressed. Due to the uniqueness of these orthotics, the process is usually takes 1-2 weeks and the cost is greater than off-the-shelf. On average they provide longer foot health benefits (some are over 5 years old!).

Perth Foot Orthotics

It is best to speak with your podiatrist when deciding on which option is best for your feet and overall wellbeing.

For further reading:

5 reasons why you should consider the Perth Foot & Ankle Clinic for orthotics

How Orthoses Help Treat Your Foot Problems