May 13, 2021
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More than ever during this Covid pandemic, hiking has become one of the most popular forms of outdoor physical activities.



The best part is that it can require very little in the way of equipment and participants can set their own pace and level of challenge. It also affords the ability and opertunity to reconnect with the beautiful outdoors that surround us. Be that in the wilds of Algonquin park, the Bruce trail, the Tiny Marsh (that isn’t so tiny actually) or a quiet ravine hidden around the corner from your house in Mississauga.

There are lots of online resources you can access through or a terrific app that Marilyn and I have just discovered called AllTrails.  After downloading it on to your phone, it will show trail options close to your location, the location of your choice, and at various levels of difficulty.  It is amazing the sheer availability and diversity of these trails, even amongst the urban environments that so many of us reside in. 


One piece of equipment that we do recommend  for fun and safe trail walking and hiking is a suitable pair of footwear, which brings us to todays footwear review. 


The Merrell Moab is primarily aimed at the day hiker with good stability, traction, and breathability. 


It is not particularly waterproof. For most companies, something waterproof means either a weight gain and/or a price increase of the shoes. All the shoes in this category are built tough and thus will weigh significantly more than a comparable running shoe.

Typically, the style of the shoe will also be influenced by the terrain. For the casual trail walk a lower cut trail walk/run shoe will be sufficient, as the terrain becomes more aggressive the ankle support correspondingly increases. This is also true with increased load carrying where the shoe becomes a boot and the mid sole requires beefing up and thus may require breaking in for the full function and comfort to be enjoyed. 

The best information to take from this is, like most unique sports the more you get into it, the better you are visiting a specialty store employing skilled staff willing to listen to your goals and needs. But be realistic about your needs, as embellishing your abilities or goals can end up costing you, not only financially, but also in comfort and satisfaction. The beauty about these specialty stores is that they are staffed with folks that are passionate about your sport or activity and general love to help, so be open to suggestions and options.


Other noteworthy models worth looking at at  Keen Targhee III Low WP, Salomon X Ultra 4 Low GTX , Oboz Firebrand II BDry, Saucony Peregrine 11


May 06, 2021
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First stop on our promised review of some suitable footwear models


The Heavy Weight Contender.


The Brooks Beast and Ariel; men’s and women's shoes respectively, are now on its 20th model and has been a “solid” performer (yes the pun was intended)!

This has been a terrific stability shoe for lager patients, for both walking and running for years. While not the lightest running shoe it delivers unsurpassed levels of control and durability. Given the frightening numbers of footwear that end up in land fills worldwide every year Brooks have ensured that the midsole in the new model is biodegradable, not perfect but it does show intent. Clearly it may be an old dog but its learned or aquired some new tricks over the years. It is available in multiple widths, however note to the good folks at Brooks, it is not readily available or readily shipped.  Even in a city like Mississauga our patients come across this frustration all too often. While they can be ordered online, we always stress that for first time buyers the you to try the shoe on to assure comfort, sizing and general fit. If there is a ready source we’ve missed please comment below as Brooks has lots to offer and we’d love to help patients source out these items.

To avoid any bias, other contenders for the heavy weight title are, Asics Foundation, Brooks  Addiction, New Balance 1540, 1260, and Saucony ProGrid Stabil. 

This is, by no means a comprehensive list but at least a few options to help you through the jungle of shoes out there.


April 29, 2021
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Over the many years we have been in practice we have largely tried to stay away from selling or recommending  one particular brand of footwear over others.

In general most shoe companies make some great shoes and some absolute rubbish, much the same as every other industry.

In the coming weeks we are going to try and acknowledge a few star performers and and what it is about them that makes them standouts and for whom they might be best suited.

As always when discussing footwear with patients, we stress that despite having identified a suitable shoe for your needs, it's imperative that you try the shoe on and judge the fit and feel for your own satisfaction.

If you have any questions or particular needs you’d like us to consider regarding shoe choices please ask away. With some of the more unique specialized sport footwear we might be limited in our depth of knowledge but we have a broad field of experience.

April 22, 2021
Category: orthotic devices
Tags: orthotic  

In a recent online forum with our colleagues we were debating the merits of various techniques for capturing foot structures in order to manufacture custom functional orthotic devices.

Most experts in our field will agree that in general the foot should be captured non weight baring with the patient ideally lying face down on a couch. So that rules out foam boxes, pressure mats, weight baring scanners, and little beds of funky nails to contour the weight baring foot (I kid you not!).




If we are making a true functional custom orthotic you can accept that if the shape of the foot is captured weight baring it's kind of like closing the stable door after the horse has already run off and is grazing someone else’s grass.

The goal is to capture the architecture of your foot at its best so we can fabricate an appliance to enable you to function in the most efficient, ,stable orientation. 

For most, that leaves us with two real options, the first of which is using plaster of paris.


This was how we functioned for the first 20 or so years of our careers and it works well in skilled hands. It is however messy, time consuming, labour intensive, and not particularly environmentally friendly. 

The second method, 3 Dimensional scanners come in various shapes and levels of accuracy. The stand out of the pack for us was the Veriscan system, which we first adopted for use in conjunction with Integrity Orthotics. The system has been revised and improved several times over the years. Essentially it utilized two laser and camera combinations on a carousel to capture a very accurate 3D image. The digital image is transferred to the  Integrity laboratory enabling them to mill out an exact replica or custom modified version of the foot using a CAD/CAM system. 


In our busy practices we quickly found a significant improvement in clinical fit and accuracy of the orthotic devices and an increased level of patient satisfaction. The environmental impact of reduced cleanup costs, shipping, waste and material, helped hammer the final nail in the plaster coffin. That said there are still occasional cases for very problematic Diabetic foot types (Charcot feet) where we still revert to a semi weight baring plaster cast when making custom orthotics or footwear.

Rest assured we will continue to look at future offerings from the scientific innovators to bring further improvements and refinements to enable you to function better.

A final thought!. One sage contributor to the online debate summarized, without a good diagnosis and appropriately written orthotic  prescription, the method of capturing the foot is of no importantance.


If you have any questions regarding this topic please comment below or message us and we'll be quick to reply.

April 15, 2021
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Digital Corns and Callouses




Continuing our recent theme of debunking some long held theories about common foot problems, the subject in question today is digital corns.  Again our online sources identify YOU as the source of the problem, or more specifically your inability to choose a shoe that doesn't crush your toes (insert eye roll emoji). 


Ok, I think we have all tried on a shoe that was a little tight for a special occasion but for general everyday life, most individuals have sufficient intelligence to know better.

Daily, we encounter patients who are suffering from painful corns on the tips of their toe,  in between, or on the top of one of their toe joints. They report gradual formation of the corns over time and often they are wearing good quality correctly fitted shoes, so what happened?

In the vast majority of cases a mechanical functional instability results in overuse of the long digital flexor and extensors muscles.

This influence during the gait cycle causes the toes to contract (curl/claw) so that the tips of the toes are driven in to the ground, or the joints of one toe rub against the bony expansion of the joint on the neighbouring toe. Sometimes the toes contract so much, or the toes are pulled up (retracted) into the top of the shoe causing pressure and the associated callous and corn is born.


Whilst observing out patients standing/weight bearing often there is little or no evidence to support this claim, unless the offending toe is become fused or hammered.  However, viewing the individual walking barefoot with our Pedigait system (our digital video gait analysis system) we can see stride after stride in slow motion showing exactly how the lesion was formed and which were the contributing structures.  Additionally, If these forces are allowed to persist long enough and in combination with other systemic illnesses like diabetes, they can result in tissue breakdown, ulceration, infection, loss of locomotion and a huge undesirable change in the quality of life.


Treatment must be based on a clear understanding of the underlying cause; otherwise, without addressing this, most interventions will be futile and unsuccessful in the long run.

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