Posts for: June, 2021

June 24, 2021
Category: Uncategorized
Tags: Untagged

Birthdays in the midst of pandemics dont really seam that much fun and its easy to get in a funk and try to let them pass quitely.


This what I arrived to this morning. What a wonderful start to the day, and what a wounderful treat it is to work surrounded by kindness and caring. Thank you so much Mel and Nicole for the suprise and for lifting my spirits. Lots of delicious treats to try and get to if Melanie hasnt been too cruel with our schedule today.



June 17, 2021
Category: Uncategorized
Tags: Untagged

The tibialis posterior, is a muscle found in the lower leg wrapping around the inside of the ankle and inserts into the medial aspect or the inside of the foot. It is one of three playing vital roles in postural stability, shock absorption and the structural integrity of the foot. Weakness in this muscle and its reduced ability to carry out its role,  is referred to as “Post Tib Disfunction”.

On occasion “Tib Post” may be congenitally absent, injured, ruptured, torn or plain old ‘overused’. The difficulty is that like a drowning victim, without help the situation predictable gets worse and ends in failure. Thus the urgent need for early detection and  identification to determine the source and extent of the injury. Without knowing the cause and extent we cannot advise an appropriate treatment plan.

Arriving in our offices the patients’ typically pinpoint the insertion of the tibialis posterior tendon as the focus of pain,  and the exact path of the tendon on the medial ankle or the generalized medial ankle and inside of the foot. Sometimes however they will be without pain and simply identify they have very flat feet or notice it has flattened over time.

Over the last 10 years we have seen a dramatic increase in juvenile and teenage cases of Post tib disfunction, often times in generally; healthy, average weight, well nourished, and active individuals. I mention the weight factor to illustrate that while yes obesity most certainly will be an additional complicating factor, it is not an identifiable cause for many in this group.



Physical examination, history taking and video gait analysis form the mainstay of identifying the condition.  The following image is of one of the simple tests we perform on potential cases where we ask the patient to stand on one foot while stabilized and rise up slowly onto the ball of the foot, for some this will be impossible or very challenging.





Treatment is often multifaceted with footwear advice and functional orthotic intervention being the essential components. Fortunately our clinical partners at Integrity Orthotics have come to our aid developing a custom orthotic devices capable of delivering the significant functional support these individuals require and doing so in a manner that is appropriate to the stage of development and severity of the disorder.

Many new clients suffering from this condition have sought treatment previously, arriving with collections of orthotics often times causing severe arch pain to be tolerable, or too soft rendering them completely ineffective.

To summarize, this condition is progressive and debilitating, reducing quality of life and affecting mental and physical well-being. The earlier a diagnosis is made, the more destruction and adaptation can be prevented.


Schedule an appointment at an office location near you with one of our dedicated specialists. We do not require a referral however pertinent information from your primary care specialist may help in our diagnosis. Bring any pertinent images (X-rays) or test results with you and if appropriate samples of your footwear. Given the nature of our specialty it is likely we will want to observe you standing or walking during the initial exam. Call The Podiatry Associates in Mississauga, at (905)568-3800. We are also located in Brantford, ON, at (519) 751-2900 and Whitby, Ontario, at (905) 433-0200

June 10, 2021
Category: Uncategorized
Tags: Untagged



The last  2 weeks have  been a bit stressful!

In our Brantford and now Mississauga offices as our workhorse; The Pedigait video-gait analysis system that we purchased almost 10 years ago developed a serious problem preventing us from gathering new video images.




It’s at times like this that we suddenly realize how crucial a component it has become in helping us deliver the services we do.It also illustrates how little I understand about computer systems and how they function, thank goodness for you strange folks that choose to specialize in this field.

 Looking back on my years of teaching as a clinical instructor in our professional programme at Toronto General Hospital, I can’t help but wonder how much better a job I could have done for the students then.

The Pedigaits primary role is helping us identify and diagnose the root cause of biomechanical disfunction. Subsequently; we can use it to evaluate both improvement in function and deterioration over time. In deciding surgical intervention and/or orthotic modification we often run a more recent Pedigait video analysis, then contrast and compare to previous captures,  to assist the decision making process.

Better still it provides an amazing platform for us to demonstrate to our patients the actual source of their complaint in a crisp clear video, in slow motion, and from every angle. We believe an important part of our  job is to inform and educate, without that our patients can never truly make an informed decision regarding which treatment course they would like us to deliver or to seek referral.

The average human eye can see 40-60 frames per second, decreasing with age. Fighter pilots and gamers can be trained to see up to 220 per minute. But processing these images requires a much slower rate in the high teens to 20 for most. Thus watching human motion at real time, even with many years of experience and training is limited in its insight and detail.

So while dealing with our short term crisis may cause some interruption in service, I apologize in advance to Dr Milioto but we will continue to pester you to leave your clinic for a few hours and return to your design lab and craft a new version of your superb system. 

June 03, 2021
Category: Uncategorized

Coming soon

Not everyone who wears sandals develops hard skin and cracks on their heels. But if you do its indicative that your feet are not very stable.




I know summer has just arrived and already I'm on your case about sandals.

But before you shed your clothes and slip on your sandals, please remember, even a contoured sandals like the one pictured below, will not significantly improve functional control. 

Your heels are going to roll in and twist causing hard skin to build up and then form vertical splits. Your big toe joint is going to lock causing heavy callouses (hard skin) on the side of the big toe and your little toes to curl down into the ground causing callous and thicken/discoloured nails.


It's OK to wear sandals, just don’t live in them. 

Remember to hydrate your body and your skin. Pick your opportunities to wear based on level of activity and yes we can help diagnose and treat the underlying cause. 


Nope! I'm not telling who’s feet these are!. But its safe to say some of us dont always practice what we preach.

By Podiatry Associates
June 02, 2021
Category: orthotic devices
Tags: orthotics   heel pain  

Heel pain can cause discomfort throughout the day and affect your ability to carry out regular daily activities. A common cause of heel pain is a foot condition known as plantar fasciitis. One way to treat this condition is with custom orthotics, which are devices worn inside the shoes. Dr. Barry Noble, Dr. Mark Bradley, Dr. Marilyn Bradley, and Dr. William Jacob, the experienced foot specialists at The Podiatry Associates in Whitby, Brantford, and Mississauga, ON, treat heel pain and can fit you for custom orthotics.

Plantar Fasciitis

Plantar fasciitis is a foot condition associated with pain at the bottom of the heel and sometimes in the arch. Running along the bottom of the foot is a thick band of tissues called the plantar fascia. These tissues connect the heel bone to the toes and provide shock absorption for the foot. Constant pressure or strain on these tissues can cause them to become swollen or inflamed, which can lead to heel pain and discomfort. One method for treating plantar fasciitis is wearing custom orthotics in the shoes.

How Orthotics Help

Orthotics are devices that are placed inside the shoes to correct a wide range of foot issues, including irregular step patterns. Orthotics help position the feet and ankles so they are in proper alignment with one another. It is possible to obtain over-the-counter orthotics, but custom orthotics deliver better results since they are tailored to each patient’s unique foot structure. We offer custom orthotics at our offices in Whitby, Brantford, and Mississauga, ON, for the treatment of heel pain.

Orthotics help with heel pain and other foot problems in several ways, including:

  • Providing added cushioning
  • Alleviating pain and discomfort
  • Providing more arch support
  • Improving stability and balance
  • Reducing strain on the feet and ankles
  • Improving alignment in the feet and lower extremities

Several types of custom orthotics are available, including semi-rigid, rigid, and soft orthotics. Semi-Rigid custom orthotics provide additional arch support, which is beneficial to individuals with flat feet. Rigid orthotics help correct irregular step patterns by improving foot positioning when walking. Custom soft orthotics provide added cushioning and support and are helpful to patients with arthritis in the feet or ankles. One of our foot specialists can recommend the right type of custom orthotic for your heel pain.

Custom orthotics can provide relief from chronic heel pain and discomfort. Schedule an appointment with Dr. Barry Noble, Dr. Marilyn Bradley, Dr. Mark Bradley, and Dr. Will Jacob for help treating your heel pain by calling The Podiatry Associates in Mississauga, ON, at  (905) 568-3800. We are also located in Whitby, ON, at (905) 433-0200, and Brantford, ON, at (519) 751-2900.