Orthotics and Bunion Treatment in Downtown Toronto

Orthotics and Bunion Treatment in Downtown Toronto

As Downtown Toronto Chiropodist and Podiatrist, we focus on the management and treatment of foot pain. Some conditions respond well to rehabilitation exercises and some  require support to help prevent the progression of foot pain. Sport medicine literature recommends those with bony problems, such as bunions, benefit from a stiffer and more supportive orthotic. 

Rehabilitation and orthotic prescription is what  Downtown Toronto Chiropodist,  Laura Desjardins has a lot of experience with. She has a lot of experience in making orthotics that prodive the rigidity needed for athletes as well. In fact she runs in a rigid orthotic herself. After finding out soft orthotics still cause her foot pain, she now feels even runners with bunion issues should be in a more supportive device for best pain relief.

 Downtown Toronto Chiropodist, Laura Desjardins, is fortunate to connect with various sport medicine researchers leading in tendon research and professors from top ranked sport medicine faculties across North America. This knowledge has helped her understand foot injuries in more detail.  Bunions are one condition that can benefit from orthotics.

What are Bunions ?

The medical term is Hallux Abducto Valgus and best described as the big toe deviating and a bony province over the inside of the joint. It can present with or without pain.

What causes them?

This problem can arise from tight fitting/ narrow toe boxes, high heels, flat feet, and pronation of the leg and foot. Pronation is when the bones fall inwards towards the midline of the body. Bones can shape based on repetitive movement in this pattern.

Treatment and Orthotics

Initial bunion pain can be treated with shockwave therapy, anti inflammatories, joint mobilization , rest ,splints, spacers, ice and support. Later stage treatment includes hyaluronic acid injections or surgery. At Downtown Toronto Chiropody clinic, Laura Desjardins treats this condition by addressing alignment, hip and foot strengthening, orthotics and footwear education. If needed, one may be referred for hyaluronic acid injections for joint pain. If conservative measures fail, then bunion surgery is the next step.

How Orthotics Help Bunions:

The condition is due to hypermobility and the foot collapsing inwards. Orthotics have to be stiff with the correct prescription to correct for your individual foot deformity. Casts or 3D scanners are the best impressions for taking your orthotic casts. That is where the true correction can be made from. Foam box and the pressure mapping are not considered gold standard with orthotic prescription making. The outcome of the effect of these devices can be compromised.

Quick tips For Bunion Treatment

Icing the area, using topical pain creams and anti-inflammatories can help lessen the ache. Simple bunion splints you can purchase, help stretch the joint capsule and offer temporary relief. These splints do not fix the bunion as the underlying issue is from the trauma. This is trauma from wear and tear on your feet such as standing, walking and running.

Key Points

Bunion pain does respond well to orthotic treatment. Bunion treatment orthotics need to be made with the correct prescription for support or else they will not prevent the collapsing of the foot . Orthotics for bunions need to be stiff with the foot corrections made in them. The casts should not be foam box. If  treatment of orthotics , exercises, footwear changes, spacers and splints do not offer relief, you should be referred to an orthopedic surgeon.

Footwear and Foot Pain Tips Toronto Chiropodist and Podiatrist

How Footwear has an Impact on Foot Health:

Foot pain can be directly related to your shoes. A lot of our foot troubles come from our repetitive day to day activities and our footwear. Those who walk around Downtown Toronto probably go to the path or grab meals outside their office. Most of my patients keep on the same shoes as their dress shoes. Going into winter that will change, however in Toronto we have access to the path, which allows people to keep their dress shoes and grab lunch, without having to step outside!

It is best to at least change footwear into more appropriate shoes for longer commutes.  Dress shoes do not have the greatest amount of forefoot cushioning and most of the designs are narrow and tapered in the toe box. A narrow toe box squishes the toes together which can lead to many foot problems including bunions and foot muscle weakness.

Foot muscle weakness is due to the lack of use ! If someone was to wear mittens to do everything each day, they would have weak hands. This is similar to the feet, that is why a larger toe box is always recommended. With a larger toe box , your feet can dynamically aid you in walking. When the toes are able to spread apart and grip withing a shoe, they are able to keep moving, strong and stay in shape. Bunions and hammertoes arise from the foot adapting to pressure on a constant basis. Buying footwear with a bit more toe box room or stretching the shoes from a shoe maker can help prevent foot problems and also improve comfort!

Running Shoes

Shoes with padding and cushioning can help reduce aches and pains in your feet after runs. People who are prone to forefoot pain should also adapt not only a strengthening regimen , but also choosing footwear of adequate support and forefoot cushioning. Orthotics can also be made to provide extra shock absorption and help with deflecting pressure on the forefoot. Shoes should be replaced every 800 km . After that point the foam compresses and looses its responsiveness, reducing its ability to help support and protect your foot.

Footwear had some a long way with the mesh and seams manufactured to help out those wider feet and bunions. If you happen to ever get blistering in your running shoes, come me, Laura Desjardins . I am well experiences with runners and know how to manage that area of concern for people.

 

Foot Pain Treatment and Orthotics- Downtown Podiatrist and Chiropodist

Foot Pain Treatment and Orthotics- Downtown Podiatrist and Chiropodist

The ideal foot is one that is cosmetically free from pathologies, free from pain and has normal biomechanics. Activities should not cause your foot pain. The foot should fit comfortably in most shoes. If you find yourself thinking you do not exhibit some of the characteristics, you may be someone susceptible to experience foot injuries or ongoing problems with your feet.

Certain activities and footwear over a lifetime can impact your foot health. Ballerinas, runners or those who need to wear high heels can undergo foot changes that impact their quality of life and overall health.

Most Common Symptoms of Foot Pain

Ball of the foot pain

This is typically known as metatarsalgia. Within that term there are many factors that can be causing your pain, which include callouses, corns, tight footwear, flexible footwear, arthritis, stress fractures, ligamentous injury, the arch collapsing and even stress fracture.

Arch pain and heel pain

This typically can be plantar fasciitis, however other factors must be rules out. Other differentials include a seronegative arthritis, nerve entrapment or stress fracture/ stress reaction.

Nerve pain and burning sensation

This can vary from a nerve entrapment, neuroma or neuropathy.

Due to the fact many conditions my seem like others, it is best to have a specialist to assess your conditions to give you the best understanding of your foot pain. I, Laura Desjardins’ goal is to get people out of pain and back to health. I provide an examination with a detailed medical history as well as a treatment plan. I have experience in extra training at Harvard Medical School in Sport Medicine, Canadian Sport Medicine conferences and my own running and foot injury experience.

I believe in a well rounded approach which may include supporting the foot with orthotics to help the injured tissue heal, along with exercises and treatment plan. I can also offer a return to sport or activity program.  Modalities and tools to help speed healing are also offered at my clinic, such as shockwave therapy, which I believe is very beneficial, however only when combined with the proper effective rehabilitative program. Sometimes, I may refer you off to a Sport Medicine Doctor, who I trust, to give you further tests or treatments.

I am a passionate runner and foot health has always been so important to being able to stay consistent and healthy. Your feet are your foundation and strong and mobile feet are important, seems how we use them each day!  I am confident I have a vast experience in footwear, orthotics and treatment when it comes to foot pain management.

 

Downtown Toronto Podiatrist and Chiropodist Tips on Foot Pain

Laura Desjardins, a Downtown Toronto Chiropodist, is passionate about foot rehabilitation, treatment and injury prevention.  Here at downtown Toronto chiropodist and downtown Toronto podiatrist, Laura takes deep motivation in helping people get back their foot health. Being an elite runner / athlete, she understands injuries and has had her share of her own experience managing foot and lower limb pain.

Laura realized most of her own injuries were foot and lower limb related, so she chose a field that would help her manage foot and lower limb pain.  This has given her first hand experience with foot pain. 

Here are a  couple tips from Laura , a downtown Toronto chiropodist, who works with an experienced downtown Toronto podiatrist. 

Common foot conditions and what to do about them.

It is recommend that if any of these issues still persist to come on in and see Laura Desjardins at our foot clinic downtown Toronto.

Bunions 

Footwear 

The initial treatment is footwear modification. While you wait to see a chiropodist or podiatrist, it is best to avoid any shoes that makes the pain worse. Simple, it may seem. You may not be aware that most of your footwear could be a source of your pain. In fact changing footwear is the number one treatment people do for their foot pain. Chose a wide toe box and forgiving material without seams across the big toe joint.

Home Treatment

Toe spacers, a certain type, can offer hassle free management to keep the toe aligned. Laura Desjardins also recommends particular splints to help the joint capsule and the muscular imbalance around the big toe. It is hog wash to think a splint will reduce the bunion, it may help improve the space between the big toe and the second and pain, but the bunion will not go away. 

Icing and anti inflammatories, oral or topical. These types of medications are to help wth joint irritation and inflammation, as long as no contraindications exist for these medications. 

Bunions can arise from other issues other than just the foot. That means there is a more complex issue requiring the help of an experienced foot practitioner, like Laura Desjardins to help you find that missing link . 

Plantar Fasciitis 

This one is a very painful and stubborn condition once it starts. Laura has personal experience with plantar fasciitis and understands what works and what does not. She also has great insight to guide you through this condition in stages through to recovery. Laura also offers Shockwave therapy along with exercises and treatment for this condition. She also has extra training from Harvard Sports Medicine for rebuilding foot strength. 

Footwear

Avoid anything that lacks support and flat. A good test is to attempt to bend the twist the shoe as if you were to twist out a dish rag. If you can completely twist the shoe, it is not good for you! This means you want a stiff sole for plantar fasciiits. 

Wide toe box, this is important to allow the foot muscles in the toes to move and strengthen while you walk and move. 

Home Treatment

Rest is always best. Laura’s rule of thumb is do not do anything that causes pain. Pain is your best navigation tool in this injury. Towel scrunches, stretching and working on rolling the foot out as well as ice is good in an acute phase. If not contraindicated, anti inflammatories can help. 

Plantar fasciitis is one of the foot injuries that can take a long time to heal because of the location on bottom of the foot. If you do not see improvements in a timely fashion, it is recommended to seek help as this condition can become chronic plantar fasciitis and even debilitating. 

Laura’s approach to plantar fasciitis includes gauging your individual phase of the condition and your individual biomechanical assessment. There are certain exercises and activities that should be or shouldn’t be done based on where your injury is in the healing phase. 

Keep in mind it is not abnormal for this injury to take months to heal. UNFORTUNATELY, the located is right under the foot in a large weight bearing area so it is bound to undergo repetitive stress. However, the chiropodist and podiatrist at our foot clinic downtown can help reduce the healing time and help give you the tools to help manage it. 

Our chiropodist, Laura Desjardins, is very keen on foot conditions and being a runner, she understands the value in getting your health back as soon as possible. Her approach is holistic in nature where she really wants to determine your underlying issue and uses Podiatric skills as well as her sports medicine knowledge to help teat those with foot pain. 

Here is a link from the Globe and Mail advocating the important of foot health and the body. https://www.theglobeandmail.com/life/health-and-fitness/fitness/how-the-feet-run-the-show-in-a-healthy-body/article23790241/

Orthotics Downtown Toronto Podiatrist and Chiropodist

Orthotics

The season is here to be changing into boots and enclosed shoes. The correlation of injuries and poorly supportive footwear is known. Speaking from experience, each time I would train in a lighter supportive shoe for an extended period of time, I ended up with an injury. This was even after taking precaution to strengthen the foot and slowly adapt to lower supportive footwear. According to a study of Sports Medicine , running in minimal footwear lead to the  increase in the likelihood of injury risk.
This brings me to my next point. I have learned the hard way . I hate foot injuries and orthotics did help in preventing my injuries along with proper footwear. This also goes for those who are walking around on their feet in Downtown Toronto. Repetitive strain is strain and certain types of footwear can predispose the likelihood of these injuries to arise.

What do orthotics do ?

They help to control abnormal forces, support the injured foot and help to prevent injuries of the foot. The nice thing about them is that you can add support to an array of your shoes. Now I understand most of the fashionable shoes do not give the most support, so it is nice you can have a custom foot orthotic with your individual prescription needs to add extra support to your footwear for your foot pain. Orthotics can also be practical , sleek and easy to move from shoe to shoe.
According to Rehabilitation Sports Medicine , orthotics are seen as a very important and useful tool in the rehabilitation process for injuries.

When would an Orthoic be needed?

Pain is a good indication that you may be a candidate to be fitted for custom foot orthotics at our Podiatry and Chiropody office Downtown Toronto. Not all orthotics are built the same and that is why they are custom. Your foot is casted and then placed into a corrected position. From there further corrections can be made. Depending on your foot pain and condition, the orthotics will be made based of that as well. It is very important to see the correct professional for your custom orthotics that your insurance recommends as they know they will do the best job at accurately prescribing the device for you.
I had great success to ward off an achilles issue with a pair designed for and achilles issues. Bunions , plantar fasciitis , metatarsalgia, hallux limitis , turf toe are all things that can be adequately treated with custom foot orthotics to help the foot heal.

What to expect?

Custom foot orthotics do take some time expect anywhere from 2- 4 weeks. I always follow up to ensure patient satisfaction. There is also a break in period to help start firing other muscles that may not have been firing before. I know I experiences this in the top of my foot and shin when I had worn an orthotic with a more control . That just felt like the soreness you get when you workout.
My approach not only includes orthotics, but I do believe in a well rounded approach which addresses strengthening and stretching as well as a biomechanical evaluation. As with any injury , time and patience as well as rest and treatment is your best approach to a speedy recovery !

Orthotics Toronto and Support

Who Can Get Foot Pain?

Being a distance runner, I have had my fair share of experience with overuse conditions. It does not matter whether you are a runner or someone who walks everywhere for transportation, or even an office worker, repetitive movements over time can result in overuse injuries. There has been many trends in the minimal footwear approach. I have also had my fair share of personal experience in trying to adapt to minimal footwear. Each time I did try to transition into this type of footwear, I did encounter more aches and pains and even injuries. I seemed to always stay healthy longer in supportive footwear, orthotics and staying on top of injury prevention drills.

My Approach

My approach to care emphasizes a well rounded approach that addresses foot injury as well as the mechanism of action which causes fatigue to the foot as well. A foot injury requires treating and rehabilitating the foot in a progressive manner that also encompasses restoring other imbalances above the foot. The underlying mechanism of action of injury should be addressed or else the foot injury may return if the original reason why it happened was not corrected.

How Orthotics Help

Orthotics, with proper footwear can also help deflect forces on the foot and provide support for injury prevention. Orthotics helped me keep injuries at bay. Each time I slowly tried to ween into a less supportive footwear, I would be on the brink of injury, notice more tissue strain or even injury. I liked the feeling of fast but I ended up feeling beat up.

Bottom of the foot pain and general foot pain is sometimes stubborn to treat as the foot takes the load of the body. It is very difficult to rest the tissues . Supporting an injured foot helps to let the injured area rest and reduce load to heal. I always promote a well rounded strengthening and stretching program combined with support and to encourage people to solely not rely on support .

For my assessments I like to perform a full lower extremity biomechanical to locate individual weaknesses. Foot pain can result from weakness above the foot which can result in adding more stresses placed upon the foot. When the foot  is injured I approach treating the area by a progressive treatment plan as well as addressing the other imbalances that may have lead to more foot strain. I do find the use of orthotics to help reduce these forces placed upon the foot and provide support.

 

 

A Downtown Toronto Foot Doctor Supplies Some Advice for Golfers

We’re one Downtown Toronto foot doctor that confesses to loving the links. One of the best times to go golfing is when the leaves start to fall. And that’s soon. Having a good swing is about more than how you connect with the ball. The ball of your foot, heel and toe are all important too.

Here’s a few ideas on how looking after your feet can increase your handicap.

The Issues

There are three issues that can affect your golf swing. A neuroma is a problem with the nerves in your foot. It can cause a problem when you’re shifting your weight as you swing through.
Arthritis is a more common issue that can show up in your big toe. It can make the follow through extremely difficult. Other golfers can suffer from heel pain. This occurs when the tissue in that part of your foot becomes inflamed. It’s a horrible way to ruin an otherwise good golf stance.

Buying Golf Shoes

There’s another area where a Downtown Toronto foot doctor can help your golf game. And that’s in helping you choose the right golf shoes.

Getting the right sized shoe is critical. Think about it. During any given round of golf, you’ll be walking long distances. You’ll be standing for several hours and shifting your weight as you hit the ball.

Measure both your feet before making any decisions. If they’re different sizes, get the one that fits the larger foot. Wearing shoes that are too small can cause bunions and even hammertoe.

Socks are important too. When you’re on your way to buy golf shoes, take a pair that you’ll be wearing with you.

Once you’ve considered the health of your feet, it’s time to take a look at style. There’s a lot to choose from. But basically, you can divide your choices into either traditional or athletic.

Leather Golf Shoes

The traditional golf shoe is generally made from leather. Not always as breathable as we’d like to see, but usually these are waterproof.

From our standpoint, athletic golf shoes have a lot going for them. They are lightweight, breathable and very flexible. Good for the feet and they come in a wide variety of colors and styles.

Spikes are available in both kinds of golf shoe. They give you a little more grip so you won’t twist your ankle. There’s lots of choice with modern golf shoes. They are a little more comfortable.

As a Downtown Toronto foot doctor, we always suggest you consider the health of your feet and your scorecard at the same time.

Foot Pain Often Requires Glute and Core Strengthening

Foot Pain Often Requires Glute and Core Strengthening 

As a foot specialist I spend a lot of time hearing about people’s foot pain. I also am able to listen to their history and connect the dots to what may have resulted in a foot condition. To be honest, it is rarely just one thing, other than a direct blow or trauma, that results in foot pain conditions. Most of what I see is overuse injuries, and that can even be walking for extended periods of time. Doctors and nurses who spend long shifts on their feet are no stranger to foot pain.

Foot injuries can happen from repetitive overuse where some structures become weakened. Sometimes an old injury that was not completely rehabilitated can cause recalcitrant issues later down the road. The foot is directly related to the forces placed upon it. Weaker structures above the foot results in more impact on the foot.

The more and more I see, the more I realize everything in the body is connected. I have always been a practitioner of the philosophy where every body part has a relationship to another. The best way to explain this is if you only treat a painful area, you may not be targeting the original cause of the problem. That is why when I help treat foot pain, I like to encourage a well rounded treatment plan that also includes core and glute strengthening.

I was at Goodlife and it occurred to me the sign on the wall next to the glute machine stated something along the lines of “Glute strength, the most important muscle for athleticism”.  This is so true! Our core and pelvis holds our centre of gravity, much of the pain and ailments related to the foot an ankle also has a relationship to the glutes and core.

Being a person who runs each day, I realized this more and more. Most of all the injuries happening to the feet are directly related ! Do not get me wrong, one still needs to strengthen the feet and rehab that area, however it is of most benefit when we also strengthen above the foot as well. So I wanted to share some tips on keeping your glutes and core strong to help prevent some injuries. Plus, isn’t it a bonus to have a toned booty and core?

Planks

This includes side planks and front planks. The best form is when you squeeze your glutes together and attempt to keep you belly facing the wall, not twist up to the ceiling.

 

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Donkey Kicks

These are great to isolate the glute muscles. Donkey kicks can be done lying flat on the floor or on all fours. This can be done with a theraband around your hips also. The gym does offer a push plate for better glute activation.

 

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Glute Bridges

Again, it is always important to squeeze your glutes at the top. Attempt to hold this for 45 seconds. Marching or transitioning into a single legged glute bridge also makes this one more challenging.

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Standing A

This one is easy to do anywhere! You can stand up in an A stance and squeeze your glute at the top . Holding only in the standing knee up position.

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Single legged Squats

Stand up straight with your back and heels in contact with a wall. Take a small step forward on your leg to be exercised. This step should be around half to one foot distance away from the wall. You can easily incorporate this daily. When you attempt to sit down, slowly lower on one leg or add in a few reps before you sit!

 

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Side steps with therabands

These are great to help activate pelvic stabilization when walking. People with weaker glutes tend to drop their hip when they walk, which can result in knee pain and also subsequent foot pain. Place a band around your ankles and gather some tension. Side-step keeping constant tension on the band. Make sure you do not bring your feet too close together and keep your toes and knees pointing forwards.

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Strengthening should be done at least 2 times a week. You do not need a gym membership in order to do these basic strengthening exercises. You can do 10 minutes twice a week and it will still add up to help keep you healthy.

I encourage that prevention is the medicine .

Treating Plantar Fasciitis with Shockwave and Orthotics Downtown Toronto

The Nature of Plantar Fasciits

If you are one of those many people who suffer from foot pain, we have solutions for you! I try my best to stay current in the recent advances in academic literature. I want to share some recent findings with you! One of the most common conditions I find in practice, is plantar fasciitis. It can be characterized as a pain in the heel or pain along the arch of the foot. Increased pain in this condition may arise from prolonged standing or activity on the feet. People tend to feel it after a period sitting or when waking up in the morning. Stretching out the band does offer some instant, temporary pain relief. Sometimes, the fascia band has been injured for some time that the healthy tissues are no longer working properly and become known as degenerative. What does that mean? It means the tissues no longer lay down healthy tissue in the manner it used to. The injury to the tissue changes the ability to repair and heal.  

My Approach to Treating Plantar Fasciitis – Extracorporeal Shockwave

How I typically treat plantar fasciitis is by the same principles of rest, support, strengthen and treating the tissue. Treating the injured area will have best benefits when one corrects the underlying issue causing the strain on the foot. This means restoring the strength and flexibility to the areas needed so that the strain on the band no longer happens. The problem about this injury is that the bottom of the foot is difficult to rest. That is why the use of an orthotic will help to lessen the strain on the tissue and offer support while standing on it. My preferred method of treatment for this is extracorporeal shockwave therapy.  

Extracorporeal shockwave therapy sends pulses into the degenerative, injured tissue to help speed up recovery. The pulses promote regeneration of healthy cells to heal the tendons and soft tissue. The treatment results in new blood vessel formation, reversal of chronic inflammation, stimulation of collagen production and loosens tissue. The treatments are usually spaced 1 week apart. I do feel the best results are when this is combined with the proper exercises so the underlying mechanism of injury is addressed. This treatment is really what helped me when I had plantar fasciitis in my earlier running years.  

Footwear and Plantar Fasciitis

Footwear can be a tricky one! Some people respond better to a lower heel drop and some respond better to a higher heel drop. I still have yet to find a holy grail which to advise people on this one. The higher heel in a shoe can alleviate the strain on tissues that don’t have flexibility. However, sometimes a higher heel in footwear can cause more focal compression on the injured tissue of the plantar fascia.  It is a bit of trial an error process. It is okay to gradually go into a little lower of a drop for those whose pain scale is quite reduced. I also implement a lot of stretching, mobility and strength work into my rehabilitation program for plantar fasciitis.  

What The Research Says for Pain Relief :

 In the academic journal Comparison of extracorporeal shock wave therapy with custom foot orthotics in plantar fasciitis treatment, it was found that both options were of benefit for those suffering with plantar fasciitis problems.  The results : Both group I and group II achieved significant improvements in our evaluation parameters (morning and evening pain) at 4, 12 and 24 weeks compared with their baseline values (P<0.001), and significant improvement observed in the group II continued at 48 weeks (P<0.05).

The study demonstrates both groups reported improvement in either scenario. Both are found to have benefit for those suffering from plantar fasciitis. I like to combine both in my practice! Orthotics can get mixed views as the person prescribing must have a sound understanding of the foot and lower limb. I am confident in my experience with my sport medicine background, that I understand the interaction of orthotics with the mechanics of the foot. Orthotics can be of great benefit when injured, to help the tissue rest and alleviate strain when recovering from an injury. 

Pain on the Ball of the Feet

Do you suffer from pain located on or near the ball/ balls of the feet? This term is a generic name for metatarsalgia, which has many different forms of manifestation.  It can be localized to the smaller area or it can be located under the big toe. Typically those who use their feet a lot in their jobs, commute often or athletes can be susceptible to this. The balls of the feet are actually the anatomical metatarsal heads. They can have many different symptoms including sensations of bruising, tenderness, aching , burning and even electric sensation .

Common causes for metatarsalgia include improper footwear, overuse , poorly fitting footwear,  or sudden impact injuries . Improper footwear, such as high heels, can cause strain or injury to the ligaments around the joint . This can lead to pain and swelling . Overuse is from repetitive wear and tear can result in the forefoot arch flattening or potentially stress fractures. Sudden impact injuries can lead to sprains around the joint .

Although there are different conditions of metatarsalgia causing this pain, the treatment options are quite similar. Treatment typically is comprised of assessing the nature of the injury, cause and a treatment plan . Initially reduction in overall impact is recommended, although most activities can still be performed with support added to the forefoot in footwear. Padding can be used short term to help support the foot while rehabilitating the foot.

One thing to note is that material comprised of these pads can lead to friction as the material absorbs sweat and may cause chaffing.  That is why an orthotic with a pad embedded into the device is better to prevent blistering, increase compliance and comfort, especially in runners . I highly recommend strengthening the foot and mobility exercises to help restore function. I always advice against flexible footwear that leads to excessive bending on the forefoot in ligament joint injury conditions. I also like to combine treatment with modalities to help speed up the healing process . The modality I like to use is shockwave for foot conditions .