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Boot contact on side and front of toes

Started by Query, May 25, 2022, 04:23:12 PM

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Query

In the past, I saw stuff on the Internet claiming that there can be medical problems if shoes or boots contact the sides or front of the toes, and I have mentioned that in this forum.

I saw a podiatrist yesterday, partly because I had occasional numbness and cramps in my big toes. (Not, BTW, just when skating.) The Podiatrist said that might be arthritis or internal swelling; asked me to get x-rays, and prescribed an anti-inflammatory gel.

During the appointment I asked her about toe contact. She said that isn't necessarily true, that such contact is usually fine. Though I suppose she meant reasonable pressure, not high pressure.

BTW she is not, AFAIK, a certified sports podiatrist (though her Bio says she treats and does surgery for sports injuries), and is not one of the few sports podiatrists that skaters in this region are often advised to see. Unfortunately, no sports podiatrists are covered by my insurance, so I saw a podiatrist who was. She didn't even know what a ball and ring (or hoke and ball) pliers were, and suggested that one could deal with tight contact points by putting a tennis ball inside a shoe (which I think might help for a very soft shoe, but not with most ice skates, unless perhaps it were done while heat molding).

Is that consistent with what the other podiatrists have said to members of these forums?

I know some people on this forum have mentioned that they skate (jump?) best if the front of their toe(s) do touch the front of the skate.

I also asked her about my understanding that one should normally have fairly uniform pressure over the rest of the foot. She didn't seem to think that was all that important. She did, however, give me a prescription for orthopedic shoes (I don't know if they provide skate boots too - that would be really nice, since I really should get new skate boots :)), and said the cost of such shoes would be covered for me, I think partly because I am diabetic.

She also said that I would probably not develop "diabetic feet" (i.e., neuropathy = a lack of feeling in the feet), if I control my glucose and A1C levels down with medicines (as I am mostly doing). I hope she is right, because it would be much harder to correctly fit shoes and boots if I do.


LunarSkater

With the caveat I've never had a need to see a podiatrist, but spent a good hour getting fit for custom boots - and that I'm working on the axel/lower doubles: Boots, especially for higher-level skaters, need to be snug all the way around. One of the reasons I'm buying customs is that my feet are technically two different sizes in Riedells. My left foot is slightly shorter and it is terrifying when I go to pick in for a toe-loop and my foot shifts inside the boot. The toe pressure you're asking about? In a properly-fitting boot, the toes brush the end; they're not crammed against it. Pressure against the side of the foot? Too-tight shoes are a problem (look at the well-documented issues people have with high heels), so too-tight skates would be as well. There is a difference between snug and too-tight , but that measurement is highly subjective.

And, as an aside, "I saw stuff on the Internet" isn't a ringing endorsement. Too many companies, bad actors, and people who honestly don't know better but have some medical/personal experience say things to get you to buy a certain product, spread misinformation -knowingly or not, or think that their personal experience applies to everyone. If you want medical information, you talk to a doctor/medical professional (in this case, a podiatrist) or look up articles on reputable journals and websites. If you want a podiatrist's view on skating, one writes a column about proper boot fit in the USFS magazine every month; maybe reach out to her if you're that interested.

tstop4me

Quote from: LunarSkater on May 25, 2022, 07:06:16 PM
And, as an aside, "I saw stuff on the Internet" isn't a ringing endorsement. Too many companies, bad actors, and people who honestly don't know better but have some medical/personal experience say things to get you to buy a certain product, spread misinformation -knowingly or not, or think that their personal experience applies to everyone. If you want medical information, you talk to a doctor/medical professional (in this case, a podiatrist) or look up articles on reputable journals and websites. If you want a podiatrist's view on skating, one writes a column about proper boot fit in the USFS magazine every month; maybe reach out to her if you're that interested.

<<Emphasis added.>>  Far too crucial to be casually dropped in as an aside.  Scream it from the rooftop!!!

Query

My Internet sources mostly weren't random people with no qualifications.

E.g., https://web.archive.org/web/20140825042454/https://www.usfigureskating.org/Content/parentsarticles/Health%20Fitness_MayJuneJuly04.pdf discussed, among other skating injuries, bunions and hammertoes, caused by excess pressure on the toes. It was written by a PT/ATC, and was (previously) placed on the USFSA website, though I don't see it there now.

There are a lot of other sites that have respectable medical credentials that mention them too. E.g.

  https://www.mayoclinic.org/diseases-conditions/bunions/symptoms-causes/syc-20354799

  https://www.mayoclinic.org/diseases-conditions/hammertoe-and-mallet-toe/symptoms-causes/syc-20350839

But I over-cautiously extrapolated to assume that contact pressure on the side and front of the toes should be very light, or none.

The podiatrist I just saw said I did not have a bunion.

I asked because a former master skate bootmaker at Harlick had looked at my feet and said he thought I might have bunions (but wasn't certain), caused by tight toe boot fit. (Before I started punching my boots on the sides of the toes, they used to hurt there.) I don't know if the master bootmaker was medically qualified, but he wasn't just a random person on the Internet.