What can we learn from an old pair of sneakers? Plenty….
Case study: 76 year old female client who is an avid walker presents with long-standing left hip pain. When we looked in to her walking shoes, we saw that she had worn out the insole around the big toe on the left, but not the right (see picture). Upon evaluation, she demonstrated stiffness of her big toe with a loss of normal extension. This is called Hallux Limitis and often progresses to Hallux Rigidity (rigid) if not addressed. This extension of her toe (ability to bend up) is needed for a normal walking pattern during push off. Since she liked to walk, but couldn’t extend her toe very well, she “pushed” the base of her toe in to her shoe until the sole broke down. She also has a history of blisters at the base of her big toe.
Not only do we need to address the issues of her chronic left hip pain, the loss of normal motion in her foot is a factor as well when we look at the biomechanical changes. Take home message? Check out those old shoes before you throw them out!
Ed Deboo, PT
Physical Therapy, Bellingham, WA