Don’t let arthritis slow you down – “motion is lotion”



I have worn a custom knee brace for my knee injuries and as a therapist and brace fitter I feel a certain kinship with my clients. When I injured my ACL playing soccer, I was so afraid that my soccer playing days were over. The pain was so intense and I was sure I would never get back on the field. Once I got my custom brace and finished my rehab, I was back! Without my custom knee brace to give me the stability I wanted, I would never have felt safe enough to return to the same level. But what I didn’t know at the time was that I would probably develop arthritis in my knee! When you are young and active, no one ever tells you that may get injured! No one ever tells you that the wear and tear on your joints could lead to premature arthritis! I quite often see patients who are still young, in their late 40’ s and 50’s who have stopped doing their activity because of arthritis in the knee. A lot of them will gradually gain more weight due to the drop in activity level and the weight gain doesn’t help with the increased joint pain one bit. It’s kind of like a vicious cycle- how do you stay active to stay healthy when arthritis in your knee prevents you from doing the activity you love? Well, motion is lotion – the more you are able to move, the more nutrients you send to your joints. Yes, it’s hard to move when you have bone on bone and the knee hurts when you walk. There are so many Osteoarthritis braces like The Thruster or the The Offloader that has a hinge that you can crank up to increase the amount of offloading on the joint space. The relief is almost instantaneous. There is no reason to let Arthritis slow you down, motion is lotion!

Stefanie Deboer, Certified Pedorthist, Burlington Orthotic Centre

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Are Your Shoe Choices for Your Kids Causing Bunions?

normal-vs-bunionMost people don’t think of Bunions when they think of children’s feet! However, I see a fair amount of bunions in children (kids, you can thank your parents for some of that!). Bunions affect the alignment of the big toe as well as lead to bone growth on the inside of the foot near the big toe joint. In my experience children with bunions usually have flat feet, very flexible joint articulations in the feet, and are involved in sports that either require tight fitting footwear or cause repetitive stress to the first toe joint (cleats, skates, dance). When we work out, we stress our muscles and they respond to the stress by growing bigger. Same thing happens in bone. When you stress the big toe joint by rolling onto it when your arches collapse or by wearing a tight cleat or skate that rubs along the side of the toe, you are creating stress to that bone and if you have hereditary factors you are going to stimulate the growth of the bone in the big toe area. Probably one of the worst cases I saw of adolescent bunions were in a 14 year old girl who skates 5x per week and whenever she takes off her skates there is marked redness in the bunion area. When she is not in skates, she is in a Puma style flat shoe. Most of the kids I see nowadays are unfortunately not wearing well structured shoes and this leads to a big discussion about style when I try and educate them about the virtues of a good shoe. Parents, you are not held harmless on this one! There have been many a conversation in my assessment room on footwear when the parent says to me “she’s never going wear a running shoe, she only wears flats.” If you have a family history of bunions and your child’s foot is flexible, they are at risk of bunions. Help them, work with them to find a compromise. I certainly am not suggesting that your child wear an ugly orthopedic shoe! The difference a good Asics, Brooks or New Balance running shoe can make to your child’s feet is quite significant, and with the cool colours and styles nowadays surely we can find a compromise. My goal for bunion treatment is accommodation to limit any future growth. This begins with footwear education as well as supporting the arches of the foot to take the pressure off the big toe.

Steve Lawcock, Certifed Pedorthist, Burlington Orthotic Centre

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ACL Knee Injury – Getting Back To The Field

ACL Knee InjuryI have been playing competitive soccer ever since I can remember, and I like to move fast. I guess that warranted my dad’s nickname for me, “Scooter!”  Never once did I ever think I would be needing reconstructive surgery on my knee to repair my ACL that was fully torn.  I was just winding up for a shot, planted my leg and twisted and that’s when I felt my entire joint open and crumbled to the ground. I had never felt pain like that as I heard the “pop” in my knee and instantly knew something major had happened. As a kid playing rep sports, you think you are invincible! Who knew that girls are more predisposed to ACL injuries than boys because we have a wider pelvic angle? I certainly didn’t at that time.

After a year of waiting, I finally had my knee repaired and soon after I was getting fitted for my first Bledsoe ligament instability brace. I was so amazed at how light this brace was. When you look at them they appear bulky and restrictive, but the magnesium frame was so light and the brace was custom made so it moved perfectly with my leg. This brace became a part of me, and helped in my recovery process.

I was motivated to get back into playing soccer again but I was quite afraid of pushing my knee too hard. I didn’t want to go through the pain that I had just gone through!  The brace was literally a helmet for my knee and gave me the stability, control and confidence to get back into what I loved doing most, playing soccer.  I had to make sure there were no metal hinges showing or exposed on the brace, and thankfully they all come with outer covers to make sure the brace is in compliance or the refs wouldn’ t have let Scooter back on the field!

Stefanie DeBoer, Certified Pedorthist, Burlington Orthotic Centre

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Heel pain after a growth spurt?

Sever's DiseaseParents work so hard in trying to get their kids active and keep them active, so it is quite disheartening for a parent when their child complains of pain. Sever’s disease is typically seen in children between the ages of 8-15, with the majority of my patients being boys in the 9-12 age range who are very active or involved in sports. The pain is quite marked when you prod around with your fingers at the back of the heel.  I see a lot of cases of Sever’s in young athletes wearing cleats where the action of the cleat digging into the ground causes a further stretch of the Achilles tendon which then pulls on the heel bone even more. Usually the pain appears to start at random and is reported as worse during activity or shortly thereafter, with rest helping alleviate symptoms. When asked to point to the area of pain, almost every patient is quick to point to the back of the heel. This disorder commonly follows a growth spurt. This is because bones tend to grow faster than the muscles and tendons of the lower limb. This growth spurt can cause the Achilles tendon to become tight, which puts extra tension on the heel bone and can lead to inflammation of the growth plate in the heel. Some cases can be chronic and if little recovery has occurred after 1-2 weeks I would recommend an assessment for further treatment. When watching a child with Sever’s walk, I quite often will see the ankles rolling inward, and the heel coming off the ground quickly. Footwear needs to be evaluated to make sure it is stable and supportive like the Asics Kayano. Even a cushioning shoe like the Asics Nimbus can make a big difference with a well-made foot orthotic to control the ankle rolling inwards.  If your child has symptoms of Sever’s pull them out of their activity for a week and the rest should make it better. If they are in rep sports and the demand on their bodies is high, a physio routine and some icing will complement the orthotic and footwear therapy nicely.

Steve Lawcock, Certified Pedorthist, Burlington Orthotic Centre

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GenuTrain: Active Support for Knee Relief and Stabilization

Very few people know the effect of supports on motion sequences as well as Prof. Dr. med. Albert Gollhofer. Although the results confirmed his assumptions, the head of the Institute of Sport and Sport Science at the University of Freiburg was still surprised by what the current study revealed.

GollhoferBiomechanics were the main focus of the cross-sectional study. Why?

Prof. Dr. Gollhofer: The laws of biomechanics are the foundation of every movement. Going against them can lead to chronic complaints. People with typical bandy legs (extra-large varus angle) are very likely to develop medial compartment osteoarthritis. The higher knee adduction angle places more strain on the medial joint segment than on the lateral segment. When you succeed in straightening the knee with the help of a support to regain a symmetrical gait pattern, you can slow down the development of deformities.

How can a support influence the gait?

Prof. Dr. Gollhofer: One way is through its proprioceptive effect. That is, through the mechanical stimuli it exercises on the soft tissue during movement. This creates feedback which is sent to our central nervous system and causes the muscle actions to change. The aim is a functional result. In the present case, the magnitude of the effect surprised me, although I was aware of the potential of the GenuTrain due to previous studies.

Proprioception requires the relevant receptors to be stimulated. There are many of these in the joint., the connective tissue, the muscles….

Prof. Dr. Gollhofer: We are concentrating on the mechanoreceptors. These are mainly located in the muscles around the knee and in the capsular ligaments. We play these proprioceptors together like an orchestra and “a good sound” is created when they coordinate the muscle contraction process appropriately and functionally. Injuries can cause particular problems at this point., however. We know that pain is conducted via the pathways of what we call group III afferents. These pain pathways strongly disturb the “good sound,” the rapid intermuscular interaction. Yet if we can improve the guidance of the joint by using supports, these afferents will send fewer signals, which restricts the pain. And this has an immediate effect on the gait.

To what degree are these rapid reactions only psychological?

Prof. Dr. Gollhofer: Only to the extent that the central nervous system knows: I am not alone. Reflexes in the peripheral areas are constantly regulating muscular control., every fraction of a second. This can be seen in the leg swing and stance phases, for example. Even before the body weight bears down, that is at the end of the swing phase, neuromuscular control ensures that the leg extensors are pre-activated in order to immediately provide for the necessary stability in the stance phase.

“This cross-sectional study proves that the GenuTrain has cross-joint effects.”

(Prof. Dr. med. Albert Gollhofer)

This also involves the ankle….?

Prof. Dr. Gollhofer: Of course, the ground reaction vector works from below. If the force is incorrectly introduced into the system, the possibility of counter-reactions in the knee is decreased, which is even worse further above. A stable gait comes from the bottom up. It makes sense to think about a bottom-up strategy using an ankle orthosis together with the GenuTrain, for example, for general instabilities. This cross-sectional study proves that the GenuTrain has cross-joint effects. The biomechanical influence of the support on the knee joint also causes significant changes to the hip.

Can the results of the study actually be transferred to real situations?

Prof. Dr. Gollhofer: When you measure specific effects in laboratory conditions, you ask yourself: How long will the effect last in everyday life? That’s exactly what we are trying to establish with a long-term Genu­Train study. Of course, we also know that all externally introduced changes to ingrained conditions will encounter a biomechanical state that has been established over years.

A patient who has an extreme varus deformity in the knee joint has adapted to a specific pattern with their ligaments, muscles and tendons. We can’t change that all at once. Patterns of movement and long-term adaptations in the soft tissues can only be coupled to new conditions over a long period of time. We also expect this from a support system. Ideally, the long-term study will show that constantly wearing the support over a long period of time causes the tendon and muscle lengths to return to a biomechanically balanced state. This would convince patients in everyday life. The initial results of our long-term study actually seem to confirm this type of effect.


The original on the knee: GenuTrain

Shaping functionality

GenuTrainThe active support consists of an anatomically-shaped compression knit with a ring-shaped, functional cushion, the Omega pad. The pad relieves pain by transferring the therapeutic pressure of the support from the kneecap to the soft tissues of the knee region. Two nubs on the lower edge of the pad, the Hoffa pads, exert regulated pressure on the infrapatel­lar fat pad and stimulate the sensorimotor receptors located there. This supports the pain-relieving effect. Furthermore, direct pressure on the kneecap is relieved. The lateral wings of the pad form an omega symbol (O). Their role is to ensure that the meniscus parts are held in an anatomical position, which also reduces pain.

Secure hold for the knee joint

When walking or running with the Genu­Train, the muscular contractions cause the pressure exerted by the support to increase and decrease, resulting in an effect similar to an intermittent compression massage. This stimulates the metabolism and helps reduce swelling and effusions of blood more quickly. In addition, wearing the support stimulates the proprioceptors in the soft tissue of the knee and on the skin. The surrounding muscles are activated and long-term stabilization for the joint is achieved.

High level of comfort

The material and shape of the GenuTrain knee support have a functional design for optimal effect and a high level of wearing comfort. The breathable, skin-friendly knit adapts to your every movement., without constricting or slipping. The material is soft and elastic at the edges of the support and in the sensitive area at the back of the knee. Lateral spiral stays ensure that the knee support keeps its shape during movement. Integrated donning aids make the supports easy to put on with little effort.

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Compression Socks: Protection from Overloading

Whether in competitive or amateur sport., more and more athletes are relying on compression products for preventative care. In this area, compression stocking specialist Bauerfeind offers its customers a strong sports stocking duo for endurance and stop-and-go sports.

Compression Sock Performance

The Compression Sock Performance sports stocking meets the needs of endurance athletes.

Anyone who participates in long-distance running or cycling is familiar with the feeling of heavy, tired legs. This is caused by the vessels expanding and losing their tension. With the new Compression Sock Performance, available from summer 2014, endurance athletes can now give their veins the ideal support. The sports stocking’s pressure profile is based on medical standards. The continuous compression decreases from ankle to calf, which improves venous reflux and the removal of lymphatic fluids. At the same time, the gentle compression stabilizes the calf and reduces typical muscle vibrations, thus preventing premature fatigue. Better support is provided for muscles over long distances, so they can continue to perform more effectively.

Quicker recovery

The Compression Sock Training sports stocking provides protection in stop-and-go sports.

The Compression Sock Training sports stocking provides protection in stop-and-go sports.

The positive impact on circulation and the muscles protects the vein system when it is under persistent stress, which in turn promotes a quicker recovery. Just how much endurance athletes benefit can be seen in a medical study* carried out during the 2011 Paris Marathon. The participants wore the previous model of Compression Sock Performance, which is identical to the new sports stocking in terms of compression strength and therapeutic gradient. They reported less muscle pain, a reduced feeling of swelling, and much better muscle recovery in the first four days after the race. Their calf veins had not dilated during the race despite the increased strain.

The knit of the Compression Sock Performance is made of fine, breathable microfiber. It can regulate heat and channel moisture away from the skin, creating comfortable micro-conditions. This has a twofold benefit during sporting activities. In addition, the microfiber makes the new sports stocking particularly light., yet still hard-wearing.

Stability for the ankle

The Compression Sock Training sports stocking is especially designed for stop-and-go sports, meaning sports that involve rapid turning and jumping movements such as football., basketball., or tennis. It features special functional zones with gentle compression. The stocking’s taping zone helps to create a feeling of greater stability in the ankle, while its muscle-toning zone specifically stimulates the calf muscles during movement. This is particularly important in these ball sports that put a great deal of stress on the ankle, because a sense of instability can quickly take the fun out of exercise – especially in people with a previous injury or naturally weaker ligaments.

The Compression Sock Training uses the same active principle as a tape bandage to create a feeling of improved stability in the ankle. The “taping zone” with a “figure of eight” design wraps around the instep and heel. The firmer, compressive knit stimulates the skin’s sensors and the deep sensors in the muscles, tendons, and joint. The improved proprioception supports the ligaments and improves coordination, providing greater security when changing direction quickly. The stocking therefore also offers increased protection from injuries.

Muscle stimulation

In the calf area, the “muscle-toning zone” also exerts gentle compression at certain points and counteracts tiring muscle vibrations. Its asymmetrical anatomical shape specifically stimulates the muscles during movement., facilitating gentle muscle building.

Like the Compression Sock Performance, the Compression Sock Training’s heel cushion eases the strain on the Achilles tendon and protects this sensitive area from pressure and rubbing when it is under great stress. Additional toe, forefoot and heel padding absorbs impact and ensures a firm grip in the shoe. The stocking’s high-quality breathable Lycra Sport material guarantees the required moisture transfer during sporting activity and creates pleasant conditions for the feet.

Simple size selection

The appropriate size of the Compression Socks Performance and Training is determined by the shoe size and the calf circumference, as the leg muscles of athletes can vary considerably. The Compression Sock Performance is available in black, white, and Rivera, a shade of turquoise. The Compression Sock Training is available in the color combinations Coal/Rivera, Silver/Rivera, Coal/Polar, and Silver/Polar.

Compression Sock Performance 2Compression Sock Performance

  • Compression over a large area, consistent therapeutic gradient that complies with medical standards
  • Improves circulation and protects the veins from overloading
  • Reduces muscle vibration (due to the compression) and prevents premature muscle fatigue
  • Ideal for use with the ErgoPad run & walk sports foot orthosis
  • Recommended for endurance sports

Compression Sock Training 2Compression Sock Training

  • Compression at certain points in the taping zone around the ankle and muscle-toning zone on the calf
  • Improves coordination thanks to its stabilizing effect on the ankle and calf muscles
  • Reduces muscle vibration (due to the compression) and prevents premature muscle fatigue
  • Ideal for use with the ErgoPad ball & racket sports foot orthosis
  • Recommended for stop-and-go sports with quick changes of direction

For further information on these and other Bauerfeind products, visit


*Allaert F .A. et al., Effects of elastic compression in French compression class II (18-21 mmHg) on the adaptation of muscular stress and recovery of marathon runners, Phlébologie 2011, Vol. 64, Number 4.

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Knee Pain

We live with it and we ignore it .. eventually, we forget about it.. then it becomes worse, affects our ability to exercise and then the real problems start. Every time I bend down, I hear a ridiculous crunching sound in my knee. It doesn’t hurt , but that noise can’t be good?  I play soccer once a week and am fairly active throughout my work day – and yes I do get a little achy in my knee. All these warning signs, and yet I do nothing about them? Well until recently. I found that a simple knee sleeve, kept my knee “together” and feeling so much more stable. Best part, it wasn’t made of neoprene, and didn’t get hot or stinky after an hour. So everyone in my family now wears one and they suffer from osteoarthritis, ligament tears, and knee instability – maybe I should blame them for my genetics?!! Call us at 905.331.4391 to see the Genutrain knee brace.GENUTRAIN_G1

Orthopedic Flip Flops? Really?

Yes, really! there is such a thing as orthopedic flip flops, and no, they are NOT UGLY! We see so many cases of heel pain and knee pain through the summer and into the fall. Winter forces us to wear boots and shoes, which are usually quite supportive. Transitioning into flip flops and lightweight summer shoes can be a major cause of heel and knee pain. When the Sole rep first walked into the clinic to show us the flip flops, we were very skeptical. Then we tried them on and were instantly impressed.  My fit test was to wear them for a whole day! So , I took them to Disney with me and wore it while trekking around Epcot Centre with the kids. People looked at me like I was insane, walking around Disney with flip flops! And they were amazing to wear at the airport too where they make you take your shoes off! While you can never replace the support of a running shoe for example, I think the Sole flips are the best supportive flip flop I have ever worn. I own 4 pair –  in different colours of course! 2 are for indoor use on my hardwood floors and the other 2 are to wear outside. At $85 and various colour options for men and women, it’s a great investment. Call us at 905.331.4391 to book an appointment with a clinician to try on a pair today.


What you were never taught about lacing your shoes

We were all taught at some point  to tie our laces. I remember being taught on a practice board, with bunny themed mnemonics! There are however some hidden secrets to lacing your shoes that most people were never taught. If you have a narrow heel and your heel slips in your running shoes, try tying a “heel lock” by using the last eyelet and creating a loop. Check the back of your shoes on the inside- is it worn through? If so, chances are pretty good that your heel is slipping in your shoe. Tying a heel lock on your running shoe keeps your foot secure and  it will make you feel more comfortable and therefore run or walk faster and longer! Watch this video on how to tie the heel lock and other neat lacing tricks. Feel free to call us at 905.331.4391 or pop in to see us if you have any questions about lacing your shoes.


Finding the right running shoe

I walked into a big sports retail store and I was amazed at the amount of running shoes on display. It seemed like every colour in the spectrum was on display. Being in the business, I forget how overwhelming it can be to buy running shoes. There are so many! A few tips I can share:

1. Never buy a running shoe without having a trained professional watch your foot motion

2. Know your foot type and match your running shoe to your foot type- if you have a neutral foot do NOT buy a shoe with arch support!

3. Examine your old runners to determine the wear pattern

4. Make sure you have at least a thumb width of space from your longest toe ( not necessarily your big toe )

5. Squeeze the heel above the sole – it should be firm. Bend the shoe- it should only bend at the break point at the ball of the foot( see image below ). If you can turn your shoe into a pretzel- try another one!

A video running analysis can determine if the shoe is right for you and can also help prevent running injuries. Call us at 905.331.4391 if you would like your running shoes professionally fitted.

Watch a video on how to pick the right running shoe.. click here….