For all patients, MRI scan referrals from Sports Physicians are now eligible for a rebate from Medicare when performed at a rebatable MRI machine. Not all MRI machines are rebatable under the Federal Health regulations and unfortunately GP and Physiotherapist MRI referrals are not eligible for a rebate at these specific machines.
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By: Dr Karen Soo BSc(Med)Hons MBBS MSpMed FACSPSport and Exercise PhysicianThe parts of a shoe
Foot mechanics during walking and runningExcess pronation, or “rolling in” can change the mechanics of the leg during walking and running. It can be associated with patellofemoral or “kneecap” pain, Achilles tendon problems and “shin splints”. Excess supination, or “rolling out”, also associated with a high arch, can result in poor shock absorption from impact with the ground. Assessing the shoeCheck your shoes for the following:
For the pronatorIn addition to the above features, the shoe should have a stability feature such as a dual density midsole, which is a higher density section of the midsole usually indicated by a coloured area. For the supinatorThese people are said to have poor shock absorption, but most of the high quality sports shoes available have good cushioning midsoles. Neutral walker/runnerThese shoes can have mild stability features or none at all, with a cushioning midsole Summary
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The two main parts of the shoe are the upper, which covers the foot, and the sole, made up of the outsole, midsole and insole. The midsole is one of the most important features in a sports shoe. It is the section between the outsole and the upper and is involved in shock absorption and control of foot motion. Encapsulation of air or silicone gel can enhance the cushioning effect of the midsole eg “HydroFlow” and “Mogo” in Brooks shoes, “Gel” and “Solyte” from Asics and Nikes’s “Air”. Stability features can be built into the midsole to control excessive motion.
1. The shoe should have a heel counter which is firm, to provide stability for the hindfoot. This can be tested by compressing the heel counter with the thumb and index finger and checking for resistance to compression.
2. The midsole and heel counter can be assessed by pressing firmly on the outsole of the heel from below. The midsole should spring back quickly, but if it returns slowly, or the whole heel counter becomes squashed, it may be time to get a new pair of shoes.
3. Torsional stability can be tested by observing if the shoe maintains its form when the forefoot and rearfoot of the shoe are rotated in opposing directions.
4. Shank stability is present if the shoe is able to bend at the foot’s metatarsophalangeal joints (“knuckle joints”). Problems arising if the break point occurs at the midfoot or not at all include calf or toe tendon injuries.