Z - Coil Is HERE!!

Family Foot and Leg Center is the only registered distributer of this fine product in Naples Florida.

Here are some commonly asked questions and answers for our patients convenience.

What types of painful conditions may be alleviated by wearing Z-CoiL® footwear?

Z-CoiL®-wearers have reported significant relief from the pain associated with many medically-diagnosed conditions, including:
• Heel spurs, plantar fasciitis, and metatarsal pain
• Lower back pain and sciatica
• Arthritis and other common joint pains

Will Z-CoiL® footwear help me jump higher?
No, but you will land softer.

How soon before I can expect results?
The relief our customers experience may be immediate, or may occur gradually, over days or even weeks. Some people enjoy complete relief from pain when wearing their Z-CoiL® shoes; others achieve only partial relief, though they may be able to reduce the amount of pain medication they take.

Is Z-CoiL® footwear stable?
Many customers report that they actually feel more stable in their Z-CoiL® footwear than in regular shoes. The coil in the heel is cone-shaped, and so it compresses straight down, following the line of least resistance rather than tipping. The flexible coil also absorbs some surface deviations to protect the ankle.


Does it take a long time to get used to wearing Z-CoiL® footwear?
Most people get used to wearing the footwear right away. Others may take several hours or even a couple of days to adjust to the extraordinary feeling of the shoes. If this is the case, we suggest you wear your Z-CoiL® shoes for a few hours each day at first, and gradually increase that time until you feel more comfortable in them.

It is also normal to experience some soreness in your legs during the first few weeks of wearing Z-CoiL® shoes, due to the increased mobility they provide. If you continue to experience pain in your feet, ankles, knees, hips, or back while wearing your Z-CoiL® footwear, however, you should take them off and return to your
Z-CoiL® distributor for a footwear adjustment.

Can objects get caught in the open coil?
Small rocks or loose materials may occasionally get caught in the coil, but they should be easy to remove with a simple shake. We do recommend caution around cords, wires, hoses, and chairs with rungs, which may catch in the coil.

Can I drive wearing Z-CoiL® footwear?
Yes, but be careful not to let the floor mat or pedals catch on the coil. Also be aware that the shoes thick cushioning may reduce your feel for the pedals. You may need to move your seat back an inch or so to compensate for the thickness of the forefoot cushioning. If you feel unsafe driving in your Z-CoiL® footwear, wear other shoes.

Can I use my Z-CoiL® footwear to play sports?
Our customers have reported using their Z-CoiL® shoes for walking, running, hiking, golf, and more, although we do not recommend them for sports that involve significant lateral movement, like tennis. You need to be the judge of how Z-CoiL® products will work for you. Many people have been able to become more active and get back in the game because of their Z-CoiL® footwear.

Can I use custom orthotics with them?
You certainly can. In fact, Z-CoiL® footwear makes an ideal footbed for custom orthotics. Skilled Z-CoiL® fitters will ensure that your prescription orthoses fit in your shoes properly. Your prescribing healthcare professional may even be able to work with the Z-CoiL® fitter to further enhance the performance of your orthotics.

Arent Z-CoiL® shoes considered high heels?
Not at all. The Z-CoiL® heel, when uncompressed, is only about 1/2 of an inch higher than the cushioned forefoot. When the coil compresses, an average distance of 1/8 to 1/4 of an inch, the heel is level or just slightly higher than the forefoot. This minimal heel rise is beneficial to most people, helping them achieve a healthier, more erect standing posture. In the rare event that this is not the case, the coils can be adjusted to a lower effective heel height.

How long will my Z-CoiL® shoes last?
The steel coils can last a lifetime, though the rubber heel pad will probably last between six months and two years with normal use. People who put their Z-CoiL® footwear to hard use may wear through the pad in three months, while those who go easy on their footwear have been known to wear them for several years. Fortunately, even if the heel pad does wear out, there’s no need to buy a new pair of shoes. The coil/heel pad assembly can easily be replaced by a Z-CoiL® distributor at a minimal cost.

By comparison, most running or comfort shoes with EVA or gel-based soles have a life of 200 miles or 3 months, at which time their cushioning is reduced by 50%.

Some of your shoes have optional foam heel covers; why don’t you cover up the coils on all your styles?
We do make an Enclosed Heel System™(ECS) that comes standard with our Z-Duty Work Boot and Z-Walker Safety Toe styles, and can also be retrofitted on our other styles. The ECS is designed to address workplace safety concerns, in environments where objects are more likely to get caught in an open coil. The molded foam material that encases the coil slows the speed at which the coil compresses, which dampens its shock-absorbing capabilities to some degree, although a stiffer coil also proves useful when a person is picking up heavy objects.

At first, many people are taken aback by the appearance of our shoes; however, those who put them on and experience significant relief from pain soon see them in a different light!

Can I order Z-CoiL® footwear over the Internet or by phone? There is no Z-CoiL® store near me.
Yes you can! In August 2010, Z-CoiL changed its long-standing policy of no internet or phone sales in response to strong customer demand. We still believe that a personalized fit is essential for maximizing the incredible pain relief benefits of Z-Coil shoes. However, for those people in pain who have difficulty visiting a store near them, we now offer Online andTelephone Sales. We ask the customer a series of fitting questions and make corresponding adjustments to the shoes prior to shipping. If further adjustments are needed, we encourage the customer to visit their nearest Z-CoiL distributor. We also offer a Risk-Free, 30-Day Trial Period.

Where are Z-CoiL® shoes manufactured?
Z-CoiL Footwear is headquartered in Albuquerque, New Mexico, where the products are designed and engineered. Our products are manufactured in South Korea. Al Gallegos had tried for years to find a U.S. shoe manufacturer willing to produce his unusual shoes, but they all laughed at his idea and turned him down. At last he found a willing partner in South Korea who had 20 years of experience, including making products for Nike® and Reebok®.

Hopefully this is helpful for you all, and please do not hesitate to ask us about our shoes, as the doctors here at FFLC will be sporting these new shoes at the Downtown and East Naples locations.

Dr Timm

OLT (Osteochondral lesions of the talus)

O.L.T. (Otherwise known as OCD of the talus)

This is a relatively common pathology that is seen at the Family Foot and Leg Center. We are not referring to an obsessive compulsive disorder of the foot, we are referring to cartilage damage within the ankle joint.

Pathology

Anterolateral lesions on the talar dome result from inversion and dorsiflexion forces, which cause the anterolateral aspect of the talar dome to impact the fibula. These lesions are usually shallower and more wafer-shaped than medial lesions, possibly because of a more tangential force vector that results in shearing-type forces.
Posttraumatic medial lesions are deeper and cup-shaped. They result from a combination of inversion, plantarflexion, and external rotation forces that cause the posteromedial talar dome to impact the tibial articular surface with a relatively more perpendicular force vector.
A study of the contact pressures on the talus with varying degrees of lateral ligament transections and ankle positions showed that the medial rim of the talus was subjected to high pressures, even without ligamentous transection. Results of another study implicated the difference in cartilage stiffness; the tibial cartilage is 18-37% stiffer than the corresponding sites on the talus.

The results of other studies indicated that the mean cartilage thickness is inversely related to the mean compressive modulus. These findings may lend credence to the clinically observed etiology of osteochondral lesions of the talus (OLTs) (ie, repetitive overuse syndrome in medial lesions and an acute traumatic event in lateral lesions).
Observations from biomechanical studies suggest that the size of the lesion may alter the contact stresses in the ankle. Statistically significant changes in contact characteristics occur with lesions larger than 7.5 mm × 15 mm; this finding indicates that lesion size may play a role in predicting long-term outcome.

Presentation

In most cases, the mechanism of injury is an inversion injury to the lateral ligamentous complex. Patients typically present with chronic ankle pain along with intermittent swelling and, possibly, weakness, stiffness, instability, and giving way.
Upon physical examination, assess joint laxity with the anterior drawer test and assess strength by comparison with the contralateral ankle. Physical examination findings of joint laxity are uncommon. Palpation may reveal tenderness behind the medial malleolus when the ankle is dorsiflexed, indicating a posteromedial lesion. Anterolateral lesions may be tender when the anterolateral ankle joint is palpated with the joint in maximal plantarflexion.

Treatment
Medical Therapy
Conservative management of osteochondral lesions of the talus (OLTs) should be attempted first. Symptomatic patients with negative findings on plain radiographs should undergo an initial period of immobilization, followed by physical therapy. Studies have shown that a trial of conservative therapy does not adversely affect surgery performed after conservative therapy has failed. Patients whose plain images indicate OLTs and those who remain symptomatic after 6 weeks should undergo additional evaluation with MRI.

Surgical Therapy
Surgical treatment depends on a variety of factors, including patient characteristics (eg, activity level, age, degenerative changes) and lesions (eg, location, size, chronicity). However, surgical treatment adheres to 1 of the following 3 principles:
1) Loose-body removal with or without stimulation of fibrocartilage growth (microfracture, curettage, abrasion, or transarticular drilling)
2) Securing OLTs to the talar dome through retrograde drilling, bone grafting, or internal fixation
3) Stimulating the development of hyaline cartilage through osteochondral autografts (osteochondral autograft transfer system [OATS], mosaicplasty), allografts, or cell culture (Carticel, Genzyme Biosurgery, Cambridge, Mass)

Arthroscopic intervention is associated with less surgical morbidity and joint stiffness, decreased rehabilitation time, and an increased functional outcome.

Postoperative Details
A postoperative rehabilitation program should be tailored to each patient's individual circumstances and goals by a licensed physical therapist. Rehabilitation can generally begin after healing is demonstrated, which may occur after 6-7 weeks of non–weightbearing status if drilling or internal fixation was performed. With the goal of attaining full ankle range of motion, physical rehabilitation includes active and passive range-of-motion exercises and a home program, edema control, and strength and proprioceptive training.

Follow-up

Pain following operative treatment of OLTs is common for up to a year. MRI changes, including edema, are slow to resolve and often match the patient's report of an achy feeling in the joint. After 6 months, a persistent effusion, a catching sensation, or severe pain signifies that healing is not progressing as intended, and further investigation with CT or MRI is appropriate.
For excellent patient education resources, visit eMedicine's Foot, Ankle, Knee, and Hip Center and Imaging Center. Also, see eMedicine's patient education articles Ankle Arthroscopy, Understanding X-rays, and Magnetic Resonance Imaging (MRI).