When I was a child I had a lot of foot problems. After getting the runaround my mom took me to see Dr. Kashuk, a podiatrist. Over a series of visits he didn’t just treat me, he helped to heal me. I could get back to having a normal kid’s life and to me what he did just seemed really cool. He helped people by solving problems. I asked a lot of questions during our sessions and Dr Kashuk asked me if I wanted a summer job, the rest as they say is history. I went to podiatry school and when I graduated Dr. Kashuk was my first professional partner. Without him taking the time to not only treat me, but to genuinely help me, I wouldn’t be writing this today.
I saw my first patient that was suffering with a diabetic foot ulcer during my second year of podiatry school. I was shocked at not only the severity of the wound but also by how common this kind of wound was in patients. I truly knew there was an issue with diabetic foot ulcers just before graduation when I saw the same patient with the same wound two years later. We had failed him. We were treating him but not healing him.
In my professional practice over the course of several decades I have worked with legendary professional athletes, iconic pop stars, and giants from the big screen and small. I worked with them to help them through the multitude of foot issues they dealt with. However the patients I struggled with the most were those with diabetic foot wounds. I used all of the latest best practices recommended by our profession. No matter what I did I seemed to be treating them but not healing them.
I wasn’t going to accept that. I started reaching out to thought leaders not only in podiatry, but specifically in diabetic foot wounds and diabetes to understand the condition better, more fully, and from the patient’s point of view. This is when the full impact of this epidemic hit me like a ton of bricks. I hired a consulting firm to analyze our data and learned that no matter what treatments we tried our success rates had not improved. I started working with labs at multiple facilities and testing all of the products commonly prescribed to help heal diabetic foot ulcers. Not only did we learn there was surprisingly little difference between them, but we also learned that none of them were very good at helping. As ineffective as the products were, I learned that very few of my patients were even using them with the regularity required to heal their wounds. I surveyed a large number of my patients to find out why. What they told me was that the products I was prescribing for their treatment were just too hard to put on and take off. On top of that, they just felt like a “patient” whenever they went out in public wearing these products. So instead of using the product that could prevent an amputation and literally save their life, they left it at home when they went to work or the grocery store. I don’t need to tell you that no matter how good a product is, it works 0% of the time that it stays home in the closet..
This is when it became clear to me that I couldn’t rely any longer on some other company or R&D group to develop the answer, I was going to have to do it myself. I struggled making prototypes for several years and testing them in a university lab. I learned that every step a patient takes causes more trauma to the wound which prevents healing. I needed to greatly reduce the amount of pressure that was being put on these foot wounds so I could create the right environment for them to heal. I finally started to see some success combining 22mm of different materials under the foot, slowing the speed of the tibia while walking, and constraining the ankle to limit momentum in the wearer’s stride which reduced the amount of force being put on the wounds on the bottom of the foot. I also noticed that most of the competitors used what is called a rocker bottom, which accelerates the propulsive phase of gait and increases pressure exactly where we don’t want it. Eliminating this greatly helped in dissipating pressure.
I was finally able to create the right environment to heal the wound! The problem now was I still had something that was difficult to put on, looked like a science project, and I had no idea how to mass produce it. I took it as far as I could on my own, but now I needed to build a team who believed in the cause as much as I did so I could start to help people at scale. Over a period of several years we built a team at Defender to help defend people's limbs and their lives. We started working with people who had formerly worked at footwear giants like Nike and Adidas, and we even attracted some top talent from our competitors who saw we actually wanted to solve the problem and not just sell a product. We brought on Michael DiTullo who has worked with Nike, Jordan, Converse, to design performance footwear for Olympic athletes, NBA players and Major League Baseball players. Michael connected us to Drew Linth, another former Nike colleague who has developed performance footwear with manufacturing partners from China to Mexico. It was this team that I knew could help me heal patients, not one at a time, but thousands simultaneously with the right product.
It took seven long years filled with trial and error, failed experiments and dead ends, but we built the Foot Defender®, a product that not only works better than our competitors, but is easy to use and looks more like a piece of modern performance footwear so you fit in no matter where you need to go with it. The response from the industry has been incredible. In one initial case study we found a wound that wouldn’t heal for 2 years healed in 26 days once the patient started using the Foot Defender every day! 49 of the first 50 patients to test the Foot Defender would not return it. We won multiple awards right out of the gate and in our first full year of sales we landed on Fast Company’s list of the most innovative companies in the world! But most importantly I can say I’m not just treating people, I’m healing them.