foot orthotics survey

[layton]

I'm curious.

 

How many of you have had prescription orthotics and have had either a resolution of symptoms, or gotten worse/new symptoms?

 

What was the reason you got them, and how have the helped or hindered? Did they create new pains elsewhere, or cure old pains unrelated to your primary complaint? Were they soft, hard, semi-rigid, half length, full length. How much did you pay $$ for them?

 

Just curious..I'm considering considering fabricating my own in office for patients.

 

Me? I underpronate/supinate and have a 11mm anatomical leg length discrepancy and just bought a pair so I haven't had a chance to really see what happens.

 

Thanks,

Mike

[Chad_A]

Mike,

 

Three years ago, diagnosed with achilles tendinitis, and plantar fascitis, r/t too much trail running on shoes that didn't fit my foot pattern.

 

Doc did the big no-no and gave me a cortisone shot in my achilles, and it worked.

 

Orthotics seemed to have helped the whole issue, overall. No aching in the bottom of the feet, etc.

 

On the other hand, I invested in a 30 dollar pair of "Sole" thermomoldable inserts, and I have them in my Alphas, and have done some long days in them, with no worries.

 

Overall, not sure what good the 350 dollar custom orthotics have done for me.

[Sherri]

I think you should definitely look into it.

 

With over 15 years of running logged on these tootsies, I've had my share of foot woes: recurring neuromas(treated initially with cortisone and then with two unsuccessful surgeries) and a ruptured plantar fascia.

 

Orthotics came into the picture pretty early on, and I've seen the good and the bad. (A lot of folks out there doing more harm than good, IMHO.)

 

Most of the ones prescribed by podiatrists were very expensive($200-400), and basically worthless. The neuromas came back again and again, even with curtailed running mileage. I've had them from all types of material combos, and in various lengths. The worst were the rigid half-lengths which made even STANDING a painful activity and made the ankles vulnerable to pain and injury.

 

Happy Ending, though! sickie Two years ago, a local shoestore owner who does the orthos for pro athletes (as well as for little old ladies) made everything right. For less than $200 out the door, he made a custom pair of orthos(his are felt, neoprene and cork--no rigid plastic) and I'm running more than ever before with absolutely no pain.

 

I didn't think it could be done, but this guy seems to know feet better than anyone and I'd recommend his approach in a heartbeat. People come from all over for his service, and it's worth every penny and more. He starts by observing and manipulating your feet, ankles, and calves, then he can tell YOU what hurts, what you injuries you've had, what injuries you're going to have, etc. Kinda like going to a fortune teller for feet.

 

Makes me a firm believer that if you're going to do it, it's worth doing right. People will seek you out for it.

 

If you want to contact him for more beta which may be helpful to you in your consideration of getting into this, I can PM it to you.

 

In conjunction with getting the orthos sorted out, I've found trigger point therapy to be especially helpful for keeping things injury- and pain-free. Maybe that falls into the treatment you already provide though?

 

Good luck, Michael!

[ericb]

Paid $350 for some after I aggravated my arch running trails. My podiatrist gave me a pretty agressive correction. I've noticed that my arch doesn't bother me, but my low back would start to get pretty wacked out. Quit wearing them, switched back the Sole brand I had in my climbing boots, and back has settled down some, with no arch issues to speak. Haven't tried logging any miles running though. I'm seeing a rehab medicine doc Monday and will bring in the orthotics and see what he thinks. May or may not try them again, or I may take them back to the Podiatrist and have him level them a bit.

[Jens]

Thanks Mike for the valuable post. I am trying to sort this out right now and I don't know much about it.

[layton]

sherri please pm me this person's contact info, and the name of his business

thanks

[tvashtarkatena]

I was diagnosed with PF in '97. Tried icing, then a cortisone shot, then off the shelf inserts, but nothing worked. I bit the bullet and got a pair of rigid 3/4 length custom orthodics ($300) and haven't had a problem since. I can run ultras and adventure race, whatever. I'd like to find a lighter pair sometime, though.

 

[rob]

I overpronate, and suffered from terrible ITB injuries (running-induced) in both legs for months. I got a pair of rigid full-length orthotics, and it made an almost immediate difference. I wear them in my boots, and also wear motion-control runners.

 

I don't know how much they cost, insurance covered it.

Edited January 12, 2007 by robmcdan

[magellan]

I also am battling PF. So far...Doctors non-custom orthos, ice, naproxen, and lastly cortosteroid. So far, not much results. Everytime I stop one of these, the pain returns. I haven't run in months and I am getting very fat.

 

Oh yeah, some massage starts tuesday.

[BirdDog]

A few years back my feet grew. Shoes/boots I'd had for years didn't fit anylonger. My toes were slammed to the end. Also, I was having calf pain, tried to stretch calves but no use. I was also having knee pain going down hill. Went to a foot Doc and he explained my tendons had stretched and my arch had fallen. Dr. prescribed custom orthodics and said maybe try superfeet insoles first due to cost. I've been wearing superfeet insoles for a couple of years - no problems. I did have to buy new boots - went from a 10 to an 11 1/2 size; in the same make/model of boot.

[layton]

cool thanks for the input

[spineguy]

For in office fabrication your best bet is full length semi-rigid, made from aquaplast or similar material. Anything more complicated requires a lot of specialized equipment/training. Just me $.02 (as a DC)

[Doug]

A few years back I was getting a lot of pain in the ball of my right foot. Went to my GP, he sent me to a podiatrist and next thing I knew I was getting my feet cast and I got some orthotics. I mainly used them in my climbing boots for about 6 - 7 years. Recently because they don't fit well in my current mountaineering boots, I quit using them, going back to the standard insoles. No problems as of yet.

 

About 8 years ago a chiropractor I was seeing started selling orthotics out of his office. I bit and bought 2 pair; 1 for everyday wear, the other for my running shoes. I used the ones for my running shoes and almost immediately began getting blisters in a couple of areas on the bottoms of my feet. Eventually I quit using them altogether and now use superfeet inserts in my running shoes and have had no problems.

 

I guess the message here is, the expensive podiatrist prescibed orthotics seemed to work o.k., but the cheaper DC made ones didn't impress me. I have an over-pronantion and high arches and the superfeet seem to do the job.

Edited January 15, 2007 by Doug

[catbirdseat]

About 8 years ago, I started getting morning heel pain that was diagnosed as plantar faciitis by a poditrist in Kirkland, one Dr. Berg. Judging from what I saw in his waiting room, he served mostly elderly ladies.

 

I asked about custom orthotics and was told they probably wouldn't help. Berg showed me how to tape my foot to support it. It worked after a fashion but was too inconvenient to keep up. I'd already tried Superfeet (the green ones), and it didn't help.

 

I went to a different podiatrist, one Stanley Newell at Northgate, who thought custom orthotics would help. My foot was cast and 3/4 length rigid beds were made in carbon fiber and epoxy. They are very light.

 

After about three months of wearing them, the heel pain gradually went away. Then I started getting knee pain. I went back to Newell and he said, "what happened to you, you were supposed to come back in 4 weeks?". He adjusted the pronation by building up the bottom of the orthotic using a cork and rubber putty and grinding it to just the right angle.

 

After that I've been fine for 6 years. No pain.

[Kevin_Matlock]

Mine aren't persciption, but I think you oughta factor in all experiences.

 

I had/have plant. faci. but instead of paying hundreds of bucks, I was told I could try some over the counter alternatives.

There are hard, 3/4 lenth inserts. Think I paid in the $70 neighborhood at the special shoe store the doc suggested.

 

It's been over 5 years and I still use them (if I don't I usually have heel pain return). I find that a combo of these inserts AND stretching before/after a run, with icing helps a lot! Also found that running the heel of my hand on the arch helps stretch this tendon and relieves the pain on the heel of my foot (for obvious reasons...).

So, I can't say with 100% certainty that my orthos "fixed" my problem, but I feel in combination with the steps mentioned above, helps me keep this condition in check.

[Trundle]

I too have had custom othotics from Stanley Newell in Northgate for many years, and have difficulty if I go without my orthotics for too long.

 

My feet may be a little more extreme than most (totally flat-footed with ZERO arch when standing, and a leg-difference), but I have tried Superfeet and had a shoe store custom build the foam-cork-plastic ones, and they have not worked well.

 

Newell really seems to know his stuff, and like Catbirdseat said, he will customize and adjust them to your feet as needed. The carbon fiber orthdics have lasted much longer than any of the rest - the plastic ones will break with hard usage.

 

My (non-qualified) recommendation for anyone with minor issues would be to start with the Superfeet or soft orthotics to see if it helps. If more is needed, spend the dough and go see a good podiatrist.

[fern]

if you are trying out Superfeet, try a bunch of different sizes, not just the ones that are "your" size. I ended up getting the best support and comfort out of a pair of size 9Mens trimmed down to fit my size 5M ski boots.

[NYC007]

anyone try these? walkfit.com ?

 

Look exactly like the ones good feet store sell for $400

[mbcracken]

Having gone thru stress fractures and nueromas, I have had all sorts of "orthotics" ranging from prescribed hard ones to prescribed soft ones to a set that I picked up at local running. I can't recall the brand I picked up at the running store but for me, these have been the most useful for me. I find for my feet (narrow and high arch) the support from prescribed footbeds seem to be too stiff for me. I think it would be helpful to be able to offer footbeds that are different stiffness. Kind of along the same thought that you adjust a footbed for sideways support, you could offer different stiffness's of footbeds.

 

Mike

[catbirdseat]

I too have had custom othotics from Stanley Newell in Northgate for many years, and have difficulty if I go without my orthotics for too long.

 

My feet may be a little more extreme than most (totally flat-footed with ZERO arch when standing, and a leg-difference), but I have tried Superfeet and had a shoe store custom build the foam-cork-plastic ones, and they have not worked well.

 

Newell really seems to know his stuff, and like Catbirdseat said, he will customize and adjust them to your feet as needed. The carbon fiber orthdics have lasted much longer than any of the rest - the plastic ones will break with hard usage.

 

My (non-qualified) recommendation for anyone with minor issues would be to start with the Superfeet or soft orthotics to see if it helps. If more is needed, spend the dough and go see a good podiatrist.

I'm seeing a pattern here already. It would seem that those with flat feet seem to do better with the hard inserts, while those with high arches seem to prefer the soft types. Granted, it's a small sample size, but it sort of makes sense.

[layton]

no, you're right on the money. nice deductive reasoning skills there broseph. there's a bit more too it, of course, but i'm pretty impressed

[tvashtarkatena]

It's true for me.

[lI1|1!]

i have high arches and oversized tarsal bones. i used to really need my presciption footbeds when i was younger but haven't worn them in years. mostly what i do is choose shoes with good arch support and good heel cushion. i can't wear thin soled shoes like vans or dress shoes, ever. i walk around in running shoes and have a rule about not buying any cheap ones. seems to take care of the problem for me better than the orthotics.

[brukb]

Mike,

I've been making orthotics for endurance athletes and climbers for a few years now, and they definitely work well when prescribed and adjusted correctly. I should clarify that I do the evaluation, castings, and direct how the devices are made, a lab actually fabricates them.

 

There are many schools of thought on how to create orthoses and I would suggest some continuing ed first ( I can recommend a course or two) to see if it is worth the investment to you.

 

I have to say I see a lot of patients come in with "custom orthotics" that are absolutely crap. I have found that to create a good pair of orthoses for an endurance athlete takes at least two hours of evaluation, including; weightbearing, non-weightbearing and comparative foot and ankle measurements, ability to asses appropriate mobility in subtalar, talocrural, midtarsal, first and fifth ray joints, dynamic weight bearing evaluation of Lower Extremity mechanics, video gait analysis of unshod walking, shod walking, and running or inclined treadmill walking if applicable, with slow-motion and freeze-frame review. Learning what kinds of materials to use for what purpose is essential as well. No one should be stuck with a pair of devices that hurt too much to wear, and end up in the back of the closet.

I charge a pretty low fee, since many insurance plans will not cover custom orthoses, and I don't want cost to be prohibitive for those that really need them. My cash price is $200, or maybe a bit more now, we just changed prices on some of our services. The full evaluation may cost more depending on how much time I need to spend and how complicated the case is.

PM me and I can answer other questions. It's great to have pros making these that have first-hand understanding of the demands of the activities of their clients.

Cheers,

Bruk

 

[catbirdseat]

no, you're right on the money. nice deductive reasoning skills there broseph. there's a bit more too it, of course, but i'm pretty impressed

I saw Doc Newell and mentioned this thread. He said that he was unaware of any correlation between arch height and preference of soft versus hard "orthoses".

 

I went to see him about an injury I suffered at Joshua Tree. He called it a hyperextension similar to "turf toe". He's making up a "leather" as he calls it, to pad and protect the affected part of the foot so it will heal faster.