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my new orthotics

Posted by Nancy S. on 11/15/00 at 08:26 (032769)

Hi, I got my new orthotics on Monday, and am very optimistic! Too soon to tell, of course, but here is the experience so far.

I went shoe hunting-and-gathering on Fri. and Sat., and ended up with a fine pair of Dexter hiking shoes at a discount store -- for $15! They were marked $30, cheap enough, but one was colored a little differently from the other. This doesn't bother me normally, but I've been reduced to trying to save every penny I can, so I pointed out the difference in color to a shoe person there, and he promptly marked them half price from what they already were. I made sure they were plenty roomy and had a thick removable insert to accommodate the orthotics.

I took the shoes with the price tag still on them to the orthotist on Mon. to get his opinion. They turned out great (which is good, because after my appt. I accidentally dropped the price tags in the toilet at the orthotist's office!). I am so impressed with these orthotics! The orthotist removed the original shoe inserts and installed the orthotics. He told me beforehand that they were going to feel funny at first, and he was right. The arches in them go right up against my arches, which I've never felt before, and that does feel weird -- BUT because I hyperpronate (the orthotist was the first professional ever to point this out to me), the orthotics he made are posted higher on the outside of my feet. He said, 'You're going to feel like you're walking on the outside of your feet at first, but actually the orthotics are redistributing your weight so that it falls evenly over your feet; it means that you are using the outside of your feet properly for weight-bearing for the first time, and putting less pressure on your arch and the inside of your feet.'

And that's what seems to be happening. I feel totally straight in these orthotics, and when I'm in them I feel no tendon or PF pain! Two things: (1) As he'd told me before, he made the heel slightly higher than normal for starters, to give my achilles, peroneal, and post tib. tendons more relief during my adjustment period. This isn't bothering me at all, and he'll slowly bring them down to 'normal' as I adjust and my tendons feel better. (2) I don't know yet whether the arches will be too high -- my arches collapse when I put full weight on them, and I am flat-footed (another thing the orthotist is the only one to have made clear to me -- he said if there is mild, medium, and severe flat-footedness, I'm medium).

So I'm to follow break-in period instructions, and if the arches are too high, he will bring them down. He thinks of the break-in period as being two weeks: wear them each day for as long as they feel comfortable; at the very first sign of real discomfort or pain, get out of them. Rest for a couple of hours and try them again. By only yesterday I could wear them for about 3 hours at a time. Then I change to Birks, or rest in the recliner. The goal is to be wearing them comfortably for 6 to 8 hours a day in two weeks. He emphasized NOT to push for that -- if I feel any arch pain at all, get out of them, because the arches can bruise and no, we don't want that. If during the two weeks it becomes clear that they're causing pain, I'm to go in sooner than the two weeks and he'll start adjusting. If the two weeks go well, I go in at the end of that time for an evaluation and to start taking down the slightly higher heels. Also if I'm not up to 6 to 8 hours a day by that time, he'll do more work on the arches or whatever other reason there may be for inability to wear them for 6 to 8 hours.

He gave me my casts, and if I want another pair made in the future the cost will be $50 less with those (I was lucky they didn't fall into the toilet along with the shoe price tags). The cost for everything, including two months' adjustments, was $290.

These orthotics are so well made -- according to everything Richard told me and has posted to others. They sit totally solidly in my shoes, there is zero movement -- but also no squashed feeling. I feel so stable and secure in them.

Beverly, the right shoes make a really big difference. I bought shoes a half size up from usual, and they are deep. They were deep even with their original insole, and removing those insoles left a lot of room for the orthotics. The Dexters I bought are a good but not overly bulky hiking shoe, and they go up over my ankles, which I definitely want because of my extra ankle and tendon problems. The very top part is pliable, thickish, soft leather and doesn't cut into my tendons. Many other higher shoes that I tried were too stiff up there and did cut into my tendons. These shoes are stiff and solid where they need to be, but I needed less stiffness at the very top where they cover the tendons. So far, at least, they seem to be just right.

Richard, I thank you profusely again -- you taught me so much and helped me know that my orthotist was doing the right things. I would never again go to anyone but a pedorthist or orthotist for orthotics. This is their life's work, folks, not a sideline -- and our problems are far too important to be put in the hands of sideliners.
You are a true gem, Richard!

Oh, Beverly, one more thing -- did I read right that you're considering getting orthotics from somone who is recommending hard plastic in them? I urge you not to do that. Hard plastic, even if cushioned, is the pits for almost everyone -- my dr., both my PTs, and my orthotist all say the same thing -- and the orthotist could make more money if he used that junk. So that's my two cents (once again!) about hard plastic. My orthotist said every case needs some give down in there, even if very subtle. (The only exception he mentioned was extremely extremely obese people.)

My keyboard was just fixed (obviously), and this is the first thing I'm writing with it in case it helps you today, Beverly. I know you're scheduled for an orthotics appt. today, yes?

Good day to all!

Nancy

Re: my new orthotics

Julie F on 11/15/00 at 10:34 (032770)

>
Hello Nancy

...and welcome back. I'm almost as pleased about your fixed keyboard as about your new orthotics. It all sounds good, and I'm so glad you decided to try again.

I was amused by what you said about feeling as though you're walking on the outsides of your feet. I've just had that experience myself - I've just come home from a mammoth shopping trip, including a visit to a specialist sports shoe shop (called 'Run and Become', isn't that a wonderful name?), where I tried and bought a pair of New Balance M851-853 trainers. They were recommended by my pod as an anti-pronation shoe - and they sure are. I felt more 'on the outsides' than I ever did with my 7-year-old orthotics, even when they were new. Maybe they weren't sufficiently anti-pronation - but I've been casted for new ones now and perhaps they'll be better.

I hope your break-in period goes smoothly and that the new orthotics give you lots of help.

All the best, Julie

Re: my new orthotics

Richard, C.Ped on 11/15/00 at 10:59 (032771)

Nancy,
That is wonderful about your new inserts. I sure hope they work out for you. It sounds like you found someone that really cares about your well being as well as the quality of their work. It also sounds like the arches are exactly where they are supposed to be.

Dexter makes some good shoes. I have a pair of saddle oxfords by Dexter. The only thing I don't like about them is the shallow toe box---will not accomodate a full lenght orthosis.

Again, that is wonderful, and you are very welcome for the information. Let me know if you have any other questions.
Richard, C.Ped
p.s. Keep that toilet lid closed butterfingers!!!!:-)

Re: my new orthotics

Scott R on 11/15/00 at 12:44 (032778)

Nancy, maybe Richard can correct me, but I thought if you pronate, you may need posts on the inside (medial side) not the outside (lateral). Pronating means (roughly) your inside ankle bone rolls inward and down, so that posts under the orthotic causing the more pressure on the outside of the foot as you indicated would cause more pronation. I'm posting from a library in Livingston, AL while on my lunch break, so it'll be Friday if and when I can see responses.

Re: my new orthotics -- OOPS

Nancy S. on 11/15/00 at 14:00 (032780)

Scott, you're absolutely right! This was not the orthotist's mistake, it was mine when I posted -- overexcited, I guess.
Scott is right -- for hyperpronation, the extra posting goes on the medial (inside) of the orthotic.

Richard, I've always found Dexters to have too little room in the toe box, too. Avoided them because of this even before I began having foot pain. This one pair I found has plenty of toe room, even with the full-length orthotics -- lucked out, I guess! I'm glad you think the arches sound like where they're supposed to be (ooo, bad grammar). I feel them and that is a new feeling, but they're not hurting me so far. I think I'm falling in love.
Nancy Butterfingers

Re: Nancy and Richard: See my new post under Treatment Board

Beverly on 11/15/00 at 15:19 (032783)

Nancy,

I'm so glad you have pain relief from your orthodics. Keep me posted. Also, glad you're back. I'll be real interested to see how you do.

So, I don't have to rewrite it, could you all see my pathetic post under the Treatment Board. I believe I saw a very ethical orthodist and a highly skilled one, and she does not think she can help me. To top it off, she's also a physical therapist.

You can just imagine how depressed I am. I drove home in tears. Whole story is in my post on the Treatment Board.
Thanks,
Beverly

Re: my new orthotics -- OOPS

Richard, C.Ped on 11/15/00 at 15:25 (032785)

Yup, Scott is correct. Sorry I did not catch that. Again, I am glad that everything seems to be working out well right now for you.
Richard

Re: my new orthotics

Julie F on 11/15/00 at 10:34 (032770)

>
Hello Nancy

...and welcome back. I'm almost as pleased about your fixed keyboard as about your new orthotics. It all sounds good, and I'm so glad you decided to try again.

I was amused by what you said about feeling as though you're walking on the outsides of your feet. I've just had that experience myself - I've just come home from a mammoth shopping trip, including a visit to a specialist sports shoe shop (called 'Run and Become', isn't that a wonderful name?), where I tried and bought a pair of New Balance M851-853 trainers. They were recommended by my pod as an anti-pronation shoe - and they sure are. I felt more 'on the outsides' than I ever did with my 7-year-old orthotics, even when they were new. Maybe they weren't sufficiently anti-pronation - but I've been casted for new ones now and perhaps they'll be better.

I hope your break-in period goes smoothly and that the new orthotics give you lots of help.

All the best, Julie

Re: my new orthotics

Richard, C.Ped on 11/15/00 at 10:59 (032771)

Nancy,
That is wonderful about your new inserts. I sure hope they work out for you. It sounds like you found someone that really cares about your well being as well as the quality of their work. It also sounds like the arches are exactly where they are supposed to be.

Dexter makes some good shoes. I have a pair of saddle oxfords by Dexter. The only thing I don't like about them is the shallow toe box---will not accomodate a full lenght orthosis.

Again, that is wonderful, and you are very welcome for the information. Let me know if you have any other questions.
Richard, C.Ped
p.s. Keep that toilet lid closed butterfingers!!!!:-)

Re: my new orthotics

Scott R on 11/15/00 at 12:44 (032778)

Nancy, maybe Richard can correct me, but I thought if you pronate, you may need posts on the inside (medial side) not the outside (lateral). Pronating means (roughly) your inside ankle bone rolls inward and down, so that posts under the orthotic causing the more pressure on the outside of the foot as you indicated would cause more pronation. I'm posting from a library in Livingston, AL while on my lunch break, so it'll be Friday if and when I can see responses.

Re: my new orthotics -- OOPS

Nancy S. on 11/15/00 at 14:00 (032780)

Scott, you're absolutely right! This was not the orthotist's mistake, it was mine when I posted -- overexcited, I guess.
Scott is right -- for hyperpronation, the extra posting goes on the medial (inside) of the orthotic.

Richard, I've always found Dexters to have too little room in the toe box, too. Avoided them because of this even before I began having foot pain. This one pair I found has plenty of toe room, even with the full-length orthotics -- lucked out, I guess! I'm glad you think the arches sound like where they're supposed to be (ooo, bad grammar). I feel them and that is a new feeling, but they're not hurting me so far. I think I'm falling in love.
Nancy Butterfingers

Re: Nancy and Richard: See my new post under Treatment Board

Beverly on 11/15/00 at 15:19 (032783)

Nancy,

I'm so glad you have pain relief from your orthodics. Keep me posted. Also, glad you're back. I'll be real interested to see how you do.

So, I don't have to rewrite it, could you all see my pathetic post under the Treatment Board. I believe I saw a very ethical orthodist and a highly skilled one, and she does not think she can help me. To top it off, she's also a physical therapist.

You can just imagine how depressed I am. I drove home in tears. Whole story is in my post on the Treatment Board.
Thanks,
Beverly

Re: my new orthotics -- OOPS

Richard, C.Ped on 11/15/00 at 15:25 (032785)

Yup, Scott is correct. Sorry I did not catch that. Again, I am glad that everything seems to be working out well right now for you.
Richard