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breaking-in orthotics

Posted by Nancy S. on 11/19/00 at 21:07 (033101)

Richard, tomorrow (Monday) will be one week since I got my orthotics. I'd like your thoughts on the break-in period.
My orthotist told me to wear them just as long as they are comfortable and don't cause pain. When they do, he said to get out of them and rest my feet for at least a couple of hours, then go back to them, and so on.
Well, I was so thrilled with them that at first I wore them for fairly lengthy periods of time, although I'm not ON my feet all that time. Wednesday night I went out and was on my feet more than usual, and they felt great. I was sooo happy! Suddenly at the end of the night I began to feel pain in my arches, so I took them off immediately and put my Birks on.
Thursday I was quite sore from overdoing it on Wed., so I rested a lot, except for an exciting deep massage by the PT, which exhausted me.
Since Friday, I've been afraid to go by the orthotist's rule of waiting until I feel pain. So I wear them a couple of hours at a time, about twice a day -- again, not always on my feet during that time.
So at this point I'm wearing them 3 or 4 hours a day, but probably only spending about a total of 1 hour on my feet.
So how do you think I'm doing? The arches are my arch, but I'm wondering if they're too much -- even when I don't feel pain, I do feel the arches of the orthotics, and I wonder if I should be feeling them there as much as I am after a week.
Other than this, I can see with my own eyes -- and feel -- how much straighter my legs and feet are in the orthotics. When in my Birks, I now see how much I pronate. I never had a way to compare before, and had no idea how much my feet roll in. It isn't hugely dramatic, but it's definitely visible and I can't believe I never noticed it before. (I still hope to use my Birks as slippers in early morning and late at night. That's what I'm doing now.)
What are your usual break-in instructions, and do you think I'm still overdoing it at the one-week point? Even if the arches fit the arches of the feet, do you find many clients need the orthotic arch lower than that of their foot?
Sorry this is so long, and thanks for any advice.
Nancy

Re: breaking-in orthotics

Bob G. on 11/19/00 at 22:39 (033114)

Nancy, I think you are doing well. At this point you can be your own advisor - you know more about your feet than anybody elso could possibly know.

With what you know, you can be your own guide.

If and when you need medical adivise or intervention, you are still the one in charge.

Best wishes, my friend! BG

Re: breaking-in orthotics

Julie F on 11/20/00 at 03:15 (033126)

Hi Nancy

This reminds me that I forgot to answer your question about orthotics in my e-mail. Yes I do wear them: I've had a pair for 6-7 years, and got myself casted for new ones a couple of weeks ago as I thought it was high time for a new pair. As I recall, the old ones took about 6 weeks to break in. I wore them too enthusiastically at first, as I do most things, and then had to pull back and go easy. I thought I'd never get on with them, but was encouraged to persevere and did, and eventually we settled down together and I wore them all the time. (In fact, I've just realized that my PF started when I left them out of a new pair of trainers I was breaking in for a couple of weeks...hmmm.) So I would say that a week is nothing. It sounds as though you're getting on fine with them, so be patient.

As for feeling them in your arches, Richard will have the answer but I would imagine that you will be aware of that for some time. It's a new experience for your arches to be supported, and of course it feels strange. After a while, your body will accommodate itself to what now feels a bit peculiar. Then it will feel normal, and will feel odd when you go without them.

It's good you can tell how much straighter you're walking. When my pod was evaluating my gait on the treadmill a couple of months ago he first drew straight lines with a felt-tip pen down the backs of my calves. He videod me walking, and then showed me the video. Wow. It showed how much more my right foot (my PF foot) pronates than my left. The line down the back of my right leg leaned in at a pronounced angle. Fascinating.

While I was writing this Parcelforce delivered my new (half-price on the internet) Birkenstocks from Germany. So now I'll open them. See you later,

All the best, Julie

Re: breaking-in orthotics

Nancy S. on 11/20/00 at 06:39 (033136)

Thanks Bob and Julie.
Julie, that line down the legs sounds like an excellent way to see the position of your feet when you walk! Your longer break-in experience makes me know I must be more patient. I do think these orthotics are great and I want them to work, and maybe I'm expecting too much too soon. I'd like to wear them all the time Right Now, because I walk so much better in them.
Both my dr. and my PT believe I should wear orthotics for the rest of my life -- because of my flat arches, pronation, and the vulnerability of my tendons. I think they're probably right, so I want to be best buddies with these new but strange things. More to you soon.
Nancy

Re: breaking-in orthotics

Richard, C.Ped on 11/20/00 at 08:07 (033138)

Hi Nancy (my personal website editor),
I do not tell people to wear the new inserts until they feel pain. I tell them to wear the insoles for about 30min the first day, about an hour the second, and so on. I always tell them that their feet may feel tired and achy. If/when they do, take the new insoles out and replace them with the original, and finish their day. I let them know that the tired achy feeling is very natural and not to worry. For low ambulatory people, I tell them that even sitting at the house watching TV or reading a book, having their shoes on with the custom insoles will allow their feet to get used to the support. I don't set a time limit for people to get used to the inserts. I don't want to give anyone 'false hopes' by telling them that it will only take a week to ten days to get used to them. You feet will let you know when they are used to them.

I also tell everyone that after a week or two, you will know if something is not right with the insoles. I have had people come back, point at their foot and tell me 'it feels like it is too high right here'. From that, I know exactly where to touch it up on the grinder. It is not rare to make adjustments to the custom insoles. When I have to do adjustments, it is only to take a little more material out of the arch to fit the shoe better.

If you are still having true 'pain', not just an achy feeling, go back to the facility that made the inserts. They should adjust the insoles to feel better.

I tell people with PF that everytime their foot hits the floor, have your shoes on with the new inserts (not counting the tired/achy feeling and the switching out thing). This even means getting up late at night to use the bathroom. I usually get weird looks when I say that.
Let me know about your progress.
Richard

Re: breaking-in orthotics

alan k on 11/20/00 at 08:50 (033146)

I am not too surprised to hear the off-hand instructions that your orthotics maker gave you about breaking in your inserts (we should really say breaking in your feet for the orthotics).

At every step of the way in dealing with doctors, etc., many of us encounter a gross underestimation of the severity of this problem. Even the standard instructions are to wear them one hour a day and gradually increase from that. Richard's instructions are more thoughtful and informed than most of the instructions we get.

I broke mine in, after already losing faith in doctors and learning a lot from this board, by wearing them only a few minutes at a time, using them to go from my computer to the bathroom, etc. on little trips like that and very gradually worked up to all day use. That may be more conservative than necessary and only possible for sedentary types like me, but it did not lead to any problems.... at first.

Later I developed, I think, tts symptoms from my orthotics, which were never adjusted, and this has happened to others as well. I would insist on adjustments once you have broken in your feet sufficiently and are not merely experiencing adaptation aches.

One good thing about orthotics vs. birks is that I suspect that orthotics, with their heel lift, do not lead to achilles problems the way long term use of birks MAY have in some of us. There has been some discussion on the board of achilles and birk problems and the answer is not clear about this, but I believe that birks with their low heel position and no special bend at the metatarsal heads (but tatamis do bend there) may in some cases place stress on the achilles and other tendons during the plantar flexion motion during treading. I continue to wear birks only myself but have to do achilles exercises every few weeks or so when I feel symptoms of tendon stress coming on. Orthotics would not cause these problems, at least not in the same way. Also, they alter the shape of your feet and in many cases this new shape may be right for you, based on the research that has gone into designing them.

alan k

Re: breaking-in orthotics

Nancy S. on 11/20/00 at 10:20 (033149)

Richard, thanks so much for your thoughtful remarks. It was especially helpful to hear that the adjustment to orthotics is increased even when wearing them while sitting. I wasn't sure about that. Do I understand you right, that you rarely need to actually lower the arch once the breaking-in has occurred -- that most of your adjustments are so that the orthotics fit the shoe better? (By the way, your spelling is NOT bad at all! I found mostly typos, expected when you've hurried to put something on your site.)
Alan, I really didn't feel my orthotist was off-hand about the instructions, or that he has underestimated the effect of these ailments. He spent a very long time with me on the first visit, and when I picked up the orthotics he spent 15 or 20 minutes discussing the breaking-in with me. Apparently at his place they have a variety of clients, some of whom need a long break-in time and others who need only a short time. He basically told me to pay close attention to my own feet and not follow an abitrary timetable.
He gave me a set of instructions that I only re-read this morning. Some extracts:

'The shoe is half of the orthotic system. A comfortable, good, supporting tie shoe that is in good condition, with a mild roll in the toe, is the preferred shoe to wear.'

'Your new orthotics will apply pressure in areas not commonly used to receiving pressure. The amount of pressure will also vary with the amount of control required in each foot. As long as the orthotics are fitting flat in your shoes, generally with the shoes' innersoles removed, and there is no other area of discomfort, we recommend a break-in procedure using the motto _'Let Comfort Be Your Guide.'_ Wear your orthotics only until they start to cause a mild ache, generally in the area of the arch, or occasionally in the middle of the foot just behind the ball of the foot. This may occur in as short a time as 15 minutes, or this may never occur. Everyone is different. Once this discomfort begins, remove the orthotics for one or two hours and only begin wearing them again as long as the achy feeling is not there. . . .'

So I don't know, I think I heard the best-case scenario and tried to be that. This orthotist does free adjustments for at least two months and has encouraged me to make use of that, esp. after the first two weeks if I'm having achiness or sooner if I have real pain. It's pretty fascinating to me that I swore off orthotics forever after getting those junky hard 3/4-length plastic things over a year ago, and now here is something so different and that in most ways feels so good. If I still had only PF, I'd still be in Birks all the time and be happy about it; they helped the PF immensely. I love Birks -- but there's no question now that they don't support the other tendons in the way I need. Sad but true.
I remember talking about Birks with you, Alan, and both of us wondering if they can adversely affect other tendons. I guess I'll never know if they actually contributed to my tendonitis in the first place. I tend to blame my first junky orthotics for a lot of things more than anything else.
Re: your orthotics: What kind are they? Hard plastic or not, 3/4 or full length? I know for a fact that my hard plastic 3/4 pair started pain in my non-PF foot, and that after months of wearing them my PF foot was just as crippled as before. If you still get occasional achilles problems in Birks, do you ever consider another pair of orthotics, or do you think the ones you have are the best that can be found/made? I'm curious, because this is a whole new planet for me that I thought I'd never revisit.
Thanks --
Nancy

Re: breaking-in orthotics

Richard, C.Ped on 11/20/00 at 10:59 (033153)

Sorry for the misunderstanding. Almost always the area I have to adjust is right in front of the heel where the arch begins. There may be just a little to much material that I have to shave off. I try not to tamper to much with the arch. I have quite a bit of people complain about how the arch feels, but only at first. I encourage them to have patience and slowly break themselves into the supports.
Richard

Re: breaking-in orthotics

JudyS on 11/20/00 at 11:06 (033154)

Nancy - I don't remember if you've described your new orthotics or not, so, would you (again)? Do you know what brand they are?

Re: breaking-in orthotics

Nancy S. on 11/20/00 at 12:05 (033156)

Judy, they're not a brand. They were made by the orthotist in the lab right there where I saw him for the evaluation. There's no generic version or name.
His name is Christopher J. Brydges, BPE, CPO, Certified Prosthetist/Orthotist.
They're full-length and look like a tapered sandwich. The middle part ('meat') is the posting, which shapes the whole thing based on the moulds he took. The upper and under layers look and feel like an extremely sturdy foam material. I mean very dense, not squashy or hole-ridden. He said he'd put them in the 'semi-rigid' category.
Because of my tendonitis, he put an extra layer of posting along the sole -- it starts very thin behind the ball of the foot and increases very gently as it reaches the heel. He will shave this off gradually as the tendonitis improves and my feet adjust to the supports.
They are thickest at the arch, of course. The whole process amazes me in its need for precision. The feet are like snowflakes, I guess -- no two alike.
My first pair, sent for by my ex-pod, did have a brand name: Pro-Life or Pro-Lite, or something like that. They are 3/4 length, hard plastic, and there is a huge drop off where they end. The orthotist I see now pointed out that my former pair were equal in shape, but my feet are not. Those cost $25 more than the true custom-made ones I have now.
Ok, I guess I've overwritten again! The new orthotics make me very wordy! I just walked out to the mailbox with no pain anywhere.
Nancy

Re: breaking-in orthotics

alan k on 11/20/00 at 18:20 (033183)

I am not sure if you were directing those questions to me or not but here is the answers for me: I wear birks all the time because my orthotics, which were 3/4 hard plastic, did not work for me and made things worse. I do have slight sensations in my achilles sometimes but I can take care of it quickly, and other than that the birks leave me pretty much free to do whatever I want without pain. I should probably start breaking my feet in to wear regular shoes again but I haven't quite gotten around to it. Birks are habit forming. I think it is a psychological block where I have to feel the form-fit of the birks or I don't feel safe. I wasn't expecting to discover this when answering this post but it suddenly occurs to me now.

Of course, when refering to my pod it was only to my pod and not any one elses, and no general conclusions can be drawn from that.

alan k

Re: also

alan k on 11/20/00 at 18:30 (033186)

Also I forgot to answer that I don't wear my orthotics ever and I am sure much better ones could be made.

Also, I didn't realize Nancy that it was you who posted there. Somehow I didn't read the name, so I rehashed our previous discussion for someone else who turned out to be you.

alan

Re: also

Nancy S. on 11/20/00 at 19:18 (033188)

Oh ok, Alan, I kind of wondered!
Sounds like you have the exact same orthotics I got last year. I wouldn't wear them either, not for a million bucks.
I know what you mean about the security of Birks -- I still put them on first thing in the morning and late at night, and I know I have to wean myself away from them now, but it's hard -- they were the first things to really make a difference in PF pain.
I'm still using the Acu-Flex for stretching and strengthening. I'm especially amazed at how much stronger my feet are. They really shook all over the place before whenever I tried any strengthening exercise; now there is no shaking at all and I feel in good control. I'm very relieved, because that shaking used to scare the wits out of me -- I thought my feet would be weak weak weak forever. My doc and PT both say I will need to keep up a maintenance exercise program with them forever because of my tight muscles and tendons.
Nancy

Re: also

alan k on 11/21/00 at 07:57 (033221)

Yeah, sorry about that, talking to you like a newbie. I had jet lag and totally spaced out. I'm glad to hear things are working out for you, and glad to hear about the new orthotics designed better this time. Perhaps if you get a chance you might ask your doc and pt which massages in the Acutai online manual would be good for your complex problems there. As you know we strongly support Thai massage on areas distant but connected to the problem, such as leg massage stretching on the hamstrings and quads. I imagine that you could get your husband into it. It is also a very nice thing for partners and is therapeutic in those ways as well.

alan k

Re: breaking-in orthotics

Dr. Zuckerman on 11/23/00 at 08:18 (033351)

I agree 100%. I tell patients that orthosis are just like contact lens there is a break in time, and you must follow the advice that was given to you or should be given to you. It you don't have a pedorthist, or podiarist.give these directions to you then you can have big problems with orthosis. Alot of times when people state that the orthosis didn't work or caused them more pain it could well be from improper break-in time.

Re: breaking-in orthotics

Bob G. on 11/19/00 at 22:39 (033114)

Nancy, I think you are doing well. At this point you can be your own advisor - you know more about your feet than anybody elso could possibly know.

With what you know, you can be your own guide.

If and when you need medical adivise or intervention, you are still the one in charge.

Best wishes, my friend! BG

Re: breaking-in orthotics

Julie F on 11/20/00 at 03:15 (033126)

Hi Nancy

This reminds me that I forgot to answer your question about orthotics in my e-mail. Yes I do wear them: I've had a pair for 6-7 years, and got myself casted for new ones a couple of weeks ago as I thought it was high time for a new pair. As I recall, the old ones took about 6 weeks to break in. I wore them too enthusiastically at first, as I do most things, and then had to pull back and go easy. I thought I'd never get on with them, but was encouraged to persevere and did, and eventually we settled down together and I wore them all the time. (In fact, I've just realized that my PF started when I left them out of a new pair of trainers I was breaking in for a couple of weeks...hmmm.) So I would say that a week is nothing. It sounds as though you're getting on fine with them, so be patient.

As for feeling them in your arches, Richard will have the answer but I would imagine that you will be aware of that for some time. It's a new experience for your arches to be supported, and of course it feels strange. After a while, your body will accommodate itself to what now feels a bit peculiar. Then it will feel normal, and will feel odd when you go without them.

It's good you can tell how much straighter you're walking. When my pod was evaluating my gait on the treadmill a couple of months ago he first drew straight lines with a felt-tip pen down the backs of my calves. He videod me walking, and then showed me the video. Wow. It showed how much more my right foot (my PF foot) pronates than my left. The line down the back of my right leg leaned in at a pronounced angle. Fascinating.

While I was writing this Parcelforce delivered my new (half-price on the internet) Birkenstocks from Germany. So now I'll open them. See you later,

All the best, Julie

Re: breaking-in orthotics

Nancy S. on 11/20/00 at 06:39 (033136)

Thanks Bob and Julie.
Julie, that line down the legs sounds like an excellent way to see the position of your feet when you walk! Your longer break-in experience makes me know I must be more patient. I do think these orthotics are great and I want them to work, and maybe I'm expecting too much too soon. I'd like to wear them all the time Right Now, because I walk so much better in them.
Both my dr. and my PT believe I should wear orthotics for the rest of my life -- because of my flat arches, pronation, and the vulnerability of my tendons. I think they're probably right, so I want to be best buddies with these new but strange things. More to you soon.
Nancy

Re: breaking-in orthotics

Richard, C.Ped on 11/20/00 at 08:07 (033138)

Hi Nancy (my personal website editor),
I do not tell people to wear the new inserts until they feel pain. I tell them to wear the insoles for about 30min the first day, about an hour the second, and so on. I always tell them that their feet may feel tired and achy. If/when they do, take the new insoles out and replace them with the original, and finish their day. I let them know that the tired achy feeling is very natural and not to worry. For low ambulatory people, I tell them that even sitting at the house watching TV or reading a book, having their shoes on with the custom insoles will allow their feet to get used to the support. I don't set a time limit for people to get used to the inserts. I don't want to give anyone 'false hopes' by telling them that it will only take a week to ten days to get used to them. You feet will let you know when they are used to them.

I also tell everyone that after a week or two, you will know if something is not right with the insoles. I have had people come back, point at their foot and tell me 'it feels like it is too high right here'. From that, I know exactly where to touch it up on the grinder. It is not rare to make adjustments to the custom insoles. When I have to do adjustments, it is only to take a little more material out of the arch to fit the shoe better.

If you are still having true 'pain', not just an achy feeling, go back to the facility that made the inserts. They should adjust the insoles to feel better.

I tell people with PF that everytime their foot hits the floor, have your shoes on with the new inserts (not counting the tired/achy feeling and the switching out thing). This even means getting up late at night to use the bathroom. I usually get weird looks when I say that.
Let me know about your progress.
Richard

Re: breaking-in orthotics

alan k on 11/20/00 at 08:50 (033146)

I am not too surprised to hear the off-hand instructions that your orthotics maker gave you about breaking in your inserts (we should really say breaking in your feet for the orthotics).

At every step of the way in dealing with doctors, etc., many of us encounter a gross underestimation of the severity of this problem. Even the standard instructions are to wear them one hour a day and gradually increase from that. Richard's instructions are more thoughtful and informed than most of the instructions we get.

I broke mine in, after already losing faith in doctors and learning a lot from this board, by wearing them only a few minutes at a time, using them to go from my computer to the bathroom, etc. on little trips like that and very gradually worked up to all day use. That may be more conservative than necessary and only possible for sedentary types like me, but it did not lead to any problems.... at first.

Later I developed, I think, tts symptoms from my orthotics, which were never adjusted, and this has happened to others as well. I would insist on adjustments once you have broken in your feet sufficiently and are not merely experiencing adaptation aches.

One good thing about orthotics vs. birks is that I suspect that orthotics, with their heel lift, do not lead to achilles problems the way long term use of birks MAY have in some of us. There has been some discussion on the board of achilles and birk problems and the answer is not clear about this, but I believe that birks with their low heel position and no special bend at the metatarsal heads (but tatamis do bend there) may in some cases place stress on the achilles and other tendons during the plantar flexion motion during treading. I continue to wear birks only myself but have to do achilles exercises every few weeks or so when I feel symptoms of tendon stress coming on. Orthotics would not cause these problems, at least not in the same way. Also, they alter the shape of your feet and in many cases this new shape may be right for you, based on the research that has gone into designing them.

alan k

Re: breaking-in orthotics

Nancy S. on 11/20/00 at 10:20 (033149)

Richard, thanks so much for your thoughtful remarks. It was especially helpful to hear that the adjustment to orthotics is increased even when wearing them while sitting. I wasn't sure about that. Do I understand you right, that you rarely need to actually lower the arch once the breaking-in has occurred -- that most of your adjustments are so that the orthotics fit the shoe better? (By the way, your spelling is NOT bad at all! I found mostly typos, expected when you've hurried to put something on your site.)
Alan, I really didn't feel my orthotist was off-hand about the instructions, or that he has underestimated the effect of these ailments. He spent a very long time with me on the first visit, and when I picked up the orthotics he spent 15 or 20 minutes discussing the breaking-in with me. Apparently at his place they have a variety of clients, some of whom need a long break-in time and others who need only a short time. He basically told me to pay close attention to my own feet and not follow an abitrary timetable.
He gave me a set of instructions that I only re-read this morning. Some extracts:

'The shoe is half of the orthotic system. A comfortable, good, supporting tie shoe that is in good condition, with a mild roll in the toe, is the preferred shoe to wear.'

'Your new orthotics will apply pressure in areas not commonly used to receiving pressure. The amount of pressure will also vary with the amount of control required in each foot. As long as the orthotics are fitting flat in your shoes, generally with the shoes' innersoles removed, and there is no other area of discomfort, we recommend a break-in procedure using the motto _'Let Comfort Be Your Guide.'_ Wear your orthotics only until they start to cause a mild ache, generally in the area of the arch, or occasionally in the middle of the foot just behind the ball of the foot. This may occur in as short a time as 15 minutes, or this may never occur. Everyone is different. Once this discomfort begins, remove the orthotics for one or two hours and only begin wearing them again as long as the achy feeling is not there. . . .'

So I don't know, I think I heard the best-case scenario and tried to be that. This orthotist does free adjustments for at least two months and has encouraged me to make use of that, esp. after the first two weeks if I'm having achiness or sooner if I have real pain. It's pretty fascinating to me that I swore off orthotics forever after getting those junky hard 3/4-length plastic things over a year ago, and now here is something so different and that in most ways feels so good. If I still had only PF, I'd still be in Birks all the time and be happy about it; they helped the PF immensely. I love Birks -- but there's no question now that they don't support the other tendons in the way I need. Sad but true.
I remember talking about Birks with you, Alan, and both of us wondering if they can adversely affect other tendons. I guess I'll never know if they actually contributed to my tendonitis in the first place. I tend to blame my first junky orthotics for a lot of things more than anything else.
Re: your orthotics: What kind are they? Hard plastic or not, 3/4 or full length? I know for a fact that my hard plastic 3/4 pair started pain in my non-PF foot, and that after months of wearing them my PF foot was just as crippled as before. If you still get occasional achilles problems in Birks, do you ever consider another pair of orthotics, or do you think the ones you have are the best that can be found/made? I'm curious, because this is a whole new planet for me that I thought I'd never revisit.
Thanks --
Nancy

Re: breaking-in orthotics

Richard, C.Ped on 11/20/00 at 10:59 (033153)

Sorry for the misunderstanding. Almost always the area I have to adjust is right in front of the heel where the arch begins. There may be just a little to much material that I have to shave off. I try not to tamper to much with the arch. I have quite a bit of people complain about how the arch feels, but only at first. I encourage them to have patience and slowly break themselves into the supports.
Richard

Re: breaking-in orthotics

JudyS on 11/20/00 at 11:06 (033154)

Nancy - I don't remember if you've described your new orthotics or not, so, would you (again)? Do you know what brand they are?

Re: breaking-in orthotics

Nancy S. on 11/20/00 at 12:05 (033156)

Judy, they're not a brand. They were made by the orthotist in the lab right there where I saw him for the evaluation. There's no generic version or name.
His name is Christopher J. Brydges, BPE, CPO, Certified Prosthetist/Orthotist.
They're full-length and look like a tapered sandwich. The middle part ('meat') is the posting, which shapes the whole thing based on the moulds he took. The upper and under layers look and feel like an extremely sturdy foam material. I mean very dense, not squashy or hole-ridden. He said he'd put them in the 'semi-rigid' category.
Because of my tendonitis, he put an extra layer of posting along the sole -- it starts very thin behind the ball of the foot and increases very gently as it reaches the heel. He will shave this off gradually as the tendonitis improves and my feet adjust to the supports.
They are thickest at the arch, of course. The whole process amazes me in its need for precision. The feet are like snowflakes, I guess -- no two alike.
My first pair, sent for by my ex-pod, did have a brand name: Pro-Life or Pro-Lite, or something like that. They are 3/4 length, hard plastic, and there is a huge drop off where they end. The orthotist I see now pointed out that my former pair were equal in shape, but my feet are not. Those cost $25 more than the true custom-made ones I have now.
Ok, I guess I've overwritten again! The new orthotics make me very wordy! I just walked out to the mailbox with no pain anywhere.
Nancy

Re: breaking-in orthotics

alan k on 11/20/00 at 18:20 (033183)

I am not sure if you were directing those questions to me or not but here is the answers for me: I wear birks all the time because my orthotics, which were 3/4 hard plastic, did not work for me and made things worse. I do have slight sensations in my achilles sometimes but I can take care of it quickly, and other than that the birks leave me pretty much free to do whatever I want without pain. I should probably start breaking my feet in to wear regular shoes again but I haven't quite gotten around to it. Birks are habit forming. I think it is a psychological block where I have to feel the form-fit of the birks or I don't feel safe. I wasn't expecting to discover this when answering this post but it suddenly occurs to me now.

Of course, when refering to my pod it was only to my pod and not any one elses, and no general conclusions can be drawn from that.

alan k

Re: also

alan k on 11/20/00 at 18:30 (033186)

Also I forgot to answer that I don't wear my orthotics ever and I am sure much better ones could be made.

Also, I didn't realize Nancy that it was you who posted there. Somehow I didn't read the name, so I rehashed our previous discussion for someone else who turned out to be you.

alan

Re: also

Nancy S. on 11/20/00 at 19:18 (033188)

Oh ok, Alan, I kind of wondered!
Sounds like you have the exact same orthotics I got last year. I wouldn't wear them either, not for a million bucks.
I know what you mean about the security of Birks -- I still put them on first thing in the morning and late at night, and I know I have to wean myself away from them now, but it's hard -- they were the first things to really make a difference in PF pain.
I'm still using the Acu-Flex for stretching and strengthening. I'm especially amazed at how much stronger my feet are. They really shook all over the place before whenever I tried any strengthening exercise; now there is no shaking at all and I feel in good control. I'm very relieved, because that shaking used to scare the wits out of me -- I thought my feet would be weak weak weak forever. My doc and PT both say I will need to keep up a maintenance exercise program with them forever because of my tight muscles and tendons.
Nancy

Re: also

alan k on 11/21/00 at 07:57 (033221)

Yeah, sorry about that, talking to you like a newbie. I had jet lag and totally spaced out. I'm glad to hear things are working out for you, and glad to hear about the new orthotics designed better this time. Perhaps if you get a chance you might ask your doc and pt which massages in the Acutai online manual would be good for your complex problems there. As you know we strongly support Thai massage on areas distant but connected to the problem, such as leg massage stretching on the hamstrings and quads. I imagine that you could get your husband into it. It is also a very nice thing for partners and is therapeutic in those ways as well.

alan k

Re: breaking-in orthotics

Dr. Zuckerman on 11/23/00 at 08:18 (033351)

I agree 100%. I tell patients that orthosis are just like contact lens there is a break in time, and you must follow the advice that was given to you or should be given to you. It you don't have a pedorthist, or podiarist.give these directions to you then you can have big problems with orthosis. Alot of times when people state that the orthosis didn't work or caused them more pain it could well be from improper break-in time.