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alternative orthotics use

Posted by Nancy S. on 11/22/00 at 11:28 (033304)

Richard, I hope you haven't left for T'giving yet. (Is that a mean thing to say?)
If you have time, would you check my posts on the s/s board under 'Amen, Sister' (which is in the HOW THE HELL IS EVERYONE'S FOOT . . . thread)? I described to Beverly how every shoe I wear, even with orthotics, is digging into my still-sore peroneal, post tib., and achilles tendons. Then I just posted to Judy there about trying the orthotics in my Tatami Nebraskas (took out removable Birks footbeds and inserted orthotics, which fit perfectly). How do you feel about this, at least as an interim measure until my tendons feel better?
I'm eager for your opinion. Thanks --
Nancy

Re: alternative orthotics use

Beverly on 11/22/00 at 14:44 (033323)

Nancy,

If you find the solution, I sure will feel curious. All I know to do is rotate shoes. Do I understand you are putting orthodics in your sandals?
I didn't think they were made for sandals, but perhaps I'm wrong.
How are you liking your orthodics and do you find they only work in certain shoes? I'm still planning to try them. Waiting for results of MRI and now I've got to figure out who will make them.
Take Care. Eat lots of turkey. I wish I could send you my homemade from scratch cornbread dressing with white creamy turkey gravy. I don't think you all have that kind up North.

Take care,
Beverly

Re: alternative orthotics use

Dr. Zuckerman on 11/23/00 at 08:08 (033349)

I am up smelling the Turkey as I read this and will try to answer this for Richard. I got to speak with him group yesterday . They are a very knowlegeable and the type of practicers that I would send my family too. I am going to be sending my patient's orthotic problems to them.

As you know the shoe is just as important as the orthosis that the sit in.
It you are having pain from the orthois rubing against the posterior tibian insertion which is the navicular bone, and rubbing at the base of the 5th metatarsal bone where the peroneal brevis tendon inserts then the following may be concluded.

1. The insert is't deep enough. for the entire rearfoot and midfoot to allow the foot subtalar joint to function properly

2. The shoe and the orthosis don't fit together . The shoe isn't deep enought to allow the foot to sit properly in the orthosis to fit into the shoe.

3. It may be possible that the orthosis isn't made to help your specific foot condition.

Ok! Now that I have pictured this without reading the insert post /I see no reason why you can't wear the Tatami Nebraskas which I have never seen before (sorry). It they hold the orthois and your foot in a corrected positon and they don't rub the tendon insertion areas then my common sense would say wear. Is there any where I can find a picture of the Tatami
Nebraskus. Are they sold in most shoe store. I think i better go on a shoe shopping tour to take a look at these shoes.

Now if Richard tell you that What I just stated isn't exactly what is true then ignore me. Richard has alot of orthosis experience and knowledgeable so my vote would be to listen to my advice until Richard Finishs his Turkey dinner. Have a great thanksgiving.!!!

Re: alternative orthotics use

Julie F on 11/23/00 at 08:37 (033352)

Dr Z, I think Nancy may be away. To see the Tatami Nebraskas (and hundreds of other Birkenstocks) go to the Birkenstock website: http://www.birkenstock-cn.com .

Enjoy your turkey and happy Thanksgiving.

Julie

Re: alternative orthotics use

Richard, C.Ped on 11/27/00 at 08:00 (033607)

Hi Nancy,
Sorry that I missed you last Wednesday. The day was super slow, and I was planning to go out of town, so I took off at 11:30. I can do that, I am the boss. :-) (BTW: if my partners, Mike and Sean read this....um...yes, I stayed the WHOLE day, whew....it sure was busy...)

Anyway, I read Dr. Z's response, and I agree. Basically, if the Birk inserts seem to fit and feel ok, great! Keep in mind that they are not custom made and do not fit your foot exactly, but, again, if they feel good, that is fine. Hope your (and everyone's) Thanksgiving was wonderful.

I hope that makes sense, I am still sleepy from the turkey. If it does not
please let me know. Talk to ya later.....

Richard

Re: alternative orthotics use -- to Richard

Nancy S. on 11/27/00 at 08:21 (033612)

Happy belated T'giving to you, Richard. I won't tell anyone that you left at 11:30 on Wed. -- of course, I don't need to, now the whole world knows!
I think my initial question got misread and wasn't complete anyway, so here it is again:

My custom orthotics seem great. The problem is shoes: any full shoe I wear hurts (rubs or digs into) one of my inflamed tendons someplace (reminder: I have PF in one foot and bilateral achilles, peroneal, and post-tib tendonitis).
So last week I dug my Birk Tatami Nebraskas out of the closet. They have a removable footbed. I took out the Birks footbeds and tried my orthotics in the Nebraskas, and they fit perfectly. Que milagro! That's how I've been wearing the orthotics since last Wednesday -- as a replacement of the Birks footbed in the Tatami Nebraskas. Of course these are only sandals, but their footbed was low, so my orthotics sit inside the sandals, and the three straps (two on top and one around the back of the heel) seem to hold my feet pretty steady.
I know this isn't ideal use of orthotics, but until my tendons calm down, do you think this is ok? It IS an improvement on not wearing orthotics at all, isn't it? The orthotics still give me that arch support I desperately need, and look and feel to me like they're correcting hyperpronation.
I know you must be busy today, just returning to work, but if you could briefly give me your thoughts on this, I'd appreciate it. Thanks, Richard!
Nancy

Re: alternative orthotics use -- to Richard

Richard, C.Ped on 11/27/00 at 10:11 (033622)

Nancy,
Sorry, I did misread your post. I'm such a goof (no comments from you Kate). I think if your inserts fit into your Birks and feel fine, it is ok to wear them until the tenderness goes away in those areas. I don't see a thing wrong with it. Just try to keep your toes warm up there.
Richard

Re: alternative orthotics use

Beverly on 11/22/00 at 14:44 (033323)

Nancy,

If you find the solution, I sure will feel curious. All I know to do is rotate shoes. Do I understand you are putting orthodics in your sandals?
I didn't think they were made for sandals, but perhaps I'm wrong.
How are you liking your orthodics and do you find they only work in certain shoes? I'm still planning to try them. Waiting for results of MRI and now I've got to figure out who will make them.
Take Care. Eat lots of turkey. I wish I could send you my homemade from scratch cornbread dressing with white creamy turkey gravy. I don't think you all have that kind up North.

Take care,
Beverly

Re: alternative orthotics use

Dr. Zuckerman on 11/23/00 at 08:08 (033349)

I am up smelling the Turkey as I read this and will try to answer this for Richard. I got to speak with him group yesterday . They are a very knowlegeable and the type of practicers that I would send my family too. I am going to be sending my patient's orthotic problems to them.

As you know the shoe is just as important as the orthosis that the sit in.
It you are having pain from the orthois rubing against the posterior tibian insertion which is the navicular bone, and rubbing at the base of the 5th metatarsal bone where the peroneal brevis tendon inserts then the following may be concluded.

1. The insert is't deep enough. for the entire rearfoot and midfoot to allow the foot subtalar joint to function properly

2. The shoe and the orthosis don't fit together . The shoe isn't deep enought to allow the foot to sit properly in the orthosis to fit into the shoe.

3. It may be possible that the orthosis isn't made to help your specific foot condition.

Ok! Now that I have pictured this without reading the insert post /I see no reason why you can't wear the Tatami Nebraskas which I have never seen before (sorry). It they hold the orthois and your foot in a corrected positon and they don't rub the tendon insertion areas then my common sense would say wear. Is there any where I can find a picture of the Tatami
Nebraskus. Are they sold in most shoe store. I think i better go on a shoe shopping tour to take a look at these shoes.

Now if Richard tell you that What I just stated isn't exactly what is true then ignore me. Richard has alot of orthosis experience and knowledgeable so my vote would be to listen to my advice until Richard Finishs his Turkey dinner. Have a great thanksgiving.!!!

Re: alternative orthotics use

Julie F on 11/23/00 at 08:37 (033352)

Dr Z, I think Nancy may be away. To see the Tatami Nebraskas (and hundreds of other Birkenstocks) go to the Birkenstock website: http://www.birkenstock-cn.com .

Enjoy your turkey and happy Thanksgiving.

Julie

Re: alternative orthotics use

Richard, C.Ped on 11/27/00 at 08:00 (033607)

Hi Nancy,
Sorry that I missed you last Wednesday. The day was super slow, and I was planning to go out of town, so I took off at 11:30. I can do that, I am the boss. :-) (BTW: if my partners, Mike and Sean read this....um...yes, I stayed the WHOLE day, whew....it sure was busy...)

Anyway, I read Dr. Z's response, and I agree. Basically, if the Birk inserts seem to fit and feel ok, great! Keep in mind that they are not custom made and do not fit your foot exactly, but, again, if they feel good, that is fine. Hope your (and everyone's) Thanksgiving was wonderful.

I hope that makes sense, I am still sleepy from the turkey. If it does not
please let me know. Talk to ya later.....

Richard

Re: alternative orthotics use -- to Richard

Nancy S. on 11/27/00 at 08:21 (033612)

Happy belated T'giving to you, Richard. I won't tell anyone that you left at 11:30 on Wed. -- of course, I don't need to, now the whole world knows!
I think my initial question got misread and wasn't complete anyway, so here it is again:

My custom orthotics seem great. The problem is shoes: any full shoe I wear hurts (rubs or digs into) one of my inflamed tendons someplace (reminder: I have PF in one foot and bilateral achilles, peroneal, and post-tib tendonitis).
So last week I dug my Birk Tatami Nebraskas out of the closet. They have a removable footbed. I took out the Birks footbeds and tried my orthotics in the Nebraskas, and they fit perfectly. Que milagro! That's how I've been wearing the orthotics since last Wednesday -- as a replacement of the Birks footbed in the Tatami Nebraskas. Of course these are only sandals, but their footbed was low, so my orthotics sit inside the sandals, and the three straps (two on top and one around the back of the heel) seem to hold my feet pretty steady.
I know this isn't ideal use of orthotics, but until my tendons calm down, do you think this is ok? It IS an improvement on not wearing orthotics at all, isn't it? The orthotics still give me that arch support I desperately need, and look and feel to me like they're correcting hyperpronation.
I know you must be busy today, just returning to work, but if you could briefly give me your thoughts on this, I'd appreciate it. Thanks, Richard!
Nancy

Re: alternative orthotics use -- to Richard

Richard, C.Ped on 11/27/00 at 10:11 (033622)

Nancy,
Sorry, I did misread your post. I'm such a goof (no comments from you Kate). I think if your inserts fit into your Birks and feel fine, it is ok to wear them until the tenderness goes away in those areas. I don't see a thing wrong with it. Just try to keep your toes warm up there.
Richard