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orthotics

Posted by John Byerly on 3/18/01 at hrmin (041796)

I have been wearing orthotics made by a Podiatrist for the last several years. About a year ago I started experiencing heel pain
which has been diagnosed as Plantar Faciitis. For the last year I have had all of the conventional treatments including, cortisone shots (4), taping, ultrasound, acupuncture, and anti-inflamatory medicines, all to no avail. Now I wonder whether the orthotics I am wearing which are made from hard plastic, may be part of my problem. My question, therefore, is should I be wearing an insert made from a softer material? After a year with this pain and having seen three Podiatrists I am searching for anything which might help.

Re: orthotics check prescription

Donna SL on 3/18/01 at 21:51 (041822)

John,

It may or may not be the material the orthotics are made of unless they are very rigid. It may be that the correction is not right for your foot, not so much the material. I had a semi rigid pair of orthotics I wore for years with no problems. Some new podiatrist altered the prescription, and made me new orthotics out of a similar semi rigid plastic, and that's when I started to get heel pain. I kept thinking it was the plastic, so I had a pair made out of a softer EVA type material off the same mold, and still got the same heel pain. This proved that it was not the material, but something wrong in the prescripion. The doctors on this board helped me figured out what was wrong, and I brought it to the attention of my Pod. He's now making a slightly different orthotic.

I found that a soft orthotic made with an incorrect prescription, can feel worse than a semi rigid plastic, especially with heel pain, because your foot will move even more in it, and it seems to emphasize the bad correcton. For example, it will cause more pull on the heels, tendons, etc. I would get a second, and maybe third opinion on the orthotic prescription, and see if they are properly made for your foot type. Also, if you find you need a lot of control in your orthotic, and a soft material will not do, then a semi flexible polypropylene, with a comfortable full length top cover can be used.

What type of foot do you have? (ie. high or low arches). Why did you get orthotics in the first place? Do your know what the diagnosis of your foot problem is? How's your ankle flexibility?

Also, try putting a very firm rubber heel lift under the orthotic. First try either 1/16, or 1/8 inch lift. If not enough go up to 1/4 inch, and see if this helps. Your pod should have these. This should take some pressure off the heels. Make sure they are not soft, because this will cause more heel pain.

Donna

Re: orthotics

Julie on 3/19/01 at 03:07 (041827)

Hello John

The hard plastic in the orthotics you are wearing may or may not be part of the problem. The fact that you've had them for several years and still have aquired PF may indicate that your feet have changed and that you need to be casted for new orthotics. This exactly describes my history re orthotics: I was prescribed and fitted for them for over-pronation, and they worked well at first. But after seven years I got PF. I have now had new orthotics for three months. They feel quite different and support my feet much more effectively. For several reasons, my PF is better, and I've no doubt the new orthotics have contributed to the improvement.

Wait and see what our resident C Ped says, but it might be time for new orthotics for you too.

You say nothing has helped. What kind of taping have you been doing? If you haven't consulted the Heel Pain Book yet, do: there are links on the home page. It's an excellent source of information. There is a section on taping in part 2 - you might find there a technique that works for you, as I have.

All good wishes

Julie

Re: orthotics

Richard, C.Ped on 3/19/01 at 07:41 (041838)

Hi John,
It is really hard to say without seeing you. If your current orthotics were fine for the first few years then recently started to give you pain, I might think that the orthotics were starting to break down a little. Either that, or something has changed with your feet. I would find a doctor who can give you a thorough gait analysis.

I would not recommend adding any kind of modifications yourself just yet. That could possibly lead to a more serious problem since we really do not know why your current orthotics are starting to hurt.

If you do go back to the doctor, let us know what he/she says.
Richard, C.Ped

Re: orthotics check prescription

Donna SL on 3/18/01 at 21:51 (041822)

John,

It may or may not be the material the orthotics are made of unless they are very rigid. It may be that the correction is not right for your foot, not so much the material. I had a semi rigid pair of orthotics I wore for years with no problems. Some new podiatrist altered the prescription, and made me new orthotics out of a similar semi rigid plastic, and that's when I started to get heel pain. I kept thinking it was the plastic, so I had a pair made out of a softer EVA type material off the same mold, and still got the same heel pain. This proved that it was not the material, but something wrong in the prescripion. The doctors on this board helped me figured out what was wrong, and I brought it to the attention of my Pod. He's now making a slightly different orthotic.

I found that a soft orthotic made with an incorrect prescription, can feel worse than a semi rigid plastic, especially with heel pain, because your foot will move even more in it, and it seems to emphasize the bad correcton. For example, it will cause more pull on the heels, tendons, etc. I would get a second, and maybe third opinion on the orthotic prescription, and see if they are properly made for your foot type. Also, if you find you need a lot of control in your orthotic, and a soft material will not do, then a semi flexible polypropylene, with a comfortable full length top cover can be used.

What type of foot do you have? (ie. high or low arches). Why did you get orthotics in the first place? Do your know what the diagnosis of your foot problem is? How's your ankle flexibility?

Also, try putting a very firm rubber heel lift under the orthotic. First try either 1/16, or 1/8 inch lift. If not enough go up to 1/4 inch, and see if this helps. Your pod should have these. This should take some pressure off the heels. Make sure they are not soft, because this will cause more heel pain.

Donna

Re: orthotics

Julie on 3/19/01 at 03:07 (041827)

Hello John

The hard plastic in the orthotics you are wearing may or may not be part of the problem. The fact that you've had them for several years and still have aquired PF may indicate that your feet have changed and that you need to be casted for new orthotics. This exactly describes my history re orthotics: I was prescribed and fitted for them for over-pronation, and they worked well at first. But after seven years I got PF. I have now had new orthotics for three months. They feel quite different and support my feet much more effectively. For several reasons, my PF is better, and I've no doubt the new orthotics have contributed to the improvement.

Wait and see what our resident C Ped says, but it might be time for new orthotics for you too.

You say nothing has helped. What kind of taping have you been doing? If you haven't consulted the Heel Pain Book yet, do: there are links on the home page. It's an excellent source of information. There is a section on taping in part 2 - you might find there a technique that works for you, as I have.

All good wishes

Julie

Re: orthotics

Richard, C.Ped on 3/19/01 at 07:41 (041838)

Hi John,
It is really hard to say without seeing you. If your current orthotics were fine for the first few years then recently started to give you pain, I might think that the orthotics were starting to break down a little. Either that, or something has changed with your feet. I would find a doctor who can give you a thorough gait analysis.

I would not recommend adding any kind of modifications yourself just yet. That could possibly lead to a more serious problem since we really do not know why your current orthotics are starting to hurt.

If you do go back to the doctor, let us know what he/she says.
Richard, C.Ped