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TTS orthotics

Posted by eileenc on 5/12/01 at 09:11 (047571)

Dear Dr. Graham: I know that you are very busy, but could you give me an idea of what to do about orthotics? I posted on this board 5/08/01 to explain my present condition. Also, most of the shoes mentioned here are for PF--except New Balance 804 and Birkenstocks. Any others? Thank you.

Re: TTS orthotics

Richard, C.Ped on 5/14/01 at 08:17 (047704)

Hi Eileen,
Sorry it took me so long to get back to you. Just to let you know, I am not a doctor. I describe C.Peds like a pharmacist for the foot. We fill prescriptions for orthopedic footwear.

With TTS, you want to relieve the pressure, or stretching of the Post tib nerve. Properly made orthotics will do this. I would go with a little softer material so as to not 'push' the nerve, but to provide cushion. A custom orthosis is the way to go. This will allow your weight to be distributed evenly, thus reducing excess pressure on one certain area.

Other means of treatment usually include NASIDs as well as Cortisone for temporary relief.

Shoes in general should be well made and not bend in the middle. I have posted before about testing the shoe. with your right hand, hold the shoe at the heel counter. With your left hand, push the toe box and heel counter toward each other. The shoe should only bend at the ball, or where your foot normally bends. For someone with TTS as well as PF, you do not want to be wearing shoes that bend in the middle. This will only aggrivate the problem.

Let me know if you have any other questions.
Richard

Re: TTS orthotics

wendyn on 5/14/01 at 22:49 (047756)

Richard - I really liked your answer! I have problems with my post tib tendon - and the new orthotics are doing wonders for my feet...I AM SO GLAD that I hung in and tried again.

I made the mistake of buying the 'too flexible' soled shoes recently - I could hardly walk after about 15 minutes. What a difference.

I get my custom birks tomorrow..here's hoping...

Re: custom birks

Nancy N on 5/15/01 at 08:43 (047788)

Wendy--

What did you learn about custom Birks 'for the masses'? How much are your costing you, etc?

Re: TTS orthotics

eileenc on 5/15/01 at 11:45 (047808)

Wow! Does it sound like we have some similar problems! I am looking at Birks but never heard of customizing them. Keep me posted. Also,what type of Dr. did you go to for orthotics? what material are they made of? Did you have anything special done to them? Thanks.

Re: custom birks

wendyn on 5/15/01 at 22:38 (047884)

Nancy - the podiatrist who made my orthotics casted me for custom birks. The casts were sent to New York. I got them back today - the right one feels good, the left not so good. I will give it a few days but I have a feeling that the left one is making the trip back to New York. I don't remember the name of the company that makes them there - I will pick up a brochure when I go back.

The sandal looks identical to a birk except the foot bed is an orthotic.

The cost was 375 Canadian (choke!) - but I am submitting it as an orthotic claim so hopefully insurance will cover some. By comparison - my orthotics were 350 and a standard pair of Birks here are about 120.

Re: TTS orthotics

wendyn on 5/15/01 at 22:43 (047885)

Eileen, these are from a podiatrist. They are my fourth pair.

1st pair from a podiatrist - I quit wearing (about 10 years ago). i quit wearing them because I didn't think I needed them...they were made of graphite - hard as rocks.

2nd pair from a podiatrist - I loved them - until they eventually (I believe) wrecked my feet and were a significant contributing factor in almost destroying my ability to walk. They were very high and very hard.

3rd pair from a physio therapist - they were a bit better than pair number 2 but even with adjustments and recasting they could never get my left one to feel good.

This last pair is from a podiatrist as well. I went to him because he comes highly recommended (my old pod actually sent all his tough orthotic cases to this guy). His attitude with my feet was that it was his job to find a way to help me, and he would do whatever it took. He did not believe that orthotics are going to work perfectly right off the bat for patients - and adjustments and changes are all part of the treatment. They are semi rigid 3/4 length with a full lenth layer of cushion/padding stuff on top.

The bottom line I think (no matter what type of professional makes them) is to find someone who is serious and dedicated to what they do.

Re: TTS orthotics

Richard, C.Ped on 5/14/01 at 08:17 (047704)

Hi Eileen,
Sorry it took me so long to get back to you. Just to let you know, I am not a doctor. I describe C.Peds like a pharmacist for the foot. We fill prescriptions for orthopedic footwear.

With TTS, you want to relieve the pressure, or stretching of the Post tib nerve. Properly made orthotics will do this. I would go with a little softer material so as to not 'push' the nerve, but to provide cushion. A custom orthosis is the way to go. This will allow your weight to be distributed evenly, thus reducing excess pressure on one certain area.

Other means of treatment usually include NASIDs as well as Cortisone for temporary relief.

Shoes in general should be well made and not bend in the middle. I have posted before about testing the shoe. with your right hand, hold the shoe at the heel counter. With your left hand, push the toe box and heel counter toward each other. The shoe should only bend at the ball, or where your foot normally bends. For someone with TTS as well as PF, you do not want to be wearing shoes that bend in the middle. This will only aggrivate the problem.

Let me know if you have any other questions.
Richard

Re: TTS orthotics

wendyn on 5/14/01 at 22:49 (047756)

Richard - I really liked your answer! I have problems with my post tib tendon - and the new orthotics are doing wonders for my feet...I AM SO GLAD that I hung in and tried again.

I made the mistake of buying the 'too flexible' soled shoes recently - I could hardly walk after about 15 minutes. What a difference.

I get my custom birks tomorrow..here's hoping...

Re: custom birks

Nancy N on 5/15/01 at 08:43 (047788)

Wendy--

What did you learn about custom Birks 'for the masses'? How much are your costing you, etc?

Re: TTS orthotics

eileenc on 5/15/01 at 11:45 (047808)

Wow! Does it sound like we have some similar problems! I am looking at Birks but never heard of customizing them. Keep me posted. Also,what type of Dr. did you go to for orthotics? what material are they made of? Did you have anything special done to them? Thanks.

Re: custom birks

wendyn on 5/15/01 at 22:38 (047884)

Nancy - the podiatrist who made my orthotics casted me for custom birks. The casts were sent to New York. I got them back today - the right one feels good, the left not so good. I will give it a few days but I have a feeling that the left one is making the trip back to New York. I don't remember the name of the company that makes them there - I will pick up a brochure when I go back.

The sandal looks identical to a birk except the foot bed is an orthotic.

The cost was 375 Canadian (choke!) - but I am submitting it as an orthotic claim so hopefully insurance will cover some. By comparison - my orthotics were 350 and a standard pair of Birks here are about 120.

Re: TTS orthotics

wendyn on 5/15/01 at 22:43 (047885)

Eileen, these are from a podiatrist. They are my fourth pair.

1st pair from a podiatrist - I quit wearing (about 10 years ago). i quit wearing them because I didn't think I needed them...they were made of graphite - hard as rocks.

2nd pair from a podiatrist - I loved them - until they eventually (I believe) wrecked my feet and were a significant contributing factor in almost destroying my ability to walk. They were very high and very hard.

3rd pair from a physio therapist - they were a bit better than pair number 2 but even with adjustments and recasting they could never get my left one to feel good.

This last pair is from a podiatrist as well. I went to him because he comes highly recommended (my old pod actually sent all his tough orthotic cases to this guy). His attitude with my feet was that it was his job to find a way to help me, and he would do whatever it took. He did not believe that orthotics are going to work perfectly right off the bat for patients - and adjustments and changes are all part of the treatment. They are semi rigid 3/4 length with a full lenth layer of cushion/padding stuff on top.

The bottom line I think (no matter what type of professional makes them) is to find someone who is serious and dedicated to what they do.