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maybe it's the shoes, not the orthotics

Posted by elliott on 2/05/02 at 22:24 (072735)

It seems almost the norm that many here go through several pairs of orthotics (expensive ice scrapers), and they just don't work. Well, maybe sometimes it's the shoes they should be going through instead (not sure how much cheaper that will come out :-)).

One of my feet is in big trouble, and the doc wants to see the orthotics I don't wear (hey, I got such a pair too!). So, in anticipation of my next visit, I got the orthotics out of mothballs, removed the insoles of my newest shoes (Brooks Addiction) and stuck them in. You know what? They're not as bad as I thought. Actually, I think this is the first pair of shoes (I must've tried close to a dozen) they actually fit well in. Here are examples where it could be the shoes at fault:

Shoe has an arch that tilts the orthotic.

Shoe is too narrow in heel to let them GET DOWN! (and dance :-)).

Shoe too wide in heel and/or orthotic slides forward in shoe when you walk.

Shoe too tight in at least one location when worn with orthotics.

You size up and then shoe too loose.

Ball and toes drop off the 3/4 orthotic at a bad angle.

Orthotics fit in shoes only without shoe insert, but then your ball/toes itch or scratch.

You cut the removable shoe inserts leaving a forefoot piece to line up with your 3/4 length orthotics only to find that you cut off too much and ruined the experiment (not worth getting a new pair of same shoes unlikely to work anyway).

Foot is raised by orthotic so it is now sitting above level of support and heel counter stiffness so that foot is falling over medially or laterally, creating instabilty rather than stability.

The list goes on. My point is, assuming the orthotics are made correctly and have been adjusted if necessary to avoid it hitting your foot wrong, maybe all that's needed, in addition to the right class of shoe for that person's foottype, is one where the orthotics fit in level, deep, and just stick, and somehow manage to work, whether with or without all or part of the shoe's removable insert. So at least in some cases, maybe the trick is to try more shoes, not more orthotics.

Re: maybe it's the shoes, not the orthotics

Carole C in NOLA on 2/05/02 at 22:52 (072740)

I'm so sure that you are right, Elliott. As you suggested in a post a while back (that I think was an excellent one), the orthotics and shoes work together. At least, they do for me.

One reason that my SAS shoes are such huge tanks are that my orthotics are quite thick and support my very high arches. There just wouldn't be room for them in a 'normal' looking shoe. With the orthotics in the SAS shoes, there's just exactly the right room for my feet... they don't slide around, but feel comfortably yet firmly cradled with about the same degree of pressure from all angles. But when I tried to put my orthotics in ANY of the other practical tie-up style shoes that I have (Easy Spirit, a different non-gargantuan pair of practical black SAS tie-ups, my Nikes), they didn't stand the slightest chance of fitting. Even if they had, the heel counter is so important and it is extremely high in these shoes. The protection and support it provides would never be there with a different shoe.

It's not that SAS is the shoe to get. Without the orthotic in it, I don't know what it would feel like at all. It's the combination that works for me. I would urge those who pay good money for custom orthotics, to have them put in a shoe selected by the pedorthist and to LEAVE THEM THERE. You may end up with a hideously ugly shoe, like me, but it may actually heal your feet, as has been my experience.

Also, who cares about ugly after work. There are some days when I really don't care who sees me wearing ugly shoes even at work. The heck with the rest of the world, I want my feet to heal. (If I care, then there are always Birkenstocks.)

Carole C

Re: maybe it's the shoes, not the orthotics

Carole C in NOLA on 2/05/02 at 22:59 (072741)

After all, once the custom orthotics are made the pedorthist ought to put them in the shoe they were made for and watch you walk in them. Then he/she can make the initial adjustment so that you are walking right. I know my pedorthist did this and I would assume that they all do.

If you put them in another shoe, you wouldn't walk the same and there would be no point in paying for a *custom* orthotic at all.

Carole C

Re: maybe it's the shoes, not the orthotics

D.J. on 2/06/02 at 10:39 (072781)

Very good point, as the podiatrist that I bought my shoes from recently put it: 'Without a good foundation, the orthotic is not able to give support' or something like that. I have been through many shoes, but none were stable enough. For my condition, I need a shoe that is extremely stable and does not bend in the arch. I'm now wearing the Etonic Stable Pro III walking shoe and it is definitely more comfortable and I'm hoping it will allow my fascia to heel and give my orthotics a chance to provide support.

Re: orthotics

elliott on 2/06/02 at 22:33 (072872)

You say your orthotics are thick. Often the difference between a cheaper and more expensive pair of orthotics is that the more expensive pair is very THIN (not to mention light and still strong), so you might be able to get them into sexier shoes.

Not to belittle a pedorthist, but sometimes you just have to try the shoes on. A little knowledge and you will know what class of shoes will work. Then you try a lot and see what feels good. Right after you convince yourself the shoes you tried in your living room definitely work, the first time you wear them outside you realize they don't work, and then you can't return them because you've scuffed the shoes. :-)

--

Re: Expensive orthotics thin to get in sexy shoes?????

Carole C in NOLA on 2/07/02 at 05:28 (072885)

It seems to me that the FIRST and most crucial thing that an orthotic should do is to heal the foot. Every day I read complaints on this board from people here about their ice scrapers and how their orthotics didn't work. That boggles my mind. Apparently I'm just about the only person here with orthotics that actually work this well. My feet are healing and I'm on the road to a relatively quick recovery, and my orthotics have been the main reason for this. If your pedorthist and some others are charging more to make orthotics that fit into fashionable shoes and don't work, rather than putting their full talents and capabilities into making orthotics that will HEAL a patient properly, without regard to fashion, maybe that is why there are so many complaints here!

I'm glad that I found a good pedorthist who would put my feet first.

An orthotic is a medical device, and ought to work for the patient.

Carole C

Re: sexy is all that matters :-)

elliott on 2/07/02 at 11:42 (072912)

I don't think you got what I'm saying. Supposedly, more expensive high-quality orthotics will be just as good as yours but a lot thinner. That is, you won't lose anything with their thinness and may even gain, in terms of comfort, decreased weight, more shoe selections. Supposedly Northwest Podiatric's orthotics (with mold done by someone competent), which Dr. Ed raves about, fit this bill. I'm not telling you to switch since you found something that works (and I wouldn't either), but if you ever want to get out of those Sherman tanks and attract that single guy you're looking for...

:-)

Re: but these are medical devices! LOL

Carole C in NOLA on 2/07/02 at 12:34 (072919)

well, but, but, but! I don't think you quite got what I'm saying either... (grin)

If a pedorthist is not competent enough to make an orthotic that works, and heals the patients feet reasonably fast, it makes little sense to me for him to try to make fancy ones that cost an arm and a leg. When my feet heal then I won't have to worry about what my shoes look like. Orthotics should be a temporary medical device that heals feet in as short a time frame as possible, not a fashionable accessory for the long term. Well, in my opinion anyhow.

As for attracting men, well I wear Birkenstocks when that's a possibility. I have always had a policy of not dating men that I work with, ever. Right from the start, my pedorthist had me wearing Birkenstocks in the evenings and my ugly orthotics/SAS combo at work. If I had a date tonight, or a party to go to, I would wear Birkenstocks. Most of the men I've dated have no idea that I wear great big ol' ugly shoes that make me look like Mr. T's grandfather most of the time. (grin)

I can wear Birkenstocks for longer and longer now that my feet are more healed, and in fact last week when I first got my Birkenstock Amsterdam clogs, I was able to ditch my ugly orthotics/SAS combination completely for about 3-4 days and just wear Birkenstocks all day. I was even walking and going to all those stores, in my Birkenstocks. But then I overdid it by standing on too hard floors for hours out at the Navy base, and now I'm back to wearing my custom orthotics most of the day in order to regain lost ground.

I do hate wearing my Sherman tanks to work, because I feel that I look old and unfeminine enough without them adding to it. It doesn't help my image or my self-image. But, I figure that in a few weeks I can start wearing Birkenstocks to work all the time again.

Carole C

Re: sexy is all that matters :-)

wendyn on 2/07/02 at 13:26 (072926)

I doubt very much that most of the women on this board are still worried about looking sexy in shoes.

I used to wear nice shoes - those days are long over for good.

Oh well. It builds character.

For most of us, you eventually reach a point where comfort and the health of your feet becomes more important than high heels.

Re: does anyone actually read what I'm saying anymore?

elliott on 2/08/02 at 07:12 (073006)

First of all, don't ignore my use of :-). Second, I am making the point that a thinner orthotic made out of advanced materials done right will actually be *superior* to the fat heavy kind. That is my point.

---

Re: effective orthotics

Ed Davis, DPM on 2/08/02 at 14:27 (073061)

Carole:

Keep in mind that individuals who post here are often people who have not had successful treatment or those with difficult cases. The vast majority of patients are happy with their orthotics.

The best combo is a good orthotic coupled with a good running shoe for starters. Once patients are feeling better, they can spend time in Birks, other good clogs, dress shoes with dress orthotics....
Ed

Re: effective orthotics, and footwear after recovering

Carole C in NOLA on 2/08/02 at 15:11 (073068)

That's the way it's been with me too. I'm extremely happy with my custom soft orthotics which I got on December 10th. I guess it's kind of shocking to me to see threads like the '101 Uses for Hard Orthotics' thread, or whatever it was called, because my soft orthotics have helped me so much. I wouldn't give them up for anything, and if someone yelled 'FIRE!!!' I'd grab my orthotics first and guard them with my life. :)

I am at the point where I am spending more time in Birks, as you mention, and last week even spent all day for 3-4 days in Birkenstocks. Most Birkenstocks are not perfect for me, but I am healed enough that I can wear them although I can't wear something like Easy Spirit without damaging my PF. I had hoped that between Birkenstocks and maybe over the counter orthotics (?) in a better looking tie-up shoe or walking shoe of some sort, I wouldn't have to have more custom orthotics made once I'm better.

This afternoon I have been searching the internet, trying to find out what kind of shoe or orthotic works best for a high arched supinator like myself who is pretty much recovered both from PF and from very tight tendons and calf muscles. So far, I've seen it mentioned that I should avoid NB shoes with medial posts and roll bars, but I haven't yet discovered what might work best for me.

Carole C

Re: effective orthotics, and footwear after recovering

Carole C in NOLA on 2/08/02 at 15:27 (073070)

Oh, and now in my search to find out about my feet, I read 'It is a common misconception that if you wear down the outside heel of your shoes, you must be a supinator'. That's a misconception that I shared. So, I guess the next step for me would be to get someone who knows about feet to tell me if I pronate or supinate or what, so that I can find out what kind of shoe will work best for me.

Carole C

Re: effective orthotics, and footwear after recovering

Julie on 2/08/02 at 16:45 (073080)

Almost everyone wears down the outside heels first, because that's the part of the foot/shoe that strikes the ground first. It doesn't mean that the wearer doesn't pronate, or doesn't pronate excessively. Pronation is the natural inward roll of the foot in the subsequent phase of the gait cycle. Excessive pronation is when the foot rolls inward more than it ought to. This is my understanding (basic, as it's such a complex process). The most reliable way to discover what one's feet are actually doing is to consult a podiatrist who has both the expertise and the equipment - a walking machine and hopefully a video as well - to observe and assess one's gait for biomechanical faults.

Re: Unfortunately......

Carmen H on 2/09/02 at 11:29 (073141)

Once a PF sufferer almost always a PF sufferer. In other words...You are more prone to get it again in your life so I wouldn't give up those orthotics and ugly shoes....never in a lifetime after you get healed.
Careful....
That ugly creep PF sneaks up out of no where as you know!
:-)

Re: Unfortunately......

Carole C in NOLA on 2/09/02 at 17:29 (073187)

Well Pooh, I want it to go away and stay away!! LOL At any rate, enough that I can just wear Birkenstocks or dinky little OTC orthotics and practical, attractive, and comfy shoes (like maybe those gorgeous ones you linked to in the thread at the top of the page), since I have no desire to wear heels or fancy-shmancy dress shoes. I'm not a person that's prone to foot problems, and never had any in my whole 53.25 years before I strained my feet cycling barefoot.

I'm not going to throw out my orthotics and Sherman Tank shoes... but I was definitely hoping they would gather dust in the closet by summer.

Carole C

Re: maybe it's the shoes, not the orthotics

Carole C in NOLA on 2/05/02 at 22:52 (072740)

I'm so sure that you are right, Elliott. As you suggested in a post a while back (that I think was an excellent one), the orthotics and shoes work together. At least, they do for me.

One reason that my SAS shoes are such huge tanks are that my orthotics are quite thick and support my very high arches. There just wouldn't be room for them in a 'normal' looking shoe. With the orthotics in the SAS shoes, there's just exactly the right room for my feet... they don't slide around, but feel comfortably yet firmly cradled with about the same degree of pressure from all angles. But when I tried to put my orthotics in ANY of the other practical tie-up style shoes that I have (Easy Spirit, a different non-gargantuan pair of practical black SAS tie-ups, my Nikes), they didn't stand the slightest chance of fitting. Even if they had, the heel counter is so important and it is extremely high in these shoes. The protection and support it provides would never be there with a different shoe.

It's not that SAS is the shoe to get. Without the orthotic in it, I don't know what it would feel like at all. It's the combination that works for me. I would urge those who pay good money for custom orthotics, to have them put in a shoe selected by the pedorthist and to LEAVE THEM THERE. You may end up with a hideously ugly shoe, like me, but it may actually heal your feet, as has been my experience.

Also, who cares about ugly after work. There are some days when I really don't care who sees me wearing ugly shoes even at work. The heck with the rest of the world, I want my feet to heal. (If I care, then there are always Birkenstocks.)

Carole C

Re: maybe it's the shoes, not the orthotics

Carole C in NOLA on 2/05/02 at 22:59 (072741)

After all, once the custom orthotics are made the pedorthist ought to put them in the shoe they were made for and watch you walk in them. Then he/she can make the initial adjustment so that you are walking right. I know my pedorthist did this and I would assume that they all do.

If you put them in another shoe, you wouldn't walk the same and there would be no point in paying for a *custom* orthotic at all.

Carole C

Re: maybe it's the shoes, not the orthotics

D.J. on 2/06/02 at 10:39 (072781)

Very good point, as the podiatrist that I bought my shoes from recently put it: 'Without a good foundation, the orthotic is not able to give support' or something like that. I have been through many shoes, but none were stable enough. For my condition, I need a shoe that is extremely stable and does not bend in the arch. I'm now wearing the Etonic Stable Pro III walking shoe and it is definitely more comfortable and I'm hoping it will allow my fascia to heel and give my orthotics a chance to provide support.

Re: orthotics

elliott on 2/06/02 at 22:33 (072872)

You say your orthotics are thick. Often the difference between a cheaper and more expensive pair of orthotics is that the more expensive pair is very THIN (not to mention light and still strong), so you might be able to get them into sexier shoes.

Not to belittle a pedorthist, but sometimes you just have to try the shoes on. A little knowledge and you will know what class of shoes will work. Then you try a lot and see what feels good. Right after you convince yourself the shoes you tried in your living room definitely work, the first time you wear them outside you realize they don't work, and then you can't return them because you've scuffed the shoes. :-)

--

Re: Expensive orthotics thin to get in sexy shoes?????

Carole C in NOLA on 2/07/02 at 05:28 (072885)

It seems to me that the FIRST and most crucial thing that an orthotic should do is to heal the foot. Every day I read complaints on this board from people here about their ice scrapers and how their orthotics didn't work. That boggles my mind. Apparently I'm just about the only person here with orthotics that actually work this well. My feet are healing and I'm on the road to a relatively quick recovery, and my orthotics have been the main reason for this. If your pedorthist and some others are charging more to make orthotics that fit into fashionable shoes and don't work, rather than putting their full talents and capabilities into making orthotics that will HEAL a patient properly, without regard to fashion, maybe that is why there are so many complaints here!

I'm glad that I found a good pedorthist who would put my feet first.

An orthotic is a medical device, and ought to work for the patient.

Carole C

Re: sexy is all that matters :-)

elliott on 2/07/02 at 11:42 (072912)

I don't think you got what I'm saying. Supposedly, more expensive high-quality orthotics will be just as good as yours but a lot thinner. That is, you won't lose anything with their thinness and may even gain, in terms of comfort, decreased weight, more shoe selections. Supposedly Northwest Podiatric's orthotics (with mold done by someone competent), which Dr. Ed raves about, fit this bill. I'm not telling you to switch since you found something that works (and I wouldn't either), but if you ever want to get out of those Sherman tanks and attract that single guy you're looking for...

:-)

Re: but these are medical devices! LOL

Carole C in NOLA on 2/07/02 at 12:34 (072919)

well, but, but, but! I don't think you quite got what I'm saying either... (grin)

If a pedorthist is not competent enough to make an orthotic that works, and heals the patients feet reasonably fast, it makes little sense to me for him to try to make fancy ones that cost an arm and a leg. When my feet heal then I won't have to worry about what my shoes look like. Orthotics should be a temporary medical device that heals feet in as short a time frame as possible, not a fashionable accessory for the long term. Well, in my opinion anyhow.

As for attracting men, well I wear Birkenstocks when that's a possibility. I have always had a policy of not dating men that I work with, ever. Right from the start, my pedorthist had me wearing Birkenstocks in the evenings and my ugly orthotics/SAS combo at work. If I had a date tonight, or a party to go to, I would wear Birkenstocks. Most of the men I've dated have no idea that I wear great big ol' ugly shoes that make me look like Mr. T's grandfather most of the time. (grin)

I can wear Birkenstocks for longer and longer now that my feet are more healed, and in fact last week when I first got my Birkenstock Amsterdam clogs, I was able to ditch my ugly orthotics/SAS combination completely for about 3-4 days and just wear Birkenstocks all day. I was even walking and going to all those stores, in my Birkenstocks. But then I overdid it by standing on too hard floors for hours out at the Navy base, and now I'm back to wearing my custom orthotics most of the day in order to regain lost ground.

I do hate wearing my Sherman tanks to work, because I feel that I look old and unfeminine enough without them adding to it. It doesn't help my image or my self-image. But, I figure that in a few weeks I can start wearing Birkenstocks to work all the time again.

Carole C

Re: sexy is all that matters :-)

wendyn on 2/07/02 at 13:26 (072926)

I doubt very much that most of the women on this board are still worried about looking sexy in shoes.

I used to wear nice shoes - those days are long over for good.

Oh well. It builds character.

For most of us, you eventually reach a point where comfort and the health of your feet becomes more important than high heels.

Re: does anyone actually read what I'm saying anymore?

elliott on 2/08/02 at 07:12 (073006)

First of all, don't ignore my use of :-). Second, I am making the point that a thinner orthotic made out of advanced materials done right will actually be *superior* to the fat heavy kind. That is my point.

---

Re: effective orthotics

Ed Davis, DPM on 2/08/02 at 14:27 (073061)

Carole:

Keep in mind that individuals who post here are often people who have not had successful treatment or those with difficult cases. The vast majority of patients are happy with their orthotics.

The best combo is a good orthotic coupled with a good running shoe for starters. Once patients are feeling better, they can spend time in Birks, other good clogs, dress shoes with dress orthotics....
Ed

Re: effective orthotics, and footwear after recovering

Carole C in NOLA on 2/08/02 at 15:11 (073068)

That's the way it's been with me too. I'm extremely happy with my custom soft orthotics which I got on December 10th. I guess it's kind of shocking to me to see threads like the '101 Uses for Hard Orthotics' thread, or whatever it was called, because my soft orthotics have helped me so much. I wouldn't give them up for anything, and if someone yelled 'FIRE!!!' I'd grab my orthotics first and guard them with my life. :)

I am at the point where I am spending more time in Birks, as you mention, and last week even spent all day for 3-4 days in Birkenstocks. Most Birkenstocks are not perfect for me, but I am healed enough that I can wear them although I can't wear something like Easy Spirit without damaging my PF. I had hoped that between Birkenstocks and maybe over the counter orthotics (?) in a better looking tie-up shoe or walking shoe of some sort, I wouldn't have to have more custom orthotics made once I'm better.

This afternoon I have been searching the internet, trying to find out what kind of shoe or orthotic works best for a high arched supinator like myself who is pretty much recovered both from PF and from very tight tendons and calf muscles. So far, I've seen it mentioned that I should avoid NB shoes with medial posts and roll bars, but I haven't yet discovered what might work best for me.

Carole C

Re: effective orthotics, and footwear after recovering

Carole C in NOLA on 2/08/02 at 15:27 (073070)

Oh, and now in my search to find out about my feet, I read 'It is a common misconception that if you wear down the outside heel of your shoes, you must be a supinator'. That's a misconception that I shared. So, I guess the next step for me would be to get someone who knows about feet to tell me if I pronate or supinate or what, so that I can find out what kind of shoe will work best for me.

Carole C

Re: effective orthotics, and footwear after recovering

Julie on 2/08/02 at 16:45 (073080)

Almost everyone wears down the outside heels first, because that's the part of the foot/shoe that strikes the ground first. It doesn't mean that the wearer doesn't pronate, or doesn't pronate excessively. Pronation is the natural inward roll of the foot in the subsequent phase of the gait cycle. Excessive pronation is when the foot rolls inward more than it ought to. This is my understanding (basic, as it's such a complex process). The most reliable way to discover what one's feet are actually doing is to consult a podiatrist who has both the expertise and the equipment - a walking machine and hopefully a video as well - to observe and assess one's gait for biomechanical faults.

Re: Unfortunately......

Carmen H on 2/09/02 at 11:29 (073141)

Once a PF sufferer almost always a PF sufferer. In other words...You are more prone to get it again in your life so I wouldn't give up those orthotics and ugly shoes....never in a lifetime after you get healed.
Careful....
That ugly creep PF sneaks up out of no where as you know!
:-)

Re: Unfortunately......

Carole C in NOLA on 2/09/02 at 17:29 (073187)

Well Pooh, I want it to go away and stay away!! LOL At any rate, enough that I can just wear Birkenstocks or dinky little OTC orthotics and practical, attractive, and comfy shoes (like maybe those gorgeous ones you linked to in the thread at the top of the page), since I have no desire to wear heels or fancy-shmancy dress shoes. I'm not a person that's prone to foot problems, and never had any in my whole 53.25 years before I strained my feet cycling barefoot.

I'm not going to throw out my orthotics and Sherman Tank shoes... but I was definitely hoping they would gather dust in the closet by summer.

Carole C