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An Excellent Website

Posted by john h on 3/08/02 at 14:13 (075965)

Following is one the better websites I have encountered to inform you about feet and help in the selection of shoes. It also has good directons to other websites. Be sure and browse throuhg the Wheeless Manual of Orthopedics on the feet that is avalilable here:

http://sportsmedicine.about.com/library/weekly/aa030799.htm

Re: An Excellent Website

john h on 3/08/02 at 14:45 (075968)

In reading some of the literature today in the Wheeless Book of Orthopedics I read this: 'Foot Orthotics: for most patients foot orthotics will provide only fair success.' 'In the prospective randomized studies by G. Pfeffer MD et al 1999, it was found that when used in conjunction with a stretching program, a prefabricated shoe insert is more likely to produce improvemnent in symptoms than a customized polypropylene device:'

'excision of the plantar spur (which is located at the origin of the FDB & not plantar fascia; there is no evidence that this improves the results over the fascia release and it may actually exacerbate heel pain by altering mechanics of the heel pad;'

I was also reminded that the purpose of the orthotic is not so much support of the arch but to correct other mechanical deficiencies. It would seem to me that all of us should be very careful before we just let a doctor slap a set of custom orthotics on us without very carefull analysing our gait, heel strike, and explaining to us exactly what he/she is trying to correct. My first visit to the doctor he did not even watch me walk and within 10 minutes was casting my feet for $400 rigid orthotics. I do not remember him asking me how much I ran or if I even ran.I really think I became worse after that experience. I would guess there are lots of people out there with orthotics that they do not need or are not really suited to the patient I know I pronate which is natural but to this day I cannot tell you if I over pronate.

Re: To John An Excellent Website

Pauline on 3/08/02 at 16:24 (075973)

John,
Good points John, I've been saying this since I started posting. Physicians can only sell orthotics to people with sore feet that will try anything to get rid of the pain. I've always said orthotics are like peanuts. They are not the universal food for all zoo animals.

There are journel articles that say dependence on orthotics can prevent the foot from maintaining it's natural strength and arch flexibilty.

John, if you and I had a $1.00 for every custom orthotic that was purchased and thrown into a pile, we'd be rich. Just imagine having return deposits put on orthotics similar to pop bottles. We'd all start collecting them tomorrow. Let's make it a high deposit though.

Re: An Excellent Website

Carole C in NOLA on 3/08/02 at 16:37 (075974)

Thanks for the website.

I think you may have an excellent point. It's hard to find a foot professional that knows what he or she is doing, and cares enough to watch you and ask the right questions, and to tell you what you need to know. My custom orthotics are huge and soft, and they hold and support my foot securely in an ideal position that will allow it to heal. They have also straightened out my gait somewhat. I have never had hard orthotics though. Maybe those are more difficult to get right.

John, if you don't severely overpronate, then it's my belief that those motion control shoes that you have would probably mess you up. Didn't you say in a post that I read in the archives, that you have 854's? I think it was you. Take it from one who now knows; if you do not overpronate, the strange effect on your gait and the attention getting after-effects on your knees and back would give you a hint that you don't. (grin)

Carole C

Re: To John An Excellent Website

John h on 3/08/02 at 18:51 (075982)

Pauline: If I had every penny I had paid for a custom orthotic we could revisit Lourdes.

Re: An Excellent Website

John h on 3/08/02 at 18:53 (075983)

Yes Carole I have 854's but as I say I really do not know if I 'over pronate' or not. I do pronate which I think is normal but I do not even know what the difference between 'over pronation' and 'normal pronation' is.

Re: An Excellent Website

nancy s. on 3/08/02 at 19:03 (075985)

and my orthotist called it 'hyperpronation.' i suppose this is the same as overpronation, which i supposedly have, but hyperpronation sounds to me like fast pronation. if so, if must be good: anything fast sounds good since the onslaught of pf etc.!
n.

Re: motion control shoes

Carole C in NOLA on 3/08/02 at 20:26 (075990)

I am beginning to suspect that these motion control shoes can cause some real problems for people who only pronate mildly or who supinate. New Balance specifies on their website that the 854 is to accomodate 'the moderate to severe overpronator'. We have some great threads discussing motion control shoes lately on the Inserts, Orthotics, Shoes message board.

And yes, it's rocket science! Nobody can get an athletic shoe these days without a duel advanced degrees in nuclear physics and materials science.

Carole C (whose Ph.D. is not in either of those, so this is tough!)

Re: motion control shoes

Ed Davis, DPM on 3/08/02 at 20:41 (075992)

Road Runner Sports publishes a catalog which includes an excellent table listing the features of most of the popular models of running shoes---it really takes the complexity out of the decision making process. http://www.roadrunnersports.com
Ed

Re: motion control shoes

Carole C in NOLA on 3/08/02 at 20:45 (075993)

Yes, I've examined their website pretty carefully. Thanks for the tip on their catalog; maybe it has more in it than they have online.

I was really surprised when the 854's caused such radical problems with my gait, because it seemed like everyone here was so gung-ho motion control shoes, and yet we all know that not that many people are severe pronators! I do not markedly supinate, as far as I know. I guess I'm somewhere in between.

Carole C

Re: motion control shoes

John h on 3/08/02 at 21:51 (075999)

Carole: the problem is what is to much pronation. I think the average individual does pronate meaning the foot rolls inward with the foot strike. But how much is to much? If you start having foot problems at age 50 and suddenly change your foot mechanics with an orthotic is their not the danger of making things worse. I really pay attention to how peoples feet strike and roll when I walk behind them at the club track. Some people' feet roll inward so much it looks like they should sprain their feet with every stride. Most people I watch most certainly have a heel strike on the outside of the foot which then rolls in. So when a doctor says you are over pronating by what standard is he making that statement? Is there some medical literature that states if your foot rolls more than 15 degrees inward you need correction? I think that most of us when we examine the heels of our shoes will show the distinctive pronation heel wear. Years ago we would have the cobbler place metal taps on our heels to prevent this wear. I think you have to be a real brainiac to figure out what and if a person needs an orthotic. Part engineer, part doctor, part shoe guy, and with a little voodo mixed in. I have two drawers full of orthotics and have mailed some of the over the counters out to several of you.

Re: More gait uncertainties! (sorry, long post)

Carole C in NOLA on 3/08/02 at 22:42 (076005)

If it matters which side the heels of your shoes wear down first, then I'm a severe supinator, not pronator, because mine are worn down markedly on the lateral side rather than the medial side!!

However, I read a website tonight that said what matters is not the wear on the heels, but the wear on the toes. In that case I am a mild pronator because the toes of my shoes are slightly more worn on the medial side than the lateral side. BG CPed was kind enough to look at photos of my bare feet from the back and front, and brought up the possibility that I might have a subtle cavovarus foot. I read his article with Dr. Manoli about this and understood it, but I can't tell for sure if it applies to me or not. All I know is that I have never felt that I was a severe anything, when it comes to gait. So, basically my conclusion from all these different possibilities is, 'HUH??????' :) I'm pretty sure I'm not a severe pronator, though.

Oh, one other thing, and it has to do with the many causes for PF. Probably some people are prone to PF because of problems with gait. But then there are some that got it simply because they did stupid things that strained their PF, like me with the bike. I don't really think that there's any more likelihood that my gait is faulty than there is likelihood that any random person's gait is faulty. I think if I had been 'good', I never would have got PF. So, the question arises: is gait correction necessary for all of us just because we have PF?

Maybe it is. Maybe a flawless gait will allow us to heal faster. Then 100% of us should wear orthotics until we are better, if we can afford them. I haven't a clue but I suspect this might be the case.

Maybe having PF puts us at risk for getting it again later on, if our gait isn't absolutely perfect, even if we got PF for reasons not related to gait. If so, then maybe identifying the amount of pronation that is too much is essentially the same as identifying how much risk of getting PF again an individual is willing to take, once they are healed.

I agree about the brainiac thing! Still, nobody cares about our feet as much as we do, so in the end if we do not have a formidably excellent DPM available to do indisputably correct gait analysis then we have to be that brainiac and try to figure this out on our own.

If we only lived in the same town, we could make a video tapes of all the heelspurs.com folks walking barefoot from the front and back and sides, and we could make it a movie, and then watch it and post what we observe about everyone's gait. It's really too bad we can't do that!

Carole C

Re: An Excellent Website

Julie on 3/09/02 at 02:02 (076012)

Nancy, 'hyper' hasn't anything to do with speed (in case you weren't joking). It's simply the anatomical term for 'too much' or 'excessive', meaning 'beyond normal'- as in 'hyperextension' to describe a knee joint (or any joint) whose ligaments are too loose to protect it from excessive movement (i.e. movement beyond a certain safe range).

I'm not sure, John, that you need to know at what precise degree, 15% or whatever, the natural rolling-in of the foot after heel strike becomes excessive pronation, and I wouldn't know if orthotics are the treatment of choice for absolutely everyone who pronates too much. But I'm sure that 'too much' rolling in (whatever 'too much' is) puts a strain on the fascia and on other structures, and that if, As Dr Z has many times told us, PF is a repetitive motion injury, 50 years of doing it is likely to result in PF.

I know there are cases of sudden injury bringing on PF, but some of these, at least, may be the cumulative result of years of faulty biomechanics - the straw that broke the camel's back. Just as the so-called 'slipped disc' is the end product of years of poor body use, although the unfortunate person who bends over to take something out of the oven and then can't straighten up for the pain thinks it came like a bolt out of the blue.

Perhaps I was just lucky, but I know that I was (a) correctly diagnosed as an over-pronator (I saw for myself on the video how severely my feet, especially my right (PF) foot roll in) and (b) that the orthotics the pod casted and prescribed helped me.(I do not think this is something that can or should be self-diagnosed.) I would guess that CORRECT correction of the over-pronation fault IS probably generally helpful, as long as the diagnosis is accurate and the orthotics properly casted, prescribed and constructed. But there are obviously many variables, one of them being the skill of the doctor making the diagnosis, others having to do with casting and constructing. And perhaps the people who have drawer full of orthotics they can't wear were unlucky, and the right orthotics would have helped them.

All shoes (well, most, I suppose) will show more wear on the outside heel because that is where the heel strikes. It's after the strike that the foot rolls in - normally or hyperly. Wear on the outside heel is not an indication of supination.

Re: Taps

Julie on 3/09/02 at 02:08 (076013)

John, I can see in my mind's eye the old shoemaker on 174th Street in the Bronx hammering nails into the taps on my lace-up oxfords. He always held the nails between his teeth.

Another trip down memory lane: thanks.

Re: Taps

John h on 3/09/02 at 08:54 (076020)

Wonder why they stopped using the taps Julie? Probably because of the new materials for the heels that lasted longer. Young boys always thought it was cool to hear thos taps strike the pavement.

Re: More gait uncertainties! (sorry, long post)

John h on 3/09/02 at 09:05 (076021)

Carole I am sure no expert in this area but think about this. If your heel strikes the ground first in normal walking and your heels are wearing rapidly on the outside then your heel is first striking the ground on the outside edge where the wear is. This is normal in munderstanding. The foot then rolls inward which I think to be normal. It may be that if your foot roll inward to severely you are an 'over' pronator. I have walked behind some people who's feet roll inward so much that I do not know haw they do not injure their feet. Some people I assume may have a heel strike on the inside of the foot and the foot would then tend to roll outward although walking behind hundreds of people I do not recall one such case. I had the owner of a sporting shoe store have me jog in his store as he watched me from behind and he did say I pronated. He did not say I over pronated. I would surmise you 'over' pronate if you are causing injury to your foot whereas many people go their entire lives with a lot of pronation that causes no problems. Having said all this there is no rule for over pronation it just depends on how your feet are responding. Doctors may sometimes be assuming if we have foot problems that it is mechanical and therefore we need to correct the foot strike they have lived with all their lives. Injuries to other parts of the anatamoy such as the hip,knees,back,achilles could all lead to us changing our heel strike which could ultimately lead to PF. A laymans thoughts. Shoot this down you doctors and put me on the right path.

Re: An Excellent Website

Richard, C.Ped on 3/09/02 at 09:44 (076026)

I have to tell you, the exam is one of my most favorite activities of orthosis fabrication. We had a 15 year old female soccer player come in yesterday with the diagnosis of shin splints and back pain. The script read 'orthosis to fit'. We put this girl through a serious exam. We finally found out she had a 1/4' difference leg length discrepancy.

Everyone should take their time in their exam. There is almost always (at least in my cases) something else going on that has not been addressed.

Richard

Re: An Excellent Website

John h on 3/09/02 at 10:52 (076028)

Richard where do I find someone who will take the time to go through this exhaustive examination and have the expertise to prescribe the correct orthosis or if one is needed. Not all doctors can do this or will do this. This seems to be a speciality all of its own.

Re: Taps

Valerie S on 3/09/02 at 10:57 (076030)

Hi.

Don't know if you guys knew this, but I used to work as a cobbler, fixing shoes... and people DO still use those taps. They make plastic ones now, that don't scuff the floors or make loud noise... but sometimes people would still ask for the metal ones, since they lasted so long. The rubber heels do last longer, although there are still a lot of shoes with crepe soles, and depending on the wearer, these can wear very quickly. Plastic heel protectors (known as 'taps' by you old-timers) are a great solution to make your shoes last longer.

... GEE... I haven't done that in years, and I still sound like a salesman! hee hee... Let me show you these rubber sole protectors, too!

Re: Taps

Julie on 3/09/02 at 11:53 (076032)

So did I! My mom didn't approve, but I loved them.

I imagine they stopped because the disposable society reared its ugly head. Nobody wants to make anything last longer, or fix anything any more.

Makes the world go round, I'm told.

Re: An Excellent Website

Richard, C.Ped on 3/09/02 at 12:57 (076038)

I do not know what to tell you John. Not everyone will give 110% when giving an exam and casting for orthotics. It is sad but true. I would suggest give 'interviews' of potential docs and c.peds.

Richard

Re: Makes sense to me. (nm)

Carole C in NOLA on 3/09/02 at 13:20 (076039)

.

Re: Taps

John h on 3/09/02 at 15:57 (076051)

Valaerie: How very interesting about the taps. If my memory is correct when I was a child it cost between $.10 and a quarter to have the metal taps put on. They generally were place on the back outside of the heel for most people. Thanks as I would never have gussed.

Re: motion control shoes

John h on 3/09/02 at 16:06 (076054)

Carol I just today bought a pair of the New Balance 841 walking shoes. They are the latest shoe they have and if you can believe their hype I should be ready to dance in short order. They do feel comfortable ($98) at Just For Feet. I may just put in the Power Step over the counter insert Dr. Z gave me. Nice wide toe box.

Re: motion control shoes

Carole C in NOLA on 3/09/02 at 17:24 (076064)

Sounds nice, John! I'm glad they feel comfortable right from the start. How did they feel after you wore them for a few more hours? I expect you to be happily dancing the night away tonight. :)

(listening to the faint sounds of dance music floating down from Arkansas)

Carole C

Re: motion control shoes

John h on 3/09/02 at 18:42 (076069)

as you must know Carole that Clogging is the ritual dance of Arkansas. I did walk around for about 3 hours looking for them and then walked 3 miles on the indoor track. doing ok as of right now. it is usually the next day that I have a problem if I am going to have one.

Re: motion control shoes

Carole C in NOLA on 3/09/02 at 19:02 (076071)

Sounds like you are doing well so far! If it was me, I'd ice my feet now because even if they are perfect for you they are still different.

I am the same way; sometimes I can't tell if a shoe is bothering me until the next day or the day after that.

Sorry, John. I don't think you can do clogging unless you are wearing clogs! New Balance won't cut it. Also, no sock hops allowed. Maybe you could do a nice jitterbug in your NB, with your honey. :)

Carole C

Re: motion control shoes

John h on 3/09/02 at 21:38 (076087)

'If you got the money honey, I got the time. We'l go honky tonkin---' who sang that?

Re: motion control shoes

Carole C in NOLA on 3/10/02 at 07:38 (076101)

Willie Nelson, but was he the first? Hope your feet still feel like it this morning... :)

Carole C

Re: An Excellent Website

john h on 3/08/02 at 14:45 (075968)

In reading some of the literature today in the Wheeless Book of Orthopedics I read this: 'Foot Orthotics: for most patients foot orthotics will provide only fair success.' 'In the prospective randomized studies by G. Pfeffer MD et al 1999, it was found that when used in conjunction with a stretching program, a prefabricated shoe insert is more likely to produce improvemnent in symptoms than a customized polypropylene device:'

'excision of the plantar spur (which is located at the origin of the FDB & not plantar fascia; there is no evidence that this improves the results over the fascia release and it may actually exacerbate heel pain by altering mechanics of the heel pad;'

I was also reminded that the purpose of the orthotic is not so much support of the arch but to correct other mechanical deficiencies. It would seem to me that all of us should be very careful before we just let a doctor slap a set of custom orthotics on us without very carefull analysing our gait, heel strike, and explaining to us exactly what he/she is trying to correct. My first visit to the doctor he did not even watch me walk and within 10 minutes was casting my feet for $400 rigid orthotics. I do not remember him asking me how much I ran or if I even ran.I really think I became worse after that experience. I would guess there are lots of people out there with orthotics that they do not need or are not really suited to the patient I know I pronate which is natural but to this day I cannot tell you if I over pronate.

Re: To John An Excellent Website

Pauline on 3/08/02 at 16:24 (075973)

John,
Good points John, I've been saying this since I started posting. Physicians can only sell orthotics to people with sore feet that will try anything to get rid of the pain. I've always said orthotics are like peanuts. They are not the universal food for all zoo animals.

There are journel articles that say dependence on orthotics can prevent the foot from maintaining it's natural strength and arch flexibilty.

John, if you and I had a $1.00 for every custom orthotic that was purchased and thrown into a pile, we'd be rich. Just imagine having return deposits put on orthotics similar to pop bottles. We'd all start collecting them tomorrow. Let's make it a high deposit though.

Re: An Excellent Website

Carole C in NOLA on 3/08/02 at 16:37 (075974)

Thanks for the website.

I think you may have an excellent point. It's hard to find a foot professional that knows what he or she is doing, and cares enough to watch you and ask the right questions, and to tell you what you need to know. My custom orthotics are huge and soft, and they hold and support my foot securely in an ideal position that will allow it to heal. They have also straightened out my gait somewhat. I have never had hard orthotics though. Maybe those are more difficult to get right.

John, if you don't severely overpronate, then it's my belief that those motion control shoes that you have would probably mess you up. Didn't you say in a post that I read in the archives, that you have 854's? I think it was you. Take it from one who now knows; if you do not overpronate, the strange effect on your gait and the attention getting after-effects on your knees and back would give you a hint that you don't. (grin)

Carole C

Re: To John An Excellent Website

John h on 3/08/02 at 18:51 (075982)

Pauline: If I had every penny I had paid for a custom orthotic we could revisit Lourdes.

Re: An Excellent Website

John h on 3/08/02 at 18:53 (075983)

Yes Carole I have 854's but as I say I really do not know if I 'over pronate' or not. I do pronate which I think is normal but I do not even know what the difference between 'over pronation' and 'normal pronation' is.

Re: An Excellent Website

nancy s. on 3/08/02 at 19:03 (075985)

and my orthotist called it 'hyperpronation.' i suppose this is the same as overpronation, which i supposedly have, but hyperpronation sounds to me like fast pronation. if so, if must be good: anything fast sounds good since the onslaught of pf etc.!
n.

Re: motion control shoes

Carole C in NOLA on 3/08/02 at 20:26 (075990)

I am beginning to suspect that these motion control shoes can cause some real problems for people who only pronate mildly or who supinate. New Balance specifies on their website that the 854 is to accomodate 'the moderate to severe overpronator'. We have some great threads discussing motion control shoes lately on the Inserts, Orthotics, Shoes message board.

And yes, it's rocket science! Nobody can get an athletic shoe these days without a duel advanced degrees in nuclear physics and materials science.

Carole C (whose Ph.D. is not in either of those, so this is tough!)

Re: motion control shoes

Ed Davis, DPM on 3/08/02 at 20:41 (075992)

Road Runner Sports publishes a catalog which includes an excellent table listing the features of most of the popular models of running shoes---it really takes the complexity out of the decision making process. http://www.roadrunnersports.com
Ed

Re: motion control shoes

Carole C in NOLA on 3/08/02 at 20:45 (075993)

Yes, I've examined their website pretty carefully. Thanks for the tip on their catalog; maybe it has more in it than they have online.

I was really surprised when the 854's caused such radical problems with my gait, because it seemed like everyone here was so gung-ho motion control shoes, and yet we all know that not that many people are severe pronators! I do not markedly supinate, as far as I know. I guess I'm somewhere in between.

Carole C

Re: motion control shoes

John h on 3/08/02 at 21:51 (075999)

Carole: the problem is what is to much pronation. I think the average individual does pronate meaning the foot rolls inward with the foot strike. But how much is to much? If you start having foot problems at age 50 and suddenly change your foot mechanics with an orthotic is their not the danger of making things worse. I really pay attention to how peoples feet strike and roll when I walk behind them at the club track. Some people' feet roll inward so much it looks like they should sprain their feet with every stride. Most people I watch most certainly have a heel strike on the outside of the foot which then rolls in. So when a doctor says you are over pronating by what standard is he making that statement? Is there some medical literature that states if your foot rolls more than 15 degrees inward you need correction? I think that most of us when we examine the heels of our shoes will show the distinctive pronation heel wear. Years ago we would have the cobbler place metal taps on our heels to prevent this wear. I think you have to be a real brainiac to figure out what and if a person needs an orthotic. Part engineer, part doctor, part shoe guy, and with a little voodo mixed in. I have two drawers full of orthotics and have mailed some of the over the counters out to several of you.

Re: More gait uncertainties! (sorry, long post)

Carole C in NOLA on 3/08/02 at 22:42 (076005)

If it matters which side the heels of your shoes wear down first, then I'm a severe supinator, not pronator, because mine are worn down markedly on the lateral side rather than the medial side!!

However, I read a website tonight that said what matters is not the wear on the heels, but the wear on the toes. In that case I am a mild pronator because the toes of my shoes are slightly more worn on the medial side than the lateral side. BG CPed was kind enough to look at photos of my bare feet from the back and front, and brought up the possibility that I might have a subtle cavovarus foot. I read his article with Dr. Manoli about this and understood it, but I can't tell for sure if it applies to me or not. All I know is that I have never felt that I was a severe anything, when it comes to gait. So, basically my conclusion from all these different possibilities is, 'HUH??????' :) I'm pretty sure I'm not a severe pronator, though.

Oh, one other thing, and it has to do with the many causes for PF. Probably some people are prone to PF because of problems with gait. But then there are some that got it simply because they did stupid things that strained their PF, like me with the bike. I don't really think that there's any more likelihood that my gait is faulty than there is likelihood that any random person's gait is faulty. I think if I had been 'good', I never would have got PF. So, the question arises: is gait correction necessary for all of us just because we have PF?

Maybe it is. Maybe a flawless gait will allow us to heal faster. Then 100% of us should wear orthotics until we are better, if we can afford them. I haven't a clue but I suspect this might be the case.

Maybe having PF puts us at risk for getting it again later on, if our gait isn't absolutely perfect, even if we got PF for reasons not related to gait. If so, then maybe identifying the amount of pronation that is too much is essentially the same as identifying how much risk of getting PF again an individual is willing to take, once they are healed.

I agree about the brainiac thing! Still, nobody cares about our feet as much as we do, so in the end if we do not have a formidably excellent DPM available to do indisputably correct gait analysis then we have to be that brainiac and try to figure this out on our own.

If we only lived in the same town, we could make a video tapes of all the heelspurs.com folks walking barefoot from the front and back and sides, and we could make it a movie, and then watch it and post what we observe about everyone's gait. It's really too bad we can't do that!

Carole C

Re: An Excellent Website

Julie on 3/09/02 at 02:02 (076012)

Nancy, 'hyper' hasn't anything to do with speed (in case you weren't joking). It's simply the anatomical term for 'too much' or 'excessive', meaning 'beyond normal'- as in 'hyperextension' to describe a knee joint (or any joint) whose ligaments are too loose to protect it from excessive movement (i.e. movement beyond a certain safe range).

I'm not sure, John, that you need to know at what precise degree, 15% or whatever, the natural rolling-in of the foot after heel strike becomes excessive pronation, and I wouldn't know if orthotics are the treatment of choice for absolutely everyone who pronates too much. But I'm sure that 'too much' rolling in (whatever 'too much' is) puts a strain on the fascia and on other structures, and that if, As Dr Z has many times told us, PF is a repetitive motion injury, 50 years of doing it is likely to result in PF.

I know there are cases of sudden injury bringing on PF, but some of these, at least, may be the cumulative result of years of faulty biomechanics - the straw that broke the camel's back. Just as the so-called 'slipped disc' is the end product of years of poor body use, although the unfortunate person who bends over to take something out of the oven and then can't straighten up for the pain thinks it came like a bolt out of the blue.

Perhaps I was just lucky, but I know that I was (a) correctly diagnosed as an over-pronator (I saw for myself on the video how severely my feet, especially my right (PF) foot roll in) and (b) that the orthotics the pod casted and prescribed helped me.(I do not think this is something that can or should be self-diagnosed.) I would guess that CORRECT correction of the over-pronation fault IS probably generally helpful, as long as the diagnosis is accurate and the orthotics properly casted, prescribed and constructed. But there are obviously many variables, one of them being the skill of the doctor making the diagnosis, others having to do with casting and constructing. And perhaps the people who have drawer full of orthotics they can't wear were unlucky, and the right orthotics would have helped them.

All shoes (well, most, I suppose) will show more wear on the outside heel because that is where the heel strikes. It's after the strike that the foot rolls in - normally or hyperly. Wear on the outside heel is not an indication of supination.

Re: Taps

Julie on 3/09/02 at 02:08 (076013)

John, I can see in my mind's eye the old shoemaker on 174th Street in the Bronx hammering nails into the taps on my lace-up oxfords. He always held the nails between his teeth.

Another trip down memory lane: thanks.

Re: Taps

John h on 3/09/02 at 08:54 (076020)

Wonder why they stopped using the taps Julie? Probably because of the new materials for the heels that lasted longer. Young boys always thought it was cool to hear thos taps strike the pavement.

Re: More gait uncertainties! (sorry, long post)

John h on 3/09/02 at 09:05 (076021)

Carole I am sure no expert in this area but think about this. If your heel strikes the ground first in normal walking and your heels are wearing rapidly on the outside then your heel is first striking the ground on the outside edge where the wear is. This is normal in munderstanding. The foot then rolls inward which I think to be normal. It may be that if your foot roll inward to severely you are an 'over' pronator. I have walked behind some people who's feet roll inward so much that I do not know haw they do not injure their feet. Some people I assume may have a heel strike on the inside of the foot and the foot would then tend to roll outward although walking behind hundreds of people I do not recall one such case. I had the owner of a sporting shoe store have me jog in his store as he watched me from behind and he did say I pronated. He did not say I over pronated. I would surmise you 'over' pronate if you are causing injury to your foot whereas many people go their entire lives with a lot of pronation that causes no problems. Having said all this there is no rule for over pronation it just depends on how your feet are responding. Doctors may sometimes be assuming if we have foot problems that it is mechanical and therefore we need to correct the foot strike they have lived with all their lives. Injuries to other parts of the anatamoy such as the hip,knees,back,achilles could all lead to us changing our heel strike which could ultimately lead to PF. A laymans thoughts. Shoot this down you doctors and put me on the right path.

Re: An Excellent Website

Richard, C.Ped on 3/09/02 at 09:44 (076026)

I have to tell you, the exam is one of my most favorite activities of orthosis fabrication. We had a 15 year old female soccer player come in yesterday with the diagnosis of shin splints and back pain. The script read 'orthosis to fit'. We put this girl through a serious exam. We finally found out she had a 1/4' difference leg length discrepancy.

Everyone should take their time in their exam. There is almost always (at least in my cases) something else going on that has not been addressed.

Richard

Re: An Excellent Website

John h on 3/09/02 at 10:52 (076028)

Richard where do I find someone who will take the time to go through this exhaustive examination and have the expertise to prescribe the correct orthosis or if one is needed. Not all doctors can do this or will do this. This seems to be a speciality all of its own.

Re: Taps

Valerie S on 3/09/02 at 10:57 (076030)

Hi.

Don't know if you guys knew this, but I used to work as a cobbler, fixing shoes... and people DO still use those taps. They make plastic ones now, that don't scuff the floors or make loud noise... but sometimes people would still ask for the metal ones, since they lasted so long. The rubber heels do last longer, although there are still a lot of shoes with crepe soles, and depending on the wearer, these can wear very quickly. Plastic heel protectors (known as 'taps' by you old-timers) are a great solution to make your shoes last longer.

... GEE... I haven't done that in years, and I still sound like a salesman! hee hee... Let me show you these rubber sole protectors, too!

Re: Taps

Julie on 3/09/02 at 11:53 (076032)

So did I! My mom didn't approve, but I loved them.

I imagine they stopped because the disposable society reared its ugly head. Nobody wants to make anything last longer, or fix anything any more.

Makes the world go round, I'm told.

Re: An Excellent Website

Richard, C.Ped on 3/09/02 at 12:57 (076038)

I do not know what to tell you John. Not everyone will give 110% when giving an exam and casting for orthotics. It is sad but true. I would suggest give 'interviews' of potential docs and c.peds.

Richard

Re: Makes sense to me. (nm)

Carole C in NOLA on 3/09/02 at 13:20 (076039)

.

Re: Taps

John h on 3/09/02 at 15:57 (076051)

Valaerie: How very interesting about the taps. If my memory is correct when I was a child it cost between $.10 and a quarter to have the metal taps put on. They generally were place on the back outside of the heel for most people. Thanks as I would never have gussed.

Re: motion control shoes

John h on 3/09/02 at 16:06 (076054)

Carol I just today bought a pair of the New Balance 841 walking shoes. They are the latest shoe they have and if you can believe their hype I should be ready to dance in short order. They do feel comfortable ($98) at Just For Feet. I may just put in the Power Step over the counter insert Dr. Z gave me. Nice wide toe box.

Re: motion control shoes

Carole C in NOLA on 3/09/02 at 17:24 (076064)

Sounds nice, John! I'm glad they feel comfortable right from the start. How did they feel after you wore them for a few more hours? I expect you to be happily dancing the night away tonight. :)

(listening to the faint sounds of dance music floating down from Arkansas)

Carole C

Re: motion control shoes

John h on 3/09/02 at 18:42 (076069)

as you must know Carole that Clogging is the ritual dance of Arkansas. I did walk around for about 3 hours looking for them and then walked 3 miles on the indoor track. doing ok as of right now. it is usually the next day that I have a problem if I am going to have one.

Re: motion control shoes

Carole C in NOLA on 3/09/02 at 19:02 (076071)

Sounds like you are doing well so far! If it was me, I'd ice my feet now because even if they are perfect for you they are still different.

I am the same way; sometimes I can't tell if a shoe is bothering me until the next day or the day after that.

Sorry, John. I don't think you can do clogging unless you are wearing clogs! New Balance won't cut it. Also, no sock hops allowed. Maybe you could do a nice jitterbug in your NB, with your honey. :)

Carole C

Re: motion control shoes

John h on 3/09/02 at 21:38 (076087)

'If you got the money honey, I got the time. We'l go honky tonkin---' who sang that?

Re: motion control shoes

Carole C in NOLA on 3/10/02 at 07:38 (076101)

Willie Nelson, but was he the first? Hope your feet still feel like it this morning... :)

Carole C