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Silly Question?

Posted by Rich on 4/11/02 at 13:33 (079279)

Ok, I have a silly question for all of you? My pod doesn't believe custom orthotics would work for me. He doesn't think I could stand the break-in period and doesn't want me to waste my money. I think that is very insightful and considerate of him! But from what I read here, almost everyone seems to be in custom orthos...

He has been really caring and conservative in my treatment. I asked about Birks with summer coming closer and he said only closed shoe, no slip-ons yet. To stay in my New Balance athletics. He did have me buy a specific OTC insert for motion control and it helped.

He's never checked my gait, that I'm aware of, only xray and MRI. I'm just curious about some of the statements that I've read here. I'm still in my boot cast, but with the warm weather...I'm thinking ahead. Thanks!

Rich

Re: Silly Question?

Carole C in NOLA on 4/11/02 at 16:13 (079314)

Rich, I don't have a pod (which has its advantages as well as disadvantages).

A lot of us have custom orthotics, but I've read quite a few posts from people who had less than perfect experiences with them. Mine have been great.

If your New Balance are working for you, with that insert, maybe that's why he wants you to continue this set-up. (?) I had a hard time finding a New Balance that I could wear comfortably. I now have a pair that I can wear for short periods of time, but I haven't yet tried to wear them for a full day. I probably can now, but I don't think I could have worn them when my PF was worse.

If he doesn't want you to wear *any* slip-on, how does he expect you to get from your bed to the bathroom in the middle of the night? That sure seems unrealistic to me. Well, but bear in mind that I'm 53 and like a lot of people my age, I do find myself making that trek almost every night in the wee hours and I need something I can slip into quickly.

Some people don't like Birkenstocks because they pull on the Achilles tendon due to the lowered heel. Maybe that contributes to his reasoning about them.

I would feel gypped if I went to a pod and he didn't check my gait (but then I've never been to one). As I recall, you had to demand the MRI, too. It makes me wonder if he is any good.

However, since I'm not a foot doctor and have never even seen one, I can't really draw any conclusions about that.

Carole C

Re: Silly Question?

Ed Davis, DPM on 4/11/02 at 21:41 (079361)

Rich:

Some podiatrists have a strong biomechanical orientation and others do not?
Why does you pod believe that you could not stand the break in period?

Consider another opinion. Docs who lack confidence in orthotic therapy may have formed their opinions because they have not gotten good results with orthotics.
Ed

Re: Thanks Dr. Ed.

Rich on 4/12/02 at 10:17 (079421)

He feels that if I experience pain with them that I will just toss them in the closet and waste my money. He told me that was his experience, he does order orthos and will if I choose, he just doesn't think I will wear them faithfully with pain.

I tried soft gel OTC, they made my problem worse but I still couldn't stand not to have something in my shoes. Then he had me try Sof-Sole Motion contro inserts for my New Balance. I felt immediate relief and continue to wear them. He did say that if he ordered me orthos they would be almost identical to the OTC, not to mention the cost.

Everything I read hear makes me wonder?

Rich

Re: Thanks Dr. Ed.

Carole C in NOLA on 4/12/02 at 10:45 (079426)

Rich, our feet are probably different but the first time I put on my soft custom orthotics I was more comfortable standing and walking in them than I was sitting down. They felt even more wonderful after the Pedorthist made some immediate adjustments (kind of 'tweaking' them so that they were perfect for me).

Pain due to my orthotics has never been an issue, and I don't think it's a foregone conclusion that you would experience any pain with custom orthotics either. So, basically I think that Dr. Ed has a good point. Maybe this guy is just no good at making and fitting custom orthotics, and doesn't know a good pedorthist like mine.

Carole C

Re: Silly Question?

R C on 4/15/02 at 12:43 (079710)

Rich,

I am not a Doctor, but I had PF for 2 years. I had no luck with custom orthotics. On the third try to custom fit, the computer-designed orthotic was so high arched that my heel and toes couldn't touch the surface at the same time. I guess it depends on the peculiarities of your feet, the quality of the design process, and the skill of the doctor (who determines the correction).

I had mixed success with off-the-counter orthotics. Two brands I tried were very harsh and aggravated the injury, even after being tweaked by the podiatrist. A third brand, tweaked by a second podiatrist, was better, but only served to hold the line.

Ultimately I was cured by (1) 4 weeks in a hard cast, using crutches to keep off the injured foot (2) 4 weeks plus of physical therapy to restore flexibility and strength (using night splints also) (3) daily stretching the preserve the progress.

Best of luck
RC

Re: RC?

Rich on 4/15/02 at 22:19 (079790)

I hope to wean out of the boot cast soon...thanks for sharing what worked for you. I already have the night splint, but it's so hard to tolerate! Not my favorite thing!! LOL

Glad to hear about your progress....keep it up!

Rich

Re: Silly Question?

Carole C in NOLA on 4/11/02 at 16:13 (079314)

Rich, I don't have a pod (which has its advantages as well as disadvantages).

A lot of us have custom orthotics, but I've read quite a few posts from people who had less than perfect experiences with them. Mine have been great.

If your New Balance are working for you, with that insert, maybe that's why he wants you to continue this set-up. (?) I had a hard time finding a New Balance that I could wear comfortably. I now have a pair that I can wear for short periods of time, but I haven't yet tried to wear them for a full day. I probably can now, but I don't think I could have worn them when my PF was worse.

If he doesn't want you to wear *any* slip-on, how does he expect you to get from your bed to the bathroom in the middle of the night? That sure seems unrealistic to me. Well, but bear in mind that I'm 53 and like a lot of people my age, I do find myself making that trek almost every night in the wee hours and I need something I can slip into quickly.

Some people don't like Birkenstocks because they pull on the Achilles tendon due to the lowered heel. Maybe that contributes to his reasoning about them.

I would feel gypped if I went to a pod and he didn't check my gait (but then I've never been to one). As I recall, you had to demand the MRI, too. It makes me wonder if he is any good.

However, since I'm not a foot doctor and have never even seen one, I can't really draw any conclusions about that.

Carole C

Re: Silly Question?

Ed Davis, DPM on 4/11/02 at 21:41 (079361)

Rich:

Some podiatrists have a strong biomechanical orientation and others do not?
Why does you pod believe that you could not stand the break in period?

Consider another opinion. Docs who lack confidence in orthotic therapy may have formed their opinions because they have not gotten good results with orthotics.
Ed

Re: Thanks Dr. Ed.

Rich on 4/12/02 at 10:17 (079421)

He feels that if I experience pain with them that I will just toss them in the closet and waste my money. He told me that was his experience, he does order orthos and will if I choose, he just doesn't think I will wear them faithfully with pain.

I tried soft gel OTC, they made my problem worse but I still couldn't stand not to have something in my shoes. Then he had me try Sof-Sole Motion contro inserts for my New Balance. I felt immediate relief and continue to wear them. He did say that if he ordered me orthos they would be almost identical to the OTC, not to mention the cost.

Everything I read hear makes me wonder?

Rich

Re: Thanks Dr. Ed.

Carole C in NOLA on 4/12/02 at 10:45 (079426)

Rich, our feet are probably different but the first time I put on my soft custom orthotics I was more comfortable standing and walking in them than I was sitting down. They felt even more wonderful after the Pedorthist made some immediate adjustments (kind of 'tweaking' them so that they were perfect for me).

Pain due to my orthotics has never been an issue, and I don't think it's a foregone conclusion that you would experience any pain with custom orthotics either. So, basically I think that Dr. Ed has a good point. Maybe this guy is just no good at making and fitting custom orthotics, and doesn't know a good pedorthist like mine.

Carole C

Re: Silly Question?

R C on 4/15/02 at 12:43 (079710)

Rich,

I am not a Doctor, but I had PF for 2 years. I had no luck with custom orthotics. On the third try to custom fit, the computer-designed orthotic was so high arched that my heel and toes couldn't touch the surface at the same time. I guess it depends on the peculiarities of your feet, the quality of the design process, and the skill of the doctor (who determines the correction).

I had mixed success with off-the-counter orthotics. Two brands I tried were very harsh and aggravated the injury, even after being tweaked by the podiatrist. A third brand, tweaked by a second podiatrist, was better, but only served to hold the line.

Ultimately I was cured by (1) 4 weeks in a hard cast, using crutches to keep off the injured foot (2) 4 weeks plus of physical therapy to restore flexibility and strength (using night splints also) (3) daily stretching the preserve the progress.

Best of luck
RC

Re: RC?

Rich on 4/15/02 at 22:19 (079790)

I hope to wean out of the boot cast soon...thanks for sharing what worked for you. I already have the night splint, but it's so hard to tolerate! Not my favorite thing!! LOL

Glad to hear about your progress....keep it up!

Rich