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NEED HELP - Calling Richard, BG, Dr. Ed and Dr.Z!!!

Posted by D.Thomas on 4/19/02 at 11:58 (080310)

Background: I was first diagnosed with PF about 7 years ago. I have high arches. The pain has always mainly been in the medial arch of both feet. Different orthotics seems to have worked until April 27th, 2001. That is the date when the real pain started and hasn't ended. The pain intiallly started because I started walking a month before the date.

The orthotics I was wearing was full length and only had arch supports from what I understand. They were made out of cork for the support in the arch and had a soft cover over the cork for the full length. When the pain started I went back to the person who made the orthotics and all he did was add cork to the arch which really didn't help that much. These orthotics appeared to have helped before April 27th as long as I didn't stay on my feet that long.

Since April 27th, I have seen 4 different Pods, 2 different Orthos, 3 different PTs and have tried 4 different orthotics. I tried a ¾ hard plastic that pushed way up in my arches, these almost put me into a wheelchair. I also tried the OTC Powersteps and the ones mentioned below. I have also been to physical therapy twice and increased my flexibility greatly but this has not helped the pain go away.

I found a good Pod I pretty much trust and here is his diagnosis (I might misspell some words because it is hard to read his writing):

Forefoot Valgus of 6 degree bilaterally
Relaxed Calcaneal stance position of 5 degree Varus bilaterally

Cavus Foot Type

The prescription he used was 'completely posted the forefoot.' It seem to lower the pain in the arch but I started getting weird vibration sensations in my feet along the inside heels and along the bottom. He lowered the prescription twice and it never stopped the vibration feeling and the arch tended to hurt more with each lowering of the prescription. The orthotic was a ¾ hard plastic with a soft full length cover glued on top. There was no arch support built in because the prescription was supposed to do the work. I also tried the Powerstep OTC which also made my pain worse in the arch. I have gone back to my cork arch supports because the pain is somewhat lower in them.

Any ideas or experience? I need all I can get, because it appears surgery is my next step. If you need more info let me know and Ill try and find out.

Thanks in advance.

Re: NEED HELP - Calling Richard, BG, Dr. Ed and Dr.Z!!!

Ed Davis, DPM on 4/19/02 at 18:55 (080375)

It may be possible to poorly tolerate an excellent orthotic if you have limited ankle dorsiflexion range of motion. That seems to occur more commonly in high arched individuals. Need to get that checked!
Ed

Re: NEED HELP - Calling Richard, BG, Dr. Ed and Dr.Z!!!

Sandy H. on 4/20/02 at 22:36 (080521)

You've had PF way longer than me (just 2 years since my first symptoms) but before you have surgery try not wearing orthotics but always wearing motion control shoes like Asics 2060, New Balance 854 and well cushioned dress shoes. The reason why I say that is that my experience sounds similar to yours. I got mild PF and then I was given orthotics that made it worse PF so I went to get the orthotics adjusted and they jacked up the arch which made it terrible PF and a whole range of ankle and other pains. I stopped wearing orthotics and the other pain went away leaving me with PF. Now I wear the motion control shoes only and those Timberlands I just posted about. I'm not nearly cured but having only mild reaction to yesterday's 3 hour mountain hike (can't run or walk fast) today. Obviously what I suggest could make things worse but surgery sounds very unappealing given the feedback posted on these boards.

Re: NEED HELP - Calling Richard, BG, Dr. Ed and Dr.Z!!!

BGCPed on 4/21/02 at 12:29 (080562)

If your foot is in that position I would ask if the orthotics have a cut out for the first met head. Also what type of forefoot post it has under 2 thru 5 met heads. Without seeing your foot and orthotic cant say for sure but you most likely have a plantarflexed 1st met that needs to be addressed. Also Dr Ed is correct you probably have tight h cord. I would also make sure you dont wear a motion control running shoe and maybe have a 3 or 4 mm lift under both heels of the device. It is not a cure for tight h cords but it will reduce some of the pull on them which may free up the foot a bit.

As I stated before if you can post a few pics of your feet from front and back wt bearing and your shoes and orthotic it may help

Re: NEED HELP - Calling Richard, BG, Dr. Ed and Dr.Z!!!

D.Thomas on 4/21/02 at 21:09 (080606)

Ok that's it. I'm calling Dr. Manoli tomorrow and setting up an appoitment. I would love to go to Seattle to see Dr. Ed, but that trip is too far and my feet would be killing me by the time I got there. I don't think they would let me ice them on the plane :) BG, I'll be seeing you in a couple of weeks and I'll bring all my orthotics and stuff. That's also interesting, the PT I was seeing told me he would be interested in seeing if we cut out a hole for the 1st met in the orthotic because of what he saw with my feet. You might have something there.

Thanks all for the help and suggestions.

And I'm not in motion control shoes. They kill me. The only shoe I can tolerate right now is the Saucony Grid Jazz.

Re: NEED HELP - Calling Richard, BG, Dr. Ed and Dr.Z!!!

BGCPed on 4/22/02 at 00:05 (080622)

Ok sounds good. I would bet that you would benefit greatly from a cut out 1st, and if you do and it has not been done then you are missing a crucial link IMHO. You may also want to try the New Bal 829/830 it is a good cusion shoe and comes in widths

Re: NEED HELP - Calling Richard, BG, Dr. Ed and Dr.Z!!!

D.Thomas on 4/22/02 at 10:17 (080640)

Wow, he is busy. The nearest date open is May 28th. I told them to put me on a list to be sooner if possible. Do I have to request you or do they automatically setup a appoitment with you?

Re: NEED HELP - Calling Richard, BG, Dr. Ed and Dr.Z!!!

BGCPed on 4/22/02 at 17:36 (080713)

Yes he is busy and Sue already called today to set up your visit with me. Hope we can help, I think we can

Re: NEED HELP - Calling Richard, BG, Dr. Ed and Dr.Z!!!

Ed Davis, DPM on 4/19/02 at 18:55 (080375)

It may be possible to poorly tolerate an excellent orthotic if you have limited ankle dorsiflexion range of motion. That seems to occur more commonly in high arched individuals. Need to get that checked!
Ed

Re: NEED HELP - Calling Richard, BG, Dr. Ed and Dr.Z!!!

Sandy H. on 4/20/02 at 22:36 (080521)

You've had PF way longer than me (just 2 years since my first symptoms) but before you have surgery try not wearing orthotics but always wearing motion control shoes like Asics 2060, New Balance 854 and well cushioned dress shoes. The reason why I say that is that my experience sounds similar to yours. I got mild PF and then I was given orthotics that made it worse PF so I went to get the orthotics adjusted and they jacked up the arch which made it terrible PF and a whole range of ankle and other pains. I stopped wearing orthotics and the other pain went away leaving me with PF. Now I wear the motion control shoes only and those Timberlands I just posted about. I'm not nearly cured but having only mild reaction to yesterday's 3 hour mountain hike (can't run or walk fast) today. Obviously what I suggest could make things worse but surgery sounds very unappealing given the feedback posted on these boards.

Re: NEED HELP - Calling Richard, BG, Dr. Ed and Dr.Z!!!

BGCPed on 4/21/02 at 12:29 (080562)

If your foot is in that position I would ask if the orthotics have a cut out for the first met head. Also what type of forefoot post it has under 2 thru 5 met heads. Without seeing your foot and orthotic cant say for sure but you most likely have a plantarflexed 1st met that needs to be addressed. Also Dr Ed is correct you probably have tight h cord. I would also make sure you dont wear a motion control running shoe and maybe have a 3 or 4 mm lift under both heels of the device. It is not a cure for tight h cords but it will reduce some of the pull on them which may free up the foot a bit.

As I stated before if you can post a few pics of your feet from front and back wt bearing and your shoes and orthotic it may help

Re: NEED HELP - Calling Richard, BG, Dr. Ed and Dr.Z!!!

D.Thomas on 4/21/02 at 21:09 (080606)

Ok that's it. I'm calling Dr. Manoli tomorrow and setting up an appoitment. I would love to go to Seattle to see Dr. Ed, but that trip is too far and my feet would be killing me by the time I got there. I don't think they would let me ice them on the plane :) BG, I'll be seeing you in a couple of weeks and I'll bring all my orthotics and stuff. That's also interesting, the PT I was seeing told me he would be interested in seeing if we cut out a hole for the 1st met in the orthotic because of what he saw with my feet. You might have something there.

Thanks all for the help and suggestions.

And I'm not in motion control shoes. They kill me. The only shoe I can tolerate right now is the Saucony Grid Jazz.

Re: NEED HELP - Calling Richard, BG, Dr. Ed and Dr.Z!!!

BGCPed on 4/22/02 at 00:05 (080622)

Ok sounds good. I would bet that you would benefit greatly from a cut out 1st, and if you do and it has not been done then you are missing a crucial link IMHO. You may also want to try the New Bal 829/830 it is a good cusion shoe and comes in widths

Re: NEED HELP - Calling Richard, BG, Dr. Ed and Dr.Z!!!

D.Thomas on 4/22/02 at 10:17 (080640)

Wow, he is busy. The nearest date open is May 28th. I told them to put me on a list to be sooner if possible. Do I have to request you or do they automatically setup a appoitment with you?

Re: NEED HELP - Calling Richard, BG, Dr. Ed and Dr.Z!!!

BGCPed on 4/22/02 at 17:36 (080713)

Yes he is busy and Sue already called today to set up your visit with me. Hope we can help, I think we can