Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

a word about finding the right orthotics

Posted by elliott on 7/16/02 at 09:31 (089765)

This has always been a major problem on this board. As with many of you, I myself have a pair of useless ice scrapers sitting in a drawer.

Dr. Ed has consistently given great advice here, most of it heeded. He has repeatedly and strongly recommended Northwest Podiatric orthotics, but that advice has gone largely unheeded; it's whatever one's pod or orthotist gives them.

Around four months ago, I got me a pair of the above orthotics in a last-ditch effort to avoid a massive surgery on a foot constantly near collapse, and which had been that way for over 1.5 years since shortly after a previous surgery that didn't go well. New surgeon sent me to a specific pod he held in high regard for this purpose. After the three-week break-in period, I noticed immediate improvement. Four months later, I can walk again, more or less without pain. (A couple of weeks ago, I unintentionally ended up walking 8 miles on a trail and had no ill effects; I haven't walked more than a mile or two straight in over a year.) The foot still doesn't feel exactly right and is not completely normal yet (if it ever will be), but it sure is nice to walk again. Now about running: maybe if I give it another 4 months...

Anyway, I don't think it's just that I lucked out. The difference between this pair and my previous ones is like night and day. Aside from fitting like a charm and actually being comfortable, these orthotics are superthin, superstrong, superlightweight, made from advanced space-age material. Don't underestimate the importance of this. Getting orthotics to fit and function in your shoes can be a major problem (for example, if your orthotics raise your foot above the level of the medial stiffness on the side of your shoe, you're in trouble). These make it less of a problem.

If you're going to try only one pair of orthotics, I suggest this be it. If you've tried others without success, suggest you must give these a chance before giving up. Mine cost $389; fortunately my insurance entitles me to one pair a year, so I had to pay only $89. But even $400 is a small price to pay to be able to walk.

If interested, here's how to find a pod to fit you. Go to Northwest Podiatric's website,

http://www.nwpodiatric.com

Click on 'doctor search', 'agree', map of U.S. (who needs Canada anyway? OK, just kidding), then click on *both* the 'Enter your state' circle *and* your own state in the drop-down menu (it doesn't work otherwise; poor programming if you ask me). Do the search, and it will spit out all the providers of this orthotic in your state. If you don't recognize any of the names or want to narrow it down to ensure a better provider, suggest asking runners who they go to for orthotics (they have greater performance needs and usually seek out the best), or call up a running club in your area (most have web sites, so in a web searcher just type in something like [your state/city]and 'road runner's club', and I betcha a site pops up), call the President of the club and ask them which pod they recommend for orthotics (I did this once and they recommended the same pod I was sent to!), and see if there's a match. In addition to getting the mold right, there are still a few decisions the pod must make for you (length, material, a few custom options), so you want someone who knows what he's doing. My material is called Superglass. Strong, yet a drop flexible for comfort. Mine is not full-length; it stops right before my toes. This ended up being good for me, as I usually need more toe room in shoes and this way I get it (even more if a shoe has a removable insert and I remove it and replace it with my orthotic; the slight drop in front of the shoe usually doesn't bother me). Pod did offer to give me a second pair, full-length, for his cost price if requested within the next three months (before the mold is thrown out), so you do have that option, although I decided I didn't need it. My pod told me that my orthotic should outlive me (I hope that doesn't mean I have only two years to live :-)), and I would need a new pair only if my arch changed shape over time (less likely the older you are).

A word about shoes: you must have a proper pair of shoes accompanying your orthotics. If you need support and the shoe is too cushy, your foot and orthotic will just sink down into the shoe and be unstable and the orthotic won't work. I tried several pairs of shoes and they didn't work until I found ones with proper support. This doesn't mean you need a pedorthist or custom shoe. Start by trying on appropriate running shoes with your orthotics in a real (not mall) running shoe store, since you can usually find something that fits and works (you should know whether you need cushioned class, stability, or motion control, with the very general rule being high-arched, medium, low-arched in that order). If none near you, do the mail-order thing and exchange till you get it right. I needed something more like motion-control shoes (many of today's versions are still comfortable). I found both an ideal running shoe and a good enough black walking shoe (for work). Note: I found that shoes like SAS do not offer stability and support at all, even though they feel oh so good trying them on and orthotics fit well in them, and even though they have a firm heel counter. This is not enough. If you need support, as a test, press the midsole at the (inner) arch of the shoe you're considering; it should be firm. If it seems too mushy, it's no good. (May take a little practice and some blown shoes to get a feel for this.)

So here's my simple rule for orthotics: try Northwest Podiatric orthotics in the right kind of shoe and allow for a breakin period; if that doesn't work, chances are you're better off saving your money in future.

----

Re: a word about finding the right orthotics

Carole C in NOLA on 7/16/02 at 14:14 (089788)

Elliott, how wonderful that you are feeling so much better! Thanks for a very interesting post. I'll try that test on my SAS shoes and my other shoes when I get home.

I agree that good custom orthotics can make a huge difference. My soft orthotics really helped, although I abandoned them in March for reasons of vanity, since they are the thickest most ungainly orthotics known to man. I could possibly benefit from slim custom orthotics like yours.

Carole C

Re: a word about finding the right orthotics

Suzanne D on 7/16/02 at 23:22 (089832)

How wonderful for you that your new orthotics have brought about so much improvement! And it is nice of you to post your experience and information to benefit others. Thank you for that.

I tried your test on my SAS Free Time walking shoes which I wear with 3/4 length Birk inserts. My shoes do feel firm in the inner arch if I am understanding your instructions correctly. In the past I have worn SAS slip ons and sandals, and they did not feel as supportive as these lace-ups I wear now. These inserts are thin and semi-rigid and do fit well in the shoes and help more than anything I have worn in the past year.

I keep wishing for some sandals that will work for me, but if I keep wishing long enough, it will be fall, and I won't need them!

Good luck in your continuing improvement,
Suzanne :-)

Re: a word about finding the right orthotics

elliott on 7/17/02 at 08:20 (089851)

This test is hard if you've never compared it to a known firm shoe (such as a motion control running shoe) but easy if you have. Not sure about your particular SAS shoe, but the two SASs I've tried were nowhere near supportive enough.

Re: I didn't say I'm so much better

elliott on 7/17/02 at 08:22 (089852)

just that I can walk!

Re: You seem lots better!

Carole C in NOLA on 7/17/02 at 10:22 (089867)

You said 'Four months later, I can walk again, more or less without pain'.

That is so cool. Being able to walk without pain is a big deal!

Carole C

Re: a word about finding the right orthotics

Carole C in NOLA on 7/16/02 at 14:14 (089788)

Elliott, how wonderful that you are feeling so much better! Thanks for a very interesting post. I'll try that test on my SAS shoes and my other shoes when I get home.

I agree that good custom orthotics can make a huge difference. My soft orthotics really helped, although I abandoned them in March for reasons of vanity, since they are the thickest most ungainly orthotics known to man. I could possibly benefit from slim custom orthotics like yours.

Carole C

Re: a word about finding the right orthotics

Suzanne D on 7/16/02 at 23:22 (089832)

How wonderful for you that your new orthotics have brought about so much improvement! And it is nice of you to post your experience and information to benefit others. Thank you for that.

I tried your test on my SAS Free Time walking shoes which I wear with 3/4 length Birk inserts. My shoes do feel firm in the inner arch if I am understanding your instructions correctly. In the past I have worn SAS slip ons and sandals, and they did not feel as supportive as these lace-ups I wear now. These inserts are thin and semi-rigid and do fit well in the shoes and help more than anything I have worn in the past year.

I keep wishing for some sandals that will work for me, but if I keep wishing long enough, it will be fall, and I won't need them!

Good luck in your continuing improvement,
Suzanne :-)

Re: a word about finding the right orthotics

elliott on 7/17/02 at 08:20 (089851)

This test is hard if you've never compared it to a known firm shoe (such as a motion control running shoe) but easy if you have. Not sure about your particular SAS shoe, but the two SASs I've tried were nowhere near supportive enough.

Re: I didn't say I'm so much better

elliott on 7/17/02 at 08:22 (089852)

just that I can walk!

Re: You seem lots better!

Carole C in NOLA on 7/17/02 at 10:22 (089867)

You said 'Four months later, I can walk again, more or less without pain'.

That is so cool. Being able to walk without pain is a big deal!

Carole C