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Birks don't work anymore. Are Mephistos any good?

Posted by elliott on 8/01/02 at 15:53 (091297)

I need a pair of sandals for around the house; will only consider a two-strap I can slip into with no hands (no ankle strap), as I'll be using it primarily as a slipper. Can't walk or stand barefoot for long (although it's not PF). I have flat feet needing stability and support. I've tried the Arizona (can tolerate the bumps, but it doesn't fit right--forefoot sort of runs off shoe on lateral side) and the Kentucky (better mold, but way too cushy, flexible and not supportive enough). I'm looking for the firmness of an Arizona footbed with the flatter last of the Kentucky footbed, which, given that's what the typical flat-footer needs, you'd think (wrongly) many companies would provide. I'll consider a clog if nothing else can be found.

I did an internet search on sandals, and the only thing possibly worth a shot I could find was Mephisto:

http://shop.store.yahoo.com/walkingco/mensanandclo.html

Not cheap either for something which probably won't work anyway. :-) Reading the description of the sandal, it says, 'unparalleled arch support and spongy latex cushioning create this sandal with maximum support and comfort'. It has it all! Just like all the other companies, they boast about their cushioning, usually warning signs to me that it is inappropriate for a typical flatfooter (it should say something like 'firm polyurethene cushioning' instead). I'll point out too that flatfooter's support and cushioning are really opposing qualities, so you can't really excel in both. Based on the wording, maybe the clog is a better buy. But then in other links, that same clog is given a somewhat different description:

http://mephistogreatlakes.com/cgi-bin/order?Zaverio

The 'soft-air latex foam midsole...shock absorption' sounds all wrong, and similar wording appears for just about every possible Mephisto I could find. Anyone know about the properties of these Mephistos, or if something else out there (not Birks) is more appropriate. Thanks.

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Re: Birks don't work anymore. Are Mephistos any good?

Pauline on 8/02/02 at 09:20 (091401)

Elliott,
My experience with Mephistos is that they are an excellent shoe that supplies what I would describe a softer support than Birks. Not a whole lot softer, don't expect spongy soft, but rather a firm support but to my foot not as high nor as defined an arch as Birks.

I felt the flater the shoe the more Birk like and those with a wedge for me more comfortable.

I purchased a pair and after wearing them in the house only decided to return them because my tender arches at that time could not tolerate their firmness. Many people love these these shoes and feel they are better than Birks. For one thing they are not as 'wide' looking and I think their styles are more flattering to the foot. I don't think that matters to you, but to women it's a big thing.

My personal opinion is that people with higher arches do well with both Birks and Mephistos. Those with a medium high arch would probably do better with Mephistos and those like me with a lower arch love our Clarks.

Anyone with P.F. probably has tried on more shoes in a month than another person tries in a year. We are all just looking for something that will provide some kind of comfort and support.

My suggestion is first a good pair of running shoes and second to try the Mephistos or Clarks from a store with a GOOD return policy. Wear them in the house for at least a week before you decide to return them. I found Mephistos need a break in period similar to Birks, which for me was a problem. My Clarks are like slippers to my feet. Each one of us is the same when it comes to P.F. pain, yet quite different in needs when it comes to shoes, and many of us have piles of failed attempts still sitting in our closets.

Re: thanks for your response; more questions

elliott on 8/02/02 at 10:29 (091406)

Firm sounds good. A little cushioning is fine. But what am I to make of those descriptions of latex-air foam cushioning? That sounds awfully soft, too soft.

I have a low arch too. Which Clark's model are you talking about (do you have a name)? Is it a slipper, sandal, clog?

The few Clarks shoes I've tried over my lifetime were very comfortable but had absolutely no heel counter, and when things got worse, I couldn't wear them anymore (in retrospect, I shouldn't have to begin with). I already have a walking shoe and a running shoe. I need just a sandal. Thanks.

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Re: thanks for your response; more questions

Pauline on 8/02/02 at 14:02 (091434)

Elliott,
The key to trying new shoes is a GOOD RETURN policy. I've learned a long time ago a P.F. patient needs time to try them out at home and if they don't work needs to be able to return them. Mesphistos I consider an expensive shoe just to chuck in a closet if you can't wear them.

The mens and womens varieties are different by design and I can only speak to the womens. The ones I tried never exhibited a soft latex air filled cushioning that I could say 'Wow' about. If it was there I certainly didn't notice any extreme softness. As I said, the ones I purchased I returned because my tender feet at that time couldn't stand the firmness of the shoe.

My Clarks are clog style sandals and believe it or not I ordered my favorite ones off QVC. I purchased 3 pair because I love them so much.
You just slip into them. They have one large piece of leather covering the top of the foot and no back strap. I live in them at home, however, I always use my running shoes for serious walking even to the mall etc.

They by far supply me with the best support for my feet when I kick off my running shoes. I do not wear an orthotic. I use a Dr. Scholl's blue running shoe liner, forget it's name, and two pieces of thin foam pads in the shape of a heels under them. It works for me.

Your best bet is to try on several pairs. By far the Birks have the deepest heel cup of any shoe I've tried. I think after trying the Mesphistos in a store you will know how soft or hard they are. Select one that you think might work and try it at home for a week on carpeting. If it doesn't work take them back.

If your purchasing sandals with the idea that they will substitute for your running shoes forget it unless your a Birk wearer. Use sandals for short term wear not for real long term walking and you'll be happier.

That's not what you want to hear, I know because I didn't want to hear that either, but with P.F. three times I've come to the conclusion my running shoes are by far my best friend, and if I get away with wearing a small heel or a nice looking sandal for a few hours on some days I accept that and consider myself lucky to be pain free and am trying to keep it that way. Now go shoe hunting.

Re: thanks for your response; more questions

jonna p on 8/03/02 at 08:16 (091469)

Take a look at Finn Comfort. Has a nice cork foot bed similar to the Birk but it has a positive heel which helps the flat foot. (I think). Also look at Romika, not as pronounced arch support but yet somehow is supportive. Clarks feel wonderful and comfortable but I find I can not stand in them for a long time due to the lack of support. But for lite duty they are great.

Good luck!

Re: more specifics

Ed Davis, DPM on 8/03/02 at 14:35 (091486)

Elliott:

What specifically, is it that makes the Birks not work?
Ed

Re: more specifics

elliott on 8/03/02 at 23:06 (091514)

As I said in my first post, my foot runs off the lateral side of the Arizona, not to mention the bumps make it feel a bit too tilted towards the lateral side for me, and I find the albeit flat footbed of the Kentucky (the two-strap version of the Nebraska) to be way too soft and flexible, not helping my flat weak right foot. In addition, I have pain on the lateral edge of my right foot, either increased or caused by the lateral rising edge of the sandal jutting into my foot. (I do have the correct size. If it matters, I have a narrower heel than most and a relatively wider forefoot.)

I'll reiterate what I've said before that I think there is a design flaw in Birks (despite it working for many). They make the footbed for higher-arched people very firm and the footbed for the lower-arched very soft. This seems to be the opposite of what they should be doing. It is the opposite of what the different categories of running shoes do.

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Re: more specifics

nancy s. on 8/04/02 at 04:35 (091522)

i don't know that it's a design flaw; i think no one shoe designer can cover all the bases represented on this board.

i have pretty flat feet: arches collapse as soon as i stand. but i can wear both the classic footbed birks and the higher-arch more-flexible footbed tatamis comfortably. just one person's experience.

are flat-footed people supposed to be more comfortable in higher-arch footwear? my own flat feet can't take a whole lot of arch. orthotics had too much arch, and though they supposedly fit my feet in the casted position (sitting, with orthotist pushing to a certain agree down from my knee) and the orthotics had numerous adjustments, my feet never could take them. the only footwear that reduce my pain (considerably) yet still provide good support are birks -- both kinds.

Re: design flaw

elliott on 8/04/02 at 09:01 (091530)

Flat-footed people are not supposed to be more comfortable in higher-arched footwear, because the built-in arch will jut awkwardly into their non-arch. Instead, they need a lower-arched last but with a denser, harder material, at least on the inner side, to offer medial support. Some unknowledgeable salesman and customers confuse this support to mean that flatfooters need built-in high-arched support, and this is false.

Again, I said it's a general rule, not that no one will have success in Birks. But take a look at what running shoes do, where there seems to be a somewhat scientifically-based consensus of how to make shoes. In general, the cushioned class shoes are for those with high arches that, since pulled taut, need cushioning to lessen the impact, achieved through less stability in the shoe. These shoes use a light EVA midsole, often combined with blown rubber outsole, which cushions further. By contrast, at the other extreme, a motion control shoe, typically made for a flatfooter--who some say have natural cushioning in the form of flabby feet--in addition to all its support and control features such as prominent heel counters, often uses the harder polyurethane for its midsole, or at the least a dual-density midsole with a denser EVA on the medial side, often combined with the harder carbon rubber outsole (although that is in part to prevent premature wear). Stability class shoes are somewhere in between. All this is relatively standard across companies, although there is some diversity as to how high a built-in arch should be (Asics and Saucony have virtually none, New Balance typically has a lot. In a book about running injuries, the pod who wrote it stated that built-in arches in running shoes are a bad idea.)

Everyone keeps saying the Tatamis are high-arched. My Kentuckys are low-arched, yet are from the Tatami line (yeah, I remember reading there are two Tatami lines).

So in general, a higher-arched person needs a shoe/sandal with a bit more cushioning, a flatfooter needs more firmness. If a company wants to cater appropriately to the masses in the various categories, this is how shoes should be made (although harder footbeds will last longer, and, given what you're paying for a Birk sandal and how long you expect it to last, outdoors, no less, this may be in part why the Arizonas are made this way). My flat-lasted Kentuckys are very flexible. To me that's a design flaw, not just because they're not working for me.

Can I ask how long ago and what brand/material of orthotics did you try?

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Re: more specifics

paula on 8/04/02 at 09:29 (091531)

elliot, for what it's worth i have been experimenting with adhesive podiatrist foam in my birkies which used to work for me but my feet got worse. seems to be helping. i put small bits here and there till i get it pain free. my foot also used to fall off the outside of the birkie but with the foam in right place it doesnt anymore. you have posterior tibial tendon problems, is that right? so do i and i understand that is why our feet splay laterally. uncorrected i walk like charlie chaplin.

Re: Two cents

wendyn on 8/04/02 at 09:42 (091533)

I've missed some of the history on the discussion (busy few days)...but my two cents would be that I can tolerate Birks far better than orthotics (3 different pairs). I am very flat footed and my right foot would roll just about on to my inner ankle in bare feet if I let it.

I cannot tolerate the soft birk footbeds now - but they were the only thing I could tolerate when my feet were really bad. Soft shoes are the worst for me - they have to have a lot of firm support.

Re: more specifics

elliott on 8/04/02 at 12:02 (091542)

I think I threw my Arizonas out in disgust a while back; too late!

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Re: all the more reason there should be a flat hard Birk (nm)

elliott on 8/04/02 at 12:03 (091543)

.

Re: Flat hard birks

wendyn on 8/04/02 at 12:20 (091546)

Elliott, I've got my 'orthotic' birks on right now - but I'll go get my other ones to compare.

The custom orthotic Birk has an arch that is as high as the standard birk, but the orthotic arch is much wider (if that makes sense).

I find my orthotics themselves to be a much larger arch as well (probably why I prefer birks to orthotics). Personally, I don't think I could tolerate soething flatter though, then I wouldn't have any arch support at all.

Have you found some flatter sandals that you think work better for you?

Re: Flat hard birks

elliott on 8/04/02 at 12:38 (091547)

Maybe that custom orthotic Birk just happens to fit you well, and the bumps on the higher Birk, if tolerated, can sometimes work even for a flatter foot. But I still can't understand why there isn't a hard flat Birk.

No, I haven't yet found hard flat sandals that might work better, hence this thread. An internet search was not very promising, with just about all companies boasting about their mushy cushioning. Based on Pauline's comments, I might try the Mephisto, possibly by mailorder (but with returns allowed).

I used to think the same thing about orthotics as you do after getting my first useless pair. But then I tried Northwest Podiatric orthotics as recommended by Dr. Ed and have changed my mind. They're unbelieveable, comfortable too. They come in varying grades of materials, some that flex a bit more than others. And it has no fluid silicone! No 800 number!

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Re: Flat hard birks

wendyn on 8/04/02 at 13:15 (091549)

I shouldn't put down my orthotics - they aren't bad really (this latest pair). I still think my Birks are more comfortable all around though.

The biggest problem with my orthotics is that they have to go in 'real' shoes. The bunions on my feet don't like 'real' shoes at all. The Birks work great for me, but I REALLY need to find something more practical for winter.

Re: Flat hard birks

Pauline on 8/04/02 at 13:55 (091550)

Elliott,
If you plan to try the Mephistos I would strongly suggest you find a store where you can try them on. Believe it or not each style feels a little different at least in women's styles.

I found the height of the wedge heel really made a diference in the overall feeling of the shoes.

With men's perhaps that could be different, but if you can find a store nearby you might be happier with your selection because you can try on the various styles. Just a suggestion.

Re: To Elliott more specifics

Pauline on 8/04/02 at 14:14 (091552)

Now I have a question for you. Why is it so necessary for people with lower arches or flat feet to have an arch in their shoe in the first place?

If the thing causes more pain than it's worth what is the point in having it? Personally after my experience with Birks and 4 pair of custom orthotics I don't think I'm meant to wear an arch support period. My feet are their happiest in a good N.B. running shoe. It supplies comfortable support because I pick one with a low arch that doesn't push against my arch.

Isn't it just possible that while we are out there searching for arch supports that they are not necessary for the entire world of feet, and actually can cause more problems for some people?

I don't think orthotics were God's gift to man. I think their more like
Podiatry's answer to a beginning low income. Sorry, but I firmly belive this. In the early days of Podiatry, incomes were not so great and the procedures they could perform were much more restricted than now, so is it any wonder a new avenue for income was found. Enter biomechanics and the custom orthotic. Everyone gets a pair and it's pretty difficult to prove that they are not needed. Still to this day few insurance companies will pick up the tab. Maybe it's because they don't believe in the concept either.

Re: To Elliott more specifics

wendyn on 8/04/02 at 15:50 (091558)

Pauline, I know for me - a flat shoe is a no-no.

I tried bowling in bowling shoes (they are as flat as they come.) It didn't even take 10 minutes for the pain to set in!!

Can you wear bowling shoes?

Re: To Elliott more specifics

Pauline on 8/04/02 at 16:45 (091561)

Wendyn,
Not flat like a bowling shoe, but with the support of a running shoe. My N.B. hardly have any arch that you can feel or see. Nothing like the hump that is in a Birk, but they sure are more comfortable than that hard bump on the Birk.

No matter what kind of bump I put in the arch of my foot it feels like a rock in my shoe.

Re: design flaw

nancy s. on 8/04/02 at 18:06 (091568)

actually, i might just be repeating the standard when i say tatamis are higher arched. mine don't really feel that way -- the arch support just seems to be in a slightly different spot. i wear the cooper and nebraska, both tatamis, and they have the flexible sole i think you're talking about. it doesn't bother me; my feet still feel well supported. the classic boston is just as comfortable. i wore that for two years, and now switch back and forth. it's a firmer footbed, as you know, probably like the arizona.

my feet don't fit the flabby idea you mention re flatfootedness, if i understand 'flabby.' they're narrow, and my heels feel like they have no fat pad left. the feet just seem like bone with a little skin thrown over it, plus a few sore tendons.

the pod i saw when this all began in 1999 ordered those hard, completely rigid, 3/4-length ice scrapers for me -- for $300 (plus $15 to pick them up in 90 seconds). they were the pits and made me worse. i should've left them in his parking lot.

in the fall of 2000 i was referred by another (good) doctor to an excellent orthotist who did all the right things and used all the right materials (eva, etc.). they're a great, extremely well made pair of orthotics -- but i never could wear them for very long, despite several adjustments. the arch is too high and too hard on the medial side, even though i overpronate. they fit my feet, they make perfect sense scientifically for what is wrong with my feet biomechanically -- but they feel lousy. in the over three years since my pf and multi-tendonitis began, birks have been (and remain) the only shoe/orthotic i can wear every day and all day. i can take a walk -- even a long one -- in new balance 608s. but then they've got to come off, and i mean immediately. no standing, or even sitting, in them.

Re: it is NOT necessary!

elliott on 8/04/02 at 20:12 (091575)

That is exactly what I said; hope we're on the same wavelength here. Please re-read my posts in this thread. Low- or no-arch is exactly how most motion control running shoes are in fact made. The control features do not come from an irritating arch, but rather from a firmer density midsole (the layer between the rubber outsole and where you foot is resting), which prevents the foot from collapsing (usually inwards), combined with a heel counter and other cutesy inventions. No arch. (Some running shoe insoles have what looks like a very slight arch, but that usually compresses when your foot lands on it.)

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Re: "real" shoes

elliott on 8/04/02 at 20:24 (091577)

That's exactly what the Northwest Podiatric orthotics go into. Besides being superlight and superstrong, they are super-thin (that they use space-age materials is no hype). They fit in just about all my shoes. In fact, if it's a shoe that comes with a thin insert, I am sometimes coming down a half-size when I replace them with my orthotics. I can even get them into some dress shoes (my orthotics have that 4/5 length where they are cut off at the toes).

There was a thread a long time ago where I discussed this. Carole C was in on it, I think you too, and I was lauding the fact that this same orthotic was superthin. I was mildly blasted (as usual) for this being irrelevant. No so! Fat orthotics, aside from fitting in only fat shoes, present problems such as putting the foot too high in the shoe, defeating the control features and often causing gait problems and crushed toes. It's hard to find any shoes that fat orthotics work in.

I get the impression I'm not getting through here. I'm not going to promise you that these orthotics are God's gift to man, but what I will say is that they are such a cut above the rest and fit in real shoes.

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Re: I think you need to...

elliott on 8/04/02 at 20:25 (091578)

call Dr. Kiper! :-)

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Re: "real" shoes

wendyn on 8/04/02 at 21:03 (091579)

Elliott, I think you are having a hard time 'getting through' because you and I seem to be talking about two different things.

I think it's positively _lovely_ for you that you found thin orthotics that fit in shoes. Having orthotics that take up too much shoe-room seems to be a common problem.

My _particular_ problem is that I have some nasty bunions on either side of my right foot. So, thin orthotics or no - real shoes hurt me. Even running shoes.

The only time I wear 'real' shoes is for an hour or so at the gym, and while biking. This is also why I try to manage in 30 below weather on ice wearing Birks. Any pressure on the sides of my feet causes the bunions to swell. Then they enlarge and press harder agains the sides of my shoes. More pressure, more swelling, more pain.

My point was that although I find my orthotics themselves comfortable, I simply cannot wear 'real' shoes.

Re: NancyS

wendyn on 8/04/02 at 21:10 (091581)

Nancy - have not heard from you much lately!

I know what you mean about the boney feet with no padding. My feet feel the same. Maybe one day they will come up with a liposuction for this - suck the fat right off your butt and inject it into your heels.

;)

Re: now I get it

elliott on 8/04/02 at 21:26 (091583)

Can't a pod cure the bunions?

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Re: Bunions

wendyn on 8/04/02 at 21:34 (091584)

I developed the bunions when I was about 19 or so. When I was around 23, I had surgery on the one on my big toe. It's a 'dorsal' bunion, meaning that it's on the top and side of my toe, rather than right on the side like most bunions.

It had been causing me excurtiating pain, enough to keep me up at night. I had an excellent orthopedic surgeon do the work, and she did a great job. The recovery was really quite painful for about 2 weeks, but I was actually skiing 6 weeks later on my honeymoon.

Following the surgery, the surgeon told me that the bunion had formed due to lousy biomechanics and arthritis. She told me that I would likely need to have it operated on again in 8 to 10 years.

That was 10 years ago, so she's pretty much right on with how long it took to come back. It's still not as bad as it was before (probably because I live in sandals now).

I'm not really sure if a surgeon would touch it now, I have RSD in both feet so they may not. I suppose if (when) it gets bad enough, I'll have to do it - but I'm not looking forward to doing this every 10 years.

Re: I think you need to...

nancy s. on 8/04/02 at 23:18 (091591)

aw, rats!

Re: NancyS

nancy s. on 8/04/02 at 23:26 (091592)

hey, wendy -- the board is too big for me now!

i hate that bony, no-padding feeling, don't you? i like your idea....

with a nice push from julie (and john), i'm taping a good deal these days with leuko tape. it really makes a difference on the days i'm on my feet too long. it seems to cut the at-night ache and recovery at least in half.

Re: Bunions

Pauline on 8/05/02 at 00:10 (091594)

Wendyn,
Was that about the time pointy shoes were in fashion? Didn't we all push our feet into those tiny points and ballerina slippers for fashion? I believe shoe design certainly aided our foot problems.

I remember seeing the bone in my foot that would have become a bunion turning red and hurting until I finally decided that I would never again break in a pair of shoes on my feet and I would look for heels with more room in the toes. No more pointed toe shoes.

We even wore our lofers tight if I remember correctly. They usually had a tendency to slip in the heels so we purchased them smaller and our toes took a beating while we broke them in.

Today if I go to a shoe store, one that actually has sales people waiting on you, and they mention 'you have to break them in' I smile and select another shoe.

Unfortunately since P.F. I like others have collected a huge variety of worthless shoes trying to find that one fashionable pair to substitute for my friendly running shoes.

Now if Pods would only work on designing a fashion shoe line for P.F. sufferers the ladies here might really jump for joy.

Re: Bunions

wendyn on 8/05/02 at 00:52 (091597)

Pauline, the last time I had a salesman mention 'breaking in a pair of shoes' - he received a few words of wisdom from me.

I did wear 'pointy' high heeled shoes for a brief period. During high school I wore mostly sandals or running shoes. I think I had only been working a year or so when the bunions started.

I asked the doctor if it was because of my shoes, and both doctors (pod and ortho) suggested that since I had the bunions at 19, genetics and biomechanics played a far bigger role than shoes.

I'm sure the Birks are helping slow down the progress of the bunions, but the big one is still coming back (even though it has lots of room in sandals.) I won't disagree with you though, those pointy shoes were bad news.

Re: NancyS

Julie on 8/05/02 at 02:58 (091599)

Hi Nancy

I'm glad the Leuko tape is working. It's so long since I've had a mail from you that I thought you'd gone for a long, long walk on the beach.

Just kidding :)). No worries:))

((((Nancy)))) (hug)

Re: Bunions

Julie on 8/05/02 at 03:05 (091600)

Wendy, I've posted in the past about my North Face Targas. I know you've tried just about everything there is, and I haven't actually seen your bunion, but I will say that one of the pluses (there are many) about the Targas is that they have a wide, roomy toebox. I have bunions too (normal ones, not interesting ones like yours :)) and these are the only shoes I think I've EVER had that give them enough room. The Targa Toebox is also the highest I've ever come across (I think I have high toes, because pressure on the tops of them has always been an issue.)

They're really a good, sturdy, supportive, stable walking shoe with a very thick sole and plenty of tread - important for me with all the stony ground I tread in Crete, and equally good on London pavements. I wear them all the time outdoors. But the toebox is the thing, that's why I thought it worth mentioning to you and your bunion.

Any good to you, this suggestion? Hope so.

Re: Bunions

Pauline on 8/05/02 at 08:33 (091609)

Can you believe it they are on the way in again. On the latest fashion list. Woe to the toes.

At least we're past the stage of pushing our feet into tiny points and breaking in shoes.

When you think about it, sounds like the shoe industries version of bronco busting.

Re: putting in a plug for mail order

elliott on 8/05/02 at 09:24 (091615)

I appreciate the concern. My experience with going to stores for such things is always the same: travel long distance to get there, don't have my size/color, they push to get me to try a different shoe/sandal, can order but it will take a few weeks. It is true that the salespeople in such stores are more knowledgeable than in others, but I'm not coming there for advice.

OTOH, with mail order, I can choose size/color, can return without hassle as stated on site, don't have to talk to anyone, no embarrassing returns. With the Mephistos, on-line the price is probably about $5 lower than the stores and most offer free shipping. All I'm risking is the cost of the return shipping, about $5.

More practically, best as I can tell from web searching, there are only three Mephisto sandals having no anklestrap: Zonder, Zach, Norman. If a store had all three in stock in my size/color, I would drive out there, but the chance of that is 0. Based on their description, style, and color, I think I've narrowed it down to one. It's just that I don't think they're gonna work anyway, so I've been delaying ordering them. As with most here, I've already spent a fortune on shoes. Have you ever noticed they always work long enough for you to dare wear them outside and then you can't return it? But I have made progress. I have a black walking shoe for work, ordered yet another to see if that's even better; should be arriving any day. None of these are available in stores locally. Have a running shoe for use in the fitness center and for mall-type walks. Just bought a light hiking shoe yesterday at REI for rougher terrain that seemed unbelieveably great in the store--I'll delay a report until I'm sure it's positive. Orthotics fit nicely in all three. But I need something for indoors to act as a slipper. I'll break down one day and order the Mephistos unless I find something better before then.

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Re: julie

nancy s. on 8/05/02 at 11:13 (091623)

i'm sorry, julie! i'm bogged down in work and heat, plus we've been plumbingless for two weeks. more soon, i swear. yes, the tape definitely is helping -- thank you!

Re: Bunions

wendyn on 8/05/02 at 11:19 (091628)

Pauline, I can't get over the ridiculously HIGH shoes and boots these girls wear now.

Re: Bunions

wendyn on 8/05/02 at 11:24 (091631)

Thanks Julie, when I finally have to break down and face winter I will keep them in mind.

I became so frustrateed with shoes that I eventually gave up. I spent way too much time having to take things back.

Maybe I will have a better frame of mind this fall!

Re: combined with superthin orthotics, of course :-) (nm)

elliott on 8/05/02 at 13:33 (091643)

.

Re: Birk shape

Ed Davis, DPM on 8/06/02 at 21:55 (091794)

Elliott:

Sounds like the basic shape of the Birk is problematic for you. I know it is an pricier option but a custom Birk would be as close to perfect as you can get. Use the corrected positive casts from your NW orthotics to have the footbed formed. I feel it is really fairly cost effective since you will have one sandal that really works and one that lasts a long time.
Ed

Re: To Elliott more specifics

Ed Davis, DPM on 8/06/02 at 22:11 (091795)

Pauline:

I really have to take exception to your statement that use of the custom orthotics has something to do with income of podiatrists. One could make that argument for any procedure that is popular in a specialty or profession. The bottom line is that custom orthotics have saved thousands of patients from surgery which is far more expensive, disabling and painful. I make about 3 to 4 times as much on a plantar fascial release with heel spur resection than on a pair of custom orthotics.

Your assertion that 'few insurance companies will pick up the tab' is incorrect. About 70 to 75% of the custom orthotics I make are reimbursed by insurance companies. That figure varies with geographical area. It is silly to imply that the presence of insurance coverage factors into the value of a service. Most individual health insurance policies in my state do not cover maternity-- 'maybe they don't believe in that concept either.'

You posed the question, 'why is it necessary for people with lower arches or flat feet to have an arch in their shoe in the first place?' It is not necessary and I know of no professional who feels it is necessary. Orthotics are used to control excessive motion (instability) particularly overpronation or sometimes oversupination. It is this excessive motion that overstrains supportive structures such as the fascia which, in turn, can lead to pain.

You had mentioned, referring to custom orthotics, that 'everyone gets a pair.' I would estimate that 10 to 15% of my patients get custom orthotics and I do not think my practice is that different from the average podiatrist.
Ed

Re: Dr. Ed

elliott on 8/07/02 at 00:03 (091809)

When you say 'corrected positive casts from your NW orthotics', is that the mold that, according to my pod, NW throws out after three months (which has long passed), or is that the orthotic itself?

At this stage I'm so put off by Birk. Still think a custom should not be necessary. All I want is a firm flat sandal (for inside-the-home use only). Still flabbergasted that all these companies alleging to make the best sandals in the world don't seem to have that, even though many with problem feet, the types willing to shell out big bucks for quality sandals, would need precisely that.

By any chance are you coming to the Mid-Atlantic region any time soon? I'd still drive far for you to examine my feet. Mentioned to the wife the idea of a Seattle vacation. 'Whatever for?', she said. :-)

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Re: Dr. Ed

Ed Davis, DPM on 8/07/02 at 14:52 (091863)

Elliott:

The labs, including NW, provide the option (to the provider) of storing the patients cast for 3 months or shipping them back. I always pick the latter option then give the corrected casts to my patients. Patients usually find the corrections on the cast interesting to look at and it gives patients the option to quickly and more economically obtain things such as dress orthotics, custom Birks, etc.
Ed

Re: Bunions

JudyS on 8/07/02 at 15:50 (091874)

Wendy - I saw a girl actually fall right off those kind of shoes yesterday when I was walking around in San Luis Obispo.....

Re: *now* you tell me

elliott on 8/07/02 at 16:28 (091880)

My pod never gave me an option to keep my casts. (Curious, is it 3 months from day of mold, 3 months from day orthotics are received by pod, or other? Molds were taken in late February, orthotics received in early March). By now my molds no doubt have been cremated and their ashes spread across the Pacific. :-) He did give me the option of ordering another pair of orthotics at his cost price within those three months, e.g., if I wanted the full-length besides the 4/5 length, but I like room in the toebox, so the 4/5 is all I need for all my shoes. Rarely ever put on dress shoes, and at this point wouldn't dare wear an orthotic without a heel post. Never thought about custom Birks.

The molds would be nice in case I lost or destroyed my first pair. The pod said that the further into the future one gets, the more a new mold is preferable in case the arch has changed shape, especially if one feels his orthotics aren't working anymore. This and the feeling they would never work to begin with contributed to my choice of not getting another pair. Assuming I keep my same insurance, which is likely, and assuming this benefit doesn't change next year (BCBS), if I hold out till January, I can get another pair on a new mold for $89 anyway. Come to think of it, my plan does not explicitly say only one pair a year (is that the rule?), only that it be a functional orthotic prescribed by a doc. My wife may need a pair soon; she has an early case of PF.

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Re: *now* you tell me

Ed Davis, DPM on 8/11/02 at 12:03 (092198)

Orthotics only weigh a few ounces but the positive casts are very heavy so UPS shipping costs go up a lot when we ask for the casts to be shipped back with the orthotics. I sort of view the return of casts to my patients as a 'value added' service. I did not always do this but found it to be helpful to patients.
Ed

Re: Birks don't work anymore. Are Mephistos any good?

Pauline on 8/02/02 at 09:20 (091401)

Elliott,
My experience with Mephistos is that they are an excellent shoe that supplies what I would describe a softer support than Birks. Not a whole lot softer, don't expect spongy soft, but rather a firm support but to my foot not as high nor as defined an arch as Birks.

I felt the flater the shoe the more Birk like and those with a wedge for me more comfortable.

I purchased a pair and after wearing them in the house only decided to return them because my tender arches at that time could not tolerate their firmness. Many people love these these shoes and feel they are better than Birks. For one thing they are not as 'wide' looking and I think their styles are more flattering to the foot. I don't think that matters to you, but to women it's a big thing.

My personal opinion is that people with higher arches do well with both Birks and Mephistos. Those with a medium high arch would probably do better with Mephistos and those like me with a lower arch love our Clarks.

Anyone with P.F. probably has tried on more shoes in a month than another person tries in a year. We are all just looking for something that will provide some kind of comfort and support.

My suggestion is first a good pair of running shoes and second to try the Mephistos or Clarks from a store with a GOOD return policy. Wear them in the house for at least a week before you decide to return them. I found Mephistos need a break in period similar to Birks, which for me was a problem. My Clarks are like slippers to my feet. Each one of us is the same when it comes to P.F. pain, yet quite different in needs when it comes to shoes, and many of us have piles of failed attempts still sitting in our closets.

Re: thanks for your response; more questions

elliott on 8/02/02 at 10:29 (091406)

Firm sounds good. A little cushioning is fine. But what am I to make of those descriptions of latex-air foam cushioning? That sounds awfully soft, too soft.

I have a low arch too. Which Clark's model are you talking about (do you have a name)? Is it a slipper, sandal, clog?

The few Clarks shoes I've tried over my lifetime were very comfortable but had absolutely no heel counter, and when things got worse, I couldn't wear them anymore (in retrospect, I shouldn't have to begin with). I already have a walking shoe and a running shoe. I need just a sandal. Thanks.

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Re: thanks for your response; more questions

Pauline on 8/02/02 at 14:02 (091434)

Elliott,
The key to trying new shoes is a GOOD RETURN policy. I've learned a long time ago a P.F. patient needs time to try them out at home and if they don't work needs to be able to return them. Mesphistos I consider an expensive shoe just to chuck in a closet if you can't wear them.

The mens and womens varieties are different by design and I can only speak to the womens. The ones I tried never exhibited a soft latex air filled cushioning that I could say 'Wow' about. If it was there I certainly didn't notice any extreme softness. As I said, the ones I purchased I returned because my tender feet at that time couldn't stand the firmness of the shoe.

My Clarks are clog style sandals and believe it or not I ordered my favorite ones off QVC. I purchased 3 pair because I love them so much.
You just slip into them. They have one large piece of leather covering the top of the foot and no back strap. I live in them at home, however, I always use my running shoes for serious walking even to the mall etc.

They by far supply me with the best support for my feet when I kick off my running shoes. I do not wear an orthotic. I use a Dr. Scholl's blue running shoe liner, forget it's name, and two pieces of thin foam pads in the shape of a heels under them. It works for me.

Your best bet is to try on several pairs. By far the Birks have the deepest heel cup of any shoe I've tried. I think after trying the Mesphistos in a store you will know how soft or hard they are. Select one that you think might work and try it at home for a week on carpeting. If it doesn't work take them back.

If your purchasing sandals with the idea that they will substitute for your running shoes forget it unless your a Birk wearer. Use sandals for short term wear not for real long term walking and you'll be happier.

That's not what you want to hear, I know because I didn't want to hear that either, but with P.F. three times I've come to the conclusion my running shoes are by far my best friend, and if I get away with wearing a small heel or a nice looking sandal for a few hours on some days I accept that and consider myself lucky to be pain free and am trying to keep it that way. Now go shoe hunting.

Re: thanks for your response; more questions

jonna p on 8/03/02 at 08:16 (091469)

Take a look at Finn Comfort. Has a nice cork foot bed similar to the Birk but it has a positive heel which helps the flat foot. (I think). Also look at Romika, not as pronounced arch support but yet somehow is supportive. Clarks feel wonderful and comfortable but I find I can not stand in them for a long time due to the lack of support. But for lite duty they are great.

Good luck!

Re: more specifics

Ed Davis, DPM on 8/03/02 at 14:35 (091486)

Elliott:

What specifically, is it that makes the Birks not work?
Ed

Re: more specifics

elliott on 8/03/02 at 23:06 (091514)

As I said in my first post, my foot runs off the lateral side of the Arizona, not to mention the bumps make it feel a bit too tilted towards the lateral side for me, and I find the albeit flat footbed of the Kentucky (the two-strap version of the Nebraska) to be way too soft and flexible, not helping my flat weak right foot. In addition, I have pain on the lateral edge of my right foot, either increased or caused by the lateral rising edge of the sandal jutting into my foot. (I do have the correct size. If it matters, I have a narrower heel than most and a relatively wider forefoot.)

I'll reiterate what I've said before that I think there is a design flaw in Birks (despite it working for many). They make the footbed for higher-arched people very firm and the footbed for the lower-arched very soft. This seems to be the opposite of what they should be doing. It is the opposite of what the different categories of running shoes do.

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Re: more specifics

nancy s. on 8/04/02 at 04:35 (091522)

i don't know that it's a design flaw; i think no one shoe designer can cover all the bases represented on this board.

i have pretty flat feet: arches collapse as soon as i stand. but i can wear both the classic footbed birks and the higher-arch more-flexible footbed tatamis comfortably. just one person's experience.

are flat-footed people supposed to be more comfortable in higher-arch footwear? my own flat feet can't take a whole lot of arch. orthotics had too much arch, and though they supposedly fit my feet in the casted position (sitting, with orthotist pushing to a certain agree down from my knee) and the orthotics had numerous adjustments, my feet never could take them. the only footwear that reduce my pain (considerably) yet still provide good support are birks -- both kinds.

Re: design flaw

elliott on 8/04/02 at 09:01 (091530)

Flat-footed people are not supposed to be more comfortable in higher-arched footwear, because the built-in arch will jut awkwardly into their non-arch. Instead, they need a lower-arched last but with a denser, harder material, at least on the inner side, to offer medial support. Some unknowledgeable salesman and customers confuse this support to mean that flatfooters need built-in high-arched support, and this is false.

Again, I said it's a general rule, not that no one will have success in Birks. But take a look at what running shoes do, where there seems to be a somewhat scientifically-based consensus of how to make shoes. In general, the cushioned class shoes are for those with high arches that, since pulled taut, need cushioning to lessen the impact, achieved through less stability in the shoe. These shoes use a light EVA midsole, often combined with blown rubber outsole, which cushions further. By contrast, at the other extreme, a motion control shoe, typically made for a flatfooter--who some say have natural cushioning in the form of flabby feet--in addition to all its support and control features such as prominent heel counters, often uses the harder polyurethane for its midsole, or at the least a dual-density midsole with a denser EVA on the medial side, often combined with the harder carbon rubber outsole (although that is in part to prevent premature wear). Stability class shoes are somewhere in between. All this is relatively standard across companies, although there is some diversity as to how high a built-in arch should be (Asics and Saucony have virtually none, New Balance typically has a lot. In a book about running injuries, the pod who wrote it stated that built-in arches in running shoes are a bad idea.)

Everyone keeps saying the Tatamis are high-arched. My Kentuckys are low-arched, yet are from the Tatami line (yeah, I remember reading there are two Tatami lines).

So in general, a higher-arched person needs a shoe/sandal with a bit more cushioning, a flatfooter needs more firmness. If a company wants to cater appropriately to the masses in the various categories, this is how shoes should be made (although harder footbeds will last longer, and, given what you're paying for a Birk sandal and how long you expect it to last, outdoors, no less, this may be in part why the Arizonas are made this way). My flat-lasted Kentuckys are very flexible. To me that's a design flaw, not just because they're not working for me.

Can I ask how long ago and what brand/material of orthotics did you try?

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Re: more specifics

paula on 8/04/02 at 09:29 (091531)

elliot, for what it's worth i have been experimenting with adhesive podiatrist foam in my birkies which used to work for me but my feet got worse. seems to be helping. i put small bits here and there till i get it pain free. my foot also used to fall off the outside of the birkie but with the foam in right place it doesnt anymore. you have posterior tibial tendon problems, is that right? so do i and i understand that is why our feet splay laterally. uncorrected i walk like charlie chaplin.

Re: Two cents

wendyn on 8/04/02 at 09:42 (091533)

I've missed some of the history on the discussion (busy few days)...but my two cents would be that I can tolerate Birks far better than orthotics (3 different pairs). I am very flat footed and my right foot would roll just about on to my inner ankle in bare feet if I let it.

I cannot tolerate the soft birk footbeds now - but they were the only thing I could tolerate when my feet were really bad. Soft shoes are the worst for me - they have to have a lot of firm support.

Re: more specifics

elliott on 8/04/02 at 12:02 (091542)

I think I threw my Arizonas out in disgust a while back; too late!

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Re: all the more reason there should be a flat hard Birk (nm)

elliott on 8/04/02 at 12:03 (091543)

.

Re: Flat hard birks

wendyn on 8/04/02 at 12:20 (091546)

Elliott, I've got my 'orthotic' birks on right now - but I'll go get my other ones to compare.

The custom orthotic Birk has an arch that is as high as the standard birk, but the orthotic arch is much wider (if that makes sense).

I find my orthotics themselves to be a much larger arch as well (probably why I prefer birks to orthotics). Personally, I don't think I could tolerate soething flatter though, then I wouldn't have any arch support at all.

Have you found some flatter sandals that you think work better for you?

Re: Flat hard birks

elliott on 8/04/02 at 12:38 (091547)

Maybe that custom orthotic Birk just happens to fit you well, and the bumps on the higher Birk, if tolerated, can sometimes work even for a flatter foot. But I still can't understand why there isn't a hard flat Birk.

No, I haven't yet found hard flat sandals that might work better, hence this thread. An internet search was not very promising, with just about all companies boasting about their mushy cushioning. Based on Pauline's comments, I might try the Mephisto, possibly by mailorder (but with returns allowed).

I used to think the same thing about orthotics as you do after getting my first useless pair. But then I tried Northwest Podiatric orthotics as recommended by Dr. Ed and have changed my mind. They're unbelieveable, comfortable too. They come in varying grades of materials, some that flex a bit more than others. And it has no fluid silicone! No 800 number!

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Re: Flat hard birks

wendyn on 8/04/02 at 13:15 (091549)

I shouldn't put down my orthotics - they aren't bad really (this latest pair). I still think my Birks are more comfortable all around though.

The biggest problem with my orthotics is that they have to go in 'real' shoes. The bunions on my feet don't like 'real' shoes at all. The Birks work great for me, but I REALLY need to find something more practical for winter.

Re: Flat hard birks

Pauline on 8/04/02 at 13:55 (091550)

Elliott,
If you plan to try the Mephistos I would strongly suggest you find a store where you can try them on. Believe it or not each style feels a little different at least in women's styles.

I found the height of the wedge heel really made a diference in the overall feeling of the shoes.

With men's perhaps that could be different, but if you can find a store nearby you might be happier with your selection because you can try on the various styles. Just a suggestion.

Re: To Elliott more specifics

Pauline on 8/04/02 at 14:14 (091552)

Now I have a question for you. Why is it so necessary for people with lower arches or flat feet to have an arch in their shoe in the first place?

If the thing causes more pain than it's worth what is the point in having it? Personally after my experience with Birks and 4 pair of custom orthotics I don't think I'm meant to wear an arch support period. My feet are their happiest in a good N.B. running shoe. It supplies comfortable support because I pick one with a low arch that doesn't push against my arch.

Isn't it just possible that while we are out there searching for arch supports that they are not necessary for the entire world of feet, and actually can cause more problems for some people?

I don't think orthotics were God's gift to man. I think their more like
Podiatry's answer to a beginning low income. Sorry, but I firmly belive this. In the early days of Podiatry, incomes were not so great and the procedures they could perform were much more restricted than now, so is it any wonder a new avenue for income was found. Enter biomechanics and the custom orthotic. Everyone gets a pair and it's pretty difficult to prove that they are not needed. Still to this day few insurance companies will pick up the tab. Maybe it's because they don't believe in the concept either.

Re: To Elliott more specifics

wendyn on 8/04/02 at 15:50 (091558)

Pauline, I know for me - a flat shoe is a no-no.

I tried bowling in bowling shoes (they are as flat as they come.) It didn't even take 10 minutes for the pain to set in!!

Can you wear bowling shoes?

Re: To Elliott more specifics

Pauline on 8/04/02 at 16:45 (091561)

Wendyn,
Not flat like a bowling shoe, but with the support of a running shoe. My N.B. hardly have any arch that you can feel or see. Nothing like the hump that is in a Birk, but they sure are more comfortable than that hard bump on the Birk.

No matter what kind of bump I put in the arch of my foot it feels like a rock in my shoe.

Re: design flaw

nancy s. on 8/04/02 at 18:06 (091568)

actually, i might just be repeating the standard when i say tatamis are higher arched. mine don't really feel that way -- the arch support just seems to be in a slightly different spot. i wear the cooper and nebraska, both tatamis, and they have the flexible sole i think you're talking about. it doesn't bother me; my feet still feel well supported. the classic boston is just as comfortable. i wore that for two years, and now switch back and forth. it's a firmer footbed, as you know, probably like the arizona.

my feet don't fit the flabby idea you mention re flatfootedness, if i understand 'flabby.' they're narrow, and my heels feel like they have no fat pad left. the feet just seem like bone with a little skin thrown over it, plus a few sore tendons.

the pod i saw when this all began in 1999 ordered those hard, completely rigid, 3/4-length ice scrapers for me -- for $300 (plus $15 to pick them up in 90 seconds). they were the pits and made me worse. i should've left them in his parking lot.

in the fall of 2000 i was referred by another (good) doctor to an excellent orthotist who did all the right things and used all the right materials (eva, etc.). they're a great, extremely well made pair of orthotics -- but i never could wear them for very long, despite several adjustments. the arch is too high and too hard on the medial side, even though i overpronate. they fit my feet, they make perfect sense scientifically for what is wrong with my feet biomechanically -- but they feel lousy. in the over three years since my pf and multi-tendonitis began, birks have been (and remain) the only shoe/orthotic i can wear every day and all day. i can take a walk -- even a long one -- in new balance 608s. but then they've got to come off, and i mean immediately. no standing, or even sitting, in them.

Re: it is NOT necessary!

elliott on 8/04/02 at 20:12 (091575)

That is exactly what I said; hope we're on the same wavelength here. Please re-read my posts in this thread. Low- or no-arch is exactly how most motion control running shoes are in fact made. The control features do not come from an irritating arch, but rather from a firmer density midsole (the layer between the rubber outsole and where you foot is resting), which prevents the foot from collapsing (usually inwards), combined with a heel counter and other cutesy inventions. No arch. (Some running shoe insoles have what looks like a very slight arch, but that usually compresses when your foot lands on it.)

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Re: "real" shoes

elliott on 8/04/02 at 20:24 (091577)

That's exactly what the Northwest Podiatric orthotics go into. Besides being superlight and superstrong, they are super-thin (that they use space-age materials is no hype). They fit in just about all my shoes. In fact, if it's a shoe that comes with a thin insert, I am sometimes coming down a half-size when I replace them with my orthotics. I can even get them into some dress shoes (my orthotics have that 4/5 length where they are cut off at the toes).

There was a thread a long time ago where I discussed this. Carole C was in on it, I think you too, and I was lauding the fact that this same orthotic was superthin. I was mildly blasted (as usual) for this being irrelevant. No so! Fat orthotics, aside from fitting in only fat shoes, present problems such as putting the foot too high in the shoe, defeating the control features and often causing gait problems and crushed toes. It's hard to find any shoes that fat orthotics work in.

I get the impression I'm not getting through here. I'm not going to promise you that these orthotics are God's gift to man, but what I will say is that they are such a cut above the rest and fit in real shoes.

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Re: I think you need to...

elliott on 8/04/02 at 20:25 (091578)

call Dr. Kiper! :-)

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Re: "real" shoes

wendyn on 8/04/02 at 21:03 (091579)

Elliott, I think you are having a hard time 'getting through' because you and I seem to be talking about two different things.

I think it's positively _lovely_ for you that you found thin orthotics that fit in shoes. Having orthotics that take up too much shoe-room seems to be a common problem.

My _particular_ problem is that I have some nasty bunions on either side of my right foot. So, thin orthotics or no - real shoes hurt me. Even running shoes.

The only time I wear 'real' shoes is for an hour or so at the gym, and while biking. This is also why I try to manage in 30 below weather on ice wearing Birks. Any pressure on the sides of my feet causes the bunions to swell. Then they enlarge and press harder agains the sides of my shoes. More pressure, more swelling, more pain.

My point was that although I find my orthotics themselves comfortable, I simply cannot wear 'real' shoes.

Re: NancyS

wendyn on 8/04/02 at 21:10 (091581)

Nancy - have not heard from you much lately!

I know what you mean about the boney feet with no padding. My feet feel the same. Maybe one day they will come up with a liposuction for this - suck the fat right off your butt and inject it into your heels.

;)

Re: now I get it

elliott on 8/04/02 at 21:26 (091583)

Can't a pod cure the bunions?

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Re: Bunions

wendyn on 8/04/02 at 21:34 (091584)

I developed the bunions when I was about 19 or so. When I was around 23, I had surgery on the one on my big toe. It's a 'dorsal' bunion, meaning that it's on the top and side of my toe, rather than right on the side like most bunions.

It had been causing me excurtiating pain, enough to keep me up at night. I had an excellent orthopedic surgeon do the work, and she did a great job. The recovery was really quite painful for about 2 weeks, but I was actually skiing 6 weeks later on my honeymoon.

Following the surgery, the surgeon told me that the bunion had formed due to lousy biomechanics and arthritis. She told me that I would likely need to have it operated on again in 8 to 10 years.

That was 10 years ago, so she's pretty much right on with how long it took to come back. It's still not as bad as it was before (probably because I live in sandals now).

I'm not really sure if a surgeon would touch it now, I have RSD in both feet so they may not. I suppose if (when) it gets bad enough, I'll have to do it - but I'm not looking forward to doing this every 10 years.

Re: I think you need to...

nancy s. on 8/04/02 at 23:18 (091591)

aw, rats!

Re: NancyS

nancy s. on 8/04/02 at 23:26 (091592)

hey, wendy -- the board is too big for me now!

i hate that bony, no-padding feeling, don't you? i like your idea....

with a nice push from julie (and john), i'm taping a good deal these days with leuko tape. it really makes a difference on the days i'm on my feet too long. it seems to cut the at-night ache and recovery at least in half.

Re: Bunions

Pauline on 8/05/02 at 00:10 (091594)

Wendyn,
Was that about the time pointy shoes were in fashion? Didn't we all push our feet into those tiny points and ballerina slippers for fashion? I believe shoe design certainly aided our foot problems.

I remember seeing the bone in my foot that would have become a bunion turning red and hurting until I finally decided that I would never again break in a pair of shoes on my feet and I would look for heels with more room in the toes. No more pointed toe shoes.

We even wore our lofers tight if I remember correctly. They usually had a tendency to slip in the heels so we purchased them smaller and our toes took a beating while we broke them in.

Today if I go to a shoe store, one that actually has sales people waiting on you, and they mention 'you have to break them in' I smile and select another shoe.

Unfortunately since P.F. I like others have collected a huge variety of worthless shoes trying to find that one fashionable pair to substitute for my friendly running shoes.

Now if Pods would only work on designing a fashion shoe line for P.F. sufferers the ladies here might really jump for joy.

Re: Bunions

wendyn on 8/05/02 at 00:52 (091597)

Pauline, the last time I had a salesman mention 'breaking in a pair of shoes' - he received a few words of wisdom from me.

I did wear 'pointy' high heeled shoes for a brief period. During high school I wore mostly sandals or running shoes. I think I had only been working a year or so when the bunions started.

I asked the doctor if it was because of my shoes, and both doctors (pod and ortho) suggested that since I had the bunions at 19, genetics and biomechanics played a far bigger role than shoes.

I'm sure the Birks are helping slow down the progress of the bunions, but the big one is still coming back (even though it has lots of room in sandals.) I won't disagree with you though, those pointy shoes were bad news.

Re: NancyS

Julie on 8/05/02 at 02:58 (091599)

Hi Nancy

I'm glad the Leuko tape is working. It's so long since I've had a mail from you that I thought you'd gone for a long, long walk on the beach.

Just kidding :)). No worries:))

((((Nancy)))) (hug)

Re: Bunions

Julie on 8/05/02 at 03:05 (091600)

Wendy, I've posted in the past about my North Face Targas. I know you've tried just about everything there is, and I haven't actually seen your bunion, but I will say that one of the pluses (there are many) about the Targas is that they have a wide, roomy toebox. I have bunions too (normal ones, not interesting ones like yours :)) and these are the only shoes I think I've EVER had that give them enough room. The Targa Toebox is also the highest I've ever come across (I think I have high toes, because pressure on the tops of them has always been an issue.)

They're really a good, sturdy, supportive, stable walking shoe with a very thick sole and plenty of tread - important for me with all the stony ground I tread in Crete, and equally good on London pavements. I wear them all the time outdoors. But the toebox is the thing, that's why I thought it worth mentioning to you and your bunion.

Any good to you, this suggestion? Hope so.

Re: Bunions

Pauline on 8/05/02 at 08:33 (091609)

Can you believe it they are on the way in again. On the latest fashion list. Woe to the toes.

At least we're past the stage of pushing our feet into tiny points and breaking in shoes.

When you think about it, sounds like the shoe industries version of bronco busting.

Re: putting in a plug for mail order

elliott on 8/05/02 at 09:24 (091615)

I appreciate the concern. My experience with going to stores for such things is always the same: travel long distance to get there, don't have my size/color, they push to get me to try a different shoe/sandal, can order but it will take a few weeks. It is true that the salespeople in such stores are more knowledgeable than in others, but I'm not coming there for advice.

OTOH, with mail order, I can choose size/color, can return without hassle as stated on site, don't have to talk to anyone, no embarrassing returns. With the Mephistos, on-line the price is probably about $5 lower than the stores and most offer free shipping. All I'm risking is the cost of the return shipping, about $5.

More practically, best as I can tell from web searching, there are only three Mephisto sandals having no anklestrap: Zonder, Zach, Norman. If a store had all three in stock in my size/color, I would drive out there, but the chance of that is 0. Based on their description, style, and color, I think I've narrowed it down to one. It's just that I don't think they're gonna work anyway, so I've been delaying ordering them. As with most here, I've already spent a fortune on shoes. Have you ever noticed they always work long enough for you to dare wear them outside and then you can't return it? But I have made progress. I have a black walking shoe for work, ordered yet another to see if that's even better; should be arriving any day. None of these are available in stores locally. Have a running shoe for use in the fitness center and for mall-type walks. Just bought a light hiking shoe yesterday at REI for rougher terrain that seemed unbelieveably great in the store--I'll delay a report until I'm sure it's positive. Orthotics fit nicely in all three. But I need something for indoors to act as a slipper. I'll break down one day and order the Mephistos unless I find something better before then.

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Re: julie

nancy s. on 8/05/02 at 11:13 (091623)

i'm sorry, julie! i'm bogged down in work and heat, plus we've been plumbingless for two weeks. more soon, i swear. yes, the tape definitely is helping -- thank you!

Re: Bunions

wendyn on 8/05/02 at 11:19 (091628)

Pauline, I can't get over the ridiculously HIGH shoes and boots these girls wear now.

Re: Bunions

wendyn on 8/05/02 at 11:24 (091631)

Thanks Julie, when I finally have to break down and face winter I will keep them in mind.

I became so frustrateed with shoes that I eventually gave up. I spent way too much time having to take things back.

Maybe I will have a better frame of mind this fall!

Re: combined with superthin orthotics, of course :-) (nm)

elliott on 8/05/02 at 13:33 (091643)

.

Re: Birk shape

Ed Davis, DPM on 8/06/02 at 21:55 (091794)

Elliott:

Sounds like the basic shape of the Birk is problematic for you. I know it is an pricier option but a custom Birk would be as close to perfect as you can get. Use the corrected positive casts from your NW orthotics to have the footbed formed. I feel it is really fairly cost effective since you will have one sandal that really works and one that lasts a long time.
Ed

Re: To Elliott more specifics

Ed Davis, DPM on 8/06/02 at 22:11 (091795)

Pauline:

I really have to take exception to your statement that use of the custom orthotics has something to do with income of podiatrists. One could make that argument for any procedure that is popular in a specialty or profession. The bottom line is that custom orthotics have saved thousands of patients from surgery which is far more expensive, disabling and painful. I make about 3 to 4 times as much on a plantar fascial release with heel spur resection than on a pair of custom orthotics.

Your assertion that 'few insurance companies will pick up the tab' is incorrect. About 70 to 75% of the custom orthotics I make are reimbursed by insurance companies. That figure varies with geographical area. It is silly to imply that the presence of insurance coverage factors into the value of a service. Most individual health insurance policies in my state do not cover maternity-- 'maybe they don't believe in that concept either.'

You posed the question, 'why is it necessary for people with lower arches or flat feet to have an arch in their shoe in the first place?' It is not necessary and I know of no professional who feels it is necessary. Orthotics are used to control excessive motion (instability) particularly overpronation or sometimes oversupination. It is this excessive motion that overstrains supportive structures such as the fascia which, in turn, can lead to pain.

You had mentioned, referring to custom orthotics, that 'everyone gets a pair.' I would estimate that 10 to 15% of my patients get custom orthotics and I do not think my practice is that different from the average podiatrist.
Ed

Re: Dr. Ed

elliott on 8/07/02 at 00:03 (091809)

When you say 'corrected positive casts from your NW orthotics', is that the mold that, according to my pod, NW throws out after three months (which has long passed), or is that the orthotic itself?

At this stage I'm so put off by Birk. Still think a custom should not be necessary. All I want is a firm flat sandal (for inside-the-home use only). Still flabbergasted that all these companies alleging to make the best sandals in the world don't seem to have that, even though many with problem feet, the types willing to shell out big bucks for quality sandals, would need precisely that.

By any chance are you coming to the Mid-Atlantic region any time soon? I'd still drive far for you to examine my feet. Mentioned to the wife the idea of a Seattle vacation. 'Whatever for?', she said. :-)

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Re: Dr. Ed

Ed Davis, DPM on 8/07/02 at 14:52 (091863)

Elliott:

The labs, including NW, provide the option (to the provider) of storing the patients cast for 3 months or shipping them back. I always pick the latter option then give the corrected casts to my patients. Patients usually find the corrections on the cast interesting to look at and it gives patients the option to quickly and more economically obtain things such as dress orthotics, custom Birks, etc.
Ed

Re: Bunions

JudyS on 8/07/02 at 15:50 (091874)

Wendy - I saw a girl actually fall right off those kind of shoes yesterday when I was walking around in San Luis Obispo.....

Re: *now* you tell me

elliott on 8/07/02 at 16:28 (091880)

My pod never gave me an option to keep my casts. (Curious, is it 3 months from day of mold, 3 months from day orthotics are received by pod, or other? Molds were taken in late February, orthotics received in early March). By now my molds no doubt have been cremated and their ashes spread across the Pacific. :-) He did give me the option of ordering another pair of orthotics at his cost price within those three months, e.g., if I wanted the full-length besides the 4/5 length, but I like room in the toebox, so the 4/5 is all I need for all my shoes. Rarely ever put on dress shoes, and at this point wouldn't dare wear an orthotic without a heel post. Never thought about custom Birks.

The molds would be nice in case I lost or destroyed my first pair. The pod said that the further into the future one gets, the more a new mold is preferable in case the arch has changed shape, especially if one feels his orthotics aren't working anymore. This and the feeling they would never work to begin with contributed to my choice of not getting another pair. Assuming I keep my same insurance, which is likely, and assuming this benefit doesn't change next year (BCBS), if I hold out till January, I can get another pair on a new mold for $89 anyway. Come to think of it, my plan does not explicitly say only one pair a year (is that the rule?), only that it be a functional orthotic prescribed by a doc. My wife may need a pair soon; she has an early case of PF.

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Re: *now* you tell me

Ed Davis, DPM on 8/11/02 at 12:03 (092198)

Orthotics only weigh a few ounces but the positive casts are very heavy so UPS shipping costs go up a lot when we ask for the casts to be shipped back with the orthotics. I sort of view the return of casts to my patients as a 'value added' service. I did not always do this but found it to be helpful to patients.
Ed