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A question about orthotics

Posted by Kathy G on 11/21/02 at 16:34 (100828)

Hi All,

I had my Footmax orthotics, which were working out beautifully, relined back in October. I thought the padding in them was wearing out. My Pod suggested that this time I have extra arch support added as well as extra padding. My orthotics don't have the amount of arch support he would like and since my feet were feeling so good, I said, sure, go for it. Then he also added some extra padding and, at my suggestion, raised the heel of one of them to compensate for my shorter leg. Well, if you have looked at my previous rants, you will see that I was without the orthotics for thirteen days, during which time I had the worst pain I've ever experienced. When I got them back, I thought I'd give them a fair shake as my poor feet were so traumatized, it was like I had full-blown PF, only worse than I'd ever had.

After four weeks, I had him remove the arch supports as my arches were really hurting. Before, the orthotics had a vinyl backing on the bottom, but when they altered it, they had to take off the vinyl and put on rubber heels, one of which is built up. We left the 'heels' on the orthotics. Now, two weeks later, my arches seem better but my heels are just horrible. I wondered if the rubber material was too inflexible for my feet. I called him today and he said that he thinks my feet may still be recovering because he's never had anyone have any problem with these heels. Have any of you had such a problem? Do you even understand what I'm trying to say has been put on the orthotics? The rubber doesn't come in contact with my feet, it's on the bottom of the orthotics.

I opted to wait a while and see how my feet do over the next few weeks. If the heels have to be removed, he can't remove them in the office as he did my arch supports, so they'll have to go out again. I just can't be without them for thirteen days, especially this time of year. I guess I'll have to get a second pair made and once they're ready, send the old ones out to be repaired. I called my insurance company and they say that they cover orthotics but my Pod seems to think that they didn't read the fine print and that they only cover orthotics that are attached to braces. If that's the case, I'm facing another $400 for orthotics. Not to mention that the first pair, on which I've already spent $491 ($400 to make and $91 to reline) will probably cost another $91 if they go out again. Actually, I'm thinking I should just chuck them and not invest more money in them. I mean, for $600, they should be made of solid gold, don't you think?

So, essentially, my question is: What kind of heels do most of you, with custom orthotics, have? Have any of you run into this kind of discomfort?

I should have waited until the orthotics wore out completely because I'm back to square one, or worse, but I thought I was doing the right thing!

Thanks for any info you have!

Re: A question about orthotics

Ed Davis, DPM on 11/21/02 at 21:05 (100845)

Kathy:

We generally provide patients with a prefabricated orthotic to wear if we have to send their orthotics away for repair. If your podiatrist does not do so, some of the better pre-fabs include Superfeet ( http://www.superfeet.com ) and the Powersteps mentioned on this site. They are economical and may be worthwile obtaining.
Ed

Re: A question about orthotics

Carole C in NOLA on 11/21/02 at 21:20 (100848)

My custom orthotics are not the rigid kind, and they are made of blue foam on a layer of semi-rigid but bendable plastic which I believe is eva or maybe it's the vinyl you mentioned. I'm holding them right now and looking at them, and the heel doesn't seem any different from the rest of the orthotic, to me. I don't have any special kind of heels put on them. The arch part has considerable building up done in a blue rubber-like plastic which looks like it was added during the custom fitting process.

Since he had to take off the usual material to put something else there to compensate for your shorter leg, it sounds like he didn't make a very good choice in what to put there. Or, maybe you are having trouble adjusting to having the extra height for that shorter leg. Could that be part of it?

They sure are expensive. Mine were $225 including the C.Ped's time and everything (except the shoes she fit them to, which were another $130).

Some insurance companies DO cover orthotics. My C.Ped's assistant told me that they never did, but I think that just means that they want to be paid now and not have to submit the forms and wait. If I were doing it over again, I'd go ahead and pay on the spot if that's what they want, but then I'd submit the forms myself and see what happens. It can't do any harm.

I'm sorry your heels are hurting again! I don't see what you can do but either go back or else go to another pod. Maybe he can fix the old ones so that you don't have to buy new ones.

Carole C

Re: A question about orthotics

Julie on 11/22/02 at 01:33 (100873)

Kathy - what a shame. Your post sets several bells ringing for me. The loudest is your pod saying that he's never had anyone have a problem with these heels - which is the equivalent of 'we've never had any complaints', or 'this is nothing to do with me, it's all the fault of your funny feet and I'm not taking any responsibility for what I did to your orthotics'.

I don't like it. I also don't like the price! and I agree with Carole that you should probably find someone else.

And I wonder if you really needed the heel lift? Sometimes, one leg shorter than the other may be a genuine difference, in which case a lift is indicated; sometimes it is a functional difference due to a scoliosis (spinal curvature) which brings one hip higher than the other. I don't know which applies to you (I'm sure you do!) but if it's the latter, a heel lift can make things worse.

I hope Dr Ed's suggestion will help you through the hiatus if you do need to be without your orthotics for a while. Good luck!

Re: A question about orthotics

Richard, C.Ped on 11/22/02 at 10:20 (100900)

Hi Kathy...
I can really sense your frustration. You might want to make sure that there was not to much lift added to the heel. Our orthothics are ground flat on the bottom. There is no seperate heel. When we have to add a lift, we add it to the whole bottom of the orthosis, leaving the proper amount of lift at the heel, and taper it to the met heads. Sometimes, a seperate heel will only make the orthosis bend or flex where the heel stops and the orthosis begins. It is really hard to explain without showing you.

I am concerend about your insurance company as well. If you would like, feel free to email me at (email removed). I will be happy to call them and ask questions about coverage.

I also want to know...what exactly is 'relining'?
Richard, C.Ped

Re: Thank you all!

Kathy G on 11/22/02 at 18:37 (100936)

Hi Everyone,

Thanks for your suggestions. Ed, I never thought of the Superfeet or Powersteps and I have no idea why I didn't. My doctor told me to get some Spenco's while my orthotics were being fixed but I had my husband bring them back for me. They really made my feet hurt. I think I'll have him send these out once more and get them back to 'normal' but first invest in a pair of one of those to see if they make the two week wait more tolerable.

Julie, I didn't fully explain about the lift. I have had a muscle spasm in my latissimus dorsi on the left side since last March. It has gotten increasingly worse despite my going to my chiropractor who is usually able to help me with my back ailments. I had this crazy idea that since my feet were so much better and I was walking more, maybe having the lift in my shoe would work. I do have mild scoliosis and a few doctors have told me over the years that I should wear a lift, but I never stayed with it for long. None of them ever thought it was severe. Now, interestingly, although my feet are dreadful, my back is unbelievably better so my assumption is that although it took six weeks, the lift is working. Seeing as the pain has been there for this long, it seems logical it could take that long. I also am waiting for the results of an X-ray my Primary Care Physician took to make sure there's nothing else awry but I don't really think there is.

As to the doctor writing me off, I don't really think he did but I'm certainly giving your suggestion great thought. He's a very nice, caring person with an excellent reputation. He seems genuinely frustrated that he can't help me more than he has. I do have an unusually sensitive body and as my chiropractor often says, 'Well, with the normal person, this shouldn't be happening, but we're talking about you!' And he's not even talking about my feet. I've been this way my whole life. The guys in the shoe store said I could pick up on the slightest little wrinkle in the interior of the shoe when no one else would have noticed it.

But I do wonder if I should go for a second opinion. And as to the price, well, we have a couple of lousy Podiatrists in the area and I swear that because the guy I go to and his partner have so little competition, they can charge pretty much what they want. My son, who has PF, says I should go to his Pod in MA which isn't far away at all and get a second opinion.

I'm greatly concerned with the way that the lift was put on the orthotic and I was in bad pain again today. I'm going to call him as soon as I get some new inserts because no matter what, I can't go into the holiday season like this.

Richard, your offer is so kind and I will email you separately. Today is my husband's day off and I just quickly signed on before we sit down to watch a movie.

Thanks to you all, once again!

Re: A question about orthotics

BGCPED on 12/11/02 at 13:35 (102731)

I am not a big fan of the FootMax device since it is not truely custom made but rather custom fit to a shell picked to match closest to your foot scan, which is dynamic and wt bearing. Most of the device have a low profile heel cup and put too much focus on just arch height and less on forefoot/rearfoot. They adjust them by heating them and bending them in most cases. I am not saying they are bad but for $400 and $90 to adjust them you may want to try a different provider and brand if you dont get resolution with the current device the way they are. What area are you in?

Re: A question about orthotics

Kathy G on 12/13/02 at 13:54 (102956)

Hi,

I'm so glad I scrolled down or I would have missed your post! I'm in Milford, NH which is near Manchester and Nashua. Since the first post of this thread, I'm doing better so I'm going to wait until after the holidays before I decide what to do next. These were made by the method using the computer where you walk across a pad. Because of the sensitivity of my feet, my Pod wasn't able to order the types he would have ordinarily for a person with PF. He ordered the type for arthritic feet and I think he was on the right track. My son has PF and his orthotics are so hard, they'd kill me. He also has PowerSteps and I wouldn't be able to wear those, either.

I really like my podiatrist and think he's extemely frustrated that he can't give me more relief. I was toying with the idea of going to Boston but may try a second opinion locally. Or maybe I'll just go back to my Pod and see if he wants to try a different type.

Any suggestions you could offer would be most welcome. You can either post here or reach me at (email removed).

Thanks so very much!

Re: A question about orthotics

BGCPED on 12/15/02 at 23:20 (103254)

I have a good friend in Vermont (think Richard may know him also)He owns Freen Mtn Orthotic Lab and during the winter he is at Stratton Mtn. He does work out of an ortho office day or 2 per week. He is a CPed, I think he can be emailed at (email removed) you can also call him at the first run ski shop at stratton. Good luck

p.s. you could also try the cped search on Richards site

Re: A question about orthotics

Richard, C.Ped on 12/17/02 at 08:48 (103385)

Brian...
If you are talking about Greg Hoffman....I know of him...but my father in law Mike, knows him well. A great guy from what I understand.
Richard

Re: A question about orthotics

Ed Davis, DPM on 11/21/02 at 21:05 (100845)

Kathy:

We generally provide patients with a prefabricated orthotic to wear if we have to send their orthotics away for repair. If your podiatrist does not do so, some of the better pre-fabs include Superfeet ( http://www.superfeet.com ) and the Powersteps mentioned on this site. They are economical and may be worthwile obtaining.
Ed

Re: A question about orthotics

Carole C in NOLA on 11/21/02 at 21:20 (100848)

My custom orthotics are not the rigid kind, and they are made of blue foam on a layer of semi-rigid but bendable plastic which I believe is eva or maybe it's the vinyl you mentioned. I'm holding them right now and looking at them, and the heel doesn't seem any different from the rest of the orthotic, to me. I don't have any special kind of heels put on them. The arch part has considerable building up done in a blue rubber-like plastic which looks like it was added during the custom fitting process.

Since he had to take off the usual material to put something else there to compensate for your shorter leg, it sounds like he didn't make a very good choice in what to put there. Or, maybe you are having trouble adjusting to having the extra height for that shorter leg. Could that be part of it?

They sure are expensive. Mine were $225 including the C.Ped's time and everything (except the shoes she fit them to, which were another $130).

Some insurance companies DO cover orthotics. My C.Ped's assistant told me that they never did, but I think that just means that they want to be paid now and not have to submit the forms and wait. If I were doing it over again, I'd go ahead and pay on the spot if that's what they want, but then I'd submit the forms myself and see what happens. It can't do any harm.

I'm sorry your heels are hurting again! I don't see what you can do but either go back or else go to another pod. Maybe he can fix the old ones so that you don't have to buy new ones.

Carole C

Re: A question about orthotics

Julie on 11/22/02 at 01:33 (100873)

Kathy - what a shame. Your post sets several bells ringing for me. The loudest is your pod saying that he's never had anyone have a problem with these heels - which is the equivalent of 'we've never had any complaints', or 'this is nothing to do with me, it's all the fault of your funny feet and I'm not taking any responsibility for what I did to your orthotics'.

I don't like it. I also don't like the price! and I agree with Carole that you should probably find someone else.

And I wonder if you really needed the heel lift? Sometimes, one leg shorter than the other may be a genuine difference, in which case a lift is indicated; sometimes it is a functional difference due to a scoliosis (spinal curvature) which brings one hip higher than the other. I don't know which applies to you (I'm sure you do!) but if it's the latter, a heel lift can make things worse.

I hope Dr Ed's suggestion will help you through the hiatus if you do need to be without your orthotics for a while. Good luck!

Re: A question about orthotics

Richard, C.Ped on 11/22/02 at 10:20 (100900)

Hi Kathy...
I can really sense your frustration. You might want to make sure that there was not to much lift added to the heel. Our orthothics are ground flat on the bottom. There is no seperate heel. When we have to add a lift, we add it to the whole bottom of the orthosis, leaving the proper amount of lift at the heel, and taper it to the met heads. Sometimes, a seperate heel will only make the orthosis bend or flex where the heel stops and the orthosis begins. It is really hard to explain without showing you.

I am concerend about your insurance company as well. If you would like, feel free to email me at (email removed). I will be happy to call them and ask questions about coverage.

I also want to know...what exactly is 'relining'?
Richard, C.Ped

Re: Thank you all!

Kathy G on 11/22/02 at 18:37 (100936)

Hi Everyone,

Thanks for your suggestions. Ed, I never thought of the Superfeet or Powersteps and I have no idea why I didn't. My doctor told me to get some Spenco's while my orthotics were being fixed but I had my husband bring them back for me. They really made my feet hurt. I think I'll have him send these out once more and get them back to 'normal' but first invest in a pair of one of those to see if they make the two week wait more tolerable.

Julie, I didn't fully explain about the lift. I have had a muscle spasm in my latissimus dorsi on the left side since last March. It has gotten increasingly worse despite my going to my chiropractor who is usually able to help me with my back ailments. I had this crazy idea that since my feet were so much better and I was walking more, maybe having the lift in my shoe would work. I do have mild scoliosis and a few doctors have told me over the years that I should wear a lift, but I never stayed with it for long. None of them ever thought it was severe. Now, interestingly, although my feet are dreadful, my back is unbelievably better so my assumption is that although it took six weeks, the lift is working. Seeing as the pain has been there for this long, it seems logical it could take that long. I also am waiting for the results of an X-ray my Primary Care Physician took to make sure there's nothing else awry but I don't really think there is.

As to the doctor writing me off, I don't really think he did but I'm certainly giving your suggestion great thought. He's a very nice, caring person with an excellent reputation. He seems genuinely frustrated that he can't help me more than he has. I do have an unusually sensitive body and as my chiropractor often says, 'Well, with the normal person, this shouldn't be happening, but we're talking about you!' And he's not even talking about my feet. I've been this way my whole life. The guys in the shoe store said I could pick up on the slightest little wrinkle in the interior of the shoe when no one else would have noticed it.

But I do wonder if I should go for a second opinion. And as to the price, well, we have a couple of lousy Podiatrists in the area and I swear that because the guy I go to and his partner have so little competition, they can charge pretty much what they want. My son, who has PF, says I should go to his Pod in MA which isn't far away at all and get a second opinion.

I'm greatly concerned with the way that the lift was put on the orthotic and I was in bad pain again today. I'm going to call him as soon as I get some new inserts because no matter what, I can't go into the holiday season like this.

Richard, your offer is so kind and I will email you separately. Today is my husband's day off and I just quickly signed on before we sit down to watch a movie.

Thanks to you all, once again!

Re: A question about orthotics

BGCPED on 12/11/02 at 13:35 (102731)

I am not a big fan of the FootMax device since it is not truely custom made but rather custom fit to a shell picked to match closest to your foot scan, which is dynamic and wt bearing. Most of the device have a low profile heel cup and put too much focus on just arch height and less on forefoot/rearfoot. They adjust them by heating them and bending them in most cases. I am not saying they are bad but for $400 and $90 to adjust them you may want to try a different provider and brand if you dont get resolution with the current device the way they are. What area are you in?

Re: A question about orthotics

Kathy G on 12/13/02 at 13:54 (102956)

Hi,

I'm so glad I scrolled down or I would have missed your post! I'm in Milford, NH which is near Manchester and Nashua. Since the first post of this thread, I'm doing better so I'm going to wait until after the holidays before I decide what to do next. These were made by the method using the computer where you walk across a pad. Because of the sensitivity of my feet, my Pod wasn't able to order the types he would have ordinarily for a person with PF. He ordered the type for arthritic feet and I think he was on the right track. My son has PF and his orthotics are so hard, they'd kill me. He also has PowerSteps and I wouldn't be able to wear those, either.

I really like my podiatrist and think he's extemely frustrated that he can't give me more relief. I was toying with the idea of going to Boston but may try a second opinion locally. Or maybe I'll just go back to my Pod and see if he wants to try a different type.

Any suggestions you could offer would be most welcome. You can either post here or reach me at (email removed).

Thanks so very much!

Re: A question about orthotics

BGCPED on 12/15/02 at 23:20 (103254)

I have a good friend in Vermont (think Richard may know him also)He owns Freen Mtn Orthotic Lab and during the winter he is at Stratton Mtn. He does work out of an ortho office day or 2 per week. He is a CPed, I think he can be emailed at (email removed) you can also call him at the first run ski shop at stratton. Good luck

p.s. you could also try the cped search on Richards site

Re: A question about orthotics

Richard, C.Ped on 12/17/02 at 08:48 (103385)

Brian...
If you are talking about Greg Hoffman....I know of him...but my father in law Mike, knows him well. A great guy from what I understand.
Richard