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For Yasmin

Posted by Julie on 4/03/03 at 14:49 (115316)

Hi Yasmin

Thanks for your email with your address. I did receive the two you sent a week or so ago, but the mail I've tried several times to send you keeps bouncing back at me with a message that says there is something missing from the domain name. Perhaps you could check this out. (Also, your email address never appears at the top of your emails, so they can't be responded to by using the reply button.)

Anyway, here is the best I can do in response to the several questions you asked about orthotics. Remember that I'm not an expert and am speaking only from my experience, so it would be a good idea for you to post the questions you asked me on the board so that one of the doctors or pedorthists can give their opinion.

Here's the email:

Hi Yasmin

It's easy for me to give you my opinion (from experience) on orthotics. I'm a great fan of them, as long as they are correctly casted and made. (More about that later.)

Since you over-pronate, and since taping is effective for you, orthotics (well made!) will almost certainly help you. Yes, there's a price to pay, which is that you do have to wear them all the time, and that does mean limiting your shoe wardrobe. Orthotics that fit into a good, supportive trainer will not fit into a dress shoe with high heels and pointed toes (but you really shouldn't be wearing shoes like that anyhow, as I'm sure you know).

I over-pronate also, and I have had orthotics since I got PF. I have
absolutely no doubt that they were a big factor in my healing. I have been fine for two years, but I still wear my orthotics all the time (when I'm not in my Birkenstocks, which I always wear indoors).

This just seems sensible to me. My orthotics were made to correct a
biomechanical abnormality. That abnormality has not gone away, and won't go away, so my conclusion is that if I want to avoid future problems I should wear orthotics forever (having them checked and adjusted or remade every few years - because feet do change). I am comfortable with this.

I think the person who made that comment to you - though correct - put it in an unncessarily negative way, as though you were going to be given a life sentence to some horrible fate! But orthotics aren't 'brutal', nor do they put your feet into an 'unnatural' position. They correct a fault, and put your feet into a position that is really more natural!

I myself am not worried about weakening muscles - our foot muscles are weak in any case because we don't go barefoot all the time. The answer to that is appropriate exercises, such as the ones I've posted on the board. Pauline has often said that she believes orthotics weaken muscles, but I don't agree with that and I haven't seen any evidence for it. Even if it were true, it wouldn't weaken the case for orthotics if your biomechanics suggest they would help.

You have to make your own decision, but I would certainly encourage you to at least investigate orthotics. I seem to remember you're in London, so if you feel you'd like to see Ron McCulloch, my podiatrist, you can get in touch with him through his website: http://www.londonpodiatry.com . He casted my orthotics, and had them made in the States because he thinks they do these things better there. That has the disadvantage that they can't be adjusted if they're not absolutely right, but fortunately this wasn't a problem in my case: they worked fine. That's the only problem I could foresee, but it could be a big one, and it might be better to go to someone who has orthotics made in Britain.

I hope this is some help.

All good wishes