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SDOs - six month update

Posted by Andrue on 9/19/03 at 06:56 (130503)

Actually a bit more than six months but it's close enough. I've had my second prescription (more fluid) for a couple of weeks now so that's also a good time to report.

I continue to be more mobile than I was when I first got the SDOs and the bottom of my feet are a lot less sensitive than they were. The idea of walking barefoot across gravel doesn't bother me in the least whereas it would once have made me cringe. I'm actually hoping that next summer I can go walking barefoot along a couple of river beds I know :)

The muscle along my arch is no longer sore and the slight bump half way along (which my massage therapist said was scar tissue) is beginning to dissapear.

The new prescription has resulted in some return to soreness in front of the heel but it doesn't last and I expect it to stop within another week or so.

When I started with the SDOs I was at the point of combining trips to the loo with other reasons to be stood up so as to minimise pain. After wearing the SDOs for a couple of months I was going for fifteen minute walks at lunchtime every other day (very handy given that this year the UK has had a pretty good summer). Right now I'm contemplating walking into town (fifteen minutes each way) just for the heck of it.

I'm not cured yet but my feet are more than functional and I don't really have to be nice to them to keep them that way. Any soreness or discomfort nearly always dissapears over night.

Oh and a note on Birkenstocks. I've now got to the point where I can't feel the arch support any more in my Arizonas. I find myself wondering if there's a Birk. with more arch support? Oh, and why is the cork so soft and comfortable? Bah. I need a harder foot bed :)

Re: SDOs - six month update

Suzanne D on 9/19/03 at 21:32 (130571)

Andrue, it's good to read that you are enjoying so much improvement!

As to your question about Birks with more arch support, the Fulda has more than the Arizona. I do not have that particular shoe, but Carole C. who posts here does and has reported finding it to be good for her feet. Perhaps she will see your post and respond to you more about the Fulda.

Does your Arizona have the soft footbed? Mine do, and that is what I need, but most people seem to like the regular footbed better. I just wondered if that was what you have.

Take care, and best wishes for continued improvement!
Suzanne :)

Re: SDOs - six month update

Carole C in NOLA on 9/19/03 at 22:03 (130576)

Andrue, I didn't answer previously because I thought maybe you had posted that you already had the Fulda. If not, here's my impression of them.

I do like my Fuldas. They are very similar in style to the Arizona, but have a different footbed (the high arch variety of Tatami footbed). The arch bump feels a little further back and a little higher... not drastically so, but I do like this footbed better. They are especially good for providing variety from the Classic footbed. Maybe they are worth a try!

The Fulda tends to run about a half size smaller. My feet are midway between a 39 and 40 in the Arizona, and a perfect fit to the 40 in a Fulda.

Hope this helps.

Carole

Re: SDOs - six month update

Nan D on 9/20/03 at 16:00 (130595)

Hi Andrue,

That is WONDERFUL news and I LOVE my SDO's too. My feet are doing so well that they tell me I might be able to run again. (See....Dr Davis, these SDO's are sold on the internet and truly are the GREATEST invention known to foot pain!:D)

I am at an approx. 6 month date too & ready for a new prescription. I wondered why you are getting more fluid? I thought since the feet improve, that possibly you would need less fluid. Which design of the SDO do you have?
Thanks,
Nan

Re: questions about these SDOs

Pam S. on 9/20/03 at 23:18 (130606)

Dear Friends:
I am very interested in this product since I have been unable to tolerate any type of orthodic. These sound so soft yet supportive. Have those of you using this product had difficulty tolerating regular orthodics also?

Is it difficult to do this long distance? I am leery about that. I bet I cannot mold my foot myself. Adjustments would be a pain mailing back and forth.

What are the drawbacks to this? It always sounds like the best thing in the world on the internet advertisement. How much does it cost? Do you need a prescription?

Is it better to go to CA in person. I could since my daughter is in school there but she is in Northern CA. I think Del Mar in in So. CA?

Any other people out there who have had success with this product? Thx Pam

Re: questions about these SDOs

Nan D on 9/21/03 at 09:57 (130614)

Hello Pam,

I know exactly how you feel regarding being skeptical of this process working smoothly. I was so frustrated w/ Pod's, useless orthotics and in so much pain, I decided it was my last chance to get any relief. I determined if I put the order on a credit card, made a copy of the site clearly stating there is a money back guarantee, WHAT COULD I POSSIBLY LOSE? ;-) I also did NOT have at the time, the HUGE BENEFIT of heelspurs for everyone's help! I had no problem molding my feet & required only one correction which they responded to immediately. No prescription is required, unless you want to use your insurance & they provide all the documentation. I sell Real Estate and am on my feet constantly. The pain was so bad in December(2002)I could barely walk. Now, I'm about 80% better and can do anything I want to do. I hope to be back to running very soon.

I say GO FOR IT because the product is defintely as good as the internet site describes! I will be happy to help you with any of the process if you have problems!
Nan

Re: Thx Nan, a few other questions

Pam S. on 9/21/03 at 21:30 (130655)

Dear Nan:
I do have a new prescription but I can hardly read what it says. I feel since I have both TTS and PF, Dr. Kiper would need to know about my case. Do you agree?

Did you have PF only? I have very flat, pronating feet. Right now only one foot is bothering me. The foot I had the TTS release on. Lucky me. Anyway, I really do not even know if trying orthodics again will make one bit of difference for me. The ortho I saw just probably did not know what else to do for me. I guess I just always have to be in process of trying to make things better like the rest of us.

I might give them a call tomorrow. I do not thing I will even fool with the other types of soft custom mades. They seem to work for most people but I am a difficult case.

I am glad you are so much better. I love to read good news. Thanks for the encouragement. I guess I will go for it. I would like to get reimbursed since my insurance covers this. Maybe I could fax the prescription to him. Sounds like he is quite responsive. Thx, Pam Do you have flat feet also?

Re: Thx Nan, a few other questions

Pam S. on 9/21/03 at 21:44 (130656)

Nan: Did you ever try these Power Steps I am reading about on another post?

Re: SDOs - six month update

Andrue on 9/22/03 at 05:51 (130667)

I don't think my Arizona has the soft foot bed, it's just cork.

Re: SDOs - six month update

Andrue on 9/22/03 at 05:52 (130668)

The Fulda sounds like it might be worth a look, then. I find that the Arizonas are slightly the wrong sizes for my feet. Something a bit smaller could be a perfect fit.

Re: SDOs - six month update

Andrue on 9/22/03 at 05:54 (130669)

I don't know about SDO design. As regards getting more fluid I think it's because my foot muscles are beginning to relax and the inflammation is dying down so I can tolerate a prescription closer to what I need.

I'll ask Dr. K as it's an interesting point.

All I can currently say is that I feel happier with more support right now.

Re: SDOs - six month update

Andrue on 9/22/03 at 06:03 (130670)

Hmmm, having written that I can see that it makes sense to have more fluid.

If it were reduced as time went on it'd either mean:

* The SDOs become less effective over time eventually resulting in them giving me no support at all.

* My arches dropping over time.

I wouldn't expect the prescription to increase continually and Dr. K. implies only one or two adjustments. I think he'll confirm that it's a case of the initial prescription being conservative or changes in my foot as it recovers.

As I posted in my initial message my soles have become a lot less sensitive to pressure. I remember watching a game show in which contestants had to stand on a log at sea for hours. Six months ago I couldn't have imagined even attempting that. Common sense and experience suggests I shouldn't give it a try just yet (no sense pushing my luck) but I no longer cringe at the thought :)

Re: questions about these SDOs

Andrue on 9/22/03 at 06:15 (130671)

They are moderately expensive (about double the cost of conventional 'hand made' orthos). I found them a little tricky to get used to at first because they tend to spread pressure around the sole of the foot and they are good at tweaking all the little pressure points that dont want to be tweaked.

I was surprised at how much tender points I actually had when I first tried them. Luckily this point tenderness goes away within a couple of weeks. Quite why I don't know. You'd expect it to flare up but that doesn't happen - or didn't for me anyway. Mind you, no one has ever been able to tell me what causes them either. Some feel like there is something embedded in the foot (kind of like a stone in my foot rather than a stone in my shoe). I can only guess that they are scar tissue or the areas of localised damage?

I still have one area of point tenderness in front of my right heel toward the inside. This got a bit irritated with the new SDOs but again is no longer a problem.

What I'd say is give them a try if you can. Don't be put off by any initial 'stone in shoe' feelings. I never found the SDOs to be painful and the point tenderness did go away quickly.

Re: Thx Nan, a few other questions

Nan D on 9/22/03 at 17:05 (130710)

Hi Pam,

Yes, I have very flat pronated feet and tried many different hard, semi hard (from Pod's), pre-made soft, etc, etc orhtotics which were all a total waste of money. I have only 1 foot which is bad too, thank goodness. The sdo's work so well because of the soft gel which molds to your feet & supports your arch & heel. It also sort of 'massages' your feet while you walk which seems to help the healing process. The Pod's prescribe all these hard, semi hard orthotics for sore feet. That makes absolutely NO sense to me. HOW can sticking something hard in your shoe possibly help a tender sore foot????(ugh!) I think Dr Kiper will be able to help you after knowing your case history. And, the best thing is, if he can't help you & they don't work.....you get your money back!YOU CAN'T LOSE !!

I hope you do try the sdo's, so we have another opinion as to their effectiveness!
Nan

Re: Thx Nan, a few other questions

Nan D on 9/22/03 at 17:19 (130711)

Pam,

Power Steps are about the only orthotic I didn't try!Does it have a $$$ back guarantee? I think if someone is willing to guarantee & refund your money, that's a powerful statement that a product REALLY WORKS! Too bad MOST of these (Pods) don't put their $$ where their mouths & hard 'ice scraper' orthotics are !!!(Except YOU Dr. Wonder.....too bad we can't clone you in every city!)

Y'all know what the BOTTOM 1/2 of the medical graduating class is called, don't you? ****DOCTOR***** ......VERY scary.....!!!!!

Re: Thx Nan, a few other questions

Ed Davis, DPM on 9/22/03 at 23:12 (130767)

Pam:

The goal of orthotics is to modify foot function. It is necessary to decrease strain on the plantar fascia in order to obtain a cure. That can be done by decreasing subtalar joint (heel) overpronation or inward roll of the rearfoot and decreasing midtarsal joint oversupination -- at the front of the foot. Keep in mind that the fascia attaches to both the heel and ball of the foot so one must pay attention to both ends. The firmness of an orthotic is related to the amount of force it takes to achieve the correction and there is a wide range of firmness available based on the weight, occupation and amount of control desired from the device. No one is 'sticking something hard in the shoe' and to say so is an innaccurate representation of what is occurring. It is important to stick to the facts.

The idea of softness is always attractive. If you take a pillow and wrap it around your feet and try walking a modest distance you will find that your feet may hurt more. The reason is that if your subtalar joint overpronates, it will pronate more when it has too little resistance and if the midtarsal joint oversupinates (stretching the part of the fascia that ends in the ball) it will supinate more on the pillow.

I have no objection to the recommendation of products but when the technique for doing so involves the criticism of legitimate, time tested modalities and techniques I am concerned.
Ed

Re: questions about these SDOs

Ed Davis, DPM on 9/22/03 at 23:16 (130768)

Pam:
One of the most significant reasons for the inability to tolerate orthotics is a tight calf muscle. Has your range of motion (dorsiflexion or movement of the foot back on the leg) been tested?
Ed

Re: experience with SDO and my pedorthist

James on 9/23/03 at 00:10 (130777)

I am bit surprised that nobody has described exactly what they are getting. The SDO appears to be two pieces of sponge rubber sewn together with a fluid filled bladder.

I was a member of an HMO that did not include podiatry and had plantar fasciiitis so I thought that I had little to lose by trying the SDO.

They are soft and squishy and feel good when you first step down on them. They are fairly bulky unlike the description given here so they could not go in my penny loafers.

I have weak ankles so I felt like I had to tread carefully since I was planting my foot on a moving surface. After spraining my ankles several times, I gave up on them.

I had to pay out of pocket for the real thing at a pedorthist's shop. He explained that with support, one needs stability, not a moving surface. He took plaster of paris molds of my feet in order to obtain a truly custom fitting device and I have had no problems since.

My advice is to see a professional. Granted, the devices are returnable so some may feel that no harm is done but after 3 fairly wicked ankle sprains and a lot of aggravation, I decided that playing around with my health was not wise. Professionals such as doctors and pedorthists are not perfect. Be careful when you hear health claims that are too good to be true and when the tactics used by the purveyors involve bashing legitimate professionals.

That is all I have to say.

Best regards to all,
James

Re: experience with SDO and my pedorthist

Ed Davis, DPM on 9/23/03 at 00:54 (130780)

James:
I appreciate your thoughts. I spent years studying the function of the foot and refining techniques to make good orthotics. I wish I could say that all practitioners place emphasis in this area. Whether you go to a good pedhorthist or podiatrist, you are not just getting a device but an evaluation. I just don't know how that can be done by mail or over the internet.

There are practitioners with varying levels of skills in all professions. Basing the sales of a product on the failings of poor practitioners is not something I am comfortable with -- not to use a worn out cliche but 'two wrongs don't make a right.'

Please visit again.
Ed

Re: experience with SDO and my pedorthist

BGCPed on 9/23/03 at 11:10 (130799)

Some good points James. Hope your devices work out for you

Re: experience with SDO and my pedorthist

Dr. Z on 9/23/03 at 11:46 (130802)

The real point is that not all patients will respond to orthosis no matter how well the evaluation and or fabrication. The proper shoe, the expectation from the patient and just how bad the foot mechanics, are just a few of the factors that neither the patient or the doctor can control. Alot of patients come in for an evaluation after years of improper foot function and biomechanics. It is can be very difficult to treat them with orthosis

Re: experience with SDO and my pedorthist

Nan D on 9/23/03 at 20:42 (130842)

James,
I am sorry you did not have as good of an experience with the SDO's as I have. I would like to know where you got them.

After spraining your ankle the first time, which doesn't seem reasonable due to the SDO, did you get them adjusted? Which design did you get? After reporting 3 ankle sprains, what were you told was the possible reason that could happen?

My SDO's simply fill in the indentions of my foot to balance & stabilize my foot. Obviously, yours must have been much too thick to fit properly and my experience has been that they responded immediately to any questions or requests for anything!
Nan

Re: experience with SDO and my pedorthist

BGCPed on 9/23/03 at 21:04 (130844)

If he claims he had 3 inversion sprains soon after he got them I would assume he knows what he is talking about. One possibility for increase in inversion instability could be that James may have a subtle or not so subtle cavus foot. That would create a large void under the medial arch. That type a void would allow for a greater amount of fluid to fill the device.

That would also support the claim that they were very thick. That device cant address all forefoot issues so in that foot type it could create an inversion instability. If he didnt change shoes at the same time then that is a good possibilty imho. Dr Ed, Z, Wander does that seem plausible?

Re: experience with SDO and my pedorthist

Ed Davis, DPM on 9/23/03 at 21:46 (130848)

BG:

I would go with your explaination.

I would also have to add a few things -- things that a high arched person with ease of ankle sprains may get in a conventional orthotic but not in an SDO: a deep heel cup with a flat/neutral rearfoot post, a lateral flange, an extrinsic forefoot valgus post.... What could be done to an SDO to create such features?

Also, such individuals amy have poor ankle proprioception so placing a movable object beneath them is not a good idea.
Ed

Re: experience with SDO and my pedorthist

Dr. Z on 9/23/03 at 22:04 (130850)

Hi,
Don't you know that SDO have lateral silcone extentions and toe crests as well. Seriously SDO may work well with shock absorption but that is where it ends.

Re: re-framing the issue

Ed Davis, DPM on 9/24/03 at 10:39 (130871)

Dr. Z: and BG:

I think that the real issue may not be SDO vs. conventional orthotics as opposed to what exactly is the best device for a particular patient. A patient who needs shock absorbtion plus some decelleration of STJ pronation may not need a custom orthotic but a prefab or modified prefab device -- that person may be served well by the SDO. Sometimes practitioners get tunnel vision and don't consider the diversity of options.

Either an SDO or similar device should be in our armementarium for those who may benefit from that and we can advise those patients appropriately and professionally without all the hype.
Ed

Re: re-framing the issue

BGCPed on 9/24/03 at 11:37 (130878)

Great points Dr Ed and Z. The silver bullet fix for all problems is what prompted me to respond to this. I think we have all seen WAY to many inserts with a cookie cutter 3/4 shape, little post under heel and the practice name printed on the top cover.

Re: experience with SDO and my pedorthist

Dr Kiper on 9/25/03 at 14:18 (131002)

James, I don't know who you are or if I was the one who treated you. It sounds to me like 'if' you were my patient, you certainly didn't follow my instructions. I make it crystal clear that your muscles through years of injury are used to the way they are working. Coming along with any orthotic has to match what your proprioceptors (neuro-muscular senses) will allow. My instructions and preliminay talks explain this and advise that if for any reason something bad is happening (such as 3 sprains in a row), you should have spoken to me or the person you were working with. I would not allow this to happen In fact, it would be unusual to make a prescription that would cause even the 1st sprain. I have never in over 4000 cases had one other patient that has had even ONE sprain.
I certainly would have advised to stop wearing them AFTER the first sprain until I could make an adjustment in the fluid volume. I am not aware of any of my previous failures that sounds close to your story.

Now let's address your stating when you first stepped on them they felt good and squishy, well if they felt in any way that would cause you to sprain your ankles they could not possibly feel good. Feeling good is a criteria of a proper fitting orthotic. Did you try running on them or playing any side to side motion sports with them? These are possible reasons for hurting yourself, until I have fine tuned the prescription AND then you may run BUT not play side to side motion sports (I don't know if this is the case).
You state you couldn't get them in your penny loafers, well obviously here again you ignored instructions. Like many people who do not work with the prescriber you probably did not remove the orthotics from the blue covers for a loafer style shoe (this precludes the fact that my patients are instructed to only wear a running shoe while we are in the fine tuning process as orthotics can feel different in different shoes, but once they are fitting properly in a running shoe then I know it will fit in other styles. If it still doesn't fit in a loafer style, then that means the shoe is too tight to begin with, because my friend had you mantained contact with whoever treated you, they would have figured that out.
So as I said you don't sound like my patient, and because you obviously didn't follow instructions and allow whomever to help you (any orthotic has to be followed up and sometimes adjusted), it wasn't the orthotic that failed, it was your failure to perform.

Re: experience with SDO and my pedorthist

Dr Kiper on 9/25/03 at 14:25 (131006)

By the way, James I didn't see you mention if you returned the SDOs and got your money back? Have you ever gotten other orthotics? Did you get you get your money back?