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

Do orthotics really work for TTS? Richardcped?

Posted by William Wilt on 4/07/04 at 14:09 (148544)

Richard,

I was wondering if orthotics really work for tarsal tunnel syndrome? I have Spenco inserts which are soft and cushy but have no support. I'm on my feet for a 1/2 hour and i got problems. Any type of orthosis you'd reccommend? Also i was told that when the mold or cast of ones foot for orthotics they are molding a bad foot to begin with as one guy told me from ' THE GOOD FEET STORE' in my neighborhood. Thaks for hte advice Richard

Re: Do orthotics really work for TTS? Richardcped?

Richard, C.Ped on 4/07/04 at 15:34 (148547)

I cant stand the Good Feet Store (That is being VERY nice). All they supply is an off the shelf piece of overpriced plastic that does not fit your foot correctly.

There is a huge uproar in the pedorthic community about these guys as well as others that supply devices without a prescription. They do not understand the damage they can do when you do not know what you are doing.

I dont think I would have much of a problem with them if their inserts were only $20 or so. They are charging up to $400 for a glorified ice scraper. They do not file insurance. They just take the money.

They should NOT be giving any kind of medical advice at all.

So, to finally answer your question. I have never seen a case that the swelling was so bad that you would need a new orthosis. I would say, only if the person is obese and suddenly loses alot of weight, then yes, I would suggest a new pair.

Find a good doc and C.Ped. They are trained to deal with these conditions properly.

Re: Do orthotics really work for TTS? Richardcped?

William Wilt on 4/08/04 at 06:46 (148579)

Richard,

I asked if orthotics can alleviate Tarsal Tunnel Syndrome and what kind of orthoisis would you reccommeend. thank you

Re: Do orthotics really work for TTS? Richardcped?

Richard, C.Ped on 4/08/04 at 08:58 (148584)

Oops.....I thought I did. I only answered the question regarding the custom device. You hit a touchy subject when you mentioned the GFS.

Ok....now to answer the question. If I were making the orthosis for you, I would take into consideration if you have ever worn orthotics before. If not, I would go with a standard EVA 40 durometer 1/2' posting, and a 30 durometer 1/8' shell. If you have worn orthotics before, I would use the 60 durometer posting and 30 durometer shell. The 40 is considered 'softer' but still provides proper support and functional control. The 60 is more dense and will not break down as fast.

I would not go with a hard plastic type.

Hope that helps.

Re: Do orthotics really work for TTS? Richardcped?

Dr Kiper on 4/08/04 at 15:49 (148597)

Orthotics should absolutely be worn for TTS. Even if the TTS is from something other than your poor alignment characteristics [doubtful], a proper fitting orthotic that meets the criteria will allow the structure of your foot to function more efficiently, taking pressure off the neuro-vascular bundle that the nerve is tied up into.

The healing process for this is slow, but if the orthotics fit correctly, it will eventually reverse the TTS [if it's related to your mechanics].

You should also try to wear them as much of the time as possible, including around the house [some orthotics will even work in slippers], as each foot step regardless of the orthotic antagonizes the healing process.

Re: Do orthotics really work for TTS? Richardcped?

Christine S on 4/09/04 at 00:28 (148613)

Richard, What happens if the orthotics hurt even more while wearing them. I have TTS and went through release on both feet this summer and I am still having problems. I was made some orthotics but they are very hard with a thin leather upper and they are very uncomfortable. Should I have some more made? Thanks, Chris

Re: Do orthotics really work for TTS? Richardcped?

Richard, C.Ped on 4/09/04 at 09:10 (148616)

I would look into it. Or either have some good cushion added to the current ones. That is why I do not usually use the hard type.

Re: Do orthotics really work for TTS? Richardcped?

Ed Davis, DPM on 4/14/04 at 16:18 (148889)

Richard:
The thing to watch out for is that the orthotics don't place too much pressure on the porta pedis since that is a presumed location of a number of TTS cases, AKA, distal tarsal tunnel. The Goodfeet people are hard to believe but sometimes, it has been the professionals that left the 'door open' for such individuals. I can identity with this dilemna as a podiatrist but also as the husband of an audiologist -- anyone, in most states could buy a franchise, Miracle Ear or Beltone, hand a shingle up and start fitting hearing aids -- that is gradually (very gradually) changing.
Ed