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For Ed Davis, DPM or others re: breaking in Birkenstocks

Posted by Joiner on 10/15/04 at 18:12 (161608)


I noticed your positive comments about Birkenstocks in another thread. I have plantar fasciitis and had seen a good bit of improvement with use of the PowerSteps, reaching a point where I had only mild heel discomfort in the mornings. Hoping to get even more relief, I began looking for a more aggressive over the counter arch support as sort of an appropriate 'next step'. Like you, it appeared to me that the Birkenstocks were a really quality product at a reasonable price.

Therefore, I purchased a pair of BirkoBalance arch supports and am in the initial few days of breaking them in. They felt wonderful when I tried them on and provided a welcome bit of extra 'push' or 'pressure' under my arch; substantially more than I feel with my PowerSteps.

After 3 or 4 days of wearing them about 2 hours per day they still feel good while wearing them with just a bit of soreness as my foot adjusts to the various 'bumps and shapes' characteristic of Birkenstocks. Having been warned that they require a bit of breaking in, this hasn't really bothered me. However, the one thing that concerns me is that after removing them from my shoes and putting back in my PowerSteps, my heels and arches begin to hurt a bit and seem a bit sore in places that had not been sore before. In addition, the initial heel pain in the morning seems to have become a bit worse than when I wore just the PowerSteps.

I'm willing to endure a little short term set back in return for long term gain but I could use a bit of reassurance at this point. Do you have any thoughts or insights including:

1. What is the normal break in time for these deep arch supports?
2. Is indeed soreness and some modest pain an acceptable part of the process?

In short, I need a little help in discerning what is just normal discomfort and what might indicate that these particular inserts just might not be for me. I've searched the archives and found a number of references to this issue but they didn't seem to get too specific.

I'd appreciate help from Ed and anyone else who might have some experiences or information about Birkenstock arch supports in general and the BirkoBalance support in particular.


Re: For Ed Davis, DPM or others re: breaking in Birkenstocks

Ed Davis, DPM on 10/16/04 at 00:38 (161628)

The Birks are somewhat firmer than the Powersteps. You have the correct idea in that time is a factor and would be looking at your improvement on a week to week basis as opposed to a day to day basis. Also take into account your activity levle and how variations in that effect how you feel the 'day after.' Be sure to read Scott's Heel pain Book to ensure that you are looking at the problem from a sufficiently comprehensive viewpoint.

Re: For Ed Davis, DPM or others re: breaking in Birkenstocks

Joiner on 10/17/04 at 13:57 (161680)

Thanks for the encouragement.

The burning sort of pain in my heels along with the additional arch soreness, both of which had not been there with the Powersteps, had me wondering if I had made a mistake in going with the more aggressive BirkoBalance supports rather than starting with the basic Birkenstock blue footbed. I had expressed concern to someone else that going with the more aggressive support could somehow actually damage my foot or stretch the fascia too much.

I think my concern stemmed from a basic misconception about which way the fascia is stretched. Initially, I thought the stretching which caused the heel pain resulted when the fascia was stretched upward in an arch (ie as if you were pushing too much from the bottom of your foot with an arch support that was too aggressive). However, if I understand it correctly, the damage comes when the fascia is stretched too much from downward pressure caused by inadequate arch support. If that is a correct understanding, I think I understand now why an aggressive arch would not cause damage. Do I have it basically correct?

Thanks again for help. I really appreciate it.


Re: For Ed Davis, DPM or others re: breaking in Birkenstocks

Cyndi on 10/17/04 at 14:17 (161681)

On my very first visit to my POD he gave me some Power Steps to use in
my shoes. In fact, he sold them at his office. I found them to be way to hard and high arch for me. My Ortho Dr told me to get a softer support at a drugstore by Dr Scholls. I did both and even when my custom orthodics arrived they still hurt my feet. I am now trying a Betula Birk that is a sandel. It also hurts so I am changing shoes every day between different sandels. Still very hard to wear enclosed shoes and socks.
As it gets colder I have got to find a sock to wear, plus a clog maybe.
Nothing seems to help me get very far without pain, even with a cane.

Re: For Ed Davis, DPM or others re: breaking in Birkenstocks

Ed Davis. DPM on 10/18/04 at 00:11 (161714)


We are trying to match your needs for support, sight unseen, with a prefabricated support and that is not easy to do. Support does not always mean arch support, as an orthotic cna be composed of a system of wedging that repositions the foot with arch support secondarily. My general advice would be to go for the softer pre-fab as it is a safer bet, that is, less likely to do harm based on what you have described.

Being checked by a podiatrist to determine yur needs can be helpful and would certainly use Scott's Book as a checklist to help ensure the comprehensiveness of the exam. The vast majority of patient with custom orhtotics are successful with unsuccessful cases having persisting problems that are more likley to make it to boards such as these.

I wish there was a 'system' to unsure the quality of your othtotic but, for now, consider working backwards... I think one of the best otrhtoic labs in the country is Northwest Podiatric Lab of Blaine, WA. I don't have their number with me since I am at home now. But if you call them and find a practitioner that uses them, that is probably a practitioner who places a premium on orhtotic success since that lab is expensive to us for the practitioner so practitioners using them are likley to 'go the extra mile' to seek success.

Re: For Ed Davis, DPM or others re: breaking in Birkenstocks

john h on 10/19/04 at 16:21 (161803)

I would think a poorly fitted support is worse than no support. I imagine there are many people wearing supports that do not need them. In the late 1950's there were some highly advertised arch supports made of stainless steel. Made in Germany. The cool guy that I was I thought they would look great even though they could not be seen. I ordered a pair although my feet were great. Maybe I thought I could jump higher or something. I cannot remember why I ordered them. One size fits all. I think I wore them a few times and as I rember they hurt so that was my first pair of orthotics. Wish I still had them as I would bronze them and place them on the mantel. I think Podiatrist were still Chiropodist (sounds like a bird doctor) at that time