Orthotic insoles; Help or Scam?

[island911]

I've recently seen a few PT(Physical Therapist) guys about trying to regain a normal gait(walking). (post surgery . .. a long story)

The first PT guy sez; I need to work on leg muscles.

The second PT guy (who specializes in "fitting Orthotic insoles) sez "oh, it sooooo obvious that your feet need orthotics. . . .it's your feet feet feet . .."

At $500 to profesionally shim my feet (pay in advance- no refunds), my BS meter is about pegged.

What sez the Pelicans out there?

[Drago]

Island,

I'm on my second set of orthotics for collapsed arches and plantar facitis in both feet.

The first set were very firm (made from cork) and absolute torture. Could not wear them.

The second set have a little spring in them and have been tolerable but the pain still remains. Every step I take is painful. I'm not sure if the orthotics are helping or not.

My Dad went through the same thing except his podiatrist also referred him to a physical therapist. After a couple of months of tweaking his inserts and going to P.T. he has fully recovered.

Me? It's been over 6 months and I don't think I've seen any improvement.

So, I'd say a combination of orthotics and P.T. are what you need.

[vash]

i think they are a scam. when i was younger, my legs and knees ached. i got hooked up with some custom orthodics. i seem to remember them made from carbon fiber (?). anyways my dog chewed them up, and i never missed them. key for me was to get off my ass, and get healthier. i can jog and hike now, without issues. on the other hand, if you have issues jogging, buy your shoes from a running shoe store, not some lame footlocker where the salesperson wears the latest foot bling. the correct shoe makes all the diff. (no matter how ugly it looks)

[RickM]

Plantar facitis with high arches here. Three pair of orthotics, none helped. Used lace-up braces to keep feet at 90 deg when sleeping.....no help. Stretching, exercise and very well made shoes are the only things that help me. Losing a little weight couldn't hurt either, although I've had this since my early twenties and in perfect shape.

[widebody911]

I think it goes both ways. I have horribly flat feet; I started wearing orthotics in high school, and they helped a lot, but I had a set prescribed by a chiro that were absolute junk. I've always been active, so it's not a function of getting up off the couch.

[id10t]

Used custom insoles for 25 of my 33 years... very worth while. Mine aren't made by PT people, but rather the same guys to who make artificial legs, etc. Warm/soft foam is used to mold the feet while they are in the proper position (I have terrible pronation - feet point a little out when "at rest") and the the mold is built up on the underside to conform to a "normal" shoe. Hard part is finding shoes with easily removeable insoles (Hi-Tek boots are good, as are Rockport walkers) but it is nice being able to put on a brand new pair of shoes and have them feel as if they are already broken in.

May be worth while to you - but if it is really a problem, see a podiatrist and get a MD opinion.

[cantdrv55]

I have a Morton's Neuroma between the third and fourth toes on my left foot. If I don't wear my orthotics on a DAILY basis, I'd be visiting my podiatrist every month for a cortisone shot between the toes. Not fun, believe me. My orthotics are made of hard plastic and was very uncomfortable at first. Now, I can't walk without them. If your podiatrist says you need them, get them from him/her. Don't buy the OTC kind.

[cantdrv55]

Originally posted by vash
i think they are a scam. when i was younger, my legs and knees ached. i got hooked up with some custom orthodics. i seem to remember them made from carbon fiber (?). anyways my dog chewed them up, and i never missed them.

Cliff, I've been meaning to tell you that you walk funny.

[84porsche]

Originally posted by cantdrv55
My orthotics are made of hard plastic and was very uncomfortable at first. Now, I can't walk without them. If your podiatrist says you need them, get them from him/her. Don't buy the OTC kind.

Same here - I have orthotics also and have had them since I was 17 but didn't start wearing them because they were really uncomfortable. But a few years ago I couldn't stand up without pain in my feet from the tendon stretching so I went through a whole bunch of tests to tell me I have flat feet and bone spurs. The podiatrist told me I have one of two options, wear the orthotics or have the tendon sliced in my feet. You can probably tell which one I picked.

[Moneyguy1]

Two Doctors are walkin down the street together and notice a gentleman with a most unusual gait. The first doctor says : That is the worst case of flat feet Ihave ever seen!" The second disagrees. "No. That gentleman suffers from deterioration of the hip joint."

With their professional egos on the line, they agree to approach the man and ask him what the problem is. They both give their prognoses, to which he politely listens and then replies:

Neither, guys..I trusted a f@rt".

[Superman]

I sold shoes for a number of years, and it looks as though those things can help some people. If you're gonna go down that road, you're taking your chances a bit. My mom had some for a while, and eventually went to another specialist who solved her hip problem by tossing the orthodics. So, they can help, but it takes quite a team of experts, including both podiatrists and orthopedic specialists to arrive at the effective solution(s).

I do have one concrete tip for you though, Island. I know the finest PT/Orthopedic Specialist in our area. I'd be happy to provide his name and phone number if you want. Just PM me. This guy has saved the Pacific Northwest Ballet Company a lot of dough in medical and industrial insurance costs, along with a litany of professional athletes. Golfers and such. He's got me sitting and standing WAY straighter and with less pain than I was a year ago today.

[Stanley]

My aunt has really bad knees (she getting total replacements on both in the next year) and has these shoes called z-coils. She really likes then and they are the only shoes that she can wear and still be comfortable. Here’s a link: http://www.zcoil.com/

[Karl2bdc]

Couple of things to realize here. If you are going to wear orthotics and expect to get results, then that means that you need to be in those orthotics whenever you are on your feet. A lot of people wear their orthotics at work, then go home and walk around bare foot in their house....um...you are telling your body to do 2 different things, or they switch to their tennis shoes which don't have them in them, and wear those. You are doing rehab for half the day, then counter acting it the other half of the day. Yea, no wonder your feet hurt. They need to be in every pair of shoes you wear. The problem with shoes...and even "special running, high quality made by little elves" shoes, is that every person's foot is different, yet the shoes are all made for an average person. Some shoes you can get different widths and such, and that is good, but not perfect. A custom made orthotic is made to fit your foot exactly, but again, unless you wear them at all times when you are on your feet, you will have pain. And just like tennis shoes, there are orthotics that are better than others no doubt. And it usually takes at least a month for your feet to adapt to orthotics.

[Drago]

I've been wearing my orthotics all day, everyday in well made shoes (Brooks Beasts) for several months and I still have pain....constant life-draining pain in my feet.

My podiatrist has done several "tweeks" to the orthotics over the course of several months, mostly canting my foot over (shiming under the heal on the inside of my foot). None of his tweeks has made any difference at all. As a matter of fact the last tweek was so painful I removed it the next day.

FWIW he did say I had the worst collapsed arches he'd ever seen.

I either need a new podiatrist or to start drinking heavily.

[MikeSid]

It all depends on your problem. As they say, "the hip bone's connected to the leg bone, and the leg bone's connected...." An orthotic might fix a problem in one area only to cause a problem in another.

I have pretty ugly feet with cavus arches and bunion deformity. I was running and playing soccer pretty regularly and developed pain to the point that I couldn't play or run. I took time off. Returned. No luck. Probably age taking a toll. So I saw a specialist, did some therapy, and eventually had custom orthotics made for both soccer cleats and walking shoes. They solved the foot pain problem. But the alteration in the angle of my foot at impact resulted in a pain in my knee.

So I guess I'd have to say that they worked for the problem that was diagnosed, but in general I don't think of orthotics as an holistic cure. YMMV.

[89911]

I had orthotics made for me by my podiatrist. Took plaster cast of my feet and they were sent out to have sport insoles made. I have very flat feet. I ran track in high school, but since then, my feet have become very flat. The last time I was running without them, the pain was not in my feet at all, but in my shins and Patellarfemoral pain (runners knee). My feet were not guiding the load of running along the outside of my foot and through the toes, but pronating and the impact was going straight through my shins and in the knees. Since then, I'm up to running 10-20 miles/ week with no symptons. I wear them everytime I can. I can't see how the one's I've had made cannot help most. And I'm usually very skeptical about any quick cures.

[Halm]

Ok, here is the deal. In my younger days, I was THE national Track and Field one mile champion. 125 mile training weeks were common. Now 35 years later, I am paying a price: 2 achillies tendon surgeries, among other things.

In any case, if it was not for custom orthotics I probably couldn't walk, much less play tennis or jog.

Keep working with your vendor. Demand that they make them right. They'll get the message, eventually.

[azasadny]

I've had Morton's Neuroma in my left foot for about 10 years. Two surgeries later, still no better. My orthopedic surgeon recommended custom-made orthotics and $350 later, my feet were better. The custom-made orthotics finally wore out after about 18 months and I bought a $30 set of "Phase IV" orthotics online and got the same relief as with with expensive orthotics. So, for my neuroma, the orthotics really helped!!

[Karl2bdc]

Mike makes a very good point in that an orthotic is going to change the biomechanics of your body, which of course will affect the knees, the hips, the spine, etc. If you are 30 years old and are just getting orthotics for the 1st time, you might notice these symptoms, because your body has been one way for 30 years, and now you are trying to change things, even through minor tweeks. Is the knee pain bad...in a sense that it hurts and the body says...hey this isn't correct, then yes. But the orthotics are putting your body back the way it is suppose to be, thus taking your knees out of bad alignment and putting them in good alignment, of course which the body has to adapt to (the body thinks that the way it is, is the correct way). Now the body has been like that for 30 years, can it change overnight, in a day, in a week, in a month? I have to explain to 70 year old patients everday that Yes, that D3 degeneration in their spine is the body's protective mechanism, it is a normal response to abnormal stresses. Can I fix it, yes.....but it took 75 years to get like that...realistically, I am afraid you probably won't be around long enough for me to be able to reapir it, what we can do though is try and get you out of as much pain as possible." Before the orthotics if you didn't have knee pain, then I would almost guarantee that later in life you are looking at arthritis or other pathology in that joint, due to the altered biomechanics. Pain is the last thing in any condition to show up, and it is the first thing to go away. You may not be aware of the symptoms, but that doesn't mean there isn't an underlying condition that will sneak up on you later.

[island911]

Originally posted by Karl2bdc
. . . But the orthotics are putting your body back the way it is suppose to be, thus taking your knees out of bad alignment and putting them in good alignment, of course which the body has to adapt to (the body thinks that the way it is, is the correct way). Now the body has been like that for 30 years, can it change overnight, in a day, in a week, in a month? . .. .

See now, this is exactlly what I don't get. "orthotics are putting your body back the way it is suppose to be," (?)
The way our feet are supposed to be, is out of toe-crushing shoes . .. constantly walking on variable surfaces. . . .actively using muscles, pulling tendons. Not held, chruched-up in some supposedly "Correct-arch" position.

I find it strange, that "thee solution" is to start shiming feet. My feet have plenty of strength and flexability. In fact, as soon as I was told how I was walking wrong, I began to correct, using only techinque . . . foot & postural awareness.

OTOH, I suppose, there are times when shimming feet is the appropiate solution to peoples problems. It's just that I get the feeling that I've been a victim of Doctural-Appointment-inertia (ya know; where Doc's have to push patients thru, so the throw a bone, (pill, device) and say go get it.)

Oh well, they may not have the time to get it right, but at least it's expensive.