Here an orthotic, there an orthotic

After two years of using perfectly satisfactory orthotics in my running shoes I noticed that there was a slight tear in the outer edge of the midsection of the left orthotic.  No big deal, just a tiny tear.  Wanting to be sure that my left foot had nothing but the best, I went back to the same reputable orthotics provider in my town for a new pair.  My previous technician had moved on and my “file” was passed on to a new technician.  An initial fitting, a 2-week wait, another fitting and $400 later, I had new orthotics that felt really, really, really bad.  It felt like I had a huge lump under the arches of my feet, not at all what I had in mind.  I went back to the orthotics technician and reminded him that I only used these for running, and surely the arches shouldn’t be that pronounced.  He had every confidence in his professional acumen and assured me that I’d get used to it.  I should expect it to take some time.  I persevered and eventually didn’t feel the hard lumps with every step.  I ran my first two half marathons using these orthotics.

When, sidelined by an overuse injury, I eventually found my angel physiotherapist months later, one of the several things she had me do as part of her initial assessment was to put my orthotics on the floor and then stand in them.  A look of horror came over her face when I stepped “into” them.  She was aghast.  According to her, the orthotics were putting me into a position of hyper-extending my knees.  I happened to have brought my old ones with me as well.  I mentioned this and after evaluating my posture in the older ones  she said, “Your old ones will do fine for now.  Whatever you do, don’t use those orthotics again.”  Her advice: stick with your old orthotics, work on adapting to your new gait, strengthen your gluts, keep up the ChiRunning technique.  So much for that $400.

Several months afterwards, as part of my quest to diminish the pain in my left foot, I paid my first visit to a podiatrist.  I thought a professional could confirm or dismiss my internet-based diagnosis of metatarsalgia and/or neuroma and advise me on the use of metatarsal pads.  Maybe she would recommend one of the pads in my collection over another.  At this time I had yet to throw out my newer orthotics – after all, they had cost $400 – and so brought both old and new with me as evidence. When I stepped onto the newer orthotics, the podiatrist had the same reaction as my physio – utter dismay.  Clearly, my feet had recognized a bad orthotic when it felt one.  The podiatrist confirmed my internet-based self-diagnosis, was non-committal about metatarsal pads, and prescribed running shoes with good cushioning in the forefront.  And … the podiatrist thought that perhaps my running shoe “broke” in the wrong place for my toes and that I’d be better off with a half size smaller.  That’s right, smaller!

At that time I didn’t even stop to think of the reality that my (old) orthotics wouldn’t fit in a sneaker a half size smaller, but I knew that my toes wouldn’t be happy at all.  I dutifully went to our local running shoe stores, and, sticking to my usual size – already a half-size bigger than my street shoes, I tried on every possible shoe with good cushioning in the ball of the foot.  Fortunately, our local stores let you return shoes that don’t quite work for you, as long as you haven’t used them outside.  So I did lots of treadmill testing and lots of returns.  I finally settled on a brand of shoe that was new to me.  I felt like I was running on clouds; it was heaven.  I was ready to get back to the trails.

This went well until I started increasing my distance.  When I hit 8 miles or so, my toes were very obviously hitting the front of the shoes.  I went back to the store and acquired shoes a half size bigger.  Bigger, not smaller!  This required me to make a little homemade extender for the front of the inside of my new sneakers, since my orthotics slid around in the bigger shoes.  Then all was great until I ramped up to about 12 miles, when my feet had swelled sufficiently for my little toes to be rubbing badly against the sides.  I went home and investigated the inside of the sneaker.  I determined that the unnecessary decoration and stitching on the sides was constraining the inherent flexibility in the weave of the shoe fabric.  I operated on the shoes, snipping out the stitching and trimming back the decorative plastic.  Fixed.  It took a long time, but I had the combination of footwear and orthotics that worked for me.  90% there.  And once I identified the Foot Smart gel pads I mentioned in a previous post I was at 100%.  Hurray.

Lessons learned:

  1. There isn’t always a health professional out there waiting to provide you with the exact advice you need.
  2. Sadly, not every health professional is going to provide you with good advice, especially if they are not runners.
  3. You need to have the confidence to determine which advice is good for you and which isn’t.

Questions that remain:

  1. How do you ensure that the orthotics you order are going to do the job?  I am hesitant about replacing my old orthotics even though they are wearing out and don’t fit perfectly in my new, bigger shoes.  Who do you trust?
  2. Would the sports orthotics sold at the grocery store do just as well?????
  3. What do I do when the shoe manufacturer changes the design of my favourite model??????

Moral of the story: Long distance runners are known for perseverance for good reasons.

See also previous blog post: Fussy feet, happy feet

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2 Responses to Here an orthotic, there an orthotic

  1. Pingback: Self-diagnosis and the Internet: good idea or bad idea? | Robby Robin's Journey

  2. Pingback: Fussy feet, happy feet | Robby Robin's Journey

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