No Need to Suffer

By Tamela Thomas, Wellness Manager

Several years ago I found myself unlucky enough to have plantar fasciatis in both feet, which basically means plenty of pain and inflammation. I was in constant agony—my heels felt as if they were hitting a rock each time I took a step. Call me a princess, but I was not having fun! I tried new shoes, lighter exercise and spending less time on my feet, all to no avail. Eventually, my doctor prescribed orthotics, and I was on the road to recovery.

My message today is to be proactive about your health. If you have been putting up with a chronic pain condition, perhaps because you've been too busy, take action. The Wellness Center can provide you with services that make you feel your best. And if you have any foot problems, consider coming to see Dr. Brent Wendel about orthotics. They worked for me!

Pain Relief: One Step at a Time

By Dr. Brent Wendel, Podiatrist

Playing sports or exercising avidly can expose your feet and ankles to additional and unusual forces. Your lower limbs are the foundation for the rest of your body, so aching ankles or sore feet can cause complications in your knees, hips and back. Foot and ankle pain might even alter the way you stand and walk! Add factors such as body mechanics, underlying medical conditions, poor weight distribution and the wrong footwear, and you risk injury.

Your feet and ankles are complex load-bearing structures with many interconnected moving parts. With that in mind, I recommend biomechanical care—orthotic devices, special shoes, shoe modifications and physical therapy—to address the mechanical function of the foot.

Orthotics

Most foot pain results from a faulty relationship between the bones and muscles of the foot. Even the slightest misalignment can result in significant discomfort, such as bunions, hammertoes, corns or pain in your arch, heel, knee or back. Custom orthotics provide much more than arch support. They realign the structure of the foot and leg to prevent bone misalignment, as well as muscle, tendon and ligament fatigue. Often, doctors prescribe them after surgery to prevent further foot deformities.

Custom foot orthotics, prescription medical devices made from non-weight-bearing molds of your feet, are designed to control foot alignment and correct injury-causing motions, such as pronation (rolling in) and supination (rolling out). The orthotic device gently, consistently directs your foot into the correct position for walking, running or standing. Finally, orthotics relieve pain and calluses by redistributing the pressure acting on the bottom of your foot.

Production of custom orthotics

Procuring proper custom orthotics is an exacting process. The quality of your orthotics depends on three primary ingredients:

1. The cast of your feet
2. The prescription the doctor writes (based on an examination and the podiatrist's knowledge and experience
3. The workmanship within the orthotic lab

You should order your orthotics from a high-quality foot orthotics laboratory that uses high-quality, long-lasting materials. This ensures comfortable orthotics that match your prescription perfectly. I use a laboratory considered by many to be the highest quality laboratory in the nation: ProLab Orthotics of Napa, Calif.

Your doctor should work with you to ensure that your orthotics are comfortable and relieve your symptoms, as well as provide detailed information on the proper shoes for your feet. Don't worry, you can still wear appropriate, fashionable shoes!

Computer-generated orthotics

Sometimes you may hear the term "customized" rather than "custom." Because of confusing marketing, customized devices can be difficult to distinguish from custom orthotics. "Customized" generally refers to orthotics made with computerized measurements: A patient walks across a force plate, which then shows pressure distribution on a computer display. Typically, the producer then slaps extra elements onto a pre-manufactured insole, tells the patient he or she is receiving "custom" orthotics and charges accordingly.

A force plate helps evaluate some aspects of foot function, but it cannot capture three-dimensional impressions of your feet. If your doctor does not take a three-dimensional plaster or fiberglass mold of your foot, you are not receiving a custom orthotic.

Off-the-shelf orthotics

You can find off-the-shelf orthotics (often called arch supports) in sport or shoe stores, online and in pharmacies. These non-custom devices, sometimes called "prefabricated orthotics," gently support your arch and spread weight more evenly along the bottom of your foot.

Some arch supports on the market are better than others. One brand might work well for your feet, while another brand may work better for your friend. Quality off-the-shelf orthotics usually cost $30 to $50.

Caveat emptor

You may have heard radio or television commercials promoting "custom fit" orthotics at shoe and orthotic retail stores. These devices are sufficient, just substantially overpriced. I say, "let the buyer beware." You should never pay more than $50 for an "orthotic" unless it comes from a mold of your foot cast by an experienced medical professional.

You have probably also seen Web sites selling "custom" orthotics made from a foam box of your feet. Foam-box casts are not a particularly effective method. You may see some improvement with these devices, but the odds of maximum improvement with any orthotic device are poor without a proper exam and prescription.