Foot Problems Clinic

[Smoked]

Hi folks.

I'm 37 and about 10 years ago I fractured my tibial plateau downhill skiing. I was on crutches for 2 months and then began physio to rebuild the muscle in my leg. After a couple months of physio I was ready to start running again and instantly had severe pain in my left knee(the broken one). I returned to physio to be diagnosed with patellofemoral pain syndrome and was prescribed some custom orthotics.

They worked great on my left knee, but the adjustment for the right knee was tough as my muscles had 27 years of dealing with my pronation to 'unlearn'..and to this day i have clicking in my right knee...but i can live with that

Over the years i've had 5 pairs of orthotics made and i haven't had too much difficulty with them..at most they are sent back once to be adjusted at the beginning and then i have 2 years of relatively pain free active living. One thing that has developed over time is a tendency to wear out my left shoes prematurely..and not on the outside of the sole either, but on the inside of the shoe. I feel like my foot is not landing level...the outside is a bit lower. Whenever this started to happen i would buy new shoes. I tried expensive shoes and they wore out just as fast so i've been buying 30$ shoes from Walmart each time.

Lately i've decided to get more serious about my overall health and so this time I decided to try to fix this problem with my shoes and boy am I regretting it.

I got my foot casts taken as always by my foot guy(chiropractor by trade). He watched me walk barefooted with my pants rolled up a bit. Then he sat me down and put my foot on the foam block and pressed down to make an impression... working the toes in and trying to 'construct' a good arch. The new orthotics came back and they hurt both my feet and my knees even with a conservative breakin. I had previously attributed my uneven foot issue to the arch support on my orthotics being too severe so i went back to my original, flatter orthotics that had been in my slippers for that past 10 years while I was waiting for the new pair to be made. At first they were quite comfortable but of course the transition from high arches to lower has caused some knee pain. My new orthotics came back and they had flattened them out so much there wasn't enough arch support and that hurt even more! So now i'm caught waiting on a prayer that these new orthotics will ever be right...wearing older ones that are okay but not perfect and having lost all faith in my doctor because he asks me more about what i think should be done with the orthotics than he tells me what needs to be done!

The other thing now is i'm having trouble finding shoes for the first time ever. I used to be able to buy anything with a flat, wide sole and good heal and arch support and they would work for about 6 months until i wore the left one out. I need to walk around for about 20 mins in the store to determine if they'll work... but now that doesn't do the trick. I buy shoes and they feel great for about 2 days and then i have pain again! I feel like my left foot isn't level again and it's leading to swelling in my hamstring in addition to the knee pain. I actually have to put a small strip of extra cut insole in my shoe on the outer edge to level my foot. This just should be necessary!

In the meantime i'm in physio again, stretching my hips, quads and hamstrings daily...i added adductors myself. All the muscles and tendons in those areas were very tight which my physiotherapist said can contribute to misalignment and poor knee cap tracking. I've noticed improvements in flexibility from this but I just can't seem to get the orthotics/shoe combo working.

I really feel like I should have left well enough alone and kept my orthotics with the high arches and just dealt with it but the propspect of getting so that I could walk around the house in bare feet again for stretches was too luring to ignore.

I'm not sure what to do next. I'm not confident when my new orthotics come back that this will be fixed. I dont' even know what I should do about shoes anymore since I dont' have any that I trust are flat. I just spent 120$ on new shoes with some birthday money and after a few days the left one is uncomfortable to my knees again. I feel helpless with this when I was trying to be smart and do what was best for my longterm health.

Should I see another specialist? What should I do?

thanks.

[Woottons]

Hi

I am afraid your orthotics are not correct for you. You should not be wearing your shoes out medially (inside edge), especially with orthotics. I am unsure why a Chirporactor is issuing you orthotics.

You need to see a Podiatrist/Chiropodist that specialises in Biomechanics/Orthotics, they will also advise you on the most appropriate footwear, it is not how much you spend but the style of the shoe, ie lace-up. It may be that you need a more rigid insole, carbon fibre lasts for up to 10 years. You also get a much better cast with plaster of paris, and not an impression box.

Due to your patella maltracking physiotherapy is advised for this. As I am in the UK I am unable to suggest a Podiatrist, but I am sure there is a website for this information.

I hope this helps.

Sam
_________________
I practise at this private clinic
http://www.thefootandanklepractice.com/

[Smoked]

Thanks for the feedback Woottons.

I think I didn't make something clear. I'm not wearing my shoes on the medial edge. I'm wearing them out on the inside of the shoe..literally. Not the inner edge of the outer sole. It's like when I step my foot is not flat but on an angle with the outer edge of my foot being lower than my inner. It feels like i'm sliding out of my shoes.

The guy I see is not just a chiropractor...he has the training to treat alignment issues(forgive me I dont' know the terminology), but I do now think i need to go somewhere that uses better methods of taking my impression.

I am currently taking physio for to strengthen my knees and reduce the pain but i feel that until my orthotics are correct it's in vain. Should I stop seeing the physio until I have the orthotics corrected?

thanks again!

[Woottons]

Hi

It's sounds like your orthotics are posted too medially ie on the inside edge, so you are putting pressure on the outside edge, hence you feel you are sliding off them, it's very difficult without seeing them. Anyway I feel you need recasting and some new orthotics.

I would still continue with your Physiotherapy, because they can give you none weightbearing exercises.

I cannot stress enough that you need to see a Podiatrist, even though the person you are seeing may be helping to realign you, you need to see someone specialising in the foot and ankle.
_________________
I practise at this private clinic
http://www.thefootandanklepractice.com/

[Smoked]

[naturallite]

Try To Do This And Post The Result Of This Treatment