Let's talk custom orthotics (Read 985 times)

Al, here is my L-O-N-G story about custom orthotics.... I started running in July 2006. I had purchased (what I thought at the time were) good shoes, Saucony Cohesions. I bought them from a well-known Sports shop (but not a specialty running store). Within days I began experiencing a really awful burning pain in my ankle AFTER running (never during). I thought it was because this was a new activity for me and my body would adjust. I'd prop my foot up and ice my ankle when it got sore and it would be fine later on. However, after about a month, I was still getting this burning pain in my ankle after every run. I explained this to my chiropractor and saw him a few times for adjustments to my feet. Yank this; pull that, snap, crack - it never helped. So, I looked in the phone book, picked a Podiatrist, and made an appointment. He asked me a couple of questions, then took about 2 seconds to watch me walk (just on the floor - no equipment), and immediately recommended custom orthotics. He had a technician take castings of my feet, and he sort of held my foot at "the proper angle" while the plaster stuff dried. I THOUGHT we were fully covered for custom orthotics, so even though the price quoted was $475.00 (Canadian), I went ahead and ordered them and gave a $200.00 deposit. However, the next day I had an uneasy gut feeling about my purchase, and did some more research. I talked to a few people - my family doctor (who is also a triathlete); the owner of a Runners store here in town; and a friend who wears orthotics. They all basically said I could not have picked a worse Podiatrist to go to. Apparently, the doc I saw doesn't have all the proper equipment and he's mainly into selling orthotics to everyone, whether they really need them or not. Apparently he also charges the most for orthotic devices, even though he doesn't sell the very best quality. I was told I should cancel the orthotics immediately. They also recommended a couple of foot specialists they felt were better. It was not an easy task, but I did manage to get my $200.00 deposit back from the first guy. Then I ended up going to two different doctors for an evaluation, one was a Podiatrist, the other a Pedorthist. (The man from the running store also gave me an evaluation – watched me run on a treadmill, etc.) All three people, the two docs and the owner of the running store told me that the Saucony shoes I was wearing were not the right ones for me feet. All recommended a neutral cushioning shoe and both doctors recommended custom orthotics. I liked both doctors. They both used computerized gait analysis (very interesting) and did a physical examination and watched me run on a treadmill. I made my choice on who to order the orthotics from based on who seemed the most knowledgeable about running. I paid $425.00 (Canadian) and our insurance covered $200.00 of the price. I have high arches on both feet, but my feet do not hit the ground the same way. My left has a normal strike, but my right foot lands on the outside edge (way too much) then rolls inward (but not evenly), and something weird happens with my toes, LOL! I was told that with the right shoes and the custom orthotics, my biomechanics would improve. So I gave away the Sauconys, I have two new pairs of running shoes that I love (Mizunos), have my custom orthotics; I have no pain at all when I run, have not experienced any injuries at all --- but I STILL get the burning pain in my ankle after every run! Ends up I have arthritis in my ankle and there is really nothing that will help. (I'm 54. I probably have arthritis everywhere!) My family doc says just rest, elevate and ice after every run. He also said running may actually help with the arthritis – eventually – but at least running will NOT make it worse. I am glad I got the orthotics though. My right foot used to land awkwardly when I ran. It always felt a bit like it was flopping and twisting a bit. Now each foot strike feels solid underfoot and every step is comfortable. They did take some getting used to though. I’ll post the break-in recommendations I got from my doc when I bought my orthotics (separately). Arlene (Sorry this is so long. I tend to ramble.......) And I wish there was preview button, LOL!

As far as cost, I just got some too (although my insurance will cover it), but I went through the Bone and Joint clinic and they are $450. They just cast my feet in instant dry plaster, but the scanning sounds much more advanced. My doctor said to make sure they weren't the hard plastic kind, even though they are custom orthotics, because that can cause problems for runners since it has no shock absorption. I'm sure they know that but just wanted to double check.

I had orthotics in high school and college.... took a 15 year sabbatical from running ... just got a new pair 3 weeks ago... here's what I learned: 1) Insurance covered all of mine, largely because I'm diabetic and diabetics are prone to foot problems... I have zero diabetic foot problems, but once in a while it's good to have diabetes. Yay, diabetes! 2) My bill would've been $500, too - had insurance not paid for it. 3) RE: hand casts or scanner --- my doctor actually just got a scanner in her one office (the one I didn't go to) and gave me the choice of scanning or hand-casted... she herself isn't so sure the scanner will be any better (said she's been doing hand casts for 20 years and has gotten pretty good at it), but the scanner company put it in for a free evaluation and she said I was welcome to try it. I didn't, only because I wanted to get them ASAP and would've had to make another appt to go to her office with the scanner. 4) Since coming back to running, I'd had all of the pre-orthotic aches I remembered from years past.... (mainly knee pain from over pronating) They went away almost immediately. 5) My Doc disagrees with Kate's on 1 thing: Because I'm a runner, she specifically recommended the hard graphite ones because they don't flex - therefore will do a better job of holding the alignment... she thinks your shoe should do the flexing... not the orthotic... Then again, you know what they say about opinions... Personally, I doubt there's much difference... But if the main question is - do orthotics help, I think the answer is yes... If I had to pay for them out of pocket, I'd probably pay the $500 rather than $250 for mail order.. $250 doesn't sound like a lot for expertise (and most doctors would also give you a price break for later pairs since they have the mold already made).

1) Insurance covered all of mine, largely because I'm diabetic and diabetics are prone to foot problems.

Marcus- I tried to comment on your blog on diabetes, but it became too difficult trying to become a member. Anyway, I wanted to comment on your diabetes. My 19-year old son (freshman at Ohio State) was diagnosed with type 1 this past June. He's doing fine on his Medtronic pump, but is still trying to figure everything out with exercise and different foods to hopefully tighten up his control. He seems to swing a lot, which frustrates him. However, at his dr's appt last month, he did have an A1C of 5.5%. Dr was very pleased, but was concerned about his frequent lows. Our family doesn't have any history with diabetes, so we are learning a lot fast. It blew us all away, when we entered him in the hospital two weeks after HS graduation with a BG of over 1000. The nurses were amazed that he walked into the ER versus being in a coma. I'm going to show him your training log and blog next time he is home.

I'll have diabetes 23 years come April, haven't had a single complication and still think it's one of the most manageable conditions a person could have... I'm a terrible fund raiser for the disease because I just think there are so many things worse than it.

Thanks M for the reply back. I'll pass along your opinion on diabetes control. Go luck with your training. I'll let everyone know if I buy a pair of custom orthotics.

Congrats, Al, and welcome back!