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orthotics

Discussion in 'Ask your questions here' started by Unregistered, Oct 18, 2009.

  1. Unregistered

    Unregistered Guest


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    I have had custom orthotics for about 15 months which had been very comfortable. Despite wearing the orthotics, I developed posterior tibial tendonitis which did not respond to conservative treatments. As the tendon became increasingly inflamed, I was no longer able to tolerate my orthotics. I had a modified kidner at which time the doctor repaired some large rips where the tendon inserted into the accessory navicular. Of course the accessory navicular was also removed. I have been out of the boot and in PT for a few weeks. I am now not able to wear the old orthotics. The doctor is going to make new orthotics for me. Is it common to develop tibial tendonitis despite wearing good shoes and orthotics? Is it common for orthotics to no longer be "usable' post surgery?

    Thank you for your response
     
  2. FootDoc

    FootDoc New Member

    I have no idea as to what biomechanical problem and specific diagnosis (if any) your orthotics were intended, so it would be impossible to offer you an answer to your initial question. But problems do often change and along with it the biomechanics. Therefore what had been prescribed previously may not work as changes occur. Orthotics are not orthotics are not orthotics. Only the name is the same.
     
  3. Unregistered

    Unregistered Guest

    The podiatrist initially prescribed orthotics due to plantar fasciitis/pronation. I suffered from plantar fasciitis for 3 years despite going through all conservative treatments such as good shoes, orthotics, taping, pt, night splints, immobilization, cortisone shot and ESWT. I guess it was fasciosis Finally, the pain was resolved after undergoing two rounds of cryo. Despite being asymptomatic, the last ultrasound (9 months ago) showed that the fascia continues to be 7 mm thick.

    Could the chronic nature of plantar fasciitis be related to posterior tibial tenonitis?

    Thanks for your reply
     
  4. FootDoc

    FootDoc New Member

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    I have not seen any general connection.
     
  5. Unregistered

    Unregistered Guest

    I am using orthotics for more than 20 years because of overpronation, but now I've noticed that my running shoes wear out at the lateral part of te shoe (!). How can I explain that? How can I know I (still) need orthotics?
     
  6. FootDoc

    FootDoc New Member

    For what complaint and diagnosis were you prescribed orthotics?
     
  7. Unregistered

    Unregistered Guest

    I had an ITB in my right knee, and metarsalgia in the left forefoot.
    Since a couple of years I have been working on the strenght of my gluteals, and on core strenght, in the hope to reduce running injuries. (Because I still get injured so now and then, fortunately not too often)
    It is mainly my right shoe that wears out at the lateral edge.

    Thank you for your help.
     
  8. FootDoc

    FootDoc New Member

    I cannot speak to whether your knee problem is associated with a biomechanical problem of the foot without an examination, and metatarsalgia is not a real diagnosis any more than hand or head pain is a diagnosis. So I still have no clue as to why you were prescribed orthotics in the first place.
     
  9. Unregistered

    Unregistered Guest

    I was told I have a fallen arch at the front of the foot. And overpronation. That is all I know...sorry
    But I do not have flat feet.
    Thank you for your reply.
     
  10. FootDoc

    FootDoc New Member

    There is no such thing as a fallen arch in the front of the foot and excessive pronation always presents as the appearance of a flatfoot of some degree. So, I really cannot advise you based on your description of your problem.
     
  11. Unregistered

    Unregistered Guest

    Thank you very much for all your patientce and efforts!
    I understand that I'll have to go back to the podiatrist...
     
  12. Unregistered

    Unregistered Guest

    You need to have your devices evaluated. It sounds like you do not have the right prescription. It is not common to develope PT when using the proper orthotics unless there is an injury or other reasons for it, such as an underlying disease or overuse syndrome or even improper shoe gear. After Surgery, it is advisable to get new orthotics.
     
    Last edited: Dec 31, 2009
  13. FootDoc

    FootDoc New Member

    In my opinion, it is unfortunate that too often the high-use podiatric and other prescribers of orthotics know more about how to milk the most out of patients than than they do with the selection and modifications of these appliances and their tailoring for specific and definable biomechanical problem. I would personally steer clear of any doctor whose first thought in most cases is to sell the patient orthotic, and from what I have read here and on forums such as this and personally experienced, such practitioners seem to be ubiquitous. It is not all that uncommon for the orthotic prescription to be in need of changing. The question is . . does the doctor have new ones made with specific changes in mind or does he/she simply hope that a new one will work better and that he/she can generate another fee?
     
  14. Unregistered

    Unregistered Guest

    I am the person that authored the first post in this thread.

    Foot Doc, I understand your feelings about orthotics especially when they were billed out to the insurance company at $500.00. Prior to the surgery, the doctor said that he may be able to just modify my old orthotics but he would determine that after the surgery. Once the surgery was done, he looked at the old orthotics and did not feel that they could be modified to really fit the foot properly. The new orthotics look completely different than the old ones. While I was waiting for my new orthotics, I did try the old ones and found that they were quite uncomfortable. When I got the new orthotics, they were comfortable from the first time I wore them. Despite the orthotics being so comfortable, the doctor wanted me to follow the break in protocol. During the break in period, I couldn't believe the difference that the orthotics made in my foot comfort.

    On the othe hand, when I went to a local foot solutions store, the pedorthist there, was trying to convince me that his orthotics are better than the ones I had. Needless to say, I never returned to that store.

    Have a healthy new year
     
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