Run Run Away

Question:

OK, I saw my podiatrist today, and he told me that it was not uncommon for orthotics to break down after only a few years of hard use. My orthotics are worn 10 hours per day on concrete at work, and for all racing and training. The covers of my orthotics have cracked and dried up, and the cushioning has been fully compressed. As stated, my current insurance will not cover the cost, but I am opting for better insurance in November during my job’s health benefit open season. The orthotics should then be once again covered. In the mean time, I went out and purchased the thinnest gel sole inserts I could find and placed them under the orthotics. Hopefully, the gel will provide temporary cushioning that I have lost until the new orthotics can be made.

Response:

I still have the casts used to make them, but I thought that they are no good any longer because my feet might have changed over the last few years. Your muscles, tendons, ligaments probably adjusted to the correction  of the orthotics but I don’t suspect this correction would cause you feet to stop pronation(assuming this is what the correction is for).

I’m guessing the reverse – the orthotics may have made the muscles, etc that control pronation weaker – unless it was some temporary condition that the orthotics were used to correct for until something else healed. If you still have the casts and foot geek says you still need the correction it should not cost as much to make another pair as you still have the mold. Some of the cost is creating the mold.

Some of the stuff I’ve read over the past year suggests that feet may change over time, esp. in response to running if a person didn’t run before or perhaps an increase in volume or barefoot running/walking. Although some of that may be more in forefoot spreading out. However, the fact that he’s got a mold suggests the orthotics were done structurally rather than functionally (pressure pads) so there may not be as much change there. Possibly but if you decide to wean yourself off them do it slowly like one a run a week for a week and then repeat. Don’t just go cold turkey.

And pick one of the shorter runs to try – not the long run He might also try ankle/foot strengthening exercises including things like toe raises or other drills with dorsiflexion to strengthen shin muscles (anterior) since he indicated shin splints as an initial reason – which may or may not be foot related. But I’m not at all familiar with implications for MN. Dot — "Success is different things to different people" -Bernd Heinrich in Racing the Antelope

Response:

It seems to me I heard somewhere that N_A_J wrote in article My orthotics are the full-length "sport" type. They have a 3/4 length molded rigid plastic plate attached to various cushioning materials. They are covered by a synthetic leather material. I have been told that it is not uncommon for this type of orthotic to flatten out over time. I still have the casts used to make them, but I thought that they are no good any longer because my feet might have changed over the last few years. I made an appointment for Tuesday, and I will discuss my options with the podiatrist. I agree with TBR that shoes have come a long way, and if I can get by without orthotics, I might go with some NB 1221’s. Thanks for the advice…

Mine are similar to your description; they were custom-made to support the left arch because of [fairly mild] plantar fasciitis.  I wore them in all shoes for three or four years, but haven’t worn them in running shoes for over ten years now.  I normally wear them in street shoes (which I don’t wear much since retirement); my PF has never returned, but I feel occasional twinges when playing golf (shifting weight to the left foot during the swing). Other foot or leg conditions might not be as forgiving as my PF was. I’ve replaced the foam padding and the synthetic leather cover once, but the hard central part has never changed. — Don

Response:

I previously posted regarding the need to wear prescription orthotics for life once you start using them. I recently ran the Chicago Marathon. The mileage from the marathon training and the marathon itself did my orthotics in.

What the hell were they made of?  I have semi rigid and have about 5 years on them and dozens of ultra and they are still behaving just fine.  Ask you Podiatrist why they are worn and see what he can do. Would this be a good time to experiment by running without the orthotics?

Sounds risky but some have weaned themselves from orthotics while others did more harm.  Are there any OTC insoles that would help (i.e. Ultrasole w/graphite arch)?

There are off the shelf orthotics that cost about $50-60. For those that need just a minor arch support to prevent some slight pronation they are fine. If your correction is more they may not provide what you need.  If your orthotics were to ease Morton’s there is a carefully placed lift in the ball of the foot area to keep your toes "separated" that NO off the shelf will provide. Am I  bound to these orthotics forever? Help!

Stop thinking about your running as a dollar cost. Getting injured and not being able to run makes $400 dollars cheap.  Spin the barrel. — Doug Freese

Response:

I originally got orthotics to deal with shin splints and a Morton’s Neuroma type pain in my right foot. Are there any OTC insoles that would help (i.e. Ultrasole w/graphite arch)? Am I bound to these orthotics forever? Help!

Was the original cause that needed orthotics functional or structural? That is, what caused your shin splints? Have you been doing anything to   strengthen that weakness or is it a structural issue? I haven’t had to deal with MN, so not sure if there’s a functional component to it, but what I’ve read sounds structural, but not sure. My guess is if your issues are functional AND you’ve done something to correct the cause, then you might be able to wean yourself from orthotics. If your issues are structural (and may be in your case), then I’d guess you may still need the orthotics. Just my $.02 not founded on any medical knowledge. I’d echo Doug’s question – what were they made of? I’ve had rigid 3/4 length for several years (5?) that I wear in all my shoes. The leather cover is polished, I’ve had to reglue the cover back after wet days in the field (or very hot – sweat), and one edge is slightly cracked, but they still function. The reason I’m wondering is last year my PT initially suggested I get full length orthotics to address some structural issues in my foot, esp. near the forefoot, which is not addressed by my present orthotics at all. After my progress with some exercises, he then decided I didn’t need them, but not sure why since the structural issue is still there. I’m reasonably fine running, but still have issues in other shoes. I was going to give him a call later this fall and see if he has any rest-of-life shoe recommendations or if a full-length orthotic might be appropriate – BUT I’ve been concerned about durability of a full-length orthotic. Thanks. Dot — "Success is different things to different people" -Bernd Heinrich in Racing the Antelope

Response:

My orthotics are the full-length "sport" type. They have a 3/4 length molded rigid plastic plate attached to various cushioning materials. They are covered by a synthetic leather material. I have been told that it is not uncommon for this type of orthotic to flatten out over time. I still have the casts used to make them, but I thought that they are no good any longer because my feet might have changed over the last few years. I made an appointment for Tuesday, and I will discuss my options with the podiatrist. I agree with TBR that shoes have come a long way, and if I can get by without orthotics, I might go with some NB 1221’s. Thanks for the advice…

Response:

My orthotics are the full-length "sport" type. They have a 3/4 length molded rigid plastic plate attached to various cushioning materials. They are covered by a synthetic leather material. I have been told that it is not uncommon for this type of orthotic to flatten out over time.

Rigid takes a "long" time to flatten out.  This notion sounds like someone that sells orthotics.  What makes you think they have broken down? I still have the casts used to make them, but I thought that they are no good any longer because my feet might have changed over the last few years.

Your muscles, tendons, ligaments probably adjusted to the correction   of the orthotics but I don’t suspect this correction would cause you feet to stop pronation(assuming this is what the correction is for). If you still have the casts and foot geek says you still need the correction it should not cost as much to make another pair as you still have the mold. Some of the cost is creating the mold. I made an appointment for Tuesday, and I will discuss my options with the podiatrist.

Unless he is one of the few honorable Podiatrists that recommends an orthotic only when they are really needed, he will say "of course you need them!" I agree with TBR that shoes have come a long way, and if I can get by without orthotics, I might go with some NB 1221’s. Thanks for the advice…

Possibly but if you decide to wean yourself off them do it slowly like one a run a week for a week and then repeat. Don’t just go cold turkey. — Doug Freese "Caveat Lector"

Response:

I previously posted regarding the need to wear prescription orthotics for life once you start using them. I recently ran the Chicago Marathon. The mileage from the marathon training and the marathon itself did my orthotics in. I also wear my orthotics in almost all of my other shoes. It’s back to the podiatrist to possibly get another pair. Unfortunately, my insurance will not cover the cost any longer. They will cost me between $400 and $500. I really do not want to incur this expense every couple of years. Now that my goal of running a marathon has been achieved, I am going to slowly go back out and rebuild my mileage with my eye on general conditioning for next year’s racing season. Would this be a good time to experiment by running without the orthotics? I originally got orthotics to deal with shin splints and a Morton’s Neuroma type pain in my right foot. Are there any OTC insoles that would help (i.e. Ultrasole w/graphite arch)? Am I bound to these orthotics forever? Help!

Response:

- Hide quoted text — Show quoted text – I previously posted regarding the need to wear prescription orthotics for life once you start using them. I recently ran the Chicago Marathon. The mileage from the marathon training and the marathon itself did my orthotics in. I also wear my orthotics in almost all of my other shoes. It’s back to the podiatrist to possibly get another pair. Unfortunately, my insurance will not cover the cost any longer. They will cost me between $400 and $500. I really do not want to incur this expense every couple of years. Now that my goal of running a marathon has been achieved, I am going to slowly go back out and rebuild my mileage with my eye on general conditioning for next year’s racing season. Would this be a good time to experiment by running without the orthotics? I originally got orthotics to deal with shin splints and a Morton’s Neuroma type pain in my right foot. Are there any OTC insoles that would help (i.e. Ultrasole w/graphite arch)? Am I bound to these orthotics forever? Help!

I have orthotics for knee problems and MN in both feet.  Mine are made of carbon fibre, are more or less indestructible (though they need recovering about every six months, and the foam pad under the metatarsal arch compresses over time) and they cost about 150 pounds sterling.  They were made in Canada, though I can’t remember the name of the firm.  If your podiatrist still has your casts you should be able to get them a bit cheaper than this. As for conditioning to run without them, I am not qualified to say. Edward — The reading group’s reading group: http://www.bookgroup.org.uk

Response:

I previously posted regarding the need to wear prescription orthotics for life once you start using them. I recently ran the Chicago Marathon. The mileage from the marathon training and the marathon itself did my orthotics in. I also wear my orthotics in almost all of my other shoes. It’s back to the podiatrist to possibly get another pair. Unfortunately, my insurance will not cover the cost any longer. They will cost me between $400 and $500. I really do not want to incur this expense every couple of years. Now that my goal of running a marathon has been achieved, I am going to slowly go back out and rebuild my mileage with my eye on general conditioning for next year’s racing season. Would this be a good time to experiment by running without the orthotics? I originally got orthotics to deal with shin splints and a Morton’s Neuroma type pain in my right foot. Are there any OTC insoles that would help (i.e. Ultrasole w/graphite arch)? Am I bound to these orthotics forever? Help!

Get a good motion control shoe, and toss those f’ing things. Shoes have come a long way in the last few years, try it without the orthos, you maybe surprised.

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