Do Orthotics Work?

I am officially convinced after over 15 years in practice that there is no “perfect” foot. My wonderful occupation allows me to help people get back on their feet! I can do that with all kinds of conservative treatment and with surgery some times. Over the years, I have found that the most effective way of relieving pain and preventing recurrences for certain conditions is through something called a “functional orthotic”. Recently, I had a patient that made me need to clarify the question: Do functional orthotics work for everyone?? Let me first explain how these things work and how they are different from an over-the counter insert (aka arch support). In the simplest of terms, an arch support comes out of a box and is based on the size of your foot. They may call themselves “orthotics” (and most insert manufacturers will call their over-the-counter support an “orthotic”). It supports the arch fine if you happen to have the similar arch type of foot the insert was modeled after. For people wanting a little more support than what they get in a regular shoe, these are fine. An arch support can give some relief to some foot problems some of the time. I use them routinely to get feet on the right track to better foot health. They act as a good starting point. I see new patients who have been battling foot pain for months who tell me they finally made an appointment with me because “My arch supports helped some for a little while, but then it stopped working.” This happens because an arch support is made out of cheaper materials. For this reason that it will quickly flatten and lose its integrity (which is what made it work to begin with) and may flatten before you get the long term relief you are seeking. Yes, it is true an orthotic is more expensive out of pocket than an arch support insert, but this is because they are custom crafted to your foot type for your condition. What a functional orthotic can do that an arch support cannot do, is control the function of your foot. Let’s look into this a little more. The foot and ankle work best when the bones and tendons and ligaments and muscles work together to place the foot and ankle in the best position to walk. This is known as the foot’s “neutral” position. To some degree, all feet are out of alignment. There is no perfect foot. And when bones, tendons, ligaments and muscles struggle enough to where they can no longer effectively control the foot and ankle, you end up with foot and/or ankle pain. Functional orthotics work by supporting and balancing the entire foot, to neutralize the abnormal pressures, thereby relieving pain. It can actually correct your abnormal foot function for the time you wear them. An orthotic is customized to your foot like eye glasses are customized to your eyes. No one else can use them because they are made for your particular problem. They last longer because they are made of a material sturdy enough to bear your weight while you walk. Can I guarantee that they will work for your foot problem? Much to my chagrin, I can’t! I can assure you however, it is worth it every penny to take a chance on them!! It really is the best chance you may have to relieve pain, prevent recurrences and even help to avoid potential surgery! Think of the lifetime of unsupportive shoes your feet have had to put up with. Isn’t it time you give them the best of what there is to offer?

The Foot Bone's Connected to the Back Bone (and Hip and Knee...)!

I heard THE BEST saying from one of our FAANT “team” members today. She said “It’s amazing that something that far down can affect something that far up!!” No truer words have been spoken when it comes to feet and what I call “podiatry philosophy”!


I saw a patient recently who was wondering why his orthopedic spine specialist sent him to see me when they had been discussing surgical intervention for his back! This is not an uncommon occurrence for a podiatrist. In fact, I see patients who have back, knee and hip pain, at the request of their orthopedic specialist, while having NO pain in their feet!

Why is this??

Rather than get into the complicated world of biomechanics, I am going to use an analogy that I like to use quite often. Visualize if you will… Your body is your house and your feet are like the foundation of your house. Stay with me! When you build a house, you want to build it on the most stable foundation, right?! You would never build on sand or on mud. You would most likely build on a solid foundation. Your house will last longer that way. No sags, no cracks in the walls, floors or ceiling, no doors that won’t shut! The same is true for your body! When your feet are unstable, even though they may not hurt, the rest of your body has to compensate for the instability. Add those cute, but mega unstable shoes and sandals, and yikes, we start to break down! Over time, unstable feet and/or unstable shoes for umpteen years can strain and injure the “house”! A proper biomechanical exam can uncover misalignment. The good news is that, sometimes, by getting control of the instability of the foot, with proper shoes and functional orthotics, the pain “above” may be much less, if not gone!
Heed your specialist’s advice! The body works a one whole unit! Don’t let your feet become the limiting factor in your recovery!

Beach Etiquette for Feet

As many of my patients know, I love to travel.  And beautiful beaches are my favorite.  During a recent trip to Grand Cayman I watched some appalling things happen to feet.  So I thought I would share my top tips for your feet at the beach.

1.  Shoes are a good thing and for numerous reasons.  But there is no need to wear cross trainers and socks all the time.  Flip flops or sandals are the way to go.  But leave the "fancy" flops for dinner out.

2.  Planning on running on the beach?  Don't do it barefoot unless you are used to running barefoot.  The sand is much softer than your treadmill and will cause things like achilles tendonitis and posterior tibial tendonitis to occur and quite possibly ruin your trip activities.  Take your running shoes for this one.

3.  Heading out in the water and not sure what type of shoreline you are dealing with?  Water shoes are great.  I've been to several beaches that looked like there was a soft sandy entrance, only to find out that  it was a rocky, spiny ledge in disguise.  But if it is soft like baby powder...let those toes free!

4.  I try to get in at least one spa day while on vacation and there is always a question of spa etiquette in different countries.  But the one thing that is never a question...wear the provided slippers everywhere!  It may be the top spa in the world but that doesn't mean the spa goers have the healthiest habits.

5.  Don't forget your feet when applying sunscreen.  One of the worst burns I ever got was on the tops of my feet.  I could wear shoes for 4 days!  Melanoma on the feet is rare, but can be the most deadly when it occurs.  And don't think that beach time is the only time your feet are getting sun.  Those walks out shopping with flips or sandals on allow plenty of sun time for those tootsies.

6.  Feel a sting or a burn while walking?  You may have stepped on glass hidden by the sand or a broken seashell.  You can also step on broken coral at the waters edge that can really hurt.  Best thing to do is immediately wash your foot with soap and water and check for anything that may be stuck in your foot.  If necessary, seek medial attention.

7.  If you are diabetic or have any problems with your sensation or circulation, always think "protect my feet"!  Check the bottom of your feet often for cuts, scrapes or burns you didn't know you had.  Again, seek medical treatment if you see any cut or burn on your feet.  The organisms that grow in the ocean can cause serious infections very quickly.

Not sure what shoes are right for your beach vacation?  Visit our certified pedorthist at Healthy Steps.

I love the beach and the water.  And I am often barefoot on the beach when I can be, I'm just careful.  But I must touch on one other topic.  If you are snorkeling and come across a beautiful coral reef, please don't touch it or stand on it.  This is not a resting area for humans.  It is a home to millions of living organisms and fish and it is our job to protect them!