Correcting common foot problems

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Re: Correcting common foot problems

#326 Post by jask » Sat Jan 22, 2011 2:53 am

Anton I do not want you to think I am rude, but the place to look is with a trained professional. The person you have seen may not be the best person for you- and I would encourage you to speak with one or more other professionals. I am biased and would recommend that you seek out an Orthotist for this sort of treatment.
The photo you posted of the footbed seemed to have an excessive forefoot post- to the point of almost creating a negative heel condition- hopefully I am wrong... in addition to new foot orthotics I would probably try increasing your heel height and putting you in a mild rocker sole.
you have a complex foot , not easily addressed over the internet and best cast by a trained professional... remember that good correction applied to a bad cast will not help.
Even if I wanted to I could not take a really good cast of my own feet, I might get close,but I have decades of experience looking at casts and I would still rather work on a cast taken by someone who can properly assess align and position my foot while casting,( and then work from that cast), than try to do that to myself.

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Re: Correcting common foot problems

#327 Post by antons » Sat Jan 22, 2011 4:03 am

Dear Jask,
I don't think that one can be rude if he gives his honest proffessional opinion. And: point taken. I'll try to find a Orthotist who accepts that I want to do the most of the work myself. And I understand that when I have a good proffessional cast made by an orthotist, that this is the starting point to make the compensations etc. myself.

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Re: Correcting common foot problems

#328 Post by antons » Sat Jan 22, 2011 5:13 am

Dear Jask,

After re-reading your post I think I can answer some questions.

If a negative heel condition means that the heel is lower then the ball then I can confirm that this is not the fact. The lowest point of the heel is 20mm higher than the underside of the ball. The perspective of the photo is somewhat misleading.

And I think I have allready a (mild?) forefoot rockersole. You can see this if you look at the orthopedic shoe.

As I understand now, after searching all the podotherpeutic websites in Holland, the mainstream of curing is preventing a Hallux Limitus to move as you do in clogs. I can't find an orthotic who uses a Hallux Wedge.

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Re: Correcting common foot problems

#329 Post by antons » Wed Mar 02, 2011 11:55 pm

Dear Fred and Jask,

Here is an update of my expierience untill now.

I could not find a podotherapist in Holland who has some knowledge about the Hallux Wedge. So I had to try out myself. I started with a Hallux Limitus on the rightfoot with a maximum angle of 55 degrees.

I made the Hallux Wedge out of a piece of cork and placed also a "pelotte". During a visit to the Orsay Museum in Paris I got a heavy cramp under my feet, so I had to remove the pelottes.

I reduced the pelottes and started using it together with the wedge the last 3 weeks.

It looks that my Hallux is more flexible now and I don't have pain there. The footbed is comfortable now.

But last sunday I made a long walk. The cramp under my foot came up again. In the car I got so much cramp in the Extensor Digitorum Longus or Extensor Hallucis, that I couldn't push down the trottle and had to use the cruise control to go home.

When walking to my home I got pain where the Achilles tendon connects to the heel bone.

My conclusion is that the Hallux Wedge is working, but that I overstressed the total system.

I have 3 questions now.

1. Is it possible that because of the Hallux Limitus the muscles and tendons are shortened and are being streched now? Should I keep this configuration and build up training more slowly?

2. Should I incorporate the wedge and the pad in the footbed?

3. How can I construct a flexible and dampening heel.

Awaiting your news.

Anton

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Re: Correcting common foot problems

#330 Post by jask » Thu Mar 03, 2011 12:36 am

Good for you! sorry to hear about your pain but I can think of few better places to be forced to get off my feet than the Orsay!
Based on what you have said,I think your conclusion is correct. How long were you using the orthotics before your Paris trip? did you start wearing them incrementally or just put them on and go all day? It may be that you are excessively corrected , or you may just be adding too much correction all at one time, by removing the pelotte you have allowed more midfoot motion, and as the Orsay would entail more standing than walking my thought is that you are (or were..) excessively corrected.
How long each day are you wearing these now?
Did your walk last Sunday involve a lot of uphill walking? If your footwear still has enough room you can try adding a firm 3 or 4 mm lift under the heel ( only ) to decrease tension on the Achilles/plantar facia.

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Re: Correcting common foot problems

#331 Post by antons » Thu Mar 03, 2011 5:40 am

Dear Jask,
I'm wearing the orthotics all day since 3 weaks now. But Paris and the long walk (flat land, because we don't have hills in Holland) were extreme for my condition.

If my conclusion is correct, then muscles and the tendons can be streched again to the original lenght. This means that I have to walk every day a bit more with the same configuration.

Should I put the 4 mm heellift under the heel or inside the shoe?

If this configuration is succesfull, should I incorporate the orthotics in the footbed, by changing the underside of the last accordingly?

How can I construct a flexible and dampening heel? What materials are needed and how to construct? Can't you point me to a website or an article on this forum?

Thank you for your fast response.

Anton

(Message edited by antons on March 03, 2011)

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Re: Correcting common foot problems

#332 Post by jask » Thu Mar 03, 2011 6:36 pm

Hello Anton,
I would normally have a client begin wearing orthotics incrementally- 2-3 hours the first day with an hour added each following day unless discomfort occurred. This sudden and dramatic change to your foots alignment can ( and did!!) result in extreme discomfort as you have found. You will not only be stretching or re-stretching muscles but realigning the skeletal structure and the load as it is distributed through bones joints and ligaments.. so discomfort is not unusual but extreme pain as you have described is a sign of excess or incorrect changes or.. overuse combined with aggressive correction.
The heel lift should be placed in the shoe under the heel of the orthotic, and I would recommend that you limit the amount of time you are wearing the orthotics for the next week or until you have no discomfort- at that point you can try to remove the heel lift and see if you can tolerate the orthotics for the same amount of time. If discomfort returns ( or does not go away) you may want to decrease the amount of correction you have built into the orthotic- examine the top surface of the orthotic for wear patterns or burnishing from excess pressure- particularly in the area on the medial arch and the area between the medial heel and the medial arch.

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Re: Correcting common foot problems

#333 Post by antons » Fri Mar 04, 2011 12:04 am

Thank you Jask,

I'll follow your advice and keep you infomed about the result.

Anton

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Re: Correcting common foot problems

#334 Post by courtney » Fri Aug 05, 2011 11:28 am

Can anyone tell me how they would add an external lift rocker sole to these?
13858.jpg


Thanks,
Courtney

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Re: Correcting common foot problems

#335 Post by mac » Sat Aug 06, 2011 12:50 pm

Sorry for the smart alec answer... Why would you want to put a rocker on a flat skate shoe? I would tell the client to bring me a different shoe!

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Re: Correcting common foot problems

#336 Post by courtney » Sat Aug 06, 2011 1:33 pm

Yeah, I know but,
Most shoes dont fit me right and I have found that these are o.k. for work. really I should make some more shoes I know.
Can it be done? I cant inside lift and orthotics in there.

Courtney

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Re: Correcting common foot problems

#337 Post by fred_coencped » Sat Aug 06, 2011 4:19 pm

Courtney,
It can be done. How much height is the lift ?
Try a band saw with a 4X4 to hold the shoe perpendicular and cut the sole in its approx. half and sandwich your external lift. Cut slow and be careful for your hands and fingers. This is not very difficult. You should consider a forefoot rocker sole and angle of progression for maintaining knee and foot alignment.

A fulcrum might be necessary for the MPJ joint if the lift stiffens the forefoot to flex.

Please advise what is the situation and reason for LLD[leg length discrepancy]. Self diagnosis can be risky with a tilt in the sacrum and resulting scoliosis. You must be prudent here.. OK. I hope this helps you.

Fred

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Re: Correcting common foot problems

#338 Post by holly » Sat Aug 06, 2011 11:00 pm

Courtney,
It depends on what you have access to. If you have use of a finisher/grinder, you could cut, pry off, or grind off the current sole to a level surface that will take a bond. Add white Soleflex (firm)or Cloud (softer) at, or a bit over, the thickness you want to add. These materials are typically sized in irons.
You can then use the grinder to carve out the rocker shape you want. Do not introduce a lean, to the right or left, in the part of the sole that is in contact with the floor.
Try it on, (with the other shoe, obviously) and see how it feels. Make adjustments. If you've removed too much material, you can glue on more.

If you were able to remove the original sole intact, you can glue it back on once you are satisfied with the shape. Otherwise, you will need to purchase a sheet of soling in the nearest match you can find, and keeping in mind any discrepancy in thickness with the sole of the non-modified shoe.
Obviously, Fred knows much more than me about the mechanics, proper locations, and risks of these operations than I do. I don't want to cover more than the nuts and bolts.
If you don't have access to grinder,(or frankly, even if you do), you might be ahead to just pay a professional. It might be a bit more than you paid for the shoes, but it will be done and done right, and you will save the frustration and you won't be covered in dust. The other thing is that to do this as I've described, (I learned in an orthopedic shop) you will likely spend as much on materials as you would spend having it done. You would have leftover materials to use in the future, but if you wouldn't actually use them, it may not make sense.
Hope this is helpful.
Cheers,
Holly

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Re: Correcting common foot problems

#339 Post by mac » Mon Aug 08, 2011 8:48 am

Courtney,
Feel free to cut the sole off of this shoe as per Fred's advice. It will be a good learning experience. What you will find inside is a hollow core with little ridges inside. It looks similar to a breakfast waffle.
It is very difficult to add much rocker to a completely flat shoe because so much material must be added to get enough "rock" to the shoe. Another thing you will discover is that the "waffle" outsole is nearly impossible to glue on because there isn't enough surface are to glue to.
Fred:
If you know a way of adding a rocker to this style of shoe while keeping it functional and aesthetically pleasing I would love to see how. Tuturial pics???

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Re: Correcting common foot problems

#340 Post by courtney » Mon Aug 08, 2011 10:18 am

Thank you Fred, Holly, & Sean,

I will read these more thouroghly.

-Fred, I had an osteopath tell me he thought I had a short leg, then a chiropractor took x-rays and measered the leg bones to my hip and said I had lld, Then a podiatrist checked my legs and ankles against each other and said same, later I talked to my Mom and she said she had a shorter leg too. So I think its probably safe to assume it is so. It's a 1/2" lift.

-Sean, thats what I was thinking, that it would be hard to glue anything to the waffle since theres not much there to stick to. What about trying to fill it with ground up cork or something?

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Re: Correcting common foot problems

#341 Post by fred_coencped » Mon Aug 08, 2011 2:43 pm

Courtney,Sean,
Sounds like a true Anatomical LLD, I would cut the sole closer to the bottom about 1/8th" above the depth of the "Waffle indentations", maybe hoping to discover a solid surface. Cork mache sounds good mixed with All purpose to fill voids.

Another concern is if the soling is gum rubber, someone else might have better knowledge. Same with some other materials.

I usually drill out 1/2" holes all over the build up keeping within 1/2" from the perimeter of the sole. Naturally this reduces some weight.

The Rocker forefoot I`d consider for you to maintain the Zero or so heel pitch. Build up the full height and taper from tread line to the toe from 1/2" heel to ball and down close to zero at the toe.

The build up should be firm soleflex, 65 durometer and the fulcrum where the toes flex with the foot. MPJ [Metatarsal Phalangeal Joint]. Also I keep the forefoot flat not rounded. This will allow your rolling over with normal dorsiflexion of the foot on the leg from midstance through heel lift and toe off gait phases.

Sorry Sean no tuturial yet.

I hope this description helps you.

OK,Cheers
Fred

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Re: Correcting common foot problems

#342 Post by jask » Wed Aug 10, 2011 10:36 pm

I would not cut that sole ( if you have not already..) in fact I would not suggest adding a rocker to that type of shoe, if you are trying to address a LLD you do not need a rocker ( which is tapered both front and rear ) assuming normal ankle motion what you require is a full length lift equal to your LLD, you can add a forefoot rocker to compensate for the rigidity of the build up material but that probably is not required.
Skate shoes can be built up but there are a number of problems; the soles are often polyurethane and difficult to glue (- use a PU specific glue, I prefer Colle De cologne), they are very flexible and this quickly compromises poor glue bonds,( I have found that gluing and mackay stitching a leather sole to the shoe affords a better glue surface to add additional sole build ups )
This type of Vulcanized sole often does not have a "honeycomb"- you can check by pulling up the insole or by probing the sole with an awl from the bottom, I would not attempt to try to split a sole that is this thin as they typically rely on a layer of material added to the inside for cushioning and are usually only 3/8ths to 1/4" thick.
The build up material (soleflex,builtrite,etc ) can be purchased with a texture or tread on one side and if you decide to rocker the forefoot you can cut or grind the taper on the side you will glue to the sole ( before you glue the addition to the shoe ) to maintain the textured tread surface.

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Re: Correcting common foot problems

#343 Post by fred_coencped » Thu Aug 11, 2011 8:14 am

Jask,Courtney and all concerned,

In Courtney`s situation it is a personal choice to venture into an external lift for a 1/2" LLD. Jask, I agree with your advise regarding the Colle de Cologne.

Courtney, only trial and error the age old empirical test will help you here with your quest for a build up. So, are you currently using an external build up? If so,exactly what are the heights?

There is no need for a rearfoot rocker. The reason for a forefoot rocker are obvious , otherwise if your build up is the entire heel to toe of 1/2" the sole will not flex. Therefore a forefoot rocker will allow the foot to rock forward as the ankle flexes from midfoot stance, heel lift and toe off.

I suggest 2 possible scenarios for you.
ONE Build up
1/2" Heel
3/8" to 1/2" at the Ball
0" to 1/8" at the Toe

OR this variation
1/2" Heel
1/4" to 3/8" Ball
1/8" to 1/4" Toe

And, as a rule of thumb an internal or external lift up to 1/4" is tolerable with the heel curve for most any heel pitch shoe even a Zero Heel pitch skate shoe. Ladies Pumps, Mens loafers and cowboy boots are another story.
So, my good fellow, just go for it....Variations can also include internal heel lifts with external. Always bear in mind the lifts should be very firm materials as we are lifting skeletal structures.

I wonder of any other bio-mechanical issues for you.

I hope this helps you,
Fred

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Re: Correcting common foot problems

#344 Post by courtney » Mon Aug 15, 2011 10:50 am

Thanks Guys,
Jask, I like the idea of the stitched sole first then the build up.

Fred, I have been wearing an internal lift with the dimensions given (you helped answer questions I had on that awhile ago, Thanks) it works great, Ijust cant fit the orthotics and the lift in.

I made some boots with the external lift that were just posted recently in the gallery.

Thanks for the help
Courtney

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Re: Correcting common foot problems

#345 Post by courtney » Wed Jan 23, 2013 7:00 pm

I just recieved and watched the HCC Dick Anderson "making orthotics DVD.

Great!!!! I really enjoyed it and learned alot.

The big bummer was it ended before the orthotics came out of the vacuum press.
What happens now?

Is there a part 2, I'm on the edge of my seat.

Courtney

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