Hi fabulous PTs on the board!

[VeloVT]

Emily,
Does your toe get swollen? One of my (older) running buddies was having big-toe pain and swelling after runs and it turned out to be -- eek! -- arthritis. PT gave him a carbon sole, which created as many problems as it solved. My "buddy" (luv that word!) went out and bought a copy of Chi Running and has been trying to apply those principles, it seems like with pretty good success.

[emily_in_nc]

Emily,
Does your toe get swollen? One of my (older) running buddies was having big-toe pain and swelling after runs and it turned out to be -- eek! -- arthritis. PT gave him a carbon sole, which created as many problems as it solved. My "buddy" (luv that word!) went out and bought a copy of Chi Running and has been trying to apply those principles, it seems like with pretty good success.

Nope, no swelling, redness, etc. Just a funny pain in the base of the toe when I walk after running. It was pretty bad yesterday after my run, but is nearly gone today. My mom has gout, but that is very different from what I'm experiencing (i.e., her toe hurts all the time when she's having an episode, not just when walking), and her attacks have nothing to do with exercising (b/c she doesn't!) but more with diet. It's possible mine is osteoarthritis, I guess, as it also runs in my family, and I'm not getting any younger (I'm 46). I think rheumatoid arthritis is usually in symmetrical joints, so my left toe would also be bothering me, which it isn't.

Thanks!
Emily

[Sheesh]

I wore my green superfeet all day yesterday (on my feet and running around for 12 hours!) and they made an amazing difference! But, by the end of the day, I had some pain in my arch near my heel. Maybe too much arch support? Or will I get used to it over time? Should I try the berry superfeet instead?

I'll wear the green superfeet again today and see how my feet feel at the end of the day. Ultimately, though, if inserts are the way to go, I need suggestions for inserts that I can wear in dressier shoes.

Thanks for the help, ladies!

[KnottedYet]

they will make your feet tired, because your feet are working in a different position now.

Pressure/pain in the arch near the heel is exactly where you will feel it if you have been overpronating and now you're being corrected by the insole. The ramp up to the arch in the insole acts like a kickstand at the sustentaculum tali of the calcaneus, and keeps your foot from collapsing.

Foot exercises will strengthen you and allow your own muscles to hold you up instead of needing a kickstand.

If the insoles get irritating, take them out and give your feet a break. 12 hours on your feet on the first day is pretty hefty.

[Sheesh]

When I went to put my shoes on, the pressure on the arch near the heel was too much. I ended up wearing my Chacos for most of the day. Towards the end of the day, I put my tennis shoes back on and I was good to go.

Knot - Do you have suggestions for foot exercises? I see my physical therapist again on Tuesday so I'll give her an update on the superfeet, but I'm not confident that she'll do much more than massage... Thanks again for your help!

[pll]

I suffered with PF in 2002-03 and found Birkenstock 3/4 insoles in my loafers. I still use them. However, I spent several months back then using running shoes (with Powerstep insoles) and Birkenstock sandals, nightsplints, taping, the works... Among the exercises I was prescribed, I remember most the toe rises.

And a "footlog" is great. You can get a good "massage" at home for as long as you need.

[KnottedYet]

Tell your PT you'd like some intrinsic foot muscle exercises (those are for the little muscles that are in the foot itself) and some extrinsic foot muscle exercises (muscles that are in your lower leg, but have tendons going into the foot.)

Ask her to teach you closed-chain lower extremity (including pelvis in there) posture exercises. (closed-chain will work balance and proprioception, too, so you get more bang for your buck!)

I wouldn't ask her to post your Superfeet until you have broken them in/strengthened your feet to the point that you can wear them all the time. If she hasn't been trained in posting, don't worry. She probably knows someone who can do it. At the very least she can check your foot/ankle posture and functional positions when you wear the Superfeet and she should be able to tell you if you even need to have them posted.

[sundial]

This is a really interesting thread and I'm fascinated with the treatment options.

My problem with shoe inserts is.......I don't know which side to put one in. I lack joint space in my right knee, so I'm 4-5 mm shorter there, but my left side is shorter than my right according to a fitting I had recently at a bike shop.

Since I wear mtb shoes with Frog pedals, I'm not able to shim the right cleat. If I wear a shoe insert, do I wear it in both shoes, the left, or the right?

[goodjude]

I have suffered with this same problem and it really just takes lots of good shoes that are more or less orthotic, stretching the calf muscles with a yoga strap pulling the toes towards you as best you can. I also would wear a special boot at night that helped to keep the toes straight and the foot flexed. Good luck. I can't wear flip-flops at all and I live in Florida. If I wear them for only one day the next day the PF starts right back up. Be patient, it does take some time to recover from. Also do not walk on the floors in your house barefoot, make sure you have good support, no bare feet! Sorry ( most comfortable):

[KnottedYet]

This is a really interesting thread and I'm fascinated with the treatment options.

My problem with shoe inserts is.......I don't know which side to put one in. I lack joint space in my right knee, so I'm 4-5 mm shorter there, but my left side is shorter than my right according to a fitting I had recently at a bike shop.

Since I wear mtb shoes with Frog pedals, I'm not able to shim the right cleat. If I wear a shoe insert, do I wear it in both shoes, the left, or the right?

Insoles you wear one in each shoe. They come in pairs, and you should wear the entire pair even if your foot problems are only one sided. You can post/ship/lift one side to deal with asymmetry.

BTW: everyone is lopsided. You only need to shim the length difference if it is very large (like 1/2 inch or more) and/or if it is causing you pain.