Podiatry V orthotics

speedalong

Hi,

my appointment at the podiatrist came through for today ... this was as a result of being referred mid June for my toenails to be cut as could not cut them myself due to hip restrictions .. needless to say can now cut them myself of a fashion ...

However they also do bio-mechanics ... decided to keep the appointment and see what they could offer me on this front.

Since my last THR (13 years ago) I have had a leg length discrepancy. Unfortunately the more recent hip op on the other side made this worse and not better. I wear insoles in my left shoe for this.

As my right hip was semi-dislocated for so many years .... it had a knock on affect with other joints and how I used them. Hence the uneven wear and tear and problems with knees etc

The podiatrist analysed my feet, gait etc and decided my right foot did indeed roll in and has custom made some insoles to help correct this. I have to go back in approx 6 weeks to see if they need adapting after wearing them in gradually.

Interestingly/disappointingly she made one for each foot (as I have problems with both feet) BUT the height difference between the new insoles no where near corrects the difference in my leg length .... (She did say I could revert back to the ortho insole on the left ... but this is just a heel raise and won't correct the foot just the leg length.)

Next week I have an orthotist appointment to check if insoles provided after op correct the leg length discrepancy satisfactorily.

T told the podiatrist about the orthotist appointment and she said I will need to decide which route to take ... why can't one of them treat both problems?

Speedy

Part of the assessment was walking up and down without heel raise, shoes or crutch - and my walking quickly deteriorated and was TERRIBLE!! (She let me use the crutch part way through the assessment.) Self referred for physio whilst there ... beginning to think will never be good enough for work by half term at this rate.

dreamdaisy

Um I don't know the exact reason why one person can't treat both areas but podiatrists do things like deal with corns and trim nails and get rid of hard skin, whereas orthotic people design - they don't do pedicures. I would expect an orthotist to have the experience/skill to equal your leg length, not a podiatrist. I think again, like clairc, you are overlapping two specialisms: I could be wrong, usually am.

It will be good to see if the new insoles help. My feet are as flat as pancakes - my wet footprint looks like what you get when you draw round your feet. I have some bought-over-the-counter insoles but it is such a faff switching them around my shoes. I wear my crocs - built-in arch support, and Hotters for posh. Walking still hurts tho - dulled razor blades however at this end of the humira wedge! I'm glad she let you use your crutch - support is still necessary, and may well be for a little while longer yet, but I am sure you will get back to school by your target date: look how far you have come already. DD

speedalong

Hi DD, othotics should design correction orthotics - but instead they just buy them in bog standard. Only ever been interested in measuring the length of my legs and ordering nearest approx foot raise.

Podiatrists do all the things you say but also specialise in how the foot works and how this affects the lower legs and gait.

The problem with these insoles and things is they interfere with the lovely supports and linings and things in comfy shoes ...

Glad you are all humira'd up ...

Speedy

marion1952

Hi Speedy

That's disappointing - not much 'joined up service' there then!!!

There must be a solution to this... it's ridiculous.. this must be a relatively common issue..

The podiatrists and the orthotists both work in the same department in the hospital I go to, and the podiatrists often call the orthotists in to the treatment room for advice about the patient..... My understanding is that the orthotists are more 'technical' and 'specialised' ..

I think the first (crucial) thing is to get the leg length insert the right height ..
then you need an insert (or two half inserts!) which will rectify both the leg length and the foot roll..
See what the orthotist says when you see him/her this week. If neither the orthotist nor the podiatrist can sort this out for you then they are not earning their salaries!!! it's not blooming rocket science ...

When do you think you will see the physio again?

Don't get disheartened.

(I have seen some shoes (pavers or padders - not sure which) where the whole inner sole comes out so that it can be replaced by an orthotic insert if necessary).

Speak to you soon

Marion x

frogmorton

Hi speedy

Sounded such a goood vist apart form that vital flaw!!!

I reckon they should do both!! I dont get it why you have to choose?

Are you going to think about it?

Didn't you like DD's - 'they dont do pedicures'!!!

LOve

Toni xx

holmesi

hi speedalong,your topic reminded me of something about the insoles and LLD ,I had the full bio mechanic thing with a private specialist and the insoles custom made[used for about twelve days ] the problem was lower back/ twisted pelvis.Then i saw a lady in hertfordshire who helps people with twisted pelvises,she gave me specific exercises which i do before i go to work and after any thing strenuous it has made a difference if you google pelvic correction it should come up with www.sohanjalaiai.com good luck with whichever path you choose and i hope you find relief soon

speedalong

Thanks Marion and Toni for your replies ... it does seem rather daft ...

Will follow up the link tomorrow, thanks holsmi.

Am wondering whether should wear ortho in one shoe and podiatrists version in other ... but could end up feeling "wonky/unbalanced" like Hileena ...

Never clear cut and simple is it?!

Speedy

skezier

Hi Speedy,

My eyesight is shot tonight but I think I sort of got the gist of this....

You will get there girl! You have more determination than you realize and come on flower the first time is always the worse and you know that.... You will get there! Yep you been told! (((( )))) and a bucket of getting there quicker drafts... taste of strawberries though Cris xx

irbrit22

Hi,
I have wonky hips and feet too. Also, a dodgy back. Lots of dislocations and hospital admissions for ops and emergencies.
All too time consuming to explain here!!
I sometimes think I go round in rings as far as feet go.
I go to my GP, a podiatrist, a chiropodist and a physiotherapist.
I have spent a fortune on trainers over the years as that is all I can wear. I have soles of all description, including ones made specially for me by the podiatrist. The latest investigation has been X-rays and the ankle bones are fine. So, I am back at physio as it is concluded that it must be ligament damage. I am doing exercises with a ball at home. After 12 years of problem feet...I still keep hoping for relief!! Wishing you some luck!!

julie47

Hi speedy

Just read your thread, wasn't on comp much yesterday

I think i would like you said try both and see which is the best for your comfort. (if they are making you choose)

I hope your problem is resolved soon

love juliepf x

speedalong

Thanks Irbrit, Cris and Julie - for your support.

I just want insoles that both correct height discreprancy and feet ...

Life ain't simple is it ...

Speedy

hileena111

Hi Speedy....No life aint simple and like you say you dont want to be unbalalnced like me LOL
I got to a podiatrist but thats only for nail cutting because like you cant reach my feet ...dont know whether that will change after the 2nd op we'll see but the appointments here are very hard to get and i only see her once every 3 months so I think until they tell me to get lost i will keep going back,. I tried to cut them before the last appt and she said "we have some lovely disigner toenails here" LOL

Love
Hileena

speedalong

Hileena - every 3 months????!!!! That is terrible!! They must be really long by then ... mine were bad enough at 6 weeks when I went and asked for the referral ... OH wouldn't oblige inbetween appointments?

I'm doing my own now of a fashion - have struggled with THR nails since had op, new resurface-replacement nails aren't easy but easier than THR. "Unique" nail cuts are IN!!

Speedy

hileena111

Yep they said that was all they were allowed to give me.....and in between times.....advkised me what kind of long file to get......and said even if I only did one a day just file at them and she would sort them out properly

Love
Hileena

geo501

Hi folks
just joined the forums. I recently had an appointment with podiatry, during this the podiatrist called in the orthoticist and they decided i needed made to measure shoes and insoles.
4 weeks later i had shoes and insoles fitted, service with a smile and all joined up.
Would custom made shoes help your problem speedy or am I being too simplistic?

dreamdaisy

It sounds ideal geo501 but was that very expensive? Don't provide details but to my way of thinking (and money restrictions) over £50 would be expensive. If they cost more than that just say yes! Were they worht the dosh tho? Are they comfortable and do they make walking easier/better? DD

dorcas

Hi speedy,

I'm coming in late to your thread, sorry! I have no brilliant solutions but lots of others have come up with really good suggestions for you to consider.

hope you do get the solution that suits you best.

love n (((hugs)))

Iris xxx

speedalong

Hi Geo ... (can't remember the numbers, sorry!)

I'm glad you have your feet sorted.

My podiatrist is at the health centre and the orthotist at the hospital .... so joined up service might be tricky...

I'm seeing the orthotist on Tuesday so will get him to measure my length dispcrepancy and TELL ME what it is. Might show him what I have from podiatry too.

Saw physio today he said if the leg length difference is no more than 2 cm then the podiatrist should be able to sort it out with customised insoles ... and to make an earlier appointment to come back to have the right insole raised some more, instead of waiting 6 weeks.

So at least I have a plan.

Thanks DD and Iris, for your ongoing interest and support.

SPeedy

geo501

Hi DD
The shoes are provided by the NHS and are free, you get 2 pairs the first year and a pair a year after that.
you are responsible for soling and heeling(healing would be great).
Speedy, glad you have a plan and hope it works out for you.

julie47

Hi speedy

Just reading your updates

glad you have now got a plan to work to

hope you soon get sorted

(things always seem to take ages dont they)

or perhaps I am just impatient

Hope you are feeling ok today

love juliepf x

hileena111

Hi Speedy,,,,,glad you know which way to turn now......

Love
Hileena

dorcas

Hi speedy

glad you've got it sorted out in your head now.... the physio seems to have been helpful with her comments eh?

a wee quetsion...having corrective shoes or insoles or whatever is decided is best.... will it ease the pressure on other joints as well as improve your balance & gait :?:


(((hugs)))

Iris xxx
ps... I loved geo's 'healing' shoe comment. made me giggle! if only!

speedalong

Hi Julie and Hileena thanks for your words of support.

Iris - Geo's healing/heeling pun made me laugh too.

In theory - improved foot position/function should improve gait and posture - as long as the other muscles and joints can adapt and tolerate the change ... that was why are asked to see podiatrist. I tried podiatry before the op when my knee was really bad too to see if it would help - but it made things worse probably because my hip was semi dislocated and that needed correcting first...

Speedy

dorcas

thanks for that speedy

will be locking that info away for reference/ another day.

please let us know how you get on speedy.

have a good weekend with S... how's school been this week?

Iris xx

dreamdaisy

Thanks for the info geo501 - I lked the pun too! DD

speedalong

Hi Iris,

will do.

Am aching in lots of places today - probably a mixture of the new physio regime and the insoles. Wore them to athletics today (I assist S, don't do the actual athletics :roll: :shock: but it is still pretty physical.)

Realised today I can now get onto my knees in a controlled manner and without holding on!! Getting up again ... still need to haul self up on furniture...

I'm a work in progress!

How is wally ... I haven't read an update in ages ... perhaps I missed one?

Speedy