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Greetings from Nova Scotia.,

I saw a lady who had a fairly low arch in weight bearting and non weight bearing, complaining of plantar fascia/medial long arch strain, met pain, HAV bilaterally, (no pain). She could not walk without great pain. I made semi-rigid polypro orthotics for her, inverting her very pronated rearfoot 5-6 degrees, gave her a 2-5 in 1/8" Poron. I fit her into a pair Saucony Shadow 5's which keep her very straight.

She is totally painfree, feet feel wonderful like they haven't in years however she now has begun to wear holes in her socks (first toe) and also she is wearing through her shoes. My inclination is to think "holes are easier to live with than pain" however she has reminded me in her thick Scottish accent that in 62 years, "A havna wern shews n stockin's lak tha' bafor an' I dunna wish to begin tha' new!"

I believe she is walking with her medial long arch supported, first ray is stable, hallux is dorsiflexed and voila ...she is hitting the upper in her shoes. Is there something I can do to help or am I missing something.

Sincerely
Freeman Churchill
Halifax NS

 

If you respond to this after Friday and I do not respond for some time, please do not be offended. I am off to Ecuador for 2 weeks.
Freeman

 

Maybe add first ray cut out or reduce thinckness of orthotic under first ray to facilitate MPJ motion. It could be that the orthotic is inducing a hallux limitus and causing an IPJ hyperextension --> hole in shoe.

 

Are the holes dorsal? When the toe dorsiflexes more with orthosis treatment, it is the whole shoe and toe that dorsiflexes and the the jplantar surface of the toe stays in contatct with sockliner. You would have to look at EHL acitivity to explain holes dorsally.

Eric