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Feeling confused about my custom made rigid orthotics
Snawbaw
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I am feeling a bit baffled at the moment - and was wondering if anyone else has had similar problems. The background of the story is about 8 months ago I went to a private podiatrist who also specialises in sports injuries. I went because I have had over many number of years trouble with repeated sprained left ankle. The ankle was being very slow to heal and painful even after 12 months post injury,
I have run for 27 years and completed marathons and half marathons etc. The ankle problem started when I used to compete in cross country races and then normal training. I have been lucky not to have had any injuries other than this. I have always run in a neutrall running shoe. Anyway my podiatrist states that I was over pronating, stated that I had fallen arches (although my feet are by no means flat) and I have bunions - I am female and weigh 122 lbs.
He made me custom rigid orthotics for the above and told me to wear neutral well cushioned shoes. I knew nothing about orthotics so I didn't question - just paid up the money! Eight months later I have developed left knee pain for the first time ever. Saw a physio on Wed and he stated it was tendonitis of the hamstring and a small knee bursitis caused by overuse. The physio commented on my "strange contraptions" (orthotics). Took them out of my neutral running shoes, told me not to wear them whilst running only for work and stuck a couple of bits of foam onto the sockliner! Gave me ultra sound, tens machine and some exercises to do and other instructions re training and to have a follow up with him again next week - at £30 a time!
Obviously I will push for an explanation next week, but I am left under the impression he does not approve of my rigid orthotics. They are only 8 months old and cost just under £200.
Has anyone else had rigid orthotics custom made only to have a different opinion by another professional and told not wear them or had injuries related to their orthotics? What do you make of it all? I think in hindsight I should have gotten semirigid ones!
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Comments
I think the general consensus is that the rigid ones are best for running in according to the specialists that I have seen! I used to hate running in mine but was told I needed to use them! I have got used to them now and as long as I make sure I have shoes that they fit into properly and leave my laces loose they are fine!
However if you didn't have any problems usually associated with pronation then I am not sure if they are worth it,
if I could get away with not using mine I would but after just 15 mins running without them I have severe hip, knee and ankle pain! 
Yes me! I hurt my hip and was advised to get orthotics which I did. When I went to a new physio he advised me to see the pod at their clinic who was the bestest pod - I was told they weren't up to much and didn't offer enough support so I got theirs - rigid carbon fibre ones but after a two months of having them I developed a pain in the arch of my foot I'd built-up running to 20 mins - I decided I'd never had probs before (in my feet) so I got rid of them completely and bought a pair of mild stability shoes and started back running again, only for my hip to start hurting again - full circle after 7 months of getting nowhere.
I saw an NHS physio who said the new ones were too high then I went to a chiropractor who told me the same thing. He said I do need orthotics just not as high but higher than my first pair! I did get the second pair adjusted but they still weren't right so I've bitten the bullet and ordered new ones from him which I'm currently waiting for. I did have a leg length discrepancy which was muscular which he has put right so dodgy biomechanics going on there too but it is so frustrating and expensive. Professional opinions do vary and it's not always easy to find the right advice but after going round the houses I am (hopefully) finally geting sorted.
It's a case of finding the right professional you trust. Sorry I can't give any more advice other than to trust your instincts.
Good luck. Am impressed with your running history!
D
I have two sets,
they work for me anyway. I have rigid 3/4 ones for everyday wear like in my workboots etc. And full length semi rigid ones for running in.
"I am feeling a bit baffled at the moment - and was wondering if anyone else has had similar problems. The background of the story is about 8 months ago I went to a private podiatrist who also specialises in sports injuries. I went because I have had over many number of years trouble with repeated sprained left ankle. The ankle was being very slow to heal and painful even after 12 months post injury,
I have run for 27 years and completed marathons and half marathons etc. The ankle problem started when I used to compete in cross country races and then normal training. I have been lucky not to have had any injuries other than this. I have always run in a neutrall running shoe. Anyway my podiatrist states that I was over pronating, stated that I had fallen arches (although my feet are by no means flat) and I have bunions - I am female and weigh 122 lbs."
Is the sprained ankle meant to be due to the over pronation and fallen arches ? Sounds a bit like the podiatrist has ignored what you went in with and given you a solution to a problem you never had.
I would try and get someone to assess whether the ligaments are too lax, maybe due to being sprained previously - it might be possible to have an op to tighten them if appropriate - also you may benefit from working on proprioception.
Also have you tried just running with an ankle support bandage (say double tubigrip thickness for better support)and ditch all the orthotics. That's what I'd do anyway.
Thanks touie2 and Missy D for your comments like you I also feel I will be going around the houses as far as professional opinion goes. I did see a 2nd podiatrist at the end of April he stated the prescription was correct as far as he was concerned but he was more in favour of the semi rigid variety of orthotics - (the original podiatrist was more in favour of the rigid ones!) but to be honest I couldn't justify splashing out for a 2nd pair. Was not told by the 2nd podiatrist that they could potentially pose an injury in the future.
The question is now I have this knee injury should I bite the bullet and get a 2nd pair made, albeit my injury is an over use one, but don' t know if the rigid orthotic contributed to it though (due to lack of cushioning).
I will have to question the physio more fully next week and get the opinion of yet another podiatist. My instinct states - yes I have overpronation in the left foot but the right foot is fine, therefore should not run in only neutral shoes, and I need an adjustment to the left foot. Like Farni I am thinking perhaps I need the semi rigid ones for running and use the rigid for work. I hope to find a good podiatirst in my area who can advise the best course of action for me at the least expense! Also a week on Saturday a rep from saucony will be visiting the local running shop so I will get an assessment from him/her too! I might also end up with information overload!!!!! 
The ankle was the major factor in me first seeing the podiatrist - I did not go with the intention of walking out the door with custom made orthotics - I did ask if off the shelf ones would do and was advised with the amount of running I do and for prevention of future injuries to get the custom made ones.
Hope Missy D your problems are getting sorted out at long last, and thanks I did not think my running history was that impressive - but thanks anyway!
I appreciate all your views and comments. Any more suggestions would be welcome. I see the physio next Wed. Just want to get back into my usual running and training again. Will see a podiatrist towards the end of August.
S
The ones that work for me are full length and more a very tough foam than rigid. I wear them in all my shoes, excepting MBT shoes/sandals and Nike Frees. I found that that was important. For me, it is important that my foot can really roll from toe to heel, unless I am running in Nike frees, when I run almost entirely on forefoot. It is important to me that I can feel the ground to some extent: it seems to facilitate the use of glutes.
That is not to say that the same will work for you. Think about it, try it, analyse it, and discuss it with physio and pod. In the end, it is you that is going to do the running. It is for you to decide whether it is doing the job or not.
Thanks Stickless for your response. What a minefield out there - 4 different sorts! What did you pick up at the FLM (? off the shelf ones)? Do you have any problems fitting your full length orthotics into certain running shoes, as I would have thought the fit would differ as different makes of running shoes differ.
I spoke to a very sympathetic podiatrist on the phone and have made an appointment on the 24th Aug, he doesn't use the rigid variety and believes a full length is best as he states other things are happening at the front of a foot that the three quarter length ones won't address.
When I saw the physio I asked him about running in motion control shoes - he didn't go into detail but said that the motion control shoes don't do what they say they do on the tin! More information is needed from the physio and podiatrist regarding injuries with and without orthotics on my next visits.
I had always in the past enjoyed running with a responsive shoe and although I have had no major concerns or grumbles running in the rigid orthotics over the last 8 months before my knee problem, I did however recently became aware of the feeling of stiffness/rigidity of the feet when running - perhaps my feet have not had sufficient flexibility and become more stiff. Unfortunately at present I am only running every other day for a couple of miles - vastly different from what I am used to!
Hi Snawbaw
Yes it's a minefield and not always easy to get to the bottom of what's really going on - our bods are very complex things! From my own experience I've discovered that orthotics are handed out too easily to correct posture and muscle imbalance when these issues would be better off addressed directly and whilst it may solve that problem - they create another one! My new pair have arrived now, got an apt on Weds for the fitting and hoping for the best.
Good luck for the 24th, hope you can keep on running til then, albeit less than normal - at least you can still get out there!
D
x
Hi Snawbaw,
I got orthotics about 18 months ago due to achilles and knee problems. My pod started me off with a 'temporary' set. They cost 70 quid and last about 2 years. I did have a few problems getting used to them. I needed to go back to get them adjusted 3 times. It took a year before I was happy with them and then got a permanent set made.
Maybe this would be a better way for you to go rather than shelling out 200 quid for another set...?
Hi, Thanks Missy D. I know what you mean -bods are complex and always changing with the natural ageing process! I am looking forward for another opinion and advice on the 24th - I will not be in too much of a rush to get orthotics made until I have had chance to discover the root of the problem and get to trust my pod!!
Thanks Running Scamp for your comments - this time I am going to ask the pod what are all the alternatives for my particular biomechanics and want to know the pros and the cons - (was a bit too eager to think that one set of orthotics was the cure to all evils and green round the ears!!!). I am also going to ask the pod re alternatives of not only temporary ones but also stability shoes - despite what my physio said about not doing what they say the do on the tin - lots of people are happy with only that!
Will update you on what the specialist sports physio says about it all after my appointment on Wed!
S
Try Footwise in London or Guildford (no, I am not related to anyone in the company nor do I have shares!). Like Stickless, above, I tried loads of different NHS orthotics and off-the-shelf ones, none of which were any good. I'd gone from being able to walk 20 miles without noticing it to being unable to get to the end of my road!
The Footwise orthotics got me walking again within a couple of weeks, and I haven't looked back.
Sass xx
Hi, Thought I would give you an update on the sports physio advice yesterday. I asked if the rigid orthotics I had been prescribed could have exacerbated the injury - he emphatically said yes!! He told me I should stop wearing these rigid orthotics for running. He also stated in his opinion that I did not actually need custom orthotics for my particular needs. He suggested that I should try off the shelf ones and he gave me his recommendation of which ones. I have also found good information on a variety of tested off the shelf orthotics from another running magazine which prove to be quite satisfactory and looks promising. I have purchased full length sports ones - made for running in mind which is made of semi rigid material, light weight and has good support and cushioning (which I need). Again it will be trial and error. I will see how it goes - I can always upgrade the insole to a stronger support and and control if I feel I need to. Thanks Sass for your recommendation - intersting website. Only drawback is the 2hr 30 min train ride to get there!!
Popsider was on the right track to - my sports physio has recommended me some strengthening exercises which will also improve the proprioception. Information on sprained ankles do suggest that there will be a weakness there - I read somewhere that up to 40% of people will have a repeat of their injury of ankle sprains.
Well I am going to postpone the trip to the Pod for now - I will see how it goes. (My trust in Pods have taken a bit of a dive!). I wonder if there is too much prescribing of custom orthotics where not actually needed going on. I am still under the sports physio anyway and there is definite signs of improvement with the rehab regimen and treatment - although I have been told it could take up to 2 months (maybe shorter, maybe longer) for my particular injury to heal. Thanks.
S