Dress Shoes and Plantar Fasciitis

[achillesg]

Do you have suggestions for this problem?

I'm a lawyer. I don't need to dress formally every day, so I often get by wearing just a sport coat and tie. The problem is that once I reached the age of 35 or so, I became susceptible to plantar fasciitis, and my Aldens and J&M's suddenly became instruments of torture.

Those shoes were moderately expensive at the time, $150 to $200, but now the same shoes, ex. a cordovan blucher, are $500 or more.

I've been wearing black New Balance walking shoes with my suit and jacket, and of course that looks sloppy, but then some type of rubber soled captoe (I call them "fake" captoes) when I wear a suit for a client conference or court appearance. These rubbersoled comfort shoes look fine from a distance of 20 yards, but up close they look like exactly what they are, inexpensive mass-produced rubber-soled shoes.

I know that the shoes are pivotal in this issue, because I can run hard for hours on the tennis court with the proper shoes and have no problem whatsoever, but then put on a dress shoe and pain sets in after walking 20 steps.

Are professionally designed orthotics a guaranteed solution to this? I'd hate to spend $300 on orthotics, $500 on shoes and then be right back where I started.

I wish someone made an elegant leather shoe that had the internal construction of my New Balance tennis shoes as I would pay dearly for that, but I'm afraid that the two shall never meet.

I know my problem is not unique because half of the 40-something males in know are from time to time hobbled by fasciitis, ruptured achilles, heel spurs or other shoe-related issue.

Any suggestions for solving the problem would be appreciated.

 

[academe]

I wear orthotics to correct falling arches and lower back pain. Prior to getting orthotics, I had so much back discomfort that I was losing sleep and spent some time in physical therapy. I'm an academic and environmental scientist by trade, so I spend a lot of time on my feet teaching, doing field work and in the laboratory. I would strongly recommend getting orthotics; mine were definitely worth the ~US$300 that I paid for them, as they have eased my back pain and I no longer have to see a physical therapist. My only caution would be to go to certified podiatrist, and to ask very carefully about how they make their orthotics. The best orthotics are made by taking both a 2D outline of your foot and 3D imprint/cast of your sole. The latter can be made using a kind of foam material that moulds around your foot to make what looks like a 3D inverse impression of your foot. The resulting orthotic is typically made out of plastic or a kind of fiber-glass like material that is quite hard to the touch. I would be wary of podiatrists that do not take the additional step of 3D imprinting/casting. Also, I would strongly avoid any kind of online service for making orthotics. They may be cheaper, but just can't deliver the level of precision you need for a proper foot correction. To buy shoes that will fit, you will then have to go to the store and try them on.

 

[achillesg]

Thanks for the feedback Academe. I tried to send this by pm, but the system only lets me do that if I've posted more than once.

 

[datasupa]

Originally Posted by achillesg

I wish someone made an elegant leather shoe that had the internal construction of my New Balance tennis shoes as I would pay dearly for that, but I'm afraid that the two shall never meet.
I haven't tried them personally but Cole Haan has a Dress Air line that has Nike Air technology cushioning. http://www.colehaan.com/colehaan/cat...,viewAll=FALSE

 

[DandySF]

It took about six months for my case of plantar fasciitis to clear up. I treated it by stretching, icing the foot, and wearing soft-soled shoes. My doctor had other recommendations as well, such as regular use of ibuprofen.

For those days when I'm going to do a lot of walking, I choose a rubber-soled shoe. From an aesthetic perspective I much prefer a leather sole, but not so much that I'm willing to compromise the health of my foot.

I hope that you are in touch with a doctor about your PF. Once it's treated and controlled you should be able to periodically break out your favored shoes.

 

[HORNS]

I agree with what academe has to say about this matter. However, I'd like to expand on what he has to say.

There is no such thing as orthotics that are not made from a custom impression of your foot. So do not go to a store like Good Feet or some other place that try to push essentially hyper expensive over the counter arch supports. That being said, there is a huge difference between over the counter arch supports and custom-molded orthotics.

Secondly, the way an impression of your foot is made is extremely important, and it behooves you to "shop around" for a podiatrist that makes the devices by taking an impression of your foot using sheets of plaster of paris. Using the foam molding is quick and clean, but it is difficult to impossible to hold your foot in the position you need it in so the mechanical strain on the plantar fascia is eliminated. See, the whole idea of orthotics is that these things are going into your shoe and holding your foot in the position that the doctor held it in while taking a mold of your feet. Also, regardless of how soft that foam is that the orthotic is made from, it will push back against your foot and distort your skin and the intrinsic fat padding you have. You will then have a device that does not cup the padding and maximize it because it is already made from a foot whose padding has somewhat spread out.

Third, an orthotic is most beneficial when it has a "post" at its heel. This raises the heel to a miniscule degree, but it acts as a flat, stable base so the heel doesn't rock back and forth - remember that the orthotic's purpose is to hold the foot in a certain position.

The material is important from a pragmatic standpoint. Graphite, fiberglass, or a combination of both are used for orthotics that have the lowest profile and take up as little room in the shoe as possible, so it would benefit you to get this type instead of plastic. Plastic is good for sports because it has a subtle "give" to it and is much less likely to crack under the stresses of running or basketball. But you don't have problems while playing sports, so I recommend the graphite/fiberglass. Tell the podiatrist to not put a topcover on the device to minimize the amount of room it takes up in your shoe. You can always have a padded surface glued to it in the future, if you wish.

A well-made orthotic is rigid but does not feel this way when you're standing in it!

Lastly, an orthotic is only part of the therapy for your plantar fasciitis. YOU MUST STRETCH YOUR CALVES AND YOUR HAMSTRINGS ON A DAILY BASIS. A foot flattens out, or pronates, when your ankle does not have adequate motion. See, if your posterior muscle group (calves and hamstrings) is tight, then your foot cannot easily reach 90 degrees to your leg, so your body cheats by pronating (your foot has to be 90 degrees to your leg so YOU can be 90 degrees to the ground!) So stretching is going to be essential so you don't continue to try to pronate in the orthotic.

Hope this helps!

 

[merkur]

..

 

[HORNS]

Originally Posted by merkur

Although I know a lot of people who swear by orthotics, I was once told by a retired orthopedic surgeon that orthotics don't actually do anything to correct foot problems due to the anatomy of the carpal bones.

I'm not sure what he meant by that, especially since carpal bones are in your hand. You must mean tarsal bones. Anyway, orthotics work very well for plantar fasciitis. Do 100% of people get 100% relief? No, but nothing works this predictably.

 

[imstr8trippin]

as we age, our feet flatten. the arch muscles weaken due to all the years of pounding on the pavement. this is probobly where your pain stems from. people with flat feet over pronate, thus putting more stress on your ankles, shins, etc. flat feet require more arch support. but, i am no expert and i would never give you a solution to a problem that i didnt fully understand. so, i suggest you see a doctor. get referred to a podiatrist who specializes in this type of thing. of course, if you dont have insurance for that kind of stuff, you could analyze your tennis shoes and get an insole or OTC orthodic insert that mimics the shape of your tennis shoes since they dont cause any problems for you.

 

[yachtie]

Interesting. My P.F. improved when I stopped wearing soft soled shoes.
Agree, you have to stretch or it'll recur

 

[Teacher]

There are high quality, attractive rubber-soled dress shoes. Allen Edmonds, Alden, and other good makers have plenty of models. Have a look at them and you problem should be solved.

 

[academe]

Originally Posted by HORNS

I agree with what academe has to say about this matter. However, I'd like to expand on what he has to say.

There is no such thing as orthotics that are not made from a custom impression of your foot. So do not go to a store like Good Feet or some other place that try to push essentially hyper expensive over the counter arch supports. That being said, there is a huge difference between over the counter arch supports and custom-molded orthotics.

Secondly, the way an impression of your foot is made is extremely important, and it behooves you to "shop around" for a podiatrist that makes the devices by taking an impression of your foot using sheets of plaster of paris. Using the foam molding is quick and clean, but it is difficult to impossible to hold your foot in the position you need it in so the mechanical strain on the plantar fascia is eliminated. See, the whole idea of orthotics is that these things are going into your shoe and holding your foot in the position that the doctor held it in while taking a mold of your feet. Also, regardless of how soft that foam is that the orthotic is made from, it will push back against your foot and distort your skin and the intrinsic fat padding you have. You will then have a device that does not cup the padding and maximize it because it is already made from a foot whose padding has somewhat spread out.

Third, an orthotic is most beneficial when it has a "post" at its heel. This raises the heel to a miniscule degree, but it acts as a flat, stable base so the heel doesn't rock back and forth - remember that the orthotic's purpose is to hold the foot in a certain position.

The material is important from a pragmatic standpoint. Graphite, fiberglass, or a combination of both are used for orthotics that have the lowest profile and take up as little room in the shoe as possible, so it would benefit you to get this type instead of plastic. Plastic is good for sports because it has a subtle "give" to it and is much less likely to crack under the stresses of running or basketball. But you don't have problems while playing sports, so I recommend the graphite/fiberglass. Tell the podiatrist to not put a topcover on the device to minimize the amount of room it takes up in your shoe. You can always have a padded surface glued to it in the future, if you wish.

A well-made orthotic is rigid but does not feel this way when you're standing in it!

Lastly, an orthotic is only part of the therapy for your plantar fasciitis. YOU MUST STRETCH YOUR CALVES AND YOUR HAMSTRINGS ON A DAILY BASIS. A foot flattens out, or pronates, when your ankle does not have adequate motion. See, if your posterior muscle group (calves and hamstrings) is tight, then your foot cannot easily reach 90 degrees to your leg, so your body cheats by pronating (your foot has to be 90 degrees to your leg so YOU can be 90 degrees to the ground!) So stretching is going to be essential so you don't continue to try to pronate in the orthotic.

Hope this helps!

+1

This is a much more precise description than mine. The "foam" I was referring to that my podiatrist used to get a mould of my foot isn't really "foam" as we think of as packing material, sponges, etc. As HORNS describes, it is actually used so that the doctor can figure-out the best was for the orthotic to hold your foot in place, in order to remediate your foot problem. I just used the word "foam" because I was at a loss as how to describe the material (don't really know what the technical name is).

 

[academe]

Originally Posted by HORNS

I'm not sure what he meant by that, especially since carpal bones are in your hand. You must mean tarsal bones. Anyway, orthotics work very well for plantar fasciitis. Do 100% of people get 100% relief? No, but nothing works this predictably.

Yes; even if they can't re-shape your bones permanently at least they alter your posture, biomechanics, etc. sufficiently to reduce/relieve pain or discomfort you may have

 

[academe]

Originally Posted by Teacher

There are high quality, attractive rubber-soled dress shoes. Allen Edmonds, Alden, and other good makers have plenty of models. Have a look at them and you problem should be solved.

"Dress casual" shoes with removable footbeds will probably be the best way to go, as they will be able to accommodate your orthotics. The problem I've found with some dress shoes is that there isn't enough height in the vamp to accommodate the new "height" of your foot with orthotics inserted. What I do is use my less expensive dress casual shoes on a daily basis, and wear my other shoes (which can't accommodate my orthotics) for days when I know I won't be walking or standing as much.

 

[HORNS]

Originally Posted by academe

+1

This is a much more precise description than mine. The "foam" I was referring to that my podiatrist used to get a mould of my foot isn't really "foam" as we think of as packing material, sponges, etc. As HORNS describes, it is actually used so that the doctor can figure-out the best was for the orthotic to hold your foot in place, in order to remediate your foot problem. I just used the word "foam" because I was at a loss as how to describe the material (don't really know what the technical name is).

What your podiatrist used was foam, but it's more like the foam florists use to hold cut flowers in place - you push your foot into it and the foam collapses down. Don't get me wrong, this method is still better than over the counter inserts, but if everyone has the information to make a fully-educated decision, then they should go for the non-weightbearing plaster of paris molds.

These inserts most certainly will not permanently change the shape of your foot, but they will hold the bones and joints in a different and more ideal alignment.

It has been my experience that orthotics that have no padding and are made from graphite/fiberglass fit into most dress shoes. If they don't, but you are no longer in pain because of the orthotics, then I guess you'll have to make some personal decisions on what's more valuable to you!

But, like academe said, you don't have to wear them every second you're on your feet - they're not essential to survival. You will have them, though, when the stresses on your feet are at their greatest - whether that's in the courtroom, walking around Manhattan for a week, or playing a pickup game of basketball.