Orthotics

You haven’t heard much from me about running since the marathon. Mostly that’s because there hasn’t been any.

Actually, that’s an exaggeration. I took a week or so off to recover, and then tied the old running shoes back on. I ran once or twice a week for the next six weeks or so, but finally had to stop entirely. My left arch, which began griping late in training, and which got seriously bitchy during the marathon itself, escalated its litany of complaint until I could no longer ignore it. When I first started noticing that I had a left arch, it was because it would begin bothering me around ten miles into a long run; during the marathon, it started hurting around mile seven; finally, it hurt half a mile into a run, which was my signal to quit.

I went to see my primary care physician in late April — and I promise this post will not devolve into a rant on the failures of the U.S. medical system, though there are elements of that contained herein — saying that I thought my arch had fallen, and that I needed orthotics. She took one look at my foot and diagnosed a fallen arch, referred me to a podiatrist, and sent me on my way. I called the podiatrist’s office that day, but the first appointment I could get was three weeks later — the day after I was set to leave for three weeks in DC. So I didn’t get to actually see the podiatrist (half my fault; half theirs) until early June. But I went, gave them my co-payment, and saw the doctor. He manipulated my feet, watched me walk around, and told me I needed orthotics.

Here’s the ranty part, though: at the end of the appointment, he tells me that my insurance company — the same company, remember, who dictated to my primary care physician to whom she could refer me — won’t cover the orthotics if his office makes them. “They have another lab they’ll want to send you to,” he says. He’d be happy to go ahead and make them anyhow, though, for $500. Being in a bit of a tight cash-flow period, though, I decide I’ve got to get the insurance company to pay for them, if they will, so I wait for them to call me with the approval information. Which they do, pretty speedily in fact, and refer me to an orthopedics lab nearby. So I have a little mini-rant built up here about why I got referred to someone who wasn’t going to be allowed to do the work, but I’ll let that slide.

I get an appointment with the orthopedics lab on June 21, and get re-diagnosed. The orthotist who sees me, incidentally, gives me the most severe diagnosis I’ve gotten, telling me that I’ve done significant damage to my feet — and by extension, my ankles, knees, and hips — by failing to address this problem sooner, but he also gives me exercises to do to improve the problem, in addition to the orthotics. He takes impressions of both my feet, says that the orthotics should be ready in five to seven business days, and that they’ll call to make an appointment when they’ve got them. Which they did, but they couldn’t get me in to pick them up until today.

But now I’ve got them, big rigid arched pieces of plastic in both my shoes. The orthotist says I need to break them in carefully, and let my feet adjust to them, so I don’t end up bruising my feet and making the whole thing worse. And he’s told me that I have to hold off on running until I can wear the orthotics all day, every day, for a week.

But oh boy. After that, I’m itching to go.

4 thoughts on “Orthotics

  1. Wow… any advice for the other runners out there? Are the excercises you’ve been given general, or specific to your problem? (would I screw myself up doing them?)

    This reminds me to buy new shoes! (I only run about 9 miles per week)

  2. The exercises are totally straight-forward: calf raises for strength; heel drops for flexibility. The key is doing both with your ankle in a neutral position — it turns out that though my calves are strong and flexible, I’ve been stretching with my ankles rolled in (because my arches have fallen, my ankles tend to roll inward), which exacerbates the problem.

  3. How exactly did your arches fall? Your tale worries/scares me.

    I have ridiculously high arches — I’ve never had pain walking or running from them, but they do limit me in my choice of shoes (I’m unable to lace or buckle many dress shoes without going a size too large), and my ankles do tend to turn inwards at times.

    I should probably maximize having health insurance for the first time in 5 years and see a podiatrist.

  4. It’d be worth seeing a podiatrist if you can, Jonathan. My arches basically fell from being pounded into the ground with an impact of something like 3 to 6 times my body weight, 750 times per mile, mile after mile after mile. But my arches were always low, and a bit more flexible than they ought to have been. You might want to get things checked out, but you sound unlikely to suffer my achy-footed fate.

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