I've had a severely pronating left foot from young (I am now 38). My right foot doesn't have a great arch but at least there is something there. Through various orthotics and generally just putting up with the pain I have made it this far. However I find I am increasingly incapacitated due to progressively more severe leg and back pain (all down my left side). This is exacerbated by tightened muscles which causes a leg length difference. To be frank I'm the breadwinner for my family and I am becoming very concerned about my ability to function day-to-day.
I'm not looking forward to the option of surgery (I've never spent a night in hospital since I was born) but orthotics don't seem to be adequately addressing my problem.
I'm Australian and live in Malaysia and I'm not confident about the options in this part of the world. I've found 2 foot surgeons in Malaysia but they've not performed a lot of procedures for a flat foot specifically. I have their profiles but thought it best not to post to this blog.
Can anyone suggest how I assess whether a surgeon really knows what he/she is talking about? Or how up to date is their knowledge of the latest procedures?
I'm freaked out by the the thought of doing the surgery but then I'm probably even more freaked out by the thought of this problem getting any worse. Any advice is greatly appreciated.
Unfortunately, one of the most important questions when checking out a surgeon is "how often do you perform this procedure or a similar one?" The answer you want is "At least once a week."
Other important questions might be "Where did you train?"
Can you find a surgeon in another country? Australia has good surgeons, but the waiting list is rather long. Japan is quite a distance from you, and I have no idea what options are available in other nearby countries.
Of course, if you did travel, you'd have to either fly back shortly after the surgery, which is tricky, or stay at least a few weeks.
The Following User Says Thank You to janewhite1 For This Useful Post: lhoward1 (05-08-2012)
There are procedures where you do not have to stay overnight in the hospital and recovery is a lot faster. This may be helpful to know in the event that you have to travel to get the surgery, and to get you back to work sooner. Look into hyprocure, they have surgeons all over the world and it's a less invasive surgery.
Also they tell you the surgeons qualification level with the procedure.
It will be better in the long run to fix the problem then to let the pain continue and create damaging effects.
For me hypocure was tried first but unfortunately it did no work so I ended up with flat foot surgery. I was lucky to live near NY where there are some excellent surgeons. I agree that choosing a doctor with lots of experience increases the odds of a good outcome
The Following User Says Thank You to roxygirl1 For This Useful Post: lhoward1 (05-08-2012)
Please do me a favor and see if you can find a good physical therapist and I am not speaking of one who is what I call a generic therapist,but I am speaking of one who has a degree in body mechanics. I have had flat feet for years; had bunions and hammer toes. AFter my surgery many years ago, I was referred to someone who made orthotics, so I wore those. In due time, I could see that the toes were going back to where they were before the surgery. This man I found explained to me that the plantar facia, which is the elastic like band that runs from the front of your foot to the heel, underneath the foot, was the cause of my problem. The orthotics made my ankles weak, which, in turn flattened the feet. He has been aligning my toes and working on my ankles and my feet are not nearly as flat. PLEASE STAY CLEAR OF SURGERY AND ORTHOTICS. Believe me, I speak my experience. Had I met this man before my surgery, I never would have had to have it done.
The Following User Says Thank You to danabarb For This Useful Post: lhoward1 (05-08-2012)
I think my search for a good PT is probably only slightly less challenging than my search for a good surgeon. Having read through a lot of posts it seems I shouldn't do the surgery unless I can be sure to have a good PT leading me through the recovery process. I'm not really any the wiser.
I currently wear orthotics which were custom made by an Orthotist. When I first saw this guy about 12 months ago he prided himself on being the only Orthotist in Malaysia and was a bit snobbish about Podiatrists. Anyway I went back to him this morning as I was in so much pain. After 10 minutes he basically told me his job was to align my foot and he had done his job. I was shocked and said how could he say his job was done when I was in so much pain. His response was to suggest I see a GP. I honestly felt so abandoned at that point. Going back to a GP is like going back to step one - I'm feeling pretty lost at this point.
Anyway, one of the 2 surgeons I sourced was kind enough to respond to an email from me last night. He has undertaken 22 procedures in the last 2 years and most of the patients were in an advanced stage due to the lack of awareness of their options. He shared some details of the procedure where he puts one large bolt up through the front of the foot (to fuse the top of the foot) and then an X-plate closer to the middle of the heel.
Is this best practice or something from the dark ages?
I am seeing the other surgeon on Friday but I think he is less experienced in this specific area.
I would avoid that man who made your inserts like the Black Plague. Just from reading your note, I don't feel he gave a hoot about you. I had a similar experience. I was sooo lame that I went to podiatrist, who is VERY well respected. He measured my feet for orthotics and the bill was more than one can imagine, but I was SO hard up to get something to help me that I paid it. Well, those orthotics made my feet much worse because they weakened the plantar facia in my foot even more. As I may have said, my feet have been out of line for years, until I came across this physical therapist. A good physical therapist can align your feet and ankles. What is causing your problem is your plantar facia which is weak, which, in turn makes the ankles weak and the rest of the leg clear to the hip. If dr. told me he could align my feet, I would stay as far away from him as possible!! That is nothing but sales pitch. My feet were as crooked as a politician when I went to this therapist and now they are almost straight. It is like a miracle. One of the exercises he gave me has really helped and if you want me to send it to you, I will. Just let me know. by the way, I do not trust podiatrists after what I have been through!
i was just reading your post and i would love if you could let me know what exercise you do for your feet. my feet and ankles are extremely pronated and flat. i too think the orthotics just made them much worse. i started wearing them for back pain when i was a kid thinking it would help my back. long story short they didnt help with anything. now i have to wear them because my feet are so broken down which im pretty sure is from the orthotics. I dont like wearing them they are uncomfortable and they only correct the problem a little bit. so again i would love to know these exercises you are doing to get out of the orthotics.
If you can get yourself in the hands of a GOOD physical therapist that will help. I found one at the gym I belong to and I also went to therapists that were supposed to be good, but they did nothing but generic therapy. To answer your question: Take those inserts out, PDQ even though it may be painful to walk and walk barefoot as much as possible. Do squats with your feet pointed in, so that your legs look like a v, if you can picture that. Squat down and keep your back straight and hold the squat. This will strengthen your legs and thighs. Also, walk up and down stairs as much as possible and, if you can, bike. Your feet are botched up because of those inserts and the same applied to me. When I first went to this guy who has helped me, it was painful for me to walk across my hardwood floors in my bare feet. Now, it is not painful and I think that is because my feet have been thrown back into line. My toes are straighter because this man breaks up the scar tissue that was down there by pulling the toes this way and that way. I also bought an electric massager at Brookstone and I apply that to my legs and feet. This will help break up scar tissue. There are also ankle exercises that you can do. I have a large rubber band that I attach to my ankles and turn ONLY the ankle outward. This I received from a therapist I had ages ago. All of this will take time, so please be patient and also feel free to ask me any questions. Oh, no one is born with flat feet; we acquire them from things like the inserts. I hope this is of some help. If you keep at this, you will find that your ankles will get stronger, you will build an arch and you will walk in a much better way. As I said, feel free to ask me anything. I don't know where you live, but if you live in my state and near me, I can give you the name of the person who has helped me.
I forgot to tell you that you should stretch the plantar facia, which is a long strip under your foot. When that gets tight, it throws the whole foot and ankle out of line. Put your hands on a counter and put one leg in back of the other with one heel on the floor. Push forward with one leg and the one that is on the floor stretch like mad.
I've taken up this advice and am pushing down the physio path. I will break the exercises I am doing currently into 3 groups.
For feet I have been given 2 other exercises. Role out a strip of bandage or material on the floor. Sit on a normal dining chair. Use your toes in a crunching fashion to pull the strip towards you. It won't move fast but it's the crunching which will build strength. Place a small weight on the end of the bandage to make it harder. The other exercise is to place a pencil on the floor. Use your toes to pick it up, play with it like a chopstick. Both of these can be done whilst at work or watching TV.
For legs, squats are good but for more gentle exercises simply do calf stretches, i.e. stand on a stair and lower heels over the edge. I felt this was painful at first and instead placed a board next to my front door against the wall at about 35 degrees. Every morning before I leave for work and when I get home I do a 1 minute stretch. Hamstring stretches, with a friend preferably or if not lie on your bed and place a towel around your foot and pull upwards keeping your leg straight. I am still only at about 50 degrees but improving. To strengthen your leg just lie on your back, keep your leg straight and raise one leg at a time into the air. Hold for 20 seconds each time.
For lower back there are a range of stretches. What's interesting is everyone from Physios, to Osteopaths, Yoga Instructors etc will essentially describe similar ways to ensure your lower back is kept healthy.