About 10 years ago, just outside of Paris, I first realized there was something different about my feet. I'd flown across the pond for a friend's wedding and was doing several weeks of sight seeing in France in conjunction. (This was back when I had 5 weeks of vacation a year! So civilized!)
On this particular day, we'd taken a train to Versailles and were walking from the station to the palace when suddenly, I just couldn't walk any more. I had shooting pains in my feet. Every step felt like I was pressing down on a 4" nail. I turned to my friend who had been walking as much as I had and asked if her feet also hurt and she just shrugged... Nope. My agony was real and alarming, and it felt like something serious was wrong. This wasn't just a little muscle strain. It felt like bones were breaking through the skin, and tendons were tearing. It felt like permanent damage.
When I got home I went straight to a podiatrist who told me the problem was easily correctable; I have high arches and just needed orthotics. He was right! I've had the same set of "active" and "casual" orthotics since, and while my feet do hurt sometimes when I'm running, or when I over-do it on the tennis court, mostly I've been fine. I assumed everyone had foot pain sometimes, and achy knees sometimes. Wasn't that a part of getting older? Arthritis, perhaps.
As I've been running I've been thinking about how just the slightest imbalance in my body, or the way I hold myself when I run - if it's not correct, could over time do any number of types of damage to me. It's one thing if you do low impact activities incorrectly, but, if I'm running 12 or more miles a week now, and I'm going to be doing 30 a week by the spring, well, I'd better make sure I'm not completely fucking myself up in a way I'd really regret down the line. This little experiment sort of started on a lark, but now I hope to find in it a new place to go with my energy, and would like to make it something I can enjoy for the rest of my life. I don't want to remember this year because every time I sit or stand, it hurts.
I asked a running friend for a referral to a podiatrist who could be trusted to make a good orthotic. I had a hunch feet might change over time and also was anxious to be able to talk shop properly with other running geeks. I thought I was told I pronate, but then when I read the descriptions, I wondered if maybe I'd gotten this wrong and instead supinate? I figured if I didn't have clarity on this very basic issue, there might be other more important things to know that I didn't even know I was supposed to know. Ya know? Anyway, good not to be talking completely out of my bum.
The doctor was charming and curious. He reminded me of myself when I first discovered the "Harriet the Spy" books as a kid and started slinking around the neighborhood looking for clues... I'd gotten myself an ominous, black detective's notebook and snuck from house to house making notes on "peculiar" things I observed, "Mrs. Cox home early from work. Making cookies for bake sale tomorrow? Will have to come back and sniff air in one hour..."
I'd brought my own pile of "evidence" for the doctor to examine - my two current pairs of running shoes, my old running shoes which I've had for about 3 years (which he nearly snapped in half dramatically and ordered me to "throw these out immediately" - I did), and all three pairs of my old orthotics. I was playing right into his role and he seemed to love it! He had me stand and walk, over and over, in the shoes, out of the shoes, just in the orthotics. "So much going on!" he exclaimed at one point. "I see numbers 3, 4 and 5!" What's he talking about, I thought! He was jotting things down.
Finally, "Harriet" had a diagnosis. I definitely pronate, but there's a whole host of other issues coming into play that needed to be taken into account. I also have normal-high arches (not "freakishly high" arches, which is what I distinctly remember my last doctor calling them), and finally, my orthotics are barely effective and definitely not adequate for sports. The exciting thing is, I really do feel they make a difference - as poorly suited to my foot as they may be; so the doctor assured me I would be happily surprised by what my new orthotics were sure to bring to my experience.
My mind began to bubble with excitement... Is this why I've hated running all along, or at least a big part? I simply have not been feeling what others have been feeling? They don't wobble and worry that they'll fall the entire time? They aren't getting giant unbalanced callouses on one foot? They can feel their toes? They don't have a pinched nerve in the ball of each foot? The doctor assured me my new orthotics would help compensate for all that ails me and make running a much more enjoyable experience.
There are several methods for molding orthotics out there - foam molding and plaster casting being the most popular. My orthotics from 2000 were foam molded; to make them, I stepped in a box of putty and a reverse image of my foot and arch were cast. I didn't know then, but that method isn't as reliable as plaster casting because when you stand in the putty, it's up to the patient to distribute her weight evenly and stand up straight (which apparently, I didn't). The plaster method, however, doesn't use gravity or the patient's stance at all. Instead, strips of cotton are dipped in wet plaster and wrapped by a technician around the patient's foot. Your feet are elevated for this, and when the plaster has dried, the cast is peeled off and sent to a lab where a computer with laser points reads the exact shape, capturing every arch and angle, and the orthotic is then made from that. The plaster orthotic is perfect, whereas the foam orthotic is, in most cases, just a little better than what you might buy over the counter from Dr. Scholl's, unless you managed to stand up correctly in the foam, in which case you probably have pretty good feet and didn't need the orthotics in the first place.
So, now I wait a month for the mold to go out to the lab and come back again. The doctor convinced me to go with a full foot bed, instead of a half. I have a half now and wanted to continue with the same, but he said the full will give him a chance to work on correcting the pinched nerves I have (and which I've always had, if he's going by the symptom of "clicking") at the front of both of my feet. The doctor also took X-rays, just to check for hairline fractures, arthritis and take a better look inside. All in all, I'm in decent shape! The appointment took over two hours though and the entire time I was emailing with my boss updating him on when I'd be back to the office... "My feet are currently in plaster casts," read my first subject heading which, out of context, alarmed him so much he called me! So embarrassing!
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