orthotics for osteoarthritis

[Yogagimp]

While awaiting decision whether to scope knee for torn meniscus, I was advised to get orthotics - where to start - from where/what type/anything to beware of!?! Please advise, thanks!

[blackbeltgirl]

People get orthotics for all kinds of foot issues - flat feet, high arches, etc.  Depending on your situation, you may want to see a podiatrist.  They will take plaster molds of your feet, and send them to a lab for custom orhtotics.  But those are about $400/pair, and not covered by most insurance.  You can also try over-the-counter stuff.  A good website is footsmart.com.  They have a lot of over the counter options, but higher quality than what you'd buy at the drug store.  YOu may want to try these, for $15-$30 before spending $400.

Good luck-
Jess

[Yogagimp]

Thanks so much for replying!  Yes, I know the indications for orthotics, but I guess I'm specifically looking for orthotics to help knee alignment (starting to get bowlegged on Left leg) I had an acl in '89 and a scope which scooped most of my lateral mensicus in '91 - Now that I'm facing a debridement on the Right knee (also an acl in '84 - old gymnast) I was told to get orthotics to help my overall alignment so that my "biomechanics" don't start to falter feet to knee to hip to back as I slip (limp) into middle age (ugh).  It was when I went to my os the other week from the 89 & 91 procedures for the new right knee insult (a simple pivot) - (he did my left) that he said, "Oh, but I'm really interested in your left knee - you are an excellent candidate for an osteotomy - not now but in about 5 years" - yikes!!!!  I always knew the possibility of a TKR existed in my far off future, but I feel the slippery slope from osteotomy then tkr is not what I want to do if I can help it...so...besides the fact that I have given up ALL high impact stuff I love to do from skiing to hiking - anything unstablizing that I can't control - I have become quite a serious yoga practioner and don't want to give it up not only for what it does for my body but for my stress level and state of mind - but I digress - the point is I'm working with my yoga teacher's teacher on alignment issues and was advised by an anesthseologist I work with who worked in ortho who suggested the orthotics - SO- back to the feet - Do you know is it better to be casted prone, standing?  Do I go to a podiatrist? How long do you wear them until you know whether they are doing more damage than good?  Sorry, I'm rambling...but thanks for listening!

[blackbeltgirl]

First - if you have flat feet, orthotics will help, but not solve any alignment issues.  I have been wearing them for years, and I do have more pain on days I wear shoes without the orthotics, so mostly I avoid that situation.

Basics - if you have flat feet, you NEED to have the cast taken while lying down.  At the podiatrists office they have you lay on your stomach and make a plaster cast of your actual arch.  You will go back for 1 or 2 fittings after they come in.  The cost for the first pair is usually about $400, and $200 for each additional pair.  I have 2 pairs - 1 designed for athletic shoes, and the other designed for dress shoes. 

If you have normal arches, or high arches, they can often take a standing mold - they have a foam box, and you step into the box to take the mold.

As to how long before you know if it's helping - at least a month.  If you haven't been wearing orthotics, they tell you to spend about 2 weeks adjusting to them.  You wear them for 15 minutes at a time, then 30, then 60, etc.  If you go from 0 to full time it can be really painful.  Once you're wearing them full time, you still may  not notice a huge improvement with them, but you might notice that you have more pain without them.  For example, if you wear orthotics normally, and put on a pair of sandals to go for a walk in the summer.... (as a result, I mostly wear Birkenstock sandals, as advised by my podiatrist).

If you're not sure if you have flat, normal, or high arches, you can do the water test.  Barefoot, step into a puddle of water, then onto a dry spot.  If your footprint looks "textbook" you have normal arches, and just want support.  If you have a very wide center area, you have flat feet.  If there's practically a gap between your heel and toes, high arches.

The website I offered earlier has a great selection of very high quality orthotics, just not custom made.  They also tell you if a specific product is good for flat feet but not normal feet, etc.  It may be worth a month or 2 and $20 before you commit to several doctor's visits and $400.

Good luck-
Jess

[Yogagimp]

Great info and thanks so much again! I will indeed go to the website you suggested...I wear birkenstocks and evne have old birk nursing shoes I will wear to work.  I'll start to research the podiatrists in my area while I wait to hear from my os. Liza