My feet hurt! Anyone been to a podiatrist.

They make your feet hurt where, exactly?  When do they bother you the most, and has anything you have tried helped?

So, ankles:  Do podiatrists do them?  Where's the demarcation line? Below ->THIS LINE<-, podiatrist.  Above, orthopod.

Scope of practice varies by state.   

For example, in California, it is foot and ankle and the structures that act on them as primary.  I think you can be first assist on any surgery though.  I was on the schedule to drain an abscess one Saturday morning and got bumped for an appendix.  I asked if the general surgeon would like an assistant, which surprised him, because doctors can sort of be selfish dicks, can I say that?  I am waiting for him to finish his appy anyway, so it is sort of a win:win deal.  Got him done faster, my case started sooner and I seem to recall the assist on the appendix paid as well as being the primary surgeon for the I&D on the diabetic foot.

I think in Alaska a podiatrist can even do minor hand stuff, but it gets too cold and dark in the winter for me up there.

For plantar fasciitis you want to stretch your calves daily, wear supports in good shoes, icing regularly, etc.  You want to be aggressive with your conservative treatment.  Pretty rare you have to do surgery for plantar fasciitis

Surgeons are not known in doctor (MD) circles as selfish dicks.  They are known as shiny happy people.

Hey, I did podiatry work once.  Cut a woman's leg off (BKA).  Left handed (it was more convienent). 

And speaking of podiatrists, I just visited my new podiatrist this morning for a follow-up visit this morning.

Looks like as a side effect of the gout diagnosis, we managed to also solve the mystery of my ongoing "achilles tendon" issues. I appear to have a bone spur on my heel bone. Guess the extra X-rays the current podiatrist took (that also showed that I've got a small piece of broken-off bone floating around in my foot) were worth the extra glow in the dark.

Note to self, should've got a second opinion much sooner. Of course now the big question is what we can do about the bone spur, preferably something that doesn't involve surgery.

Recovery on a posterior heel spur resection is tough, fun surgery to do though.  You may find heel lifts help a lot.

How are the arch supports insoles numbered ?

Is it something like +1. , +2 etc

And is it the same with shoes that have the arch support built in ?

Doctor told me I had flat feet ,  which I had as a kid and thought had gone away !

My feet and ankles have been hurting for years after a long walk but it's getting worse.

Thanks for your advise

Toebra said:

They make your feet hurt where, exactly?  When do they bother you the most, and has anything you have tried helped?

The pain is normally in the ball and heel of my foot. When I added arch supports my arch hurts as well. Walking doesn’t bother me just standing still. If I take my shoe off when I’m in pain and rub my feet with my hand I feel no discomfort. Inserts help reduce the pain somewhat but only for a day or two.

when I first started this job that has me standing all day, my feet and ankles would swell badly. I had to very loosely tie my shoes and yes I’m using diabetic socks. After three months of this, my feet no longer swell and my ankles swell just slightly. My the morning they are normal again. Because of my problems I’ve had with colitis, I’ve gotten out of my mentally high stress career in hopes of staying more relaxed but I think I’ve traded that for a physically stressful job.  

If you are standing in one place, will they put a rubber mat down for you to stand on?  You should wear support stockings even if you are having less problem with swelling.  Measure circumference of calf for size, compression is in mm Hg, just like a barometer.  Start with lower compression, like 15 mm or less, and work up to higher compression, 30, or even 45 mm.

 Both feet, one more than the other, about the same?  By ball of the foot, where do you mean?  Near the big toe, little toe, middle toe?  Back of heel, bottom of heel, when you say arch, do you mean on the bottom, the side, where exactly.    When does it hurt and where?  Is it when you first get up and improves walking around, or worse after you are on them.  The supports make the arch hurt, did the pain in other places, the heel and ball of foot diminish a little, a lot, not at all?  Have you tried anything that helped?  What sort of shoes do you wear at work?

If it bothers you to stand in one place, you may find it helps to stand with one foot in front of the other, like you are taking a step, rather than next to each other.  If your calf muscles are tight, and they probably are, putting your foot in front of you can give you some relief by taking it off tension.  If you do not stretch your calf muscles regularly, they are tight.  Don't try to stretch by hanging your heel off a step and push your heel lower than your toes, you are liable to tear something.  Do stretches with foot flat on the ground, toes pointed straight ahead.  Bend forward at the ankle, both with the knee straight and bent.  Stretch, count 10, then do the other one. 

Did I mention you should be wearing support stockings.  If you have a cardiologist, ask them first, don't want to squeeze the juice out of your leg, into your vascular system and overload your heart.  That could suck more than somewhat, like running too much oil in your motor, except the rebuild is a lot more expensive, and you can't do it yourself in the garage

Toebra knows his e36 m3....but I've known that from my Pelican days.

Toebra said:

Recovery on a posterior heel spur resection is tough, fun surgery to do though.  You may find heel lifts help a lot.

I'm already using the silicone heel cups and as you said, they do seem to help a lot. I still ended up selling multiple cars because I had problems working the clutch, though.

At least the heel spur explains much better why the angle of the clutch pedal matters so much right now and why the achilles tendon injury didn't heal.

Also, words you never want to hear a doctor utter are "recovery is tough" and "fun surgery" .

Lift in shoe changes angle the tendon is pulling on, also makes the back of the shoe hit a different spot, one that is not so painful.  Try scooting the seat in the car forward a little, that may help with a posterior heel spur when you are working the clutch.  

You sort of have to fillet the tendon off the bone, remove the spur then reattach the tendon.  There are some very groovy soft tissue anchors for this sort of thing.  Long, difficult recovery.

In reply to Toebra :

Busy day. Just now getting chance to catch up.

A rubber mat won’t work since I’m on one of three warehouse equipment. Reach, pallet trucks or order picker. The order picker is where I have most of my issues since you need constant pressure on the dead pedal. I try to shuffle my feet which helps a little but on the OP I have limited mobility. Good to know about hanging my heal off edge of a step. I was doing this since it felt good.

In trying to describe the pain, all I can say is if you step on hot pavement in the summer any part of my foot that touches the pavement would burn from the heat except my toes. It’s been several years since I used the insole with arch support but what I recall is my entire foot hurt but I had a painful mound in my arch.

Please don’t tell me I need those old man stocking up to my knees. I might consider it while I’m working with long pants but no way in the summer with shorts.

I do have a appointment with my general practitioner in a couple weeks so I’ll run this by him and I’m sure he’ll have a plan of action.

I greatly appreciate your input!

What shoes do you wear?  I would expect you to do better with a stiff sole, like a boot.  

Sort of sounds like tarsal tunnel

I already told you to wear the grampa support socks, don't wear them with sandals though, does something to the integrity of the space/time continuum

Toebra said:

Lift in shoe changes angle the tendon is pulling on, also makes the back of the shoe hit a different spot, one that is not so painful.  Try scooting the seat in the car forward a little, that may help with a posterior heel spur when you are working the clutch.  

Thanks - I remebered you advising that before (when I still thought it was an issue with the actual tendon) and it's helped a lot with some of the cars like the NA Miata. Others, I just couldn't make work for longer trips.

You sort of have to fillet the tendon off the bone, remove the spur then reattach the tendon.  There are some very groovy soft tissue anchors for this sort of thing.  Long, difficult recovery.

"Long, difficult recovery" really sounds like "explore other options before surgery", which is pretty much what the current podiatrist also suggested.

Toebra said:

What shoes do you wear?  I would expect you to do better with a stiff sole, like a boot.  

 

 

Redwing steel toes work shoes. I’ll never buy these again. I was always told they will break in and be the most comfortable shoe. I should have went with my instinct. If it’s not comfortable when you try it on, it never will be.

I started having pain in my feet several months ago. I self-diagnosed it as plantar fasciitis.

The shoes that saved me from pain are made by Hoka OneOne. They may not work for every one or every foot or every foot issue, but they work for me. I have three pairs of them including some slip on flip flops that are very cushiony that I basically wear most of the time in the house.  I used to live barefoot most of the time unless I was outside.

The other thing that worked wonders for me is KT Tape. When I am at a customer's site for work, I can't wear cushy flip flops or running shoes. If I get any foot pain from my work shoes KT Tape helps. They have youtube videos on how to use if for different issues.

Sorry to sound like a canoe with the links, just figured they may help someone.

Thanks! I’ll check it out.

The podiatrist I started seeing last year finally fixed my feet. Turns out I had gout, that left me with midfoot arthritis. I also walk wrong as in step on the outside of my foot and roll inward. So now along with allopurinol for gout I wear a quality running shoe designed for pavement and custom insoles that cost 74 bucks. The shoes hurt at 165 a pair pretty much everywhere after tax. But the shoe and insole combo finally made 8 hours of concrete and concrete stairs not hurt. 

Finished reading this, it's funny like TJ above the shoes I'm referring too are hoka one one. I wear the bondi6 and dont walk barefoot at all

The Dancer has seen a podiatrist on a few occasions- I imagine Toebra probably winced at seeing what I call her here if he's had to deal with many in the past. First time she went in to see hers he walked in and saw her sitting on the exam table and without looking at her chart or asking her immediately asked if she was a ballet dancer from how her legs and feet were when sitting. Unfortunately for her, the most significant prescription/direction the MD could (and did) give her was, "Stop dancing and doing more damage to your feet..." but that's the last thing she's likely to do. 

I could probably benefit from seeing one as well- I've got pretty flat feet (the opposite of the Dancer's), but they don't generally give me any problems. Likely a small miracle given my snapped Achilles' a few years back (not due to just normal use- had my feet twisted while trying to push a car and it rolled back...), but that's likely due a lot to having had a fantastic surgeon and good and strict PT's during the recovery. 

Ballet dancers, tough as nails and all ate up with crazy, in my experience.

In reply to Toebra :

Mine is much more toward the sane end of the spectrum, but from what I've seen of others that's a pretty solid assessment...

Timely thread! 

I had a lisfranc break in 2016 on right foot. Two screws, three wires in my right foot, cast for a couple months, then few more months of recovery before they removed screws and wires. I have had minor pain ever since, usually before foot "warms" up in the morning. I admit I may have to not been patient enough with recovery, pushed getting back on it too soon. 

Last week, foot started to hurt. Has gotten worse over last number of days to point I need to get it checked. I'm limping and foot really hurts when I'm sitting, and foot is at lowest point. Do I start with a podiatrist? Go back to surgeon/doctor that did 2016 surgery? I'm currently on couch with it elevated. 

You probably need to have a Lisfranc joint fusion.  Hopefully you have not been on the couch 2 months.  Maybe give the cat who did the reduction on it before a call