Saturday, October 1, 2011

Respect the Feet

Feet are the Rodney Dangerfield of the human anatomy; their health tends to be ignored until there’s a crisis, like diabetes or advanced arthritis. I was lucky enough to get started earlier in the cycle. I could never have reached my present level of fitness if I hadn’t had my feet fixed.

In 1994 I had started walking around the track at the Y and I noticed little pains on the sides of my feet. When Dr. Hoffman first looked at them he said, “These are pretty good feet but they’ll stay good longer if you get orthotics and wear them.” “That’s for me,” I said, and began a relationship that has been long, successful, and slightly weird. Casts were made of my feet and were sent away to the orthotics-works. A pair of plastic inserts came back and I started to wear them. Dr. Hoffman said, “If you feel any pain, come back.”

Things went along pretty well until about 2000 when I started exercising more and spending hours working in a darkroom with a cement floor. During this period I noticed a very painful spot at the back of my right hip. I went back to Dr. Hoffman and he adjusted my orthotics by filing down the plastic or gluing on little pieces of cork. He said, “If it’s not right, come back.” We repeated this process many, many times; the pain just wasn’t going away. I started experimenting myself, taping on little bits of cardboard to the orthotics to see what would help. Usually I ended up with cardboards taped to the orthotic on the right side rather than the left.

Finally, Dr. Hoffman identified the source of the problem: my right leg is about ¼” shorter than the left. When you’re young, you easily compensate for such minor asymmetries. As you get older, especially with the exercise I was doing, a little flaw can mean big trouble. Dr. Hoffman built up the orthotic on the right side and the pain went away.

In my post, "An Unfashionable Body", I talked about how I seem to have inherited my paternal grandmother's physique. In old age my grandmother had terrible trouble with her left knee and had to have cortisone shots to deal with the pain. I suspect this was because she had the same short right leg; the left knee got crunched together for all the decades of her life, including five pregnancies, and nobody ever spotted the real problem.

I still get pains in my feet sometimes. Oddly, they usually come not when I’m walking around but in the evening when I’m lying in bed. These days it’s likely to be a consistent dull ache in some small spot. When that happens I try taping cardboard pieces to the corresponding spot on the insert.  Sometimes the lumps of cardboard get pretty big. When I think I’ve got it right, or when the “edits” have gotten way too complicated, I take the orthotic in to Dr. Hoffman and he laughs. Then in three or four minutes he comes up with a rational solution, taking away the cardboards, filing, and gluing on cork. It’s a good thing he’s patient and has a sense of humor.

This experience has taught me that foot problems can cause knee, hip, and back pain. If that pain goes on for a long period it will damage or destroy the affected bones. I wonder how many knee and hip replacements could have been headed off if the underlying foot problems had been corrected in time.  Note to insurers, legislators, and anyone else wanting to cut health care costs: recommend that everyone over forty have their feet checked by a podiatrist at least once.

The pictures below show my orthotics, top and bottom. The right side has “edits” by Dr. Hoffman and by me. 

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