In the ten years that I have been working as a Pedorthist the biggest challenge I continue to face is convincing patients to change their footwear. On the flip side, my most rewarding moments over the years have been watching patients make better footwear choices once they realize the benefits well-fitted, supportive shoes can bring.
One of the most common conditions I treat in my clinic is forefoot pain, often metatarsalgia. More often than not, patients who are experiencing forefoot pain come for an assessment wearing shoes that are too tight or too small. When I explain that their poor fitting footwear is exacerbating their condition, they usually begin by asking for a solution to make it work better. Sometimes it can take some convincing to get them to try a better fitting, more supportive pair of shoes.
Many patients with forefoot pain also think they only require cushioning to fix the problem. They don’t realize they need to address the mechanical issues of their condition. Metatarsalgia is a condition that responds very well to custom foot orthotics. In my clinic, I can fabricate custom foot orthotics that address the unique needs of the patient. In the case of metatarsalgia I often create semi-rigid orthotics with support on the metatarsal heads – the tops of the five long thin bones that run from the toes through the foot. Depending on the patient’s condition I may also recommend shoes with rocker (curved) soles to take the pressure of their painful forefeet.
Whenever I first meet a patient I complete a full assessment of their lower limbs so that I fully understand the cause of their condition and can recommend the best way to treat it. As every patient is different, my job often involves pulling together all of the pieces of the puzzle and each day I rely on my training in physical education and massage therapy, combined with my C. Ped, to provide a full body approach to treatment. When all of the pieces are in place, there is nothing more rewarding than watching a patient enjoy the benefits of being mobile and pain free.
By Paul Makinen, C. Ped Tech (C), C. Ped (C), Halifax, NS