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Saturday, July 10, 2010
Plantar Fasciitis: Help with OTC Products
I love the ease of designing a beneficial insert for my plantar fasciitis patients with the use of Your Sole (or Sole) inserts as the foundation. I tell my patients to get one of the several soft athletic versions. They can go online at http://www.yoursole.com/ to find locations. REI stores generally tend to carry them. The package implies you should heat mold them in the oven, but I prefer patients to try them first and see if the arch is tolerable. The heating process will always flatten the arch support somewhat. The insert tends to last a good year with routine use, but like all OTC (over the counter) inserts, are always in a state of disrepair. The durability of custom made inserts may in the long run be the best option, but this can begin to change the biomechanics for the better with the patient immediately.
One of the reasons I like this insert is that it is durable without having plastic. When you are searching for stability, plastic is very appealing, but very difficult to adjust. The photo above shows my grinding the most dense material (hardest) away from the heel area making it softer. The Golden Rule of Foot with Heel Pain/Plantar Fasciitis: The Insert designed should transfer the weight to the arch (borderline obnoxious at times) and float the heel. If you look at many of the OTC inserts, they are normally too hard in the heel or not high enough in the arch. If you use this criteria, you may find another insert that works well. The Sole insert just tends to be the most predictable.
After the heel is ground away of some of its bulk, a softer heel insert can be taped or glued to the bottom. I personnally love Spenco for its cushion and its durability for this purpose.
If the arch is not supportive enough (remember my borderline obnoxious comment), another product is excellent for arch support to reinforce the undersurface of the Your Sole insert. I would purchase a small Longitudinal Metatarsal Arch Pad and place it under the arch area as demontrated. You can purchase through http://www.hapad.com/ . It has an adhesive backing and made of fairly thick felt. The felt can be peeled in layers if the full thickness proves too much arch. You can also cut the arch support area out of old shoes and glue/tape under the arch for reinforcement.
The blue dot is just a reminder not to put the added arch padding too close to the weight bearing surface of the ball of the foot (first metatarsal head). If the arch support goes too far forward, blisters will occur in the arch as the first metatarsal pushes off the ground against a too bulky support.
This is a side view of the Your Sole insole with the Hapad reinforcement to the arch.
Here is the top view barely showing the arch reinforcement.
Another help if the arch collapse continues (over pronation) is to wedge the bottom (arch side) with some form of durable material. Again old inserts can be used and the material taped or glued on. You should never feel like you are so tilted that you are rolling to the outside (over supination). Here I use a fairly durable cork and rubber composite.
Here is the side view of the arch area with the arch support and the wedging glued underneath.
I hope this has been helpful. When you begin to get heel pain, these products can be very helpful in starting you on the road to recovery sooner.