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Sunday, July 3, 2022

Correspondence Related to Left Neuroma, New Orthotic Devices custom made, and some Right Foot Symptoms

Hi Dr. Blake,

Very interesting wearing shoes for the first time since Aug. 2019, and wearing orthotics for the first time ever.

I delayed my “2 week report” because things were so different everyday, and I couldn’t figure out how to describe it in email.

Now that it has been 3 weeks, here’s a brief report. I’m hoping that we can talk on the phone, as a prelude for meeting up in person so that you can see my gait and consider tweaks.

I have pasted a table below my signature showing my 3 weeks of wearing time. I only counted standing/walking time, of course. I have managed to get up to slightly more than 7 hrs, but discovered on the way there that normally I am on my feet 5-6 hours per day. 

Overall things were surprisingly good until I got close to 7 hrs, then some bunion pain, and foreshadowing of corns arrived. 

I have gotten used to the new way my feet balance, and my usual tight IT band aches and pains have disappeared. My ankles, knees, and hips feel like they are much better aligned. I had shin splints for 4-5 days, but they went away.

I am wearing the orthotics with a pair of New Balance 860 running shoes, and with a pair of New Balance clodhopperish walking shoes. The clodhopper walking shoes are probably better. Both pairs of shoes were essentially new, and not broken in at all. (I bought them in my search for shoes that might work with my neuroma a good year before I first saw you.) I haven’t worn the Chaco sandals in at least 2 weeks. The orthotics don’t work in the other 2 pairs of shoes, due to neuroma pain.

I ice my feet at night, and use NeuroOne every morning, and often also at night. I also do nerve flossing.

Left Foot (the foot with the initial neuroma issues)

• Neuroma pain comes and goes, as it did with the Chaco sandals. It is never worse than the worst days with the Chacos, and is often more comfortable than the Chacos. Intermittent bristly or mildly burning pain, sometimes aching. Clicking in the first few minutes when  I first start out walking in the morning.

• Some of the pain might actually be from that callus that you have worked on in the middle of the ball of my foot.

• Today i began to feel the foreshadowing of a corn on my little toe. See Right Foot notes for more on corns.

• Something to talk about real time: I noticed that the neuroma pain has decreased as my orthotics wearing time has increased. Would tweaking the orthotic with the neuroma in mind help, and/or will wearing them longer without tweaking help more? (Part of the reason that I waited to report in was that the neuroma pain was coming and going so much.)

Right Foot (lesser neuroma issues, tailor’s bunion)

• Neuroma pain mostly gone.

• Initially, there was no bunion pain. Bunion started to hurt as my time on my feet passed 6 hrs. The little toe bunion sleeve you recommended definitely helps, but it still hurts some. Definitely hoping to nip this in the bud, so it doesn’t get worse. 

• Started to get whispers of a corn on my little toe. Many years ago I had some shoes that gave me corns on my little toes, and I still have some Dr. Scholl’s small corn cushions, which solved the problem back then.  Turns out that Dr. S no longer makes this kind of small corn cushion. Everything on their website is bigger, and a different shape. I only have 13 of the antique-style corn cushions left, so I could use your help with finding a solution. The corn “foreshadow” is hurting now, as I sit here typing.

• I have a touch of intermittent sciatica in my right hip that started with wearing the orthotics. 

• Something to talk about real time: I also get some pain along the “rim” of my right foot. Is it possible that the orthotic is tipping my foot a little to far over, so that the little toe, bunion, and “rim” of my foot hurt? 

There you have it. Email definitely does not seem like the best way to discuss this stuff, but I am hoping that this message will serve as a good outline for a real time discussion.

Many, many thanks. It is oddly thrilling to be wearing shoes again, I just wish it were a tiny bit more comfortable.

Best,


Date (June 8-29)

# of hrs/minutes standing/walking in orthotics

8

1 hr

9

10

1 hr 30 mins

11

2 hrs

12

2 hrs 40 mins

13

1 hr

14

2 hrs 55 mins

15

16

4 hrs

17

4 hrs 30 mins

18

19

5 hrs

20

3 hrs 45 mins

21

5 hrs 40 mins

22

23

2 hrs 35 mins

24

5 hrs  35 mins

25

6 hrs 40 mins

26

7 hrs  5 mins

27

1 hr 50 mins

28

6 hrs 25 mins

29

7 hrs


Dr Blake's comment: One of the ways you get to understand how the body works is by making a change and seeing the response. I sure wish all of my patients could be as great in looking at the pros and cons of my new orthotic devices. The left Morton's Neuroma has dictated that she wear wide shoes, which can be inherently unstable if too wide for the foot. Her symptoms are improving both footwise and up the leg. The right sciatica and rim pain are signs of slight over correction, so I will have to adjust that soon. Rich 



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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.