The Ghost in the Machine

If you have been to the drug store or grocery store lately you may have noticed the Dr. Scholl's machine. It looks impressive enough, with colorful images of your feet that show the different pressures. After standing on the machine for a few seconds it spits out a number and that is the pair of foot supports that you are supposed to use. Simple right? Wrong.
Custom foot supports, or orthotics as they are called by foot doctors, are a complicated science. The science of how living things move is called biomechanics. This is the science that one must you to properly diagnose and treat conditions with a pair of orthotics. The machine has none of this training. The foot is a very dynamic structure with 28 bones, 33 joints and over a hundred ligaments in each foot. Placing the foot in the proper position is crucial in obtaining a good representation of this moving target.
As an example, we have all heard of someone having 20/20 vision. What that means is that at a standard of 20 feet a person can see a size of type that has been designated as the standard font. This system breaks down if you measure people at 10 feet or with a different font size. When molding someone for an orthotic in my office I have similar standards that I have to abide by. The foot, ankle and knee must be in the standardized position. If not taken in this very specific way the mold is useless. This is exactly what happens with these machines. There is no uniformity. There is no standardizing.
As someone who has prescribed hundreds of orthotics in my career I can tell you that there is an art as well as a science involved. You have to know the activity level of the patient and the types of shoes they most often wear. There are some sport specific adjustments that can be taken into account and let us not forget the follow up. When you get a pair of orthotics from me or my colleagues you are sure to have the devices evaluated and any adjustments made in order to get the results you want. Every year thousands of people buy a 1/4 inch drill bit. None of these people want a 1/4 inch drill bit...they want a hole that is 1/4 inch around. The same can said for orthotics. No one really wants a piece of custom molded plastic in their shoe...they want pain free walking, running, golfing etc.
People often ask why orthotics are so expensive. The answer is because they are time consuming if you are going to do them correctly. You can get a piece of padded plastic out of a machine in a grocery store all day if you want to, just don't call that an orthotic. The ghost in the machine is not going to follow up with you. The ghost does not care if the device works. The ghost is not going to adjust the device and improve your comfort and quality of life.
You do get what you pay for in life and this is just another example of cutting corners and you will suffer for it. Remember that when you do end up with a inferior device you only have yourself to blame...the ghost in the machine doesn't care.


Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
www.sarasotafootcarecenter.com

Do You Want Feet Like Your Grandmother?

There are so many wonderful things your parents can pass on to you: stocks, fine china, a condo at the beach...but what about bunions? Yep, that is right, bunions. An enlarged, boney bump on the big toe side of the foot, that can cause pain and difficulty fitting in shoes, is called a bunion. I know what you are thinking..."aren't those caused by shoes?" The answer is no. Bunions or hammertoes (contracted, arched toes) are not CAUSED by shoes. Now the symptoms, (meaning redness, pain etc.) can be worsened by ill-fitting shoes, but the cause is something much less preventable.
Genetics determine our hair color, eye color and the way we walk, among other things. If you just so happen to be made with a flatter foot you increase your chances for developing hammertoes and bunions in the future.
So what can you do to avoid having feet like your grandmother? Are you doomed? No, you are not doomed. There are things that you can do to slow the process and treat it if you already have the signs and symptoms of these conditions. There are devices called orthotics, (custom molded shoe inserts that are provided by a foot doctor) that can change the way you walk and thereby limit or even prevent hammertoes and bunions. Wearing shoes that do not cause increased friction and rubbing on the toes and joints will help to limit your pain, but it will not slow this process down in any way. Finally, surgery is the treatment IF you have bunions and hammertoes that are painful for you everyday. Only you and your foot doctor can decide what is best for you and your feet.
As far as your grandmother is concerned, give her a call, she misses you!

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com/