Shoe Type and/or Insoles?

[standingtall]

Started to post this in Medical Devices, but it doesn't really fit there either so my bad if I've posted in the wrong place. I have neuropathy and poor circulation in both feet from about mid-sole through the end of my toes. This started about four months ago during one of my attacks. Since that time, I have tried several types and brands of shoes along with a couple of types of insoles. The best combo I have found so far is actually Asics gel tennis shoes with a Dr. Scholl's gel insert. I have found that keeping the laces as loose as I can, while still keeping the shoe tight enough as to not move around on my foot is best.
I have also tried a Spenco brand of insoles but they were not as comfortable as the Dr. Scholl's gel, but the Dr. Scholl's brand will only last about four months for me. I also thought wearing sandals was a good idea, but they seem to aggravate my problem and I can only guess it is from lack of support. I may see a podiatrist as a last resort as I can't imagine that there is not something out there to help this condition with my feet. My PCP has been no help, and my neuro said to ask my PCP!
This is not a post for advice on other things to check related to my problem, as I am running down those issues already. No offense to anyone.........but just looking for advice on footwear from someone who may have already had a similar issue.

[Scott1]

Hi,

I had a similar problem many years ago. Ultimately I had pain in my feet even when I was lying down and all the suggestions on footwear turned out to be useless. There were two things going on. 1) circulation and 2) tightening of tendons across the bottom of the foot and up into the calf.
For circulation you will need to make some lifestyle changes. The first change is introducing something that lets your blood vessels dilate. I set out a long and complicated explanation (sorry) of what is going on in the regimens section called "beyond Avonex and Valtrex". The circulation issue can be helped by taking L-arginine but it should really be part of the broader protocol I have set out.
The second part involves getting the tightness out of the foot and the calf. If you let it go ultimately your whole leg will be affected as the hamstrings get involved then it will be the hips, pelvis and back. Start fixing it now as it is a really difficult set of related issues to unwind. Go to a good Pilates studio and ask for a spiky ball. Roll that across the base of your foot morning and night. It may hurt to start with but it will stop fascia adhering and keep the foot supple. Ask for some calf exercises and do them as often as you can. Pilates is great anyway but you need to prevent that tightness developing in your feet.
The one thing you may discover if you use the spiky ball is your feet are different sizes. It was a real surprise to me when I found that out. I had been crunching up my left foot to fit the same size shoe as my right foot took! You almost need to retrain your leg to move properly when you get the right sized shoe on it.
Regards

[standingtall]

I appreciate the reply and will check out the post you mentioned. I have found that stretching does help, but have already been stretching for tightness in the calves. So, I guess I need to ramp that up some with some additional stretching of other types.
I am unfamiliar with pilates, what is the purpose of the spiky ball? Why not a smooth ball?

[Scott1]

Pilates is a regime aimed at strengthening the core muscles in your torso and isolating the smaller muscles throughout your body for exercise that are often weakened through under use due to modern sedentary lifestyles. It gained popularity with ballet dancers originally and has now broadened into many branches of sport. I have read that the Australian Ballet will do 1 hour of Pilates then a 1 hour warm up of ballet exercises before a performance. The reason they do Pilates first is they will injure themselves in the ballet warm up if they don't. The best contact sports people use Pilates so they can stay on their feet when they take a hit whilst those lacking core strength end up on the ground. You can start at a very basic level but there is no end to the variety of movements. It becomes very addictive. If you want to see how advanced it can get look up "advanced Pilates" on Youtube. You won't be starting at that level. The movements you do might be very small and basic but you will be surprised. I've done it for a long time now and prefer ex dancers as they have the best eye and they are fun to work with.
The spiky ball is a really dense rubber ball with a lot of bumps all over it. The bumps mimic what a finger would be able to do if you wanted to push it into a tight spot. A flat ball just doesn't get there . The balls have different degrees of hardness so you may start with a soft one and progress to harder balls as the foot becomes more supple.

Regards

[Luvsadonut]

The second part involves getting the tightness out of the foot and the calf. If you let it go ultimately your whole leg will be affected as the hamstrings get involved then it will be the hips, pelvis and back. Start fixing it now as it is a really difficult set of related issues to unwind. Go to a good Pilates studio and ask for a spiky ball. Roll that across the base of your foot morning and night. It may hurt to start with but it will stop fascia adhering and keep the foot supple. Ask for some calf exercises and do them as often as you can. Pilates is great anyway but you need to prevent that tightness developing in your feet.

Ive been looking at hips/knee/ankle alignment for a while now as Im convinced that if I could straighten the alignment my mobility would be so much better ( I can currently slowly walk about 750 metres or so). When I walk and bend my knee, my knees want to fall inwards yet my feet point outwards with the little toe touching the ground first which makes for very awkward gait. Ive looked into Psoas muscle release aswell as stretching calves etc but not much relief so far. Any ideas?

sorry if this is too off topic I will repost if necessary.

[Scott1]

That's a tricky one! I tried to move my leg as you described to see what happens and struggled to copy it. Have you tried releasing the TFL and the adductors. If you roll on the TFL it will probably hurt like mad but it will eventually release. If you do Pilates, you could try circles and big/little frogs on the reformerwith legs in straps. As well as the Psoas, I'd look at the hip flexors, quads and hamstrings. Doing an exercise like "Clams" might help but from what you have described you might find that hard. It sounds like you need someone watching you to see what you actually do. It's going to take a while by the sound of it.

Regards

[Luvsadonut]

Ive tried various Pilates exercises but not with the reformer. Generally the exercises aren't too difficult, I had a gait analysis appointment and the outcome was to do clam and other exercises but I didnt get much improvement. I think stretching the inner muscles is the key rather than strengthening? Ive heard that if you have a Psoas release it also releases emotional stress, that interests me, however, I think its difficult to find a practitioner who can do the release correctly. I think I will try to start doing Pilates more frequently though...how often did you practice it? How long did it take before you could feel noticeable differences? Noticeable differences are pretty much impossible with this illness!

[standingtall]

Thanks again for the great information. What you have said makes sense. I will check it out. Since my dx's, I have changed my diet and exercise greatly. Before I did none, now I do some! But honestly, the exercise always is last on my list. Diet and supplements are really integrated into my lifestyle now and that is where I have to get the exercise level at also. I lost over 40lbs. by just eating healthy, following a modified paleo diet. I supplement with nothing too exotic, just good high quality vitamins and minerals. Exercise consist of walking, biking, some light weights and cardio. I stretch daily and try to get one of the before mentioned exercises every day, but sometimes I am doing good to exercise every other day. It just comes down to making it a priority.

[Scott1]

Hi again,

When I started doing Pilates I quickly realized once a week was a waste of time. By the time you went back any benefit had gone. Twice a week with a one day gap between session 1 and session 2 is enough to make a difference.

Standingtall, you're right. You have to make it a priority.

Luvsadonut, I luv's your name! The first thing to note is if you thought it was easy then you were not doing it properly. I agree it's very important you find the right practioner. Pilates has different (but similar) schools. Ask the teacher what her/his background is and why they got into Pilates. In Australia,the dominant ones are Pilates International and Polestar but there are others. In the US they are different on the West Coast than the East. Some are a bit precious but generally they do the same thing. Most of the really good practioners have done a three year course and know hundreds of exercises. Treat it like personal training. Don't go to a big group class. They won't be watching you individually. Be in a class of no more than four people, preferably less. There should be a constant dialogue between you and the teacher. If they are not asking you what you are noticing then you are in the wrong place. All Pilates teachers are taught not to hurt you so they tend to focus on technique when you are doing the basics. If you did clams and said it was easy a proper instructor would have strapped a couple of kilos of lead weights around your ankles and said have another go. (They may have, of course, rolled their eyes and wondered what you were doing but said nothing) All teachers should nominate a number of repetitions they want you to do. Just use the number as a reference point; if they say 3, do 10. If they say 10, do 15. If they leave you sitting there just do more with little breaks. Soon they will know to keep you moving. People like us have to exercise outside our range of comfort. If we are inside the range there is no benefit because we have stiffness and weakness that mere mortals don't properly understand. Always push to exceed the requirement. Instructors will always start at low level because they are trained not to hurt you. Just go for it.
Stretching is important but it needs to be in many directions. I hate rotating and can't get a proper stretch unless I fatigue certain muscles first. If it's easy then either your technique is wrong or tell the teacher to crank the difficulty up. Usually it's technique at fault. That's why I love ex dancers. They have a fantastic eye for that stuff. Ex athletes and Physiotherapists are proficient (and sometimes very good) but generally they don't have the eye. I'm doing Pilates today and I just think I'm going to see my best friend.

Regards