Three very similiar patients; one female and two male, having narrow, bony feet have all had chronic, longstanding arch and/or heel pain, accompanied by extreme plantar foot “sensitivity” and pain for many years.
Each were on the brink of disaster alignment-wise, when a seemingly benign event (new orthotic, unexpected prolonged hiking) occured, changing them forever, sending them along a downward spiral of worsening, unrelenting foot pain. All have see countless foot specialists (podiatrist,orthopedists) and have tried a bundle of different shoes and orthotics with no success whatsoever. All have also presented with shoes that are too long and deep for their bony, skinny feet.
As a board certified orthopedic podiatrist, I would have previously tried to cushion their orthotics or grind in a plantar fascial groove to offweight an otherwise tight, bow strung, plantar fascia. What I have learned instead, using F-Scan pressure mapping is that standard orthotic treatments don’t always work. Instead, fine tuning the trajectory parameter is essential to prevent excessive dorsiflexion of digits 2 or 3 during the toe-off phase of the gait cycle.
Before and after results are listed below. Symptomatic relief using these principles in my three patients has not been immediate, but over 2-3 months time, all patients were 80% improved from before the study trial.
Dr. Jenny Sanders Shoe Blog 