The Pains of Club Feet

Pain is a funny thing - everyone hates it, but it serves a critical purpose. Without pain, we would not know when to stop, avoid, refrain, etc., from doing the very thing that causes the pain. This is especially the case in a diabetic, for example. As many people with diabetes are vulnerable to peripheral neuropathy, essentially, the loss of their sensory nerves in their feet and legs, they lack this critical feedback mechanism. This makes them susceptible to the formation of ulcers, that, if left untreated, can lead to amputations, and even worse complications.

For those of us with club feet, pain is both a motivator and a de-motivator. We want to do all the things our family and friends do, all the things our jobs demand of us, but as time goes on, we find it more difficult to ignore our pain. We may seek out other surgical solutions, start to use pain medications with greater frequency, stop doing all the things we love to do, try other mechanical responses to the pain. We risk addiction with the pain meds, less-than-hoped-for results from the surgical procedures, or disappointing results from the mechanical modalities. We may fall victim to some of the myriad quack solutions as we become willing to try almost anything to alleviate this chronic pain. We also risk depression, and loss of faith in solutions of any kind.

There is, however, a mind-set that can help get through this dark night we often find ourselves in. This mind-set is constructed of several elements. First, don't give up. This is critical, because without it, we can in fact succumb to addiction and depression, and quite honestly, neither are solutions, merely additional problems, and potentially more destructive than the pain itself.

Second, be willing to try some things again, but from different approaches. That pair of orthotics didn't work? Try a different podiatrist or orthopedist for the evaluation and/or casting, and try a different orthotic lab for the devices. Not all professionals have the same skills or sensitivity to the particularities of club feet - in fact, few truly do. Or pain meds - if the type or combination's you've been using aren't doing the job, or are screwing up your ability to function, ask your doctor to recommend a different approach. Be willing to try alternative approaches - acupuncture, which has a long history of success at pain reduction; massage (don't be afraid to tell your massage therapist how to do the job right on your feet - you know better than they do what works, and what hurts;) Self-massage - I use a device called the iSqueeze, a really remarkable foot massager - not cheap, but see it as an investment in your long-term comfort. Some medical plans may cover such purchases, if you can satisfy their demands for proof of need (and I suspect you can.)

As for surgeries - this should always be your last resort. Foot surgeries for post-club feet are usually a speculation on the part of the clinician. The truth is, many soft-tissue surgeries on adults have long recovery periods, especially tendon surgeries. They require extensive and religiously attended to physical therapy for the best possible outcomes. This means at least doubling the amount of recovery time most surgeons say will be necessary - they want you to feel confident, so they tend to understate the time require for complete recovery. Don't take my word for it - go talk to a couple of physical therapists. They are the professionals that get to see the failed surgeries as much as the successful ones. And talk to others who have had the same procedures for the same issues. You will find as many successes as failures, which should be an indication that your odds for success are about the same, regardless of what the surgeon would want you to believe.

There are many kinds of pain associated with club feet. Some of us have pain in the sinus tarsi region, deep inside the subtalar joints. We may describe it as "bone pain." Some have recurring cramps - in the arch, the calf, even the toes. I have one kind of pain I haven't been able to ever get a satisfactory answer to. It occurs occasionally, thankfully. It feels like my lower legs become "heavy," almost as if the circulation is being blocked, which may well be the case. Given that most club footers have some amount of muscle atrophy in the calf and feet, due largely to all that casting and bracing, it seems reasonable to assume our blood vessels are also somewhat proportionally smaller, and thus prone to "sluggishness." I am also certain there are other types of pain, other degrees, locations, triggers , and more.

With that in mind, what is your pain like? Where, under what conditions, how acute or how chronic is that pain? What do you do to alleviate the pain, and what works best for you? Do you employ massage, and how does that work for you? Foot adjustments? Foot soaks? Ultrasound? Share your solutions with the rest of the club foot community. You have nothing to lose, and many things to gain!