The "Shoe Thing" Again

I think in some ways the hardest thing for us clubbies to come to terms with is that we really can't do some things the same way non-handicapped people are able to do those same things. This doesn't mean we shouldn't still strive to do what we desire to do, but on one front in particular, we have a specially difficult time - buying shoes. We want to be able to do the same thing anyone else does - walk into the shoe store and buy that really sexy/cool/stylish pair of shoes and walk out wearing them. But - you know what's coming - we will pay a real price for doing so.

They may not have anything that actually fits both our feet, and our orthotics. They may have something that fits, but we can't wear them for more than an hour or so before our puppies are whimpering like crazy, and we never wear them enough to get our money's worth out of them. Or, we may wear them despite their lack of support, and then pay the price of days of more severe pain. And for many of us, the option of custom footwear is too expensive, too hard to find, just not stylish enough.

But there are types of footwear that can at least be modified, with rocker soles, lifts, better support, etc., that are within our price range, and maybe not too ugly. Even with that, the real problem is our self-image versus our self-comfort. That is the real battle. And all I can counsel after 60 years, and more than 30 making shoes and orthotics for people with a very wide variety of difabilities involving their feet and gait is, that beauty involves much more than your shoe style. It involves your sense of happiness, of comfort, of involvement in all the other aspects of life, outside the difability facing you daily. It is always your choice - both the shoes you choose, and the self-image you choose.

 

And yet I continue to make the case for finding and spending whatever it takes to get the right shoes for your specific feet. The way I see it now, we clubbies have only two choices for finding reasonable comfort - amputation and prosthetics, or custom shoes and orthotics. No amount of experimental surgery will make a real, long-term difference, especially fusions - they just move the problem and pain to another joint or set of joints. There are enough stories from clubbies who have gone down this road, with mostly failed experiments, many more years of pain and frustration, and perhaps eventually amputation anyway. But it isn't for every clubby, especially when we get older, where our bodies are less able to adapt to prosthetics as they would have been had we had it done earlier in life. 

 

So this leaves getting smarter about footwear and orthotics. Yes, they cost, and yes, you may have to work outside any insurance system to get what you need. But aren't you worth it? Isn't having less pain, remaining ambulatory longer, recovering faster after a long day on your feet - isn't that worth the price? Only you can answer these questions, but be sure to ask one more question - what price happiness?

Hello, Mt. View!!

OK, now I am curious. Hello, mysterious visitor from Mt. View, California! Please identify yourself! You are the closest visitor to this blog yet, and we must connect! Are you also in the Facebook adult/teens with club foot group? Stand up and be noticed!! Let's do lunch!

An Amazing Journey

Readers of this blog will remember one of my recent guest posts, done by Lacey Phipps. She is the young clubby who after years of unnecessary suffering decided to have her legs amputated, and be fitted with prosthetic legs. Well, recently, she was selected as the recipient of a new pair of prosthetics by an amazing outfit in Virginia, USA, and I feel I must help her story get wider spread, and to help others learn about the incredible people at Hattingh Incorporated dba Prosthetic Care of VA, who have been in the orthotic and prosthetic business for decades. As it says on their page, "John Hattingh CP, LCPO (SA) is an educator and leader in Prosthetics. His attitude towards his patient is "No prosthetic issue cannot be solved."

 

These amazing people paid Lacey's way from Texas, put her up at a local hotel, schlepped her around and to and from, and made and fitted her for top-notch below-the-knee prosthetics, began her rehab training, and got to know a few other clubbies by their posting Lacey's progress to all her friends and to the adult/teens with clubfoot Facebook group. To see Lacey in one of her first walking trials, look at this: Video.

I can't wait to post a video of her doing her favorite dancing. What an inspiration to clubbies everywhere!!

Go, Lacey, GO!!!

That "Hate To Get Out of Bed" Feeling

Normal logic suggests that, all else being equal (strange saying, as nothing is generally equal to anything else in this life), when your feet hurt at the end of the day, a good night's sleep will make them feel better in the morning. Hogwash. That's what I said - hogwash. Something about your feet just laying there all night seems to make them even more tender first thing in the morning. That is, if they let you get any sleep at all. So, is there any way to change this situation?

The answer to this is - sort of. There are a number of things you can do to allow your feet a better night's sleep, and to reduce the amount of inflammation during the night so that the pain is actually reduced by morning. Note I say "reduced," and not "stopped." That is because we all have somewhat different levels of pain, inflammation, and abilities to recover. Plus, the greater the amount of activities that occurred the prior day seems to play into this equation, though again, it can vary.

So, here are some tips: (The links supplied should be copied and pasted into your browser's address bar.)

• Invest in a blanket raiser. This is a simple device, sort of a frame that slips under the foot of your bed to drape the blankets over, which allows your feet to stay warm without the weight of the blankets pulling them down. One such place to see what this looks like is at http://www.toespace.com/ where you can see how simple such a device is. Those of a more enterprising bent can easily make their own.

• Consider elevating your legs at night. The simplest solution is some large pillows at the end of the bed, but you can also acquire a large foam wedge. The idea is to get your legs above the level of your heart. This will help reduce edema - inflammation - significantly. If your legs have the tendency to fall outward, then simply place a couple of smaller pillows under the outsides of your upper legs. This will reduce pressure on the femoral head and the hip joints. Here is a link to one example (there are many places to buy these - this is not an endorsement of this specific seller): http://www.makemeheal.com/mmh/product.do?id=10052

• Ice packs - use ice packs or wraps for at least twenty minutes before going to bed. This is another way to get the inflammation down. Here is a link to a page with many examples of the ice wraps available: http://www.amazon.com/s/?ie=UTF8&keywords=ice+packs+for+feet&tag=googhydr-20&index=aps&hvadid=1099039481&hvpos=1t2&hvexid=&hvnetw=g&hvrand=18577333431008496381&hvpone=&hvptwo=&hvqmt=b&hvdev=c&ref=pd_sl_3bblda0974_b

• Take some aspirin before bed. If regular aspirin is too much for your stomach - maybe you have an ulcer, in which case regular aspirin is NOT a good idea - you can take what is called enteric-coated aspirin. This type of aspirin doesn't dissolve in your stomach, but in your intestines, so is safe for those who have issues with aspirin. Aspirin is one of the very best medications for the reduction of inflammation, better than many prescription NSAIDs (non-steroidal anti-inflammatory drugs). Cheaper, too! 

• Massage your feet. Use a nice lotion, maybe even something like Tiger Balm, or any other deep-heating cream or lotion. Stretch the joints of your feet slowly and as fully as you can. Move the joint to the end of it's range of motion and hold it for a few minutes before releasing it. Where possible, move each joint in both directions, to help open the joint spaces temporarily, thus giving them a little break. Be nice to yourself, especially to your feet! You deserve it! Some samples of good lotions and creams can be found here: http://www.amazon.com/s/ref=nb_sb_noss?url=search-alias%3Daps&field-keywords=deep-heating+pain+relief+creams+and+lotions&rh=i%3Aaps%2Ck%3Adeep-heating+pain+relief+creams+and+lotions

No one of the above suggestions will do the trick - you really need to try them all, until you find the right combination that works for you. But I am convinced that it is possible to wake up with your feet feeling a lot better than when you laid down to go to bed last night. Develop your own ritual. Be nice to your feet! And they will thank you for it!

You Body is a Four-Story Wonder!

You probably, like most people, see your body as a single item - your body, and nothing else. But modern science (ain't it a grand thing?) will tell you that in fact, your body isn't even all yours. We are home to, and most likely fully dependent for survival on, hundreds of species of other beings that perform very critical tasks on our daily behalf. Bacteria. That's what I'm talking about! No, actually, I won't be talking about bacteria - that's just a ploy to get you to read further.

 

What I AM talking about are the four levels of your body that we use to describe how you compensate when your table, er, supports, well, that is, your legs are not of equal length. Like the table I spoke of in the last post, your two legs have to perform in a similar fashion as that table - they need to provide equivalent stability in as bi-lateral a fashion as possible. When they fail to do so, the body becomes imbalanced, and force the body to begin compensating for that imbalance.

 

To describe that compensation, and to aid in determining how to respond to effectively change that compensation back to a more normal bi-lateral state, we need effective language and ideas in order to communicate what is wrong, where it is wrong, and what to do to respond to the problem. This is no different than any other scientific or technical issue - without good, descriptive, and accurate language, we cannot effectively resolve the problems that crop up.

 

We begin by dividing the body into four segments - primary - from the floor to the knees; secondary - floor to hips; tertiary - floor to shoulders; and quaternary - floor to the top of the head. As the body is essentially a structural chain, changes made at lower levels of that chain promulgate proximally - that is, from the initial location of the imbalance upward toward the center of gravity. Because we humans - as well as every other being and object on Earth - reside at the bottom of a gravity well, anything that alters our balance alters how we react and operate in relationship to the direction of gravity. This is a very important concept for the purposes of our understanding of bi-lateral biomechanics, just as it is for that table.

 

So when we talk about how a given body compensates for an imbalance in their bi-lateral functioning, we describe where those compensations occur, and to what degree they are occurring, by indicating to and at what levels we see compensatory changes. If, for example, we see a simple change where the foot on the apparent short-limb side of the body begin to walk more on the ball of the foot, raising the heel more rapidly on the affected side, but no change in the levels of the hips or shoulders, we would describe this as a primary compensation. And for most primary compensations, the body often maintains only that level of compensatory involvement for many years, sometimes for life, without eventually moving to another level of compensation.

 

But there is no guarantee of this. Our bodies are being acted upon by forces both external and internal. Gravity we cannot resist, but that is also true for many of the internal forces at work. One example is the state of any one individual's ligaments. Not everyone has the same tone to their ligaments - some of us have very tight ligaments, some fairly middle-of-the-road ligaments, and still others have a very loose ligamentous tonality. The term "ligamentous laxity" properly describes what is more commonly known as "double-jointedness." It merely means that such an individual's ligaments are so loose as to permit their joints a far larger range of motion. Such people are sometimes more prone to injury, but they are also prone to developing more and far more problematic compensatory mechanics. We will touch on this more in future installments here.

 

For now, just remember that your body works to manage compensatory demands by adjusting itself across these four levels. Note that each level incorporates all the levels distal, or below that level, so Secondary also encompasses Primary, and so on. This, too, will be important to recall in our other installments.

 

Next time: why you can't resist my compensatory charms!