Saturday, April 14, 2012

Shoe Recommendations For Patients Recovering From Foot Fractures and Injuries.


Shoe Recommendations 
For Patients Recovering From
Lisfranc Injuries...
(As well as any Sprain or Fracture of the Foot)




I know this sounds terrible but 
I love treating fractures...

I enjoy treating patients with fractures because:

1. On the 1st visit, patients will leave the office in significantly less pain than when they walked into the office using simple non-painful conservative treatment. 

2. Once the fracture is healed - we focus on getting patients into proper shoegear, arch support and possibly bracing so they can get back to doing all the activities they enjoy! 

I love my profession because I have the opportunity of helping people heal from foot and ankle injuries and get back to their lives.
Over the years, I have discovered that if patients follow the recommendations below - our success rate is amazingly high!


LISFRANC'S INJURIES.

So, let's talk about Lisfranc Injuries...
The Lisfranc Joint (also known as the Mid-Tarsal Joint) is in the midfoot and, in my opinion, it is the most common foot injury. 
Although it can be caused by direct trauma (and if that happens - you are going to the Emergency Room and possibly having surgery), I find that the wide majority of Lisfranc Fractures or Sprains are caused by an often minor twisting of your foot on a stair or curb and, if you happen to be barefoot, wearing flip-flops or a shoe that bends through the midfoot area - there is a very high probability that you are going to break a bone or pop a ligament.  

I see this type of fracture every single day
One day last week I saw four Lisfranc fractures before lunch. The amazing thing was not one of them knew how they did it!


In my opinion, this fracture is caused by taking a
wrong step in a crappy shoe!
And it's not you're fault because 
80% of shoes out there are crappy 
and there is tons of misinformation about what makes a good shoe...

One of the main reasons I started the blog was because of my frustration with all of the misinformation about shoes.
I'm passionate about this topic because I have spent the last twelve years in private practice striving to help people heal foot injuries and get back to their lives.


So...
These Rules Are Stringent 
BUT
You ARE Recovering from a Foot Fracture
and you need to protect your foot!
You went through a lot of pain and time in "the boot" or on crutches to take the chance of wearing bad shoegear and re-injuring...


So...




THE RULES 
FOR WHEN YOU ARE RECOVERING FROM A FRACTURE OF THE FOOT:

1. No barefoot! 
Ever. 
The only time you are barefoot and standing is in the shower. 
2. No Flip-Flops. 
I don't care how "good" they say the flip-flops are - they're not. 

3. No Walking Around the House Wearing
Only Socks.
 Zero biomechanical protection. 

4. No Flimsy Bedroom Slippers.
Any slipper that bends or flexes is garbage.

5. As a bedroom slipper around the house - wear Croc RX Clogs with the strap 
in the back.  
As soon as you get out of the shower, dry yourself, put on your Crocs.
If you get up in the middle of the night to go to the bathroom, when you get out of bed, straight into your Crocs and off you go.
Yup, the strap MUST be to the back. 



IF YOU ARE RECOVERING FROM A FOOT INJURY / FRACTURE / SPRAIN 
ANY SHOES THAT YOU WEAR 
MUST HAVE:

1. A Thick Rigid Sole
If you can bend or flex it - it is garbage.
Put some muscle into it, please - no wimpy "bends"...

2. Arch Support
Whether it is Custom-Molded Arch Support or an Excellent Over-The-Counter Insert - you need arch support.
Unless you are one of the 10% of people who can't tolerate arch support in which case, do not wear arch support. 

3. A Wide, Soft Square Toebox. 
Google: Extra-Depth Shoes and there are many brands of shoes that have extra-depth for the toes.
No cock-roach kickers, please -- they are bunion factories. 

4. Rearfoot Control. 
Every single shoe MUST have rearfoot control. 
If you are not biomechanically controlling the rearfoot - you are not controlling the mid-foot - which will lead to more chance of re-injury, pain, strain as well as knee, hip and lower back mechanical strain. 
To stay in a backless shoe, you are gripping your toes down when you walk. There are tendons that start below the knee and go all the way down to your toes - they are also passing through or connecting into the bones that make up the Lisfranc's Joint and a biomechanically uncontrolled rearfoot equals more strain, more pain and more chance of re-injury. 



ONE "SHOE DAY"
IN  THE LIFE OF SOMEONE RECOVERING FROM A LISFRANC'S FRACTURE
(Any midfoot fracture or Injury)


 6am
Good Morning!
 I have to let the dog out so I guess I'll get out of bed and right into my Crox RX Clogs 
(making sure that the strap is to the back) and let the dog out. She's fascinated with the Geckos and Hummingbirds...

6:30am
Exercise
I'm going to put on my Diabetic socks (even though I'm not diabetic), my Tri-Lock Brace, which I got from my Podiatrist and I use when exercising (for at least 6-12 months after a Lisfranc's Injury) and I'm going to put on my 
New Balance walking shoes so I can take my dog for a thirty minute walk. 
Luckily, my Podiatrist sent me to the New Balance store and gave me a prescription for:
RX:
New Balance Walking Shoes
with Roll Bar Technology and
a wide base for more stability
(Because it's an RX and medically necessary it should make them tax deductible...)



9am
Work
My foot feels pretty good so I don't need to wear my brace to work today -- but I'm going to take my Tri-lock brace to work so that if my foot hurts I can put it on. 
I went to Dr. McCarthy's blog and found the search box (top right hand corner) and searched for:
"Top 20 Women's Comfortable Dress Shoes"
and found a great shoe for work. 
I wrote down what I liked and went to the store to try them on -- my brace fit into some of them but not all so, in the early days of recovering from my injury, I wore the chunkier shoes with my brace and once I was further along in the healing process, I didn't need my brace anymore. 
Anything on this list would be fine with someone who has healed from a foot fracture
because I know all of these shoes meet her criteria on that stringent list from her blog...



2pm
Go Play!
Wow, I can't believe it! Work shut down early and now I can go do whatever I want! 
Let's look and my options...

Beach:
I'm going to wear my Amphibious Teva's or Chaco's (with a rearfoot strap) whether I am on the sand or in the water because it'll be more comfortable and I'll have more fun. 

Water Aerobics
Am I going to do water aerobics barefoot? 
Oh heck no! 
My Pod told me she sees a surprising number of fractures from women bouncing around in the swimming pool -- I think I'll wear my Amphibeous Teva's (with rearfoot strapping). Right after I was recovering from my foot fracture, I had to wear a pair of New Balance Walking Shoes with Roll Bar Technology and a wide base (for more stability) in the pool


Hiking
I didn't like any of the hiking boots Dr. McCarthy featured on her blog so I went to REI and I picked out a boot I liked but I made sure that the sole didn't flex or bend. The salespeople must have thought I was crazy because I walked around -- bending and flexing all the shoes before I tried them on. I then picked a great boot that felt the best on my foot and met all Dr. McCarthy's criteria for proper shoes. 
She told me that no matter what she says, 
I'm the acid test. 
 If I try on a shoe and it's not comfortable -- 
I don't get it. 
Yoga
I don't care what anybody thinks! 
I went through too much to get my foot healed to risk re-injuring it by being barefoot so I am going to wear my New Balance walking shoes with Roll-Bar Technology and a wide base
I love Yoga and I want to keep doing it so 
Dr. McCarthy wrote me a prescription that I gave to my Yoga studio that says it's medically necessary for my to wear my shoes in class. 

7pm
Home at Last!
I used to not want to wear my Croc RX Clogs around my husband because I thought they were goofy but, guess what -- I got him in Crocs Rx around the house and he had the following benefits:

1. 
30% Improvement in knee, hip and lower back pain within 3 weeks.

2. 
We saved a truckload of money in medical bills - everything from foreign bodies, warts, tendonitis, fractures, heel pain, calluses, ect.

3. 
His feet are prettier! 
Turns out that kooky Dr. McCarthy was right! She said, "You're either beating up your feet or you're beating up your shoes -- think what your shoes look like after a couple of years -- that's what's happening to your joints."


10pm
Good Night!
I'm so glad that my day tomorrow doesn't include going to see my Podiatrist! 
We got the fracture healed and as long as I do the right things when it comes to protecting my feet, 
I don't need to see her. 
I can live my life and have fun!

Gee, 
I wonder why a Podiatrist would be giving out advice that would decrease her business?
 Hmm, I wonder if it's because she figures it's a better marketing plan to fix people's foot problems and then protect their feet with proper shoes so they don't need to keep constanly coming back and she gets new clients from "Word of Mouth" referals from happy patients? 
That must be it...



Have a Great Day!


Dr. Cathleen A. McCarthy

:)




98 comments:

Anonymous said...

Found you via barking dogs today. Will be checking out the Dansko sandals for narrow feet!

My feet have minor issues (no breaks so far just various aches & pains), and I've learned to be more selective with shoes.

I wear Haflinger supportive clog-style slippers around the house. And I have recently discovered many styles of Rieker shoes have great heel control and fit my foot perfectly. Some styles not so much, and they have to be actual Riekers not their other brand.

valleycat1

Nina Wikstrom Aguilar said...

I am so excited to find your blog!! I have had rheumatoid arthritis for about 37 years...yup, that's right. 37 years. I have had more than 30 different procedures to my feet and ankles, fusing joints, repairing joints, taking out neuromas, finally taking out the MTP joints completely, then back to take off the meta-tarsal heads (which were curling down thru the bottom of my feet)....it goes on and on. I have just recovered from taking 20-year-old hardware OUT of one foot, and I am back in my regular shoes. I have not worn heels in maybe 35 years...and I am happy there are more really good shoes available now. Thanks so much for all you are doing to help us!!!

Unknown said...

What is cock-roach kicker?

Doctor of Podiatry Discusses and Recommends Shoes. said...

A cock-roach kicker is a "Doris Day shoe" -- high heels with such a pointy toe -- you can chase a cock-roach into the corner and kick it to death.
An expression we used to use back in New Jersey...
:)

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Nina,
Thank you so much for reading the blog and for all the lovely comments! I hope that the blog helps and --
You made my day!!
Dr Cathy McCarthy
:)

Nina Wikstrom Aguilar said...

I want to leave a suggestion for any other women like me .... who have terrible fore-foot destruction (and pain). I CANNOT wear heels. If I even remotely bend over forward, I have a tendency to fall flat on my face---because I can't control my toes. (All the MTP joints are gone and the big toes are fused solid.) Women's shoes, even the supposedly flat shoes, still have an inch heel, usually. I have to wear men's shoes, although some of them also have an elevated heel!! I just bought a pair of slip-on MEN"S Keens...and I can wear most shoes with a rocker bottom. Dansko's are all too high a heel, but MBT sandals work well. (Note: the mbt's work great for my feet, but I tend to pound on my knees a bit harder.)
I am always looking for flat, slip-on shoes with lots of support and cushy padding. Dr. McCarthy, thanks so much for creating this blog!! Can you suggest any specific shoes that might work for me? thanks a lot!
Namaste, Nina

Stanley Boyer said...

True! If a customer is satisfied with the result he expected to have, then there’s a 100% possibility that he would recommend excellent services to others. Moreover, a professional’s advice for choosing the right diabetic shoes is significantly required. Otherwise, a miss-match of shoes will happen that may cause foot fracture, thus worsening the foot’s condition.

Anonymous said...

I am excited to read this blog! I am recovering (slowly) from a talus fx and dislocation. None of my ortho docs have given me any advice on how to move forward with finding appropriate footwear. I am looking forward to using your tips!
Thank you!
Melissa

Doctor of Podiatry Discusses and Recommends Shoes. said...

Thanks Melissa!
I hope the blog is helpful and I wish you a speedy recovery!
Dr McCarthy
:)

Anonymous said...

I am so happy I came across your blog. I fractured my fifth metatarsal and it has been almost 4 weeks since I broke it. I'll find out on Wednesday if it is healing. I hope so! I'm ready to get on with my life. And my doctor is not a good communicator so I'm glad you are giving us some good advice on shoes and I will be buying what ever you recommended for shoes and socks. I just want my foot to be 100% healed. Thank you so much.

Doctor of Podiatry Discusses and Recommends Shoes. said...

Dear Anonymous,
Thanks for reading the blog! I hope that your fracture heals well. I also recommend that after your fracture is healed, that you wear a tri-lock ankle brace, which you can probably get at your Pod's office for 6-12 months with any sports or increased activities and on an as needed basis - for additional protection and biomechanical control.
Hope that is helpful,
Cathy
:)

Sherry Sulisz said...

Hello - really enjoyed reading your blog! I am recovering from a lisfranc injury from a car accident in November 2012. No surgery, thankfully. It seems to be healing well. I have been wearing the crocs rx relief around the house and new balance 927 when I go out. With summer, I'm wondering if you can recommend some good sandals - will be going to Disney in August, so I'll need something to last me all day. Thanks so much!

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Sherry,
Thanks for reading the blog! I'm glad to hear that you are healing well after your Lisfranc's injury!

For a summer sandal (dressier), I would look at:
1. The Wolky - Tulip, Ruby, Open-Toed Cloggy or the Jewel.
2. Any of the Dansko sandals that have rear-foot strapping.
3. A Naot sandal such as the Paris that has a hidden metal shank inside it.

For a more casual sandal, try a Keen or Merrell but just make sure it has a thick rigid sole and rear-foot strapping. Also, check out the Chaco Z1 or Z2 for when you hit the beach.

Have a great day!
Cathy
:)

Anonymous said...

I am nearly 9 months after my lisfranc surgery. I have 4 screws inside my foot, and still feel that I am slowly progressing. However, I have not decided if it is more beneficial to remove the screws due to discomfort and pain. Also I was curious as to what would be your recommendation for a mens dress shoe (with a suit) for work.

Thank you for any advice!

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Anonymous,
I apologize for my delayed response!I would recommend RX Crocs around the house (with the strap to the back), New Balance 928 with custom-molded orthotics for exercise and a men's dress shoe with a hidden steel shank in it. I recently bought my husband a Dansko 'Wayne', which is a casual dress shoe and it is working well for him. Try the Dansko men's dress shoes. If you live in a city where there is a Dansko store, I would recommend you go there. Also, do a google search on men's dress shoes with a steel shank.

I would recommend you pursue conservative treatment before you decide to have a second surgery. I did an article on the blog about a patient who had a Lisfranc's fracture with 3 screws (two of which were broken in half) and, after we got him in CMO's and proper shoes, he was fine.

Good luck!
Cathy
:)

Anonymous said...

I am glad I found yoru blog...
Please advice, I have my stress fracture if my sesamoid bone...and finally off my boots and crutches after 6 weeks...still I need to wear the tennis shoes and insert for 4 weeks to back to my dr.
So, I am working as an profeesional in my job that meeting. Can you advice any shoes for woman dress and dress paints/ suit for my typical injury. Also for home inside my house...sure I cannot bearing my bare foot.
Thanks much!
HN

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Anonymous,

For anyone recovering from a sesamoid fracture, some shoe recommendations are:

1. RX Crocs in the house as a bedroom slipper

2. New Balance 928 or 1540 for exercise.

3. For work - Wolky Cloggy (closed toe), Sketcher Shape-Up Mary Jane, a Mary Jane with a Rocker Bottom Sole, Alegria Paloma or Abbi.

Check with your doctor if you are having any problems!

Let me know how it goes...

Cathy
:)

Sahal said...

Dear Dr Cathy
Your post is very informative, thanks a lot
I have had 4th metatarsal trauma fracture and was on NWB but yesterday my pod said I can walk without giving me any instructions on what to wear, I tried all of my shoes and nothing fit because my foot still swollen
What do you suggest for sneakers other than new balance for females? what should I look into when I buy one?
Another question does wearing closed shoes make my foot more swollen?

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hello Sahal,
I'm glad to hear that you are recovering from the 4th met fracture! Because of the swelling, your foot has probably gone up a size and may stay that way for up to 1-2 years. As you continue to protect it with excellent shoes, the size may decrease in time. Have the shoe store remeasure your foot to determine your new shoe size.

I would recommend that you start at the beginning and get into RX Crocs around the house and NB 928 or 1540 as you ease into proper shoes. You have to walk before you can run! Meaning, don't jump into dress shoes to quickly - you are still on the mend. Start with the basics: Rx Crocs and NB 928 or 1540.

Once you are comfortable in the NB (all day) - then you can bump up to different types of shoes. Did you talk to your Pod about getting in a brace while you are easing into proper shoes? I find the use of tri-lock bracing with the NB will allow you to get back into your exercise routine quicker and with less swelling as well as decreased chance of reinjury.

Give yourself at least four weeks in Rx Crocs around the house and NB 928 or 1540 before you bump up to any other type of shoes. I would also suggest you have a discussion with your Pod about either a custom-molded orthotic or an excellent over-the-counter insert for arch support.

Once you are on the mend and in NB all day with no problems - then you can try something like:

1. Wolky CLoggy (open or closed-toe), Tulip, Jewel or Ruby
2. Allegria Paloma or Abbi
3. Dansko Professional or Dansko sandals with rearfoot strapping.
4. Chaco Z1 or Z2 or a Keen's amphibious sandal for the beach and in the surf, ect.

These are a few suggestions!

Check out my lists using the search box:
1. Top 20 COmfortable Women's dress shoes
2. Top 20 Comfortable Sandals

Hope all is well and I hope this was helpful!

Be careful out there,
Cathy
:)


Rosana said...

Hi Dr.
Thanks for your post it makes a lot of sense. I have a lisfranc fracture in my right foot. It is been two years and I have been wearing most of the time running shoes with strong arch support. My physical therapist also put on them Sole insoles for more support. Most of the days my foot feels fine but I work as a teaching assistant and there are days that I have to be on my feet up to 6 hours of course I end up very sore. What brand of brace would you recommend for extra help? Thank you

Doctor of Podiatry Discusses and Recommends Shoes. said...

HI Rosana,

Crocs RX around the house - with the strap to the back.

New Balance 928 or 1540 with custo-molded orthotics for exercise

A tri-lock brace to wear on an as needed basis for exercise or the 6+hour days (you can get this from a Pod)

A low Dansko shoe or sandal with rearfoot control to use for dressier occasions

Chaco Z1 for the beach or pool

When you try the shoe on - if it doesn't feel good - don't get it.

That's a good start!

Best wishes and let me know how it goes!
Cathy
:)

Kelly M said...

Hi! June 29th I broke my 3rd and 4th metatarsal bones of my right foot. Ive been treated by the immediate care dr. I was in the boot and crutches for 10 days. Then lost the crutches. Just today he moved me from the walking boot to a walking shoe. . He said in 2 weeks I can prob start wearing regular gym shoes. Would the New Balance ones still be the best suggestion? And I can get a script for that? Also I need to fly to another state in 2 weeks for work, will the walkinh shoe be sufficient? Thank u. So glad I found your blog!

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Kelly M,
I'm sorry it's taken so long for me to respond!
The New Balance 928 or 1540 should work very well for you. Get RX Crocs for around the house as a bedroom slipper. You can call our front desk at 480 563 5115 on Monday and ask for a RX for the NB sneakers and we will mail it to you - it will give you 10% off the price at the NB store. Or you can ask your Dr for an RX for the NB 928 or 1540. Do not get any other NB #'s! They will not be good enough for you. You may also want to get a Bioskin tri-lock brace to wear with the NB sneakers as you ease back into exercise.
Hope all is well!
Cathy
:)

Terri said...

Hi Doctor!
So glad you have this blog! Three weeks ago, I broke my 5th metatarsal head, clean break. Didn't dawn on me to see a podiatrist, and went to an orthopedic office and was Xrayed,treated by a PA and was placed in a walking boot. My dilemma is that my family and I have prebooked a tour of Italy that leaves in 3 1/2 weeks. the PA said it should pose no problem if I wear good walking shoes. After reading your blog, I ordered NB928. What I need to know now is when can I start wearing them? Do I need to wait till the 6 week healing period is done? I'd like to break them in before the trip, but don't want to cause further harm. Any advice is greatly appreciated. Wish I lived in Arizona instead of Mass, I'd visit you instead of writing!
Thanks, Terri

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Terri,
Sorry to hear about your injury! Yes, you absolutely have to stay in the CAM for 6 weeks - if you get out of it early, you are slowing the healing process and can cause complications. I would recommend getting the Bioskin trilock brace to wear with the NB928 for your trip to Italy as that will help control the swelling, limit motion and decrease pain. I know it is a pain, but I would consider taking the CAM with you - just in case you need it! Get your RX Crocs for the hotel room and wear your NB928 during the day. You are in the healing period and it is really important that you rest, elevate and wear your CAM.
Have a wonderful trip!
Cathy
:)

Unknown said...

Hi Doctor,

I injured my lisfranc ligament in July and was operated on the following week with ORIF. 2-3mm displacement. One screw was placed through my first cuneiform to my second metatarsal. It has been almost 3 months and my cast was removed at the 6 week mark for PWB. I was just instructed that I can not use the boot anymore and should move to sneaker with a 3/4 Spenco RX ortho arch. I was instructed to put this on top of the shoes default padded sole. However, this makes my foot sit so high in the shoe. If I get the NB1540, would I need additional orthotic support? In addition, would you suggest removing the hardware ? My doctor said he would do either but saw no Reason to remove. Is the recommendation for no barefoot walking forever or only in the first 12 months of recovery. Thanks for all your help!

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hello,
I'm sorry to hear that you've had the Lisfranc's injury. I would highly recommend that you get the NB 928 as they are better than the 1540 for the injury you are recovering from. I would recommend that you get either a custom molded orthotic or an OTC insert like Powerstep. Any insert you get should replace the insert that comes with the shoe, otherwise, as you say, it crowds the toes and can cause problems. The no barefoot rules are forever. I agree with your Doctor, there is no reason to remove the hardward unless they are causing pain or problems. You should also talk to your Doc about bracing (tri-lock brace) for increased activities such as sports.
Hope that was helpful and good luck!
Cathy
:)

Margil Garcia said...

hello, my name is margie i am 24years old and i am on my fifth week of recovery from a bone fusion TMT 1,2 and 3 i am in the military and running is crucial for me. for now i am temporarily disabled and then i will be on a walking profile until i am able to run again. my doctor says running is not recommended though i still want to run if not this year at least next and so on. what is the best shoe i could wear?? also no highheels? what about wedges?

Margil Garcia said...
This comment has been removed by the author.
Margil Garcia said...
This comment has been removed by the author.
Pam said...

What a great site! Thank you! I crushed my calcaneus and did serious damage to my STJ in April 2013.. I had an ORIF with 9 screws and one plate. I am still having issues with pain. I can't find a good shoe. I'm actually going to Disney next week for 6 days and am stressing about the pain of walking all day. What type of shoe do you recommend that I try? I'm doing PT 2x a week but haven't gotten guidance on shoes. Of course I'd love something fashionable but at this point in my recovery, I'm looking for comfort. Thank you.

Unknown said...

I'm having surgery on a misdiagnosed lisfranc injury in two weeks. I'm in New Balance with a custom orthotic right now. What do I need for after surgery? I'm a professional person with a business casual office.

Doctor of Podiatry Discusses and Recommends Shoes. said...

Dear Pam,

I am so sorry that I wasn't able to respond to your question before your trip! My husband and I were on our annual vacation and out of the country. I hope you had a wonderful vacation and even though the advice is late - here it is:

I would wear the New Balance 928 with diabetic socks and a custom molded orthotic (or, if you don't have an CMO - use an over the counter insert such as powerstep or even a Dr. Scholl's which I don't usually recommend but you might need more cushion than control due to your injury).

I would also get a Bioskin Tri-Lock brace from your Pod or an over the counter Futura brace that goes from your midfoot to above your ankle so that you have less motion through the site of injury and therefore less pain.

Crocs RX for the hotel room and around the pool!

I'm so sorry I wasn't able to repsond earlier! I hope all went well...

Cathy
:)

Unknown said...

I don't know if you are still checking this but I have a question. I've had fusion on three joints and am still Non-weight bearing. I have the New balance 928 with a custom orthotic for when I can wear shoes again. I have narrow, slim feet and the normal foot is already a half size smaller. My feet are swimming in crocs so I wondered If they would be a good choice. I have to get a medium for the left and I'm walking out of the right shoe! I won't be able to tolerate straps on the top of the injured foot which is my usual solution. I also have Naot and Drew shoes. How can I make the shoes fit on the uninsured foot.

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi unknown,

I'm hoping you meant to say 'uninjured' foot instead of 'uninsured' foot...?

If you are still non-weighbearing after your surgery that means you are still in the healing process and the ONLY thing you should be wearing on that foot is is the CAM Walker or surgical shoe that your surgeon gave you. Once your surgeon clears you to wear normal shoes - then you will be able to begin to tolerate straps on the top of the foot and you can begin wearing the RX Crocs as bedroom slippers in the house (please discuss this with your surgeon). The best thing to wear once your surgeon clears you for normal shoes is the NB 928 with CMO's and I might even suggest you wear them as bedroom slippers for the first one year after recovery.

I hope all goes well and I wish you the best as you recover from your surgery!
Cathy
:)

Basil said...

Hi,

Great advice, I'm a guy, 41, not overweight, slim in fact. Broke 5th metatarsal 6 weeks ago. Spiral fracture mid shaft. 4 weeks in a cast then X-ray showed bone union had started, so no more cast, just walking with one crutch and advised to start putting weight on foot, no crutches. No shoes prescribed but I asked if my practically new Nike Air Sky Raiders would be ok. They have arch support, thick soles. I hate them but needs must. Dr said they're fine.

Now, it's a at 6 week mark, still only wearing Nikes even for work. Can put weight on foot & walk almost normally for few metres, but pain is mid sole and on top of big toe & down along that bone on top,of foot. I think this is due to muscles not used to these trainers (normally live in converse & work flat shoes) & of course trauma to whole of foot.

I'm dying to get back in to converse but what would you think of wearing Kickers boots? These are same as pair I own http://www.kickers.co.uk/p/men/mens-kick-hi-(dark-red)/111789?cm_vc=CAT_CS

Any help is greatly appreciated!

Stu
UK

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Basil,
I'm sorry for the delayed response! If you want to get Kicker men's shoes - make sure that the one you choose has a thick and rigid sole that does not bed at all as well as a wide base in the midfoot area. If you find a boot that you like that has a leather sole, take them to a Cobbler and have them add a full length shank to the bottom of the shoe so that it eliminates any motion through the entire foot area. After a 5th met fracture, it is very importatn that you do not wear any shoes that bend or flex or don't have a wde, solid base.
I hope you continue to get better!
Cathy
:)

Kelcie said...

I had surgery Friday for a lisfranc injury and fracture to 2nd, 3rd, and 4th metatarsals, they put in 2 plates and 9 screws. I still have 3 months before I need to worry about any type of shoes, I plan to get some of the RX Crocs that you recommend for around the house. However, I am wondering what you recommend for exercise? I am also in a wedding 8 weeks after I SHOULD be getting out of my walking boot and into regular shoes. What would you recommend for a dressier shoe? My doctor does plan on going in and removing the hardware but I will still have them in at the wedding. (not sure if that will affect my shoe choice for the wedding)

Thank you so much, I am soo happy I found your blog!!

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Kelsie,
I'm sorry to hear about your foot injury!

Once you are easing into regular shoes, I would highly recommend the New Balance 928 with a custom molded insert or a really good over the counter insert like Powerstep or one of the New Balance inserts that you can purchase at the store.

The wedding is tougher. Some thoughts are:
Allegria (with rearfoot control)
Wolky Sandal (Ruby, Tulip, Jewel, CLoggy)
Fit Flop shoes (with rearfoot control - NOT the flip flop).
Oops - husband put dinner on the table - gotta' go -
Best of luck and if I have more ideas for dress shoes, I will post them.
Cathy
:)

Anonymous said...

Hi there,
31 year old dancer with a Lisfranc fracture of the second and third metatarsals. Your blog has been amazingly informative for me, and I may call you soon for a NB 'script if my own Dr doesnt prescribe it. I had surgery four days ago, to install an Arthex knotless tightrope. I was curious if you had an opinion on the efficiency of this method (as opposed to screws/plates) in restoring stability and flexibility, particularly as it pertains to dancing? Also, do you have any brace/ortho insert recommendations for dance shoes (salsa high heels, burlesque platforms, ballet slips and pointes)? I always wore dr.shoals high heel inserts and custom toe cushions over the top of my foot when possible. I don't know that I will dance again, but my dr.s say I will...and so im trying to be proactive in my healing. Thank you so much for your time and response, I love your blog, and if your book is on GooglePlay Ill soon be enjoying it as well!
Respectfully,
Michelle

Donnell said...

Thank you for writing this blog. On the first of the year I rolled off what you called a "garbage" shoe and received a Jones fracture,a fifth metatarsal break. It healed without surgery after wearing the boot for 6wks with absolutely no weight bearing using only crutches and a knee walker. I have been walking in regular shoes now for 6 weeks. After reading your blog I realized I have not been wearing proper shoes(too much flex in the forefoot area by toes) and that's probably why my feet and ankle hurt and I cant seem to walk very long. I am dying to take my 2 mile walks again as I have gained weight since the injury. Do I also need to be wearing a tri-lok brace?I have a NB 927 (according to an older blog you wrote) on order. You mention 928 and 1540 in the newer blogs. Which would be best for my injury? I have a normal arch and normal to wide foot. My feet can have a tendency to roll out if my arch is too high. I tried a powerstep pro insert I got from my POD (I put in an olderpair of running shoes)but they seem like they don't give me enough cushion and make my feet sore. But how do I know if its because my foot is still healing or they area not right for me? I've always felt better in more of a padded shoe with cushion due to the years of teaching aerobics. Im now 57. Im going through my closet and finding I need to buy a lot of new shoes and the pocket book cant afford it. Im in a dress a lot so will also need a casual dress shoe. (Im checking your other blogs for shoe recommendations as well). I will definitely order a new pair of crocs rx for around the house. Thank you so much for caring enough to respond, any suggestions are much appreciated.

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Michelle,

I'm sorry to hear about your injury! I can't give you an opinion on the surgery technique withour more information but it sounds like you have an excellent doctor.

The brace I prefer is the Bioskin Trilock brace, which may be a bit bulky for some dance shoes but is worth a try. I would recommend that you get a custom-molded orthotic made specifically for the dance shoe of your preference. Your Podiatrist or Ortho Specialist should be able to make you a "sports specific" prescription orthotic for your dance shoes.

I wish you the best and thanks for the kind words!
Cathy
:)

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Donnell,

I'm really sorry to hear about your injury! I'm glad that you are on the mend.

The NB 927 is fine because it is an older version of the NB 928.

I would get the RX Crocs Relief or Ultimate Cloud for a bedroome slipper.

For a dress shoe, try the Allegria Paloma, Alli or Debra. Also, the Wolky Cloggy and for sandals, the Wolky Ruby, Tulip or Jewel.

If you are having any pain or discomfort, I would recommend the Bioskin Trilock brace, which you should be able to get from your doctor.

The Powerstep OTC insert is one of the better ones. Does your insurance cover custom-molded inserts? Your Podiatrist' office staff should be able to check coverage for you. If the powerstep is too hard, buy a thin Odoreater or Spenco (flat) to put over the insert for more cushion. My favorite OTC insert is the one we use at our office, which is Footsteps.

I hope that was helpful!
Cathy
:)

Donnell said...

Cathy, Thank you so much for your suggestions. I will definitely apply them asap. Donnell

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Donnell,
Hope everything goes well for you and thank you for reading!
Cathy
:)

Eleanor said...

Hi. I'm in a bit of a quandary. Replaced all my footwear over the past 2 years to flexible soles as have Morton's neuromas in both feet. Mainly wear Hotter and Rieker - and have been walking pain free for the past year, but had a foot injury which is probably Lisfranc - never did get a proper diagnosis, but something keeps going! 3 months later and after 6 weeks in an Aircast boot, I still can't walk outside for pain and physio seems to be making it worse. Am thinking the tri-lock brace would be good to try and have ordered some medical crocs, but my Hotter Mist walking shoes have flexible soles - rocker soles seem to cause me hip pain - any suggestions for a shoe with a rigid sole that will also not aggravate the Morton's neuromas please? I am in the Uk. Thanks!

Eleanor said...

Also - can you recommend which kind of diabetic sock please? Thanks

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Eleanor,
I'm glad to hear you ordered your RX Crocs for bedroom slippers. I would recommend the New Balance 928 or 1540 for work-out shoes. For sandals, look at the Wolky Ruby, Tulip, Jewel or Cloggy.
With a Morton's Neuroma, every time you push motion through that area, you are aggravating it so it is very important that you get shoes with a thick, rigid and non-flexible sole, wide toebox and rearfoot control.

There is no particular brand of DM socks I recommend, but you can do an internet search for options. Or you can go to a running store and get socks from them. They tend to be pricey but they are worth every cent.

Thanks for reading and I hope this is helpful!
Cathy
:)

Anonymous said...

Just wish I lived in Scottsdale, or at least had found you sooner -- this site is incredible and your information incredibly.

Is surgery the only option for a Lisfranc fracture that has been getting progressively worse for several years ? I know what caused mine -- wearing 3/4 orthotics (custom made after unsuccessful surgery for Hallux rigidus) with New Balance 926 sneakers (specifically recommended by an MD for my foot problems). I could feel the crack and now have a painful bone spur/bump on top of my foot.

Is it too late for me to follow all your advice? (I confess that I'm sitting here barefoot)

Eleanor said...

Thank you so much Cathy! I couldn't get New Balance 928 or 1540 in the Uk - we seem to have a lot less models to choose from. There are two models that are 'motion control' - one is the 956 walking shoe with roll bar, the other is the 1340 running shoe, which doesn't have a roll bar but has something else that does the same kind of thing apparently - one reviewer said this shoe was a 'good replacement for the old 851'. Couldn't get the 956 quick enough (I'm going away next week), so have ordered the 1340. Do you think this shoe will do? Link here: http://www.newbalance.co.uk/New-Balance-1340/W1340,en_GB,pd.html?dwvar_W1340_color=Silver_with_Blue&start=1&cgid=20000&prefn1=itemType&prefv1=Motion%20Control. Anyway I am sitting here with my Tri-Lock on after standing too much in the house today, and it really helps! I can't walk outside at all, it's agony, and am trying to wean myself off the aircast walker. I also think I may have an undiagnosed mid-foot injury. Have seen two Orthopaedic consultants and had x-rays and scans and told nothing broken or dislocated. So what's this bone sticking out of my foot, I ask? People prod it, and poke it and no-one seems to know,plus my foot is wider and flatter and I am told it is normal - sigh. So I'm 'doing it myself' with help from your article - thank you. But may try seeing a third Orthopaedic Consultant in case there is something needs 'putting back in place'. Should have the New Balance shoes tomorrow, but the Crocs won't get here for 3 weeks - I think they must be coming from the US. Meanwhile I'm wearing my Rohde slippers in the house - do you think they will do for now? It's those or standard Crocs at the moment. http://www.charlesclinkard.co.uk/womens-c1/slippers-c6/rohde-allison-ladies-unlined-slippers-2292-p6549.Many many thanks again for your great advice - and it all makes such sense. Best wishes.

Fleur Forsyte said...

Hi Cathy,
I am overwhelmed by all this info and I have no idea where to start. I am a dancer and I am having problems lately with scottish dance. there is a lot of skipping and pas de basque... in it. Recently I expereinced a metatarsal pain in my right foot. After an app with a podiatrist it turned out I have a fracture in one of the two small bones (cannot remember the exact name) and it is also swallen.
I have been adviced to rest to see if the fracture would heal in a month. The doctor gave me some OTC inserts, kind of rigid, called Sole (from yoursole.com) and some pads to try to fit where the pain is... very confusing!
I wonder if there is something better that I can try? I had great hopes that I would be advised more... that some miraculous shoes would be made for me so I can dance again with no problem!
So thanks a lot Cathy for taking the time to help us!
Fleur

Eleanor said...

Amazingly I now have diabetic socks, NB trainers and Wolky sandals delivered within 2 days, so I can travel next week! Get your credit cards out people. Unable to get either of the New Balance trainers in the Uk - but the 1340 I found is classed as medical/diabetic and motion control so will try them - they feel supportive with the ankle brace - but they only come in Silver! Ugh! I have never worn silver shoes in my life - can't find anything else though, so silver it is, and I will pretend it is shiny grey - and they will come in useful if I ever go to a fancy dress party as the tin man. The Wolky Jewel sandals have great soles, look nice in red, and almost kill two birds with one stone, in that they are near the height of my aircast walker so make walking a bit more even (am only wearing the walker for the travel until I get there). I'm not keen on the thinner straps - they are a bit harsh and uncomfortable, but will tolerate that for the soles. If they made the thinner straps out of the nice leather of the rest of the shoe, they'd be perfect. If anyone knows of a way of getting New Balance 928's (or 1540) in the Uk without paying $200 please tell me! (About $100 dollars is postage and import charges). And they look much nicer in white leather. Cathy's advice for the tri-lock brace and the right shoe is spot on - I actually dare walk outside now. Spent £250 on travel and £200 on shoes and socks! But it's worth it and now I can take our son to visit my parents and have some kind of half-term holiday.

Eleanor said...

Thank you Cathy. I hope I've done the right thing getting the NB 1340.

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Anonymous,

It's never to late to start good habits with your feet and to start wearing better shoes!

I hate to tell you this, but the cause of your Lisfranc's fracture probably wasn't caused by your orthotics or your NB shoes. There is probably another answer to what caused the fracture. Sounds like you already had some serious foot issues and even a foot surgery, so I would be shocked if the NB 926 and CMO's are the cause of the fracture. I think your doctor actually did give you good advice with the shoes and the inserts.

First step to feeling better is to forget the whole barefoot thing. Check out my article MY FEET HURT: TOP 10 THINGS TO DO TO ALLEVIATE FOOT PAIN. Do not jump into Lisfranc's surgery - that should be your last option. Also, check out my article THINKING ABOUT FOOT SURGERY? TEN THINGS TO CONSIDER BEFORE YOU HAVE FOOT SURGERY.

Sorry for the delay in response, I've been out of town. I hope that when you make the changes with foot habits and better shoes that your foot pain resolves and you don't need surgery!
Cathy
:)

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Eleanor,
Sorry for the delay in response - I've been out of the country. I haven't every actually seen the NB 1340 in person, so it's hard for me to figure out how good it is. Does it bend or flex at all? If it does - it's not good enough for you. I also have never seen the Rohde slippers in person! Sorry I can't give you better information on these shoes!
Cathy
:)

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Fleur Forsyte,
Sorry for the delayed response!
If you have broken bones (probably the sesamoids from what you are describing) then you need to be in a below-the-knee CAM walking boot for at least 6 weeks. Elevating, resting and, after you are healed, you need to wear protective, rigid soled shoes. Scottish dancing is beautiful, but very rough on the sesamoids. Sorry there are no easy answers! If you have a fracture - get immobized with CAM so that your foot can heal. If it is truly a fracture, anything less than immobilzation, rest and elevation can result in a delayed healing and chronic pain and swelling. Please follow up with your doctor for treatment and monitoring of the fracture.
Best of luck!
Cathy
:)

Eleanor said...

Just an update - hope this helps anyone else starting to walk again. NB1340s were too bendy at the toe so they went back. Emailed New Balance who said they can't get me the 928 in the Uk. Rohde slippers no good on hard floors. Wolky jewel sandals brilliant - wearing them indoors until the Crocs arrive. Tri lock brace brilliant - especially at the end of the day when pain is worse. Physio wants me to start walking outside without the aircast walker now. 15 minutes (Wolky sandals and tri-lock brace) and I was in a lot of pain for the rest of the day. So rested this morning. Tried some Clarks Wave Walk shoes with rocker soles - great shoes but not enough cushioning in the sole. Today I have just walked by the river for 15 minutes trying my old Brasher Hillmaster walking boots - they seem good! Very thick rubber soles and very supportive. Downside is physio is telling me to walk around barefoot and do tip toe stretching exercises - both of which made it worse last time, but going back to see Specialist next week. I will insist on a diagnosis! Been given a wobble board to use, which I am doing carefully - mainly to stretch back of legs.

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Eleanor,
Sorry to hear the NB 1340 didn't work. I recommend not walking barefoot, which will only aggravate the situation, cause more pain and swelling, slow healing and increase your risk for worsening the condition as well as cause more damage.
Glad to hear that you are finding shoes and bracing that is working for you!
Cathy
:)

Cookie said...

I twisted my foot walking to work three weeks ago. I didn't notice the discomfort until the following day. Slight swelling and uncomfortable walking barefoot. I did the "RICE" treatment and just as things were getting back to normal I twisted it again. I'm doing the "RICE" again, but I think I should get it checked out. The symptoms are the same as the first time I twisted it. Your advice would be appreciated.

Yours truly,

Twisted Twice

Stacey Burton said...

What if you have a lis franc injury thata left u with a fat foot. Ive been in Abeo brand sandles and gym shoes but can't figure out what else is going to get past the hump.

Eleanor said...

I decided not to walk barefoot anyway because it hurts. Saw specialist again and he did an MRI. Should have the results in a few days. I've been managing quite well with my Brasher boots and been able to walk outside for short distances. And then our six year-old trod on my foot - aargh! What is it with six year old boys. Set it all off again.

Eleanor said...

Specialist said 'working through the pain' is only the next stage if the MRI is clear. He also suggested rigid soled shoes so looks like you are way ahead of the game with the right advice Cathy - thanks.

Eleanor said...

Had my second MRI and apart from some arthritis in my big toe and tendinopathy at the right ankle, specialist says my MRI shows nothing. As neither my big toe nor my right ankle bother me this doesn't help and I am still left wondering why I have such severe pain on walking on the left underside of my foot, 5 months after a foot injury. It is not nice not getting a diagnosis and being told there is nothing wrong with it! Anyway I will continue to follow the regime for the Lisfranc injury as it seems to work. Thanks Cathy

Eleanor said...

Back to square one! Apparently it is a tendon injury with tendinopathy - my posterior tibialis tendon - so explains pain and protrusion on left side of mid foot and underneath. Consultant agreed that working through the pain wasn't a good idea - common sense really. Wrote me a new referral for physio saying they could adjust the exercises to allow for the tendon and big toe things. Had physio on Thursday and I am so angry! Not going back. Words like bovine spring to mind. I am taken to the gym and told to walk up and down stretching from my heel right up onto my toes (the thing that caused the setback last time). This causes a lot of pain - I tell her - she tells me to keep doing it and has me walking up and down like this like a Sergeant Major, pushing me to do more and harder.

Anyway - can't walk again now - severe pain and swelling have had to get back on bed with leg up the last two days - and back to my tri-lock brace. Have emailed Consultant to say physio was too strenuous and should I go back to see him.

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Cookie,
Sorry for the delayed response. I would recommend that you follow up with your Pod to get x-rays to make sure that you don't have a stress fracture. Also, make sure you are in proper shoes because wearing shoes that are too flexible or don't meet the criteria for what makes a good shoe can make you vulnerable to more sprians.
Hope that helps!
Cathy
:)

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Stacey,
Sorry for the delayed response! Sorry to hear you have a 'hump' after the Lisfranc's injury. I assume that you're talking about on the top of your foot? If that is the case, then with sneakers, you can 'skip a lace' over the hump and that will help decrease pressue. Another option is to take your shoes to a Cobbler and have him or her stretch your shoe over the area of the hump, which also helps decreased pressue on that area. Yet another option is to line the inside of the shoe with 'off-loading' moleskin, which can be tricky and should be done by a Cobbler. The point of off-loading the hump is to build up cushioning with moleskin AROUND the hump - not on it. A common mistake is adding moleskin over the area of the hump/pain, which only increases the pressure and causes more pain.
I hope that was helpful!
Cathy
:)

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Eleanor,

So sorry to hear about the setbacks! How frustrating for you!!

Hang in there though. No matter what is going on, proper shoes, inserts, rest, elevation, arch support and possibly bracing should help you get back to where you were. If ANYBODY tells you it is a good idea for you to be barefoot, stick to your guns and don't do it. You have what I call 'biomechanically challenged' feet, which means that unless you are in proper shoes and inserts - you are prone to foot issues, re-injury and pain. The good news is, you improved previously and you can do it again.

Continue follow up with your doctor if you are having more pain to make sure there are no new issues.

I wish you the best of luck!
Cathy
:)

Eleanor said...

Thank you Cathy, it was really starting to get me down as still unable to walk on it after a week even with the foot brace and my walking boots - 10 minutes had me calling for a taxi. Just had to pull out of the annual Shakespeare play. I bit the bullet last week and ordered the New Balance 928's from Amazon in the US and they have just arrived. Cost an extra £50 but when the Consultant mentioned orthotics I remembered these. They feel great. They are very slightly too big, but I am pretty sure the next size down would be too small. Just a millimetre or two at the heel. I am wondering if there is something I can put in to help the fit. Only slight issue so far is that because the sole is quite stiff my arthritic big toe seems to be working a bit harder, but I think that is tolerable. Won't try walking outside in them for a couple of days until yesterday's excursion has settled down. Definitely not going back to the same physio. Many thanks for your advice and support. The irony is I was walking perfectly well (with cushioning for the neuromas) with no problem at all before this injury.

Anonymous said...

I've been out of town, too, and thank you SO much for your reply. Do you mind if I ask you some more questions? I didn't give all the details before, but my prior surgery was actually on the other foot, for hallux rigidus. The podiatrist was conservative and just cleaned out bone spurs etc. but the joint immediately started to tighten up again. Even after vigorous PT, it never regained flexibility and now 5+ years later I basically have a frozen big toe on my right foot and can't wear any shoes that put any pressure on my toe joint or require it to flex.
The Lisfranc injury (if that is what it is) is on the OTHER foot. After my unsuccessful chilectomy, the podiatrist made orthotics for both feet but when I tried them in the New Balance 926s, I felt the joint below my middle toe crack. After several tries, I stopped using the orthotics (and wearing the New Balance shoes) and began looking for shoes that don't hurt my feet. I have found a few (MBTs, one kind of Alegria, one kind of Earth shoe, and a "Klog," although I worry whether it is a good idea) but most aren't made anymore so they aren't a permanent solution. For dress, I wear flats (which let me kind of shuffle!!). However, the fracture has gotten more and more painful and I now have a visible bump on top of my foot, which seems to be getting bigger.

As soon as I read your blog I ordered 2 pairs of Crocs Relief. (The extra is for gardening outside -- does that sound OK to you?) They are more comfortable than going barefoot but I have now been using them for several weeks and am still getting pain when walking outside.

I read your warnings about foot surgery (agree with everything), and have been following the recommendations in Ten Ways to Relieve Foot Pain. (Except for the orthotic -- I tried one from the Walking Co but wasn't comfortable with it.) I also have consulted a number of podiatrists and MDs over the years, but so far haven't found one I feel comfortable with.

I am worried about having anything done surgically, since my past experience wasn't successful and I know it takes a long time to recover. But I am
SO frustrated because I have always been active and walking is my main exercise; I give walking tours and actually am thinking of moving to an area where I can walk more and drive less. But I can't do that if I can't walk for any length of time without pain.

I feel too young to be having this problem! (Relatively -- 59!) The pain isn't excruciating but it keeps getting worse, so I wonder having surgery will at least stop its progression.

Do you have any other ideas for me? Do you ever do phone consultations? Perhaps you know someone in my area to recommend.

Thank you again. Your blog and your conversations with readers provide an amazing service.

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hello,
I would be happy to schedule a phone consultation (please ask for Callie and tell her we need 30 minuteseither right after lunch 480 563 5115). I would need you to fill out our medical history paperwork and I would like to be sent a copy of the actual x-rays of your foot and any MRI reports (don't need the actual film on the MRI - just the report).

Don't do landscaping or gardening in your Crocs. You need to wear a rigid soled boot or NB 928 for gardening. Reading your letter, I'm hearing a couple of things -- ballet slippers and barefoot. If you are ever barefoot or in a shoe that bends through the 1st toe joint or the Lisfranc's, you are doing damage and increasing wear and tear. You simply can't do it.

The surgical solution for what you are talking about is to fuse the joint. You can either fuse a joint surgically OR you can 'fuse' the joint by wearing a shoe that never allows you to put motion through that joint. They are both doing the same thing - one with surgery and one with shoes. If the shoe doesn't work, you can take it off. If the surgery doesn't work, you are stuck. Whether you have surgery or not, you have to do the right thing with shoes (no cheating with ballet slippers, ect - or you are only setting yourself backwards!).

You are only 59, which means you are YOUNG! There is plenty of hope!!

Do you ever skip entire days of brushing your teeth? No, because if you don't brush your teeth they are going to eventually rot. So, don't skip a moment of wearing good shoes. If you are not constantly wearing correct shoes and taking care of your feet, they are going to break down. It's a lot easier to get a set of new fake teeth then it is to get new set of feet!

Hope all is well!
Cathy
:)

Alex said...

Hi Cathy
Thankyou for your help. I fractured distal shaft 5th metatarsal 5 weeks ago. Had tubigrip and was told to begin to bear after 2 weeks - bought a hard sole shoe and used crutches to make a start partial weight bearing. No healing on x ray at 5 weeks - but fracture is stable and clinical healing - am to start weaning off crutches and may begin driving when ready. But wot shoes to get? Am planning to go back to work in 2 weeks. What about Rx crocs or motion control shoes i.e trainers for flat footedness. Thankyou for providing this resource - most helpful.

Eleanor said...

Well - I am not much further on. My New Balance 928s with the trilock brace have been a godsend - they are light and comfortable and enabled me to walk a bit again, but only for about 15 minutes then I get pain and start limping. Foot isn't getting better after the 'strenuous' physiotherapy. Been back to Consultant again and am now totally confused. The pain and swelling I have is the outside of foot (he confirmed it is a tendon) but the tendinopathy on the scan is on the inside (posterior tibialis) and that doesn't bother me in the slightest - probably from my old ankle injury of many years ago. Consultant said MRI had not shown nothing on the left side (although the MRI was before I got 'injured' again by the strenuous physio). I am concerned the left side tendon has torn - due to the amount of pain after 3 weeks (10 days foot up) and burning feeling - he said he doesn't think so. He said he had no problem with the idea of me 'starting from scratch' and going back in the aircast for a bit, but doesn't seem interested and has more or less discharged me. Excuse me! I can't walk! I tried the aircast walker again one afternoon and it's the only way I can walk without pain,so may have to go back into it for a while. But would still like to know if the tendon has torn or not, because as I understand it, if it has, it won't get better and will need an op and don't want to keep waiting for it to improve if it isn't going to. Plus I'd like to know because if it has torn I will be sueing the physio! So really I am back to square one - the pain has always been on the outside and underneath of foot and feels like tearing - yet I keep being told there is nothing on the MRI in that area. I might have to go to GP and ask him to refer me for another scan - although he'll probably say no. So I wondered Cathy, if a tendon has torn, can you get right just with footwear as for other foot injuries?

Meg said...

Hi Cathy,

Thank you for all the wonderful advice in your blog. After almost ten weeks, I'm recovering from a fifth metatarsal break (Jones) and the doc has cleared me to ditch my walking boot and start wearing normal shoes again.
Not sure what sort of hard soled shoes I should be getting. At this point, I'm still walking with a limp as I still feel pain and stiffness when I try to flex my foot. There is pain on the balls of my foot, close to where my little toe is. Would a cushy Skechers shoe with foam work or would that impede my recovery? Any advice would be greatly appreciated...thank you!

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Alex,
I'm sorry for my delayed response! And I'm sorry to hear about your fracture. What kind of work do you do? It helps me make better recommendations for work - do you need a boot or a dress shoe?

If you work in a boot, I would recommend a boot with a full length steel shank and, of course, a thick rigid sole. If you wear a dress shoe, look for a Dansko, which usually have a thick, rigid sole with no motion. ANother option is to get a New Balance 928 in black leather or brown and get a RX from your doctor stating it is medically necessary that you wear the NB at work for 2-4 months.

My husband's 'go-to' shoe is a Dansko Wayne with a custom-molded orthotic in it. I have noticed that the Dansko Wayne does have a little bend in the front and weakens over time so I have to replace it every 6-8 months.

Also, look into getting a Bioskin tri-lock brace to wear as you ease into normal shoes. Most Pods carry excellent bracing so check with your doctor as insurances often pay for bracing.
Hope that was helpful!

Cathy
:)

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Eleanore,
I'm sorry for my delayed response!

Yes, even with a partially torn tendon, you can get better with conservative treatment. I treat this type of situation all the time with great success. You can be having pain in an area that shows nothing on MRI because of a variety of reasons, including the fact that you may be compensating, limping and creating mechanical strain in areas that show no pathology on the MRI.

You have to be 100% compliant with the RX Crocs as bedroom slippers, New Balance 928 or 1540 with a Bioskin Tri-Lock brace and, if the pain is above a 4/10, bump up to wearing the below the knee walking boot until the pain improves. Also, elevating and resting is crucial to facilitate healing.

I'm sorry that you're going through so much frustration with your foot pain! Hang in there - foot injuries, even when treated correctly, can result in low grade chronic pain and swelling for up to 1-2 years AND, if you wear poor shoegear and are non-compliant (which I know you are not) it can result in re-injury.

Take care!
Cathy
:)

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Meg,
Thank you for reading the blog! So sorry for the delayed response and I'm sorry to hear that you had the Jone's fracture.

Here are my recommendations:
* RX Crocs in the house as a bedroom slipper (with the strap to the back).
*New Balance 928 or 1540 with a Bioskin Tri-Lock brace as much as possible for 4-8 weeks after you get out of the walking boot. Wear the brace with the NB for all exercise or increased activity for up to one year.
*Sandals: the Wolky Tulip, Jewel, Ruby or Cloggy. You can also wear the tri-lcok brace with this.
*Dress shoes: Anything with a thick, rigid sole that has absolutely no flex or bend, has a wide base, wide toebox and midfoot and rearfoot control.

As far as Sketchers go - make sure it has a thick, rigid non-flexible sole. Add arch support if possible. Make sure it has a wide toebox and rearfoot control. If you wear any shoe that bends of flexes - you are going to increase pain, swelling, mechanical strain and slow healing.

Hope that was helpful!
Cathy
:)

Jackie Saez said...

I’m sooo glad that I found your blog!!!!
I have not had any fractures or injuries as bad as the ones mentioned above, thank God! I have a torn brevis tendon on my right foot from a slip and fall injury and being overweight did not help at all. I am currently wearing a boot that I have to learn to get along with for the next 6 months. I was shocked to know that, but glad that surgery was not necessary. However, the swelling and the pain is not subsiding and not only that...my left foot is almost as swollen as the injured foot and it hurts much more!! I’m going to have my pod check it out in case I have injured the other foot as well. Hope not. My back and hip are also hurting from the limping and walking. I work in an office so I really dont have to walk much, that is why it is weird to me that the left foot is getting so swollen. I wanted to ask you if there are any shoes that you could recommend for the uninjured foot to balance out the boot on the injured right foot. Something casual for the office and with the holidays not too far away I cannot even imagine what I’m going to wear! But at this point, all I care about is comfort and a speedy recovery.
Thank GOD for your blog!! Very Helpful!!!
Blessings,
Jackie

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Jackie,

Thank you for reading the blog and thank you for all the kind words!

I don't know the specifics of your case, but I'm a little confused as to why you have to be in a boot for six months. A tendon usually takes from 6 weeks to maybe 2-3 months to heal, but - did you mean to say six weeks?

I would highly recommend that you make an appointment with a Pod for x-rays and evaluation of your other foot. In the meantime, RX Crocs Ultimate Cloud as a bedroom slipper and New Balance 928 or 1540 as a shoe. Either custom-molded orthotics or at least a good over-the-counter insert like Powerstep for inside of the New Balance shoes.

Did you talk to your doctor about Physical Therapy to speed up healing? Also ask about tri-lock bracing and do some research on Epi-Fix injections, which also help speed up healing on soft tissue such as tendons.

Hope all is well and best of wishes!
Cathy
:)

Sue Lewis said...

This looks like a really useful site! I injured my foot on 1 August while running. I was wearing Nike running shoes (fitted professionally) but caught my foot on a stick, rolled the foot over outwards, and ended up with a comminuted fracture of the cuboid, damage into the calcaneal (?) joint, plus an avulsion fracture of the navicular. After 6 weeks non-weight bearing I have done one week walking with my big black boot, and have another three weeks to go.
I was training for my first marathon at the time, and I have a charity place to run the London marathon in April 2015. I realise that there may well be issues for me to reach that objective now, but i am very keen to do everything i can towards making it still a possibility.
Do you have any advice specific to this situation, including what I should or should not do / wear when i return to starting some running, which I hope might happen sometime in November.
All advice would be very gratefully received!!!
Sue

Zeeq Zaq said...

This is a great posting - very helpful!

Three 3 months post surgery, and 7 fancy new Lisfranc screws, I'm hunting for shoes (casual/sneakers), at the moment and I am using your rules as guidelines. My problem is that New-Balanace has just never really fit my size 13 wide feet. I like the 1540, but they are just too narrow in the toe box, even the 6E, or there is some seam that irritates some of the toes.

Thus, I started looking elsewhere, and it is really hard to find something. My size requires online orders mostly, which makes it tricky to just try shoes. I've tried NewBalance 1540, 847, and 928. Aldo, Brooks Beast/Addiction, Saucony Stabil, Asics Fortitude 3, and Asics Foundation.It seems my Asics Fortitude is my best fit, but is that a good option?

My injured foot is still a really tight, around the toe box and they don't make wider, but hopefully swelling will reduce soon.

Oh, and how much should it still reduce in width ??

Are Asics Fortitude okay?

How tight can my toe-box be?

Alternatively, are there other shoes anyone knows of that might work for me? Are there any hiking shoes that might work for everyday shoes, perhaps ?


Sorry, lots of questions, but you are a great resource.

Thanks so much!

Anonymous said...

Hi just broke my 5th metatarsal (avulsion fracture) 2 weeks ago. I am in a CAM walker boot for 6 weeks. I am non weight bearing for 2 weeks then begin walking in boot for 4 weeks. Need to know what kind of shoe for work after. Feeling some discomfort but very little (non weight bearing) at this point. What is your suggestion.

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Anonymous,

Sorry to hear that you got the Jone's fracture! RX Crocs in the house as bedroom slippers, New Balance 928 with a trilock brace when you get out of the CAM for 2 to 4 weeks.

As far as work shoe recommendations - Are you male or female and what type of work?

Thanks for reading!
Cathy
:)

jenny e said...

Hi.
I am recovering from a midfoot fracture. Split cuboid in half, repaired ORIF 12 SCREWS and plate, navicular fracture and cuneiform fracture. They had to manipulate my arch joint back into place. 12 weeks NWB now into PWB in boot. No direction from Ortho as to what type of shoe once boot comes off. I did this mess in wedge shoes! HElp!!

Thanks, jenny

Anonymous said...

Hi Cathy,

Do you have any opinion on shoes if the New Balance options don't fit my wide foot?

Thanks

Anonymous said...

Hi Cathy,

Do you have any opinions on sneakers when the "New Balance" options don't fit my wide foot ?

Thanks

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Jenny E,
Sorry to hear you had such a horrible foot injury!

The basics are:
1. RX Crocs with the strap to the back as a bedroom slipper.
2. New Balance 928 with a trilock brace as you ease back into activites.
3. A custom-molded orthotic or Footstep or Powersteps OTC inserts.

You will be limited to these for at least 1-3 months after you get out of the CAM.

For more info, see my article on this blog: My feet hurt: top ten things to do to alleviate foot pain.

As I am not your sugeon, please check with your Ortho and get approval on this plan!

Good luck!
Cathy
:)

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Anonymous,
Did you specifically try the NB 928 and the 1540? They should fit your wide foot and I would recommend that you go to a NB store to get a proper and professional fit.
If that doesn't work, let me know,
Cathy
:)

jenny e said...

Thanks so much for your response!! Have you any experience with Aebo walking shoes?

Thanks!!

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Jenny,
Do you mean Abeo? If so, some are good and some are bad. Find the Abeo shoe that has a thick, rigid and non-flexible sole with a wide base and rearfoot control. That should be the best one. If you can bend or flex the shoe - don't bother purchasing it. Look for one that meets the criteria!
Have a great day,
Cathy
:)

kmh76 said...

My husband fractured his calcaneus 10 months ago and is now walking with a cane. What type sneaker or boot would you recommend

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi KMH76,
I'm sorry to hear that your husband had this horrible injury! I would highly recommend that he make an appointment with his podiatrist to have a further discussion on shoegear, but the basics are:

RX Crocs Ultimate Cloud with the strap to the back as a bedroom slipper.

New Balance 928 or 1540 with custom-molded orthotics. He may need to wear a Bioskin tri-lock brace with the shoe - or he may (depending on the severity and his insurance coverage) need and be eligible for a custom-molded AFO (ankle foot orthosis, i.e. csutom molded brace). Other options are the Z-Coil shoe, which helps with shock absorption.

Possibly a lace up boot for more biomechanical control, but it is crucial that the sole be thick and rigid with as little flexibility as possible.

I'm assuming that when he sustained the calcaneal fracture that his doctor also got a lower back x-ray. Studies show that calcaneal fractures have a high corrolation to spinal stress fracture that often go undiagnosed. If he is having any back pain and has not had lower back x-rays - I would recommend that you request them from your PCP.

Hope all is well and good luck!

Cathy
:)

Anonymous said...

Wow so happy I stumbled across your site! I've learned so much from you and it seems as though my doctor doesn't have a clue about the right type of shoes. I heard a pop one night in my R foot and couldn't walk on it. MRI results showed peroneus longus tendinosis with partial tear at the level of cuboid and mild marrow edem in the cuboid which may be stress related. I was in the boot for 8 weeks. I'm walking with Xsensible Stretch Walkers, thick rugged sole. I believe I should get the New Balance 928? RX Crox for out of the shower and is there any type of sandle that I could wear? Thanks for your help, Caroline

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Caroline,
Sorry for the delay on answering your questions!
I have not seen the Xsensible Stretch Walker in person, so my recommendation is that if the sole bends or flexes at all then you should try on the NB 928. I looked up the Xsensible shoe and it looks like it has a good sole, but I know that looks can be deceiving. Glad to head you got the RX Crocs!

For sandals, I would recommend one of these four Wolky's -- Jewel, Cloggy, Tulip or Ruby. You could also use a Birkenstock sandal that has a strap in the back. In my opinion, there is nothing better that these four Wolky sandals.

Thank you for reading the blog!
If you have any limpers in your life I would love it if you can share the blog with them,
Cathy
:)

Eleanor said...

Hi Cathy - all your advice has been spot on. I am still not walking much due to the odd setback, but if it's acute (like when someone has just trodden on your foot!) I go back to elevation - 2 weeks seems to do it, then the aircast for a few days then the trilock and nb 928's. The Wolky sandal is the perfect match for the aircast boot heightwise, although it's a bit wet for those at the moment so looking for an alternative. And I wear the rx crocs around the house. I am so glad I can walk in something. When this latest setback has settled down I hope to get back to being able to walk for 30 minutes a day with the tri-lock and nb928's which is where I was at before. I'm looking to get a pair of the Alegria Paloma so I don't get cold toes with smarter shoes, or to have something to wear on other foot with the aircast.
The only problem I have now is can't get hold of Wolky Cloggy or NB928's now (I wanted to get the black 928's now the weather is wintry) - I got them sent to the Uk from the US via Amazon before but they have stopped shipping to the Uk now, so if you know of a stockist that ships to the uk I would be very grateful.

Eleanor said...

Also what do you think of the Alegria Alli please? The sole looks the same as the Paloma but it is more of an ankle boot than a shoe which I thought would be better for winter - it's described as a Loafer

Treeguy said...

I have a broken sesamoid on left foot. I have been in the hard surgical shoe for two months, still have some swelling, some pain but not terrible but then I only walk around the house pretty much. I have a newer pair of NB 990's in the wide but not sure if those will work for me or not. Any suggestions or thoughts for me? Thanks George

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Eleanor,
Sorry for the delayed response! My husband and I were on our annual vacation and have been out of the country. I like the Alegria Ali. Just make sure that the sole has as little bend and flex as possible. I'm glad to hear that your foot issues seemed to have stabilized!
Happy Holidays and thank you for reading the blog!!
Cathy
:)

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Treeguy,
I'm sorry to hear that you've had a sesamoid injury. It's one of the more frustrating foot injuries as the sesamoid bones are in a high pressure area and they are located within the flexor tendon, which means it has a less than optimal blood supply and therefore can be a slow healer.

Suggestions:

*I believe that the surgical shoe is not as good as a blelow the knee walking boot (CAM walker) for healing the sesamoid bones because if you don't stop the motion of the ankle then the flexor tendon is constantly moving and the sesamoid bones are located within the tendon - so it continues to aggravate the sesamoids and slow healing. Talk to your Pod and perhaps consider bumping up to a CAM walker. To stop motion through the fractured sesamoid bones - you must stop motion at the ankle because the tendon starts below the knee, comes down and wraps around the inside of the ankle bone and ends just under the distal tip of the big toe.

*After six weeks in a surgical shoe - if it has not healed - then you may want to talk to you Pod about a Bone Growth Stimulator, which is often covered by insurance and significantly speeds up the healing rate.

*RX Crocs Ultimate Cloud as bedroom slipper - after it heals so you can continue to protect the sesamoid bones.

*New Balance 928 with a custom molded orthotic or a good OTC insert like Powerstep -- with off-loading of the sesamoid area (which a Pod can do).

*Elevate and rest!

*Maybe go non-weightbearing with a "Roll-About" for a couple of weeks while you are in the CAM walker to significantly speed the healing rate.

Sorry for the delayed response! Just got from vacation and am just now catching up on the blog. Thank you for reading the blog and I hope all goes well!

Cathy
:)