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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

:)




279 comments:

1 – 200 of 279   Newer›   Newest»
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

Unknown 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
:)

Unknown 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
:)

Unknown 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
:)

margiesblg 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?

margiesblg said...
This comment has been removed by the author.
margiesblg 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.

Unknown 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
:)

Anonymous 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

Unknown 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
:)

Unknown 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
:)

Unknown 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

Unknown 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

George Farmer 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
:)

Unknown said...

Great post, broke my. Rt 5 metatarsal 11 week's ago my doc just advice on a rigid sole shoe for walking and exercise, bought new balance 1540 I have flat feet too,should I had bought the 928? Still tender and a bit of pain when I walk, also carry my 22 lb baby around the house, dress shoe what do u recommend?? Thks yessy

Unknown said...

My friend had a foot injury not too long ago. I wonder if she knew that she shouldn't be walking around in bare feet. I don't think she owns any Crocs or anything like that for around the house. I should talk to her about it. When it comes to your feet, you have to be careful. http://thefootandanklecarecenter.com/

Anonymous said...

Hi,
My 12 year old daughter broke her sesamoid bone 12 weeks ago. She is finally out of a boot and looking for the best shoe to wear with orthotic. A sneaker would be best since she is 12 and won't wear clogs... One PT recommended Brooks running shoes. Are New Balance better? what would you recommend? Thank you!!

Elli Savery said...

Hi doctor! Thanks for all this helpful information. I have seronegative rheumatoid arthritis, and just got MRI results: a 2nd metatarsal head stress fracture and bone damage in my MTP joint area. Can I recover in New Balance roller-bar shoes? Or do I need to recover in the boot? I tried bending a pair of New Balance 626s and they do, in fact bend. Wear them? Or are they garbage? Thanks!

Unknown said...

I have been wanting to find my Mom a good pair of shoes to help her recover from foot surgery. She always buys the cheapest shoes with no support. It seems like a shoe with good arch support would really help her. Hopefully, I can convince her to try a different type of shoe. http://www.manhattanpodiatry.com

Zachary said...

Hello everyone. I'm doing pretty well with recovery, and had my hardware removed about a month ago.
My motion-control Asics shoes that shoes I bought after the cast is looking pretty bad.

Options are limit for my shoe fit, so
... do I need to keep on buying motion control shoes forever ? Just something with good arch support?

My physical therapist says Prostep orthotics for life is a good idea.

Do you Agree?

Much thanks for all your advice.


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

Hi Zachary,
I would highly recommend that you continue with motion control shoes for the rest of your life. Since you've already had foot surgery, I recommend that you invest in a pair of cusom-molded orthotics from your podiatrist or at least an excellent pair of over-the-counter inserts such as Footsteps or Powerstep.
THe best walking shoe is still the New Balance 928 for motion control or the Brooks Beast, which is a motion control running shoe. I like both of these better than the Asics motion control shoes.
Good luck and thank you for reading!
Cathy
:)

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

Hi Rachel,
You sound like a wonderful daughter! Get your mom the RX Crocs Ultimate Cloud or Relief as a bedroom slipper and take her to a New Balance store and have her try on the NB 928. She might not like how they look, but tell her they are her exercise 'go to' shoe while she recovers from her foot surgery. Once she has recovered, she will love the NB 928 and not want to get into any other shoe because she will have gotten used to having less foot pain.
Good luck and thank you for reading!
Cathy
:)

Zachary said...

Thanks doctor. I just wish the NB or Brooks had a better fit.

I ordered a few sizes and widths 4 months ago, I have to bump up a whole shoe-size to get the width.

Perhaps my standards have changed, so
I'll try them again.

Much thanks,
Zachary

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

Hi Nora.
Thanks for your great comments! I'm sorry for the delayed response - I've been a bit under the weather. I agree that when it comes to feet that you can't be too careful!
Thanks for reading!
Cathy
:)

Unknown said...

I broke my 2nd metatarsal bone and did not recall doing it. Just thought I had a sprain. I must have done it getting up off the floor while playing with the cats. By the time it was x-rayed and diagnosed, it was 10 days after the break. My 2nd toe is now shorter. I have been in a boot for 6 weeks and still need few more weeks. With osteopenia, the podiatrist did not want to operate to pin the bones together correctly; said they might turn to mush. I am worried that I will have pain and/or arthritis the rest of my life. I am headed out today to buy some Crocs RX (hate how they look). I have narrow foot with the 2nd and 3rd toes longer than all others so shoes have been difficult fit all my life. Thanks for your advice.

Anonymous said...

Fracture 5th metatarsal.Would you recommend wearing a good sneaker that is my regular size 7 or alittle larger 7 1/2 ???

debbie said...

Thank you SO much for the info here! I have been diagnosed with a plantar plate tear. Any suggestions for shoes (especially summer ones!) or will they be the same for the ones you recommended in the above posts? Thanks again!! Debbie :)

Zachary said...

I have some helpful information to add to this blog entry.

I found out the Brooks will sell you 2 shoes of different sizes. My "new" foot is larger than it used to be so I actually ordered one size 13 and one size 12. I have the Brooks Addiction walking shoe and Brooks Beast running shoe. Awesome shoes.


** VERY IMPORTANT NOTE: **

Do NOT order from their website, but go to a "specialty running store" ...like a running shoe store. Then ask the store to make the order for you. My store charged me $20 extra for the service ... but actually gave me all 4 shoes.


Hope that helps someone. Just some info since this website has a very high google rating. Just make sure to read the IMPORTANT note from me.

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

Hi Mary,
Sorry to hear about your injury. I hope the RX Crocs are working for you and remember to make the NB 928 your 'go to' exercise shoe. Talk to your podaitrist about custom-molded orthotics and, if your insurance doesn't cover them, you can always cash pay or get a good over-the-counter insert like Footsteps or Powerstep.
Thanks for reading!
Cathy
:)

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

Hi Anonymous,
When it comes to sizing - go shopping after 2pm when your foot is a little more swollen and ask the salespeople to measure your foot with socks on. Try on the correct size and if it feels tight or is not comfortable - go up one-half size. I would rather see you in a shoe that is a little to large than a shoe that is too tight. Remember that after a foot injury, you can have low-grade chronic swelling for up to two years.
Thanks for reading!
Cathy
:)

Unknown said...

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shoe inserts for height

Anonymous said...

Doctor McCarthy,
Thank you for the amazing resource of your blog. I have a delayed union, comminuted, inter-articular fracture of the proximal phalanx of my big toe, a grade three sprain of the first MTP joint, and a lot of swelling--even three months in. I'm dreaming of walking in shoes, even the most sensible of shoes, again (I'm still in an air cast with crutches). I've ordered the NB 928s and am happy to have them on hand as a transition shoe. Unfortunately, the Crocs Rx clogs, although roomy in the toe box, are too tight across the top of my foot (even my good foot). Do you have an alternate suggestion for house shoes/slippers for someone with very high arches? Would Teva sandals with their adjustable velcro straps provide enough support?
I welcome your suggestions.

Sand

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

Hi Sand,
Sorry to hear you had such a bad injury! For a bedroom slipper, you could try a Birkenstock sandal - just make sure it has a strap in the back. Even though it doesn't have a rear-foot strap, another option is the Vionix Orthoheel slipper that is approved for diabetics by the APMA. I usually recommend this for anyone who is elderly or has lots of swelling. Also, you can ask your podiatrist for two surgical shoes, which will work as bedroom slippers until your swelling comes down and you can fit into the Rx Crocs.
Thanks for reading!
Cathy
:)

mamadanz said...

oh my gosh. this blog is awesome. free foot advice that actually works and is detailed! I LOVE YOU! (just sprained my foot. How you ask? I got old and fat and walked! jk. i walked on an uneven lawn and ouch. ( after 6 weeks of boot torture I'm looking for a shoe to avoid this from happening again and will never take my feet and walking for granted as long as i live!). you're a lifesaver doc! thank you.

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

Dear Mamadanz,
Thank you for all your kind words! I'm glad to hear you're getting better and getting back to activites. Your new best friends are the Rx Crocs Ultimate Cloud and New Balance 928. Of course, check with your podiatrist...
Thank you for reading!
Cathy
:)

Pickle said...

Hi, I wonder if you can help me. I am in the UK, so not sure if the shoe availability is as good here. I had a traumatic lisfranc injury to my left foot a year ago while pregnant. Most of the bones in my foot were broken, the cuboid was completely crushed. It was internally fixed, with the fixings removed 6 months ago.
I have been left with altered sensation along the outside edge of my foot which results in severe burning with pressure on it. My foot is also extremely wide at the toes (4e at least), and has some extra depth as my toes are misshapen and crossed.
So, are there any shoes out there for me?! I have tried Asics wide but the pressure on the side of my foot is unbearable. I am stuck between the pressure pain, and the need for support.

Anonymous said...

Hello Dr McCarthy,

Thank you for the detailed guidelines on Lisfranc injuries. I am a 35 yr old male patient met with a Car accident in January. Car crashed into a concrete pillar of an overpass bridge.
Right midfoot fracture/dislocation of first through fifth tarsometatarsal joints. Third metatarsal neck fracture.

Surgical Fixation done as below:
Open reduction and internal fixation of the first tarsometatarsal joint using a 2.7 mm plate and 2.7 mm screws (5).
Open reduction and internal fixation of second tarsometatarsal joint usinq a 3.5 mm screw.
Open reduction and internal fixation of third tarsometatarsal joint using a 3.5 mm screw.
Closed reduction and percutaneous pinning of fourth and fifth metatarsals using a 0.62 K-wire.
Open reduction and pin fixation of the third metatarsal neck fracture.

I was nonweightbearing on the right foot for 12 weeks since Feb. The pins were removed after 6 weeks but the plates and 7 screws still remain. And my doc told the hardware will remain unless there are problems with the hardware. I am allowed full weightbearing but in the aircast and will be transitioning to shoes next week. The doc advised shoe that doesnt flex. I checked multiple shoes in stores that have rigid soles, am still confused. And I have long history of lower back problems too. I am wondering if I shall see a Podiatrist for further recommendations on my footwear? I checked online and came across Pedorthists and also read about the Fit Specialists at NBRx-certified retailers. Could you help on my next steps and let me know your recommendations for my foot condition.

Thanks
Srini

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

Hi Pickle,
What a great name!
Sorry for the delay in response. For an exercise shoe, I would recommend the NB 928 with orthotics or the Hoka One One Stinsen. Wear your Rx Crocs Ultimate Cloud or Relief (or Mammouth) as a bedroom slipper. For neuropathy pain, I would recommend that you look into Metanx,which is a prescription strength and helps to decrease nerve damage pain and get some repair to the nerve sheath and possible re-growth to the small fibers of nerve that go to the skin. There are some nice topical pain relievers for nerve damage, such as Biofreeze.
Let me know how it works out,
Cathy
:)

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

Hi Srini,
Sorry to hear about the accident!
I would recommend New Balance 928 with an orthotic, which (after an injury like yours) would be a wise investment. If the orthotics are outside your budget, I recommend the Powerstep insert, which you can purchase online. Also, you can try the Drew Surge, which also has a rigid sole and wide toebox. As a bedroom slipper, you need the Rx Crocs Ultimate Cloud or Relief. When you purchase the NB 928, double check to make sure that the sole doesn't bend or flex as some shoes can be defective or poorly made. Find the NB 928 that bends and flexes the least (as quality can vary).
Good luck!
Cathy
:)

Lori T said...

I appreciate your post so much. I had a complete Jones Fracture in September of last year. The last x-ray showed that it is almost healed but not completely. I was hoping to spend time at the beach and other water areas with my daughters and husband this summer. I'm tired of wearing my Asics (my doctor had me get the 33-M because the sole doesn't bend in the midfoot) to the pool. What is the best sandal for my break: Teva, Keen, Merrell, Chaco?? I haven't been able to see/bend any in public. Thanks for your help :)

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

Hi Lori,
Great questions! Of course, check with your podiatrist to confirm that this is the right choice for you. I would go to REI and get the Keen's Newport H2 with the most rigid, non-flexible sole and I would also ask you podiatrist for a tri-lock Bioskin ankle brace to wear on the beach and in the water for any increased activites or sports. Many podiatrist carry excellent bracing and insurance often covers the cost. Playing in the sand and water will cause increased motion, so you need the added protection of a brace if you are doing anything too strenuous. I sometimes give my patients two braces -- one for the water and one for land.
Clear this with your podiatrist and I hope you have a great summer!
Cathy
:)

Lori T said...

Thanks so much Cathy :)

Owen said...

Hello all!

First, I am so glad accurate and detailed information like this is being offered.

Now for background - in mid 2013 I somehow sustained a R foot sesamoid fracture, due to walking everywhere in poor shoes. Go figure. So I sought a Podiatrist, got an MRI, went through weeks of PT, wore a boot for about 7 weeks in the meantime, got a catscan(which actually revealed the fracture), did more PT(which included a really cool therapeutic ultrasound device I still have and use occasionally), had a cortisol injection and FINALLY started being able to walk on my foot again, albeit gingerly. This all took about 8 months to really sort out from 1st visit to last.

In Spring 2014, I got Merrick hiking boots that support my my arches and my ankles, when my Pod gave me the go ahead to wear normal shoes again. So far so good. I go back to school Fall '14. Things are fine.

Actual dilemma--- Now for the rest of school, I need shoes that can be worn in the medical setting, ie on my feet all day, walking back and forth from one hallway to the other. What would you suggest? I'm not certain what sort of walking shoe I might need or what sort of features it should have.

Anonymous said...

Hi, I am female who fractured my little toe near where it connects to the neighboring toe. I am buddy wrapping it, staying off of it as much as possible and have a boot for when I go out.

I am going on a trip to a very hot climate out of the country 5 weeks after the injury. My foot is medium with but more on the wide side. Is there a sneaker and sandal you would recommend. Also, any other advice? Thank you so much!!!

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

Hi Owen,
Sorry to hear you had a sesamoid fracture - they can be difficult and challenging to heal!

For a bedroom slipper - wear Rx Crocs Ultimate Cloud or Relief OR Birkenstock sandal (with a strap in the back)

For a medical setting, your best choices are:
New Balance 928
Hoka-One-One Stinsen
Dansko professional Clogs

I would recommend that you get orthotics from your podiatrist OR you at least get an excellent OTC insert such as Footsteps or Powersteps to put into the NB or Hoka. The Dansko Professional clog usually will not accommodate an insert and doesn't need one. Do not get the backless/clog Dansko - make sure it has rearfoot control. I recommend that you go to the store and try them on.

Best wishes and thank you for reading!
Cathy
:)

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

Hi Anonymous,
Great timing!
My newest article is about toe fractures and what are the best shoes to wear. Don't buddy splint the 5th toe to the 4th (explains why in the article)! Check out my article, which is loading with everything you need to know about toe fractures and what shoes will work...

Put 'how to treat a broken toe' in the search box and it will take you to the article.

Thanks for reading and I hope you have a great trip!
Cathy
:)

Anonymous said...

Thank You for your help!

Unknown said...

Hi Cathy,

I have a navicular stress fracture and am struggling to find information about how best to manage recovery. Its been a very long haul and I am getting quite fed up with the poor/conflicting information I have had from the various clinicians who have been involved in my care (physios, podiatrists, sports physician, surgeon). It seems there is very little information anywhere, especially because I am not the typical navicular stress # patient.

Because I did the injury getting fit by gradually increasing walking to about 30-40km/week rather than being some kind of athlete doing high-impact stuff, it took me some time to convince everyone that my diagnosis was correct! We all eventually agreed that as I have an accessory navicular and lots of ankle scar tissue from previous sprains that there was indeed a fracture. I had conservative treatment with 6 weeks immobilisation and NWB, it seemed better but then as I returned to exercise the pain returned. In retrospect it seems unlikely conservative treatment was ever going to work as there was malunion and bony fragmentation visible on the CT at that time.

7 1/2 weeks ago (more than a year after the initial diagnosis) I had a debridement, removal of bony fragments in the joint, and a bone graft, screws and a plate. 6 weeks NWB and am now gradually returning to weight bearing and doing a bit of work on the stationary bike. My surgeon is an utter failure when it comes to communicating what I should expect (I know - an orthopaedic surgeon who can't communicate, what a surprise!!). I am getting pain in the places where I get pain with an unhappy navicular, but not sure if this is normal at this stage. I would really appreciate any advice you might have about recovering from navicular surgery, and especially about what shoes I should buy for the period when I get out of the boot, and what hiking boots I should buy when I am able to hike again. I have high arches, a neutral foot with no pronation, an inflexible ankle, and tight calf muscles and am utterly sick of having a broken navicular!

Many thanks, Jenny.

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

Hi Jenny,
UGH! I am so sorry to hear about your long journey on the way back from a navicular stress fracture - they can be very challenging and frustrating!! Since I have never seen you as a patient, I can only give you generalized information regarding the type of fracture you have. You absolutely can NEVER walk barefoot again. The only time you should be barefoot and standing is in the shower, no exceptions. As a bedroom slipper, you should consider the Rx Crocs Ultimate Cloud or Relief, the Birkenstock sandal with rearfoot control or even an excellent shoe.

I would limit you to wearing the New Balance 928 and, when you purchase them, make sure that the sole has no motion or flexibility at all. Some shoes can be defective or poorly made, so if your NB 928 bends or flexes, try another NB 928. I highly recommend that you invest in custom-molded orthotics from a podiatrist. In my opinion, podiatrist (and pedorthotists make the best orthotics). If that is out of your price range, at least purchase the Powerstep inserts online. Arch control is crucial for healing the navicular as you do not want any strain on the PT tendon or the navicular as you ease back into activities. I would also recommend an excellent brace from your podiatrist - to use for any exercise for 1-2 years at least.

Has your doctor gotten you a bone growth stimulator? Insurance often covers them and I would have you using one on a daily basis until you are completely healed. If your insurance does not cover one, sometimes your podiatrist can get one for you anyway.

The trick is to get healed and then, after you are healed, make sure that for the rest of your life you are in proper shoegear with good arch support. In ten years, if you start wearing flimsy flip flops or shoes with no rearfoot control or walking barefoot -- the navicular stress fracture could reoccur. You may have an underlying biomechanical foot structure that makes you prone to developing excessive stress on the navicular. The good news is that you can control that with proper shoes, orthotics and occasional bracing for increased activities. After any foot or ankle injury (even with the best of care), you can end up with 1-2 years of low-grade pain and swelling. You will decrease pain and swelling with excellent shoes and biomechanical controls of your foot in the form of a thick, rigid sole, wide toebox, rearfoot control and arch support.

Best wishes and thank you for reading!
Cathy
:)

Unknown said...

Thank you Cathy, that is super helpful. I guess I will have to resign myself to a life of ugly but sensible shoes!

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

Not necessarily ugly!! You just have to know what you are looking for to find good looking shoes that are good for your feet - that is what this blog is about!
:)

Anonymous said...

Dear Doctor,
Thank you for the great insight.I am 33 old female and I had a jones fracture on my right foot. I was in NWB cast for 6 weeks.It's been a week since the cast is removed and the bone is fixed too.At this stage, I can walk without support but occasionally using crutch on my good leg.I know it will take couple of weeks to get back to walking normally and I cant wait.I wanted your advice regarding what kind of shoe should I wear at this stage and once I am back to my normal routine esp at work.Also when it is recommended to wear heels post injury or should I avoid them completely. Do you recommend any supplements too like calcium or vitamins? Thanks a million

Owen said...

Thanks so much, Cathy!

I ended up with some nice custom inserts from The Walking Company, and the Dansko clogs... which I liked so much I bought in the incorrect color! (ie, black instead of white) Well, at least I know my size for that pesky online order...

Anonymous said...

Great blog, I learn a lot here on how to find the best and affordable secondhand shoes. I found this website http://www.boex.tv/ and they have a lot of different secondhand shoes in affordable sizes.

Nimrod said...

Hi,
Great blog. I had a cuneiform medial fracture. I'm a week after cast (5weeks in cast).
Will probably get the NB you have been recommending.
There is no Rx crocs where i live, only regular type crocs. Could regular ones still be ok for "home shoes"?
But I'm a hiker, and love merrell hiking shoes. I hope they are ok for my foot?
Rhanks

Petite1 said...

Thank you for this great blog. Last fall I stepped on a nasty crack and sprained my foot. Went to urgent care to rule out a break and did RICE for 3 weeks, and when not better went to pod who said I developed cuboid syndrome. I wore a DeRoyal sports orthosis for a few weeks, and then went to PT. Progression was slow and I ultimately was diagnosed with PTTD. After months of PT I was released and feeling confident enough to book a trip for the fall and was about 95% better. I have been doing a follow-up fitness PT program and using the Alter G treadmill to build back to 100%. A few weeks ago things suddenly got worse, so went back to pod who diagnosed tiny stress fractures in 2nd and 3rd metatarsals. I am in the boot and go back to see him in a week. I am SO bummed because my trip to Europe is in just over 5 weeks. I see on this blog that you told someone she would be OK on a trip in special NB shoes and a brace, but I want to be super careful not to re-injure if I'm healing, since Europe trips typically involve a lot of walking. Any insights much appreciated. I'm in the Chandler area so could make the long drive to get your opinion, if needed.

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

Hi Owen,
Glad to hear that everything worked out with the Danskos!
Hope all is well,
Cathy
:)

MsWill2u said...

HELP Please. 
-Plantar Fasciotomy Surgery (L&R) 2006
-Radiofrequency Endovenous Ablation (L&R Leg) 2007
--2nd Meterarsal, mid shaft, Foot Fracture Surgery
(Plate & Screws) 3 June 2015
*Just weened off the boot.
-Severe Metatarsalgia (L&R)
I am not even close to being over weight.
Had to give up running and now even casual walking, foot pad pain is SEVERE! *burning and pain (L&R)
I need shoe recommendation that supports 2nd metatarsal plate/screws, plantar fasciiti and especially Metatarsalgia.

A big challenge, please help. What shoes do you recommend? Thank you.

Anonymous said...

I'm not quite recovered from a 2nd metatarsal stress fracture suffered in mid June, and am going to France for vacation in mid September. Is there such a thing as a fashionable walking shoe that will also be okay for my foot? If not, what would be my best option? Thanks

Anonymous said...

*Regarding previous post, I should have specified a fashionable Womens walking shoe.

omd said...

i am so happy to find your blog. I have a comminuted fracture of the 5th metatarsal after a slip and fall. I have been on a CAM walking boot for 8 weeks now and will have to go back to work soon wherein I would need dress work shoes. What would you recommend. I am looking at the naor pleasure shoe but I have a wide foot and you said it should be for narrow to medium feet. What would be the best for me?
Thank you

Roxanne said...

So excited to find your site! I've spent the last 2 days devouring every word and comment! I am 2 years post op from a shattered calcaneus (ORIF then a very bad staph infection). I'm doing very well, all things considered, after a very long recovery...back in the gym walking on a 8.5 incline, resumed all my old activities. Still have some pain all the time but it is like "white noise" in the background that I just try to ignore. I'm trying to find shoes to wear with dresses for church, etc. I'm 63, tall and slender, with a medium width post-op foot. Still wear my CMOs in my gym shoes but can manage without them for special occasions. Just had my dorsiflexion measured and it is still zero :-) Thank you for this wonderful service you are providing!!

Anonymous said...

I have a question but should describe the (somewhat lengthy) problem first. I'd use an ID but don't have a Google account and never heard of the other two! I had a midfoot trauma midsummer and finally got in to see the podiatrist August 12 (this is a typical delay for VA Medical Care for veterans), who told me it was a contusion (not Lisfranc) but would still take six months to heal and that I should use alternate ice and heat and needed to wear "special shoes" that would brace or splint the bottom of my foot all that time, including when I did physical therapy (for other issues) and medically proscribed exercise program which both take place in a pool. (We are not talking water aerobics, it's an extention of the physical therapy involving walking round a "river channel" pool forward/backward/sideways.) It is extremely important for me to get back to the pool; a six month or longer wait is inadvisable due to gradual weight gain during years of undiagnosed joint and thyroid problems causing heart/lung issues to worsen. Yep, a real catch 22 situation! Unfortunately our appointments are absolutely limited to 15 min which, after describing the problem and having an exam plus at least half of the time spent by the doctor typing up medical notes, does not leave much for patient education. A second problem is that I live in a tiny town with no shoe store or any other place to buy ANY kind of footgear other than the charity thrift store (!), have no car or other form of transportation, and no one to give me a ride to another city/town. I have tried looking online for shoes to order but until now couldn't find much useful (just ads and uninformed laypeople also trying to figure it out). I finally gave up and went back to physical therapy/exercise two days ago and found it's impossible without a foot brace (intense pain after 20 min of simple, slow, very careful walking). I should also mention that this is now self-directed physical therapy using a routine developed by a PT but no longer under that PT's supervision as the VA only allows a few visits to a PT for any condition and then cuts the veteran loose to continue on their own indefinitely even with a chronic problem. So here is the question...would these crocs you advocate work as a water PhxThx and exercise shoe, and, have you got any advice on how to order them without being able to try them on first (my shoe size differed according to type of shoe and brand for years, and at this point I have no idea which size would be right for anything)! Thanks.

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

Hi MsWil2U,
I'm so sorry for the delayed response! I'm also sorry to hear that you've had such a tough time with your feet!
I'm glad you read this article, which hopefully will give you all the information you need in detail about proper shoes.
I think it's really important that you wear the NB 928 (and make sure that the sole doesn't bend at all!) with a custom-molded orthotic. If orthotics aren't covered by your insurance or not in your budget -- I recommend getting the Powerstep inserts online. Have your doctor add cookie pads to the inserts if that is appropriate (do not try to add them yourself because if the placement is wrong it may cause problems. Rx Crocs Ultimate Cloud or Relief as a bedroom slipper (or Birkenstock sandals with rearfoot strapping) -- to use just to putter around the house until you can get into a better shoe.
Start with these basic recommendations as this is the foundation of getting you better. Of course, check with your doctor and get your custom-molded orthotics from a podiatrist as they are the best at making orthotics.
Wishing you the best!
Please let me know how things are going and, once again, so sorry for the delayed response!
Cathy
:)

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

Hello Anonymous,
I have a terrible feeling that I might have missed your deadline of your trip to Paris! So sorry for the delay in responding! When I went to Paris, I wore an Alegria boot (it was November and cold). The Wolky Cloggy or an Alegria enclosed shoes with rearfoot control should work well for Paris. Also, if you want to wear a sandal, I would recommend the Wolky Jewel, Tulip or Ruby. There were alot of women with much more fashionable shoes on than I was wearing, but, after walking all day long for 10 days of Paris, my feet felt pretty darn good!
Hope all is well and I am so sorry for the delayed response!
Cathy
:)

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

Hi omd,
Sorry for the delayed response! Until you are completely healed, I would limit you to a New Balance 928 with a tri-lock ankle brace for all day wear (you can get an excellent brace from you podiatrist) and the Rx Crocs Relief or Ultimate Cloud as a bedroom slipper. Once you are healed and pain free, that is where you make the transition to 'cuter' shoes. I would try a Dansko women's dress shoe (make sure there is rearfoot control - no mules!) and make sure that the Danko has no motion at all through the sole, which must be thick and rigid. You've suffered a bad fracture and your foot needs a shoe that has no motion through the site of the 5th metatarsal. Make sure there is a wide toebox, midfoot and rearfoot control. Dillard's and many other larger department stores carry Dillards and you may even be lucky enough to work in a city where there is a Danko store!
Wishing you the best and please let me know how things are working out,
Cathy
:)

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

Hi Roxanne,
So glad to hear that you are getting better from your horrible injury!

For dress shoes, I would recommend that you try:
1. Wolky - Jewel, Ruby, Tulip or Cloggies
2. Dansko Marcelle or Harlowe (add some heel cushion if needed -- Tully's heel cups are the best).
3. Try other low-heeled Dansko women's dress shoes, which you can usually find at major department stores like Dillards, ect.
4. Alegria Paloma or Abbi.

Don't forget to wear good bedroom slippers like the Rx Crocs Relief or Ultimate Cloud in the house.

Have you tried the Hoka One One Stinsen ATR for exercise? They offer excellent support and shock absorption, which is very helpful for any heel pain issues. New Balance 928 is always an excellent option, also.

Best wishes!
Cathy
:)

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

Hello Anonymous,

First of all, I'd like to say thank you for serving our country. I am grateful to you and people like you who have served in the armed forces and helped to keep our country strong and safe.

I'm sorry to hear that you've been struggling with foot issues!

I would highly recommend the Rx Crocs Relief or Ultimate Cloud as a bedroom slipper. Please call our office at 480 563 5115 on Monday and tell the ladies at the front desk that you are a friend of mine and give them your information, including address and shoe size (tell them that you are calling in regards to Crocs and please leave a return phone number so there are no mix-ups). Tell them to leave the message on my desk as I am not in the office till Tuesday. It would be my pleasure to ship you a complementary pair - no charge - as a small token of my gratitude for your service to our country. :)

Next, for the pool - I recommend that you get the Keen's Newport H2 for wearing in the pool. You should NOT be walking in the pool without protective shoegear. Since you live in a small town and are not sure of what will or will not fit - what you are looking for is an 'amphibious sandal' that you can wear in the pool -- it needs to have a thick, rigid and non-flexible sole with forefoot, midfoot and rearfoot strapping. Another option for the pool is to get a good pair of older sneakers (with a thick, rigid sole) and wear those in the pool. You could also try a Birkenstock sandal (must have a strap in the back) and wear that in the pool. Payless shoe store sometimes has knock-off Birk sandals that are well made and less expensive. Just make sure the sole doesn't bend.

The best 2 walking shoes to wear are the New Balance 928 or the Drew Surge! Do you have custom-molded orthotics from the VA? If not - you are eligible to get those through the VA's prosthetic lab. VA labs are excellent at making orthotics!

Best of luck and please call us on Monday!
Cathy
:)

Roxanne said...

Cathy - you are truly wonderful! Thank you for the great recommendations. If you ever have any patients with calcaneal fractures who want to talk to someone who has "been there, done that", I would be happy to give you my email and/or phone number. It is a very overwhelming injury, but there IS light at the end of the tunnel.

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

Hi Roxanne,
Thank you for your kind words! Calcaneal fractures are one of the more challenging foot injuries to recover from and I'm glad that you are seeing the light at the end of the tunnel. The key is to always wear excellent shoes and inserts and protect your feet so that you can get back to life and enjoy yourself. Thank you for your offer and I will keep that in mind for any future patients with similar injuries.
Best wishes and thank you for reading!
Cathy
:)

Anonymous said...

Hello again, Cathy, "Anonymous Veteran" from Sept 18 here. ;) Thanks for the advice, I spoke with VA prosthetics directly, who confirmed they can obtain or make anything necessary but explained they need a referral from a VA podiatrist. I've left a message with Podiatry, now it's a matter of a little time and some persistence. ;)

I did call your office this morning after approximating my shoe size according to a chart I found on the net --evening foot tracing measured at almost exactly 10" heel to longest toe and 4" widest part of ball of foot (both largest foot) which gave 9D or 9 wide on the chart-- since my shoes at home range in size from 8-10 and from medium to extra wide!! If that method lacks something, please let me know. I am making up a box for charity donation myself now; I have always had trouble getting decently fitting shoes and you've inspired me to get rid of everything in the "make-do" category. It's funny to look back and realize that the best fitting footgear I ever wore in my life were my military boots which were so good I dispensed with the moleskin blister-prevention everyone else used the first couple of weeks. It's funnier to note that they were a men's size --as have been most of my non-dress shoes lifelong-- due to the fact that I am a woman whose feet don't conform to the slenderness considered feminine!

Anonymous said...

I am so glad I found this blog. My mom had/has severe hammer toes after suffering a stroke that affected her left side. She had surgery to straighten the toes almost 6 months ago and she is still experiencing a lot of pain, however, it's not time to get some closed toe shoes for the Fall/Winter. I'm glad I learned about extra-depth shoes; which I found several on Amazon.com by Dr. Zen and Dr. Comfort.

Thanks again!
J.P.

Anonymous said...

Hi Cathy,
Thank you so much for this post, not enough information like this out there, so very helpful! Was hit by a car 4 weeks ago and since I have been in a NWB boot cast after suffering a lisfranc injury with one minor dislocation so don't need surgery. What do you recommend I wear when I am told I can weight bear again in time, bearing in mind I'm a university student in England? Would a Dr Marten boot be sufficient support for day to day wear, with arch support inside? Thank you so much.
Jane

Anonymous said...

Dr McCarthy, Jane again, also was wondering what shoes other than crocs you would recommend to wear around the house? Very used to just wearing socks pre-accident but clearly not a good option during recovery of a lisfranc injury. Will definitely invest in a TriLok Brace to wear around the house with your slipper recommendation and day to day at university. Thank you again for this information, had a traumatic time and doctor's not very informative so relieved to find this blog.
Jane

Roxanne said...

Thank you so much for repeatedly recommending Crocs RX for wearing around the house. I really didn't want to wear them because they are...well...Crocs. But I broke down and got a pair this week because my foot ached so badly while doing chores in my slippers. Within 24 hours the pain I have had for two years post calcaneus fracture has GREATLY diminished. You are an angel. Thank you, thank you.

goPACK said...

What a very helpful site! I have 2 foot dilemmas and curious about treatment as well as shoes.

For years I have endured painful feet due to the padding of my feet deteriorating. I believe it's called: "plantar fat pad atrophy" so I never walk barefoot. I'm in my early 60s and not very overweight. Finding shoes has always been a problem because I wear about a size 35 shoe and require good support (almost an impossible combination).

Then back in the spring, I was diagnosed with sesamoiditis by a Podiatrist obviously due to inflammation. But, he never made any suggestions other than to take an Aleve daily. So, I visited my pedorthist who has always been much more helpful than the podiatrist. He fitted me with a Birkenstock soft bed sandal which I think has been helpful. I don't see any mention of this in any posts and curious why...

With my sesamoiditis accompanied by fat pad atrophy, will I always suffer from both issues? Can I ever expect to be free of foot pain again? I really appreciate your advice with stretching, exercise, meds suggestions, etc. as well as shoe suggestions.

Thank you so very much!!!

Xty said...

Found your blog very helpful. I had pseudo jones fracture 2 months ago . Its healingbut not completely healed per xray . I am returning to work and i work long hours(12 hr shift) and i mostly on my feet . I need help with finding right shoes. Still having pain on the injury site as well as heel pain. I have higharches. Thanks

Anonymous said...

Hi Dr McCarthy,
Thank you for this great blog!!
My daughter recently suffered a lisfranc injury (luckily no surgery) and is due to come out of the walking boot after 6 weeks weight-bearing in it (post 6 weeks nwb), do you think this new balance model http://www.newbalance.com/pd/new-balance-624v2/KX624Y-V2.html?dwvar_KX624Y-V2_color=Black&chart=size#color=Black&size=6&width=M would be suitable as a replacement for the 928? Hope to hear from you asap!!
Thank you again,
Anne

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

HI Jane,
Sorry about the delayed response!
I highly recommend that your stick to the Rx Crocs Relief or Ultimate Cloud as bedroom slippers. You can also get the Mammoth Crocs, which are fleece lined. It's a long term plan! They are the best and will prevent foot issues. For exercise shoes, get the New Balance 928 (for when you get out of the cast) and I would recommend the over-the-counter insert Powersteps, which you can purchase online for about $25.
Just remember, you can wear any shoe that you want to -- as long as it meets the four criteria that a shoe must have to be comfortable and prevent further injury:
1. thick, rigid and non-flexible sole
2. wide toebox
3. rearfoot control
4. arch support, which you can add with Powersteps or a dress orthotic

I hope you are healing well and remember that you should never wear a shoe that puts any motion through the previous site of injury!
Best wishes,
Cathy
:)

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

Hi Roxanne,
Thank you for the feedback! I'm so glad that the Rx Crocs helped and I hope you continue to feel wonderful!!
Cathy
:)

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

Hello GoPack,
Sorry for the delayed response! The Birkenstock sandal is an excellent choice for your foot type. I'm confused on your question about not reading about it in the previous posts - are you referring to Birkenstocks or your foot issues? I have written about the Birkenstock sandals previously and it is important that you only get the Birks with rearfoot strapping. Your Pedorthist put you in the perfect shoe for your foot type as the Birks meet the 4 criteria of what makes a good shoe, which is it must have a thick, rigid and non-flexible sole, wide toebox, rearfoot control and arch support. The key to less foot pain is to have a sole that is thick and rigid and NEVER allows motion through the bottom of you foot (to protect the sesamoids and to prevent further wear-and-tear to the forefoot fat pad). The soft foot bed is an added benefit, but consider it the icing on the cake (the 'cake' is that the sole is thick and rigid).

As far as future foot pain, the answer is that if you ALWAYS wear proper shoegear and wear the Rx Crocs Relief or Ultimate Cloud as bedroom slippers (you must be completely compliant with proper shoegear) -- you will be able to MANAGE your foot pain. If you are wearing shoes that don't meet the 4 criteria of what makes a proper shoe and if you are not wearing Rx Crocs Relief or Ultimate Cloud as bedroom slippers -- the pain will not stop. And if the pain does stop, it has stopped because you are limping and now putting stress on other joints that will eventually begin to hurt.

It's all good news! As long as you protect your feet with proper shoes and bedroom slippers - you are going to be able to manage your foot pain, which means that when you experience a flair up in foot pain - you must ask yourself three questions:
1. What am I wearing on my feet? (fix: get in better shoes)
2. What have I done? (fix: if you've injured yourself, go to you pod and get an evaluation and x-rays)
3. What is the weather like? (anti-inflammatories and rest until the pain subsides with better weather)
Usually, the flair up in foot pain can be linked back to these three top offenders.

Best wishes and thanks for reading the blog!
Cathy
:)

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

Hi Xty,
Sorry for the delayed response!
I recommend the New Balance 928 with orthotics (either custom-molded or a good over-the-counter like Powersteps). You could also try the Drew Surge, which is excellent. When you have a high arch, you can 'skip' a lace over the midfoot area, which alleviates pressure on the top of the midfoot. I would recommend that you go to the store and get properly sized. Also, since you are working 12 hours a day, I highly recommend that you wear knee high compression hose (15 mmHG).
Thanks for reading the blog!
Best wishes,
Cathy
:)

Unknown said...


Hi cathy
I really loved your blog wow you're awesome

8 days agoI was hit by a car and had my 5th metatarsal
The doctor described me to wear those rigid boots its heavy and painful i feel better when i take it off
It hurts my ankle
Am i wearing it in a wrong way?
Is it better when i sleep to take the socks off or wear them?
I'm scared for not getting healed
Sorry for askinf alot
Thank you

Unknown said...

I'm a professional minor league athlete and I suffered a jones fracture in march, got cleared in June, re-injured in June/July. I'm still feeling soreness but no pain. Is there a specific basketball sore that I can use to play in to continue my career? Thanks. Great blog.

Unknown said...

I meant shoe that I can wear. Sorry

Anonymous said...

Hi, Dr. McCarthy

Thank you so much for your blog! I am fresh out of a boot after 6 weeks, had a stress fracture of the 3rd metatarsal. I don't have a clue how it happened. I have osteoporosis at age 58 so am anxious to heal and start walking. My podiatrist offered no tips for this point on, he said I could wear any shoe I want, he does not prescribe triloc braces for stress fractures, and he said I could be more active in 2 weeks. After 2 days I already have foot pain again. I did get some Crocs and keep them on in the house, and I have a pair of NB 928 shoes on order. Can you give me a make & model number for the triloc brace? I've researched some on the web, but want to make sure I get the correct kind. It sounds like it might help with the pain. Thanks so much for giving so much of your time on this blog, it is excellent! Becky B.

Swacker said...

After breaking 4 metatarsals 2 months ago, I'll be losing my boot soon and transitioning to shoes. I have a question about your Crocs recommendation. I remember my grandchildren often tripping when wearing Crocs. It seemed that if they drug their feet at all, the very non-slip sole "grabbed" the floor and caused tripping. I have hard surface floors throughout my home and this concerns me. Have you or your patients had any experience with increased tripping incidents while wearing CrocsRX?
Thank you for the great info you provide, and thanks in advance for answering my question.

Roxanne said...

Hi Swacker - I took the advice on the Crocs RX after shattering my heel into 7 pieces. We have all hardwood floors and ceramic tile in our home, and I have had zero issues with slipping (I wear the strap behind my heel). After being in constant pain for 2+ years, my pain has almost totally disappeared since I started wearing the Crocs constantly at home. It was truly the best piece of advice I've been given!

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

Hi Roxanne,
I love that you're calling me Swacker, but I don't know why! I'm glad the Rx Crocs helped and so glad to hear you are feeling better. Thanks for reading!
Cathy
:)

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

Hello Unknown,
Sorry for the delayed response! Also sorry to hear that you got hit by a car!!
If you broke your 5th metatarsal, I am hoping that the heavy boot is a 'below the knee pneumatic CAM walker'?
They are heavy, but if you are having too much pain then you need to call you doctor. It might be that the boot is the wrong size or that there are other issues going on. It might also be that you are walking too much and being too active. After a 5th met fracture, it is important that you rest and elevate your foot as much as possible.
As far as sleeping with socks on or off, I say that you do whatever feels the best.
I would recommend that, while healing from the fracture, that you sleep with a sock on and an ace wrap over the sock. Don't make the ace wrap too tight - it only needs to be gently snug to help your foot feel much better.
I hope you heal well and best wishes for the new year!
Cathy
:)

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

Hello Unknown,
If you are an athlete then it is crucial that you are in the right basketball shoes! I don't have a specific recommendation for you because I don't know your foot type, but I do recommend that you wear a basketball shoe that meets these four criteria:
1. thick, rigid sole with absolutely no motion or flexibility and it has a wide base (particularly through the area of previous injury)
2. Wide toebox
3. Excellent rearfoot control. With your history, I would recommend that you try high top basketball shoes for more biomechanical control of the foot and ankle.
4. Get a custom-molded orthotic! You are an athlete and orthotics are an investment and will pay off in less injuries and increased mechanical advantage that could translate into giving you a competitive edge. In my opinion (and I am biased) podiatrists make the best orthotics!

*If you do not like the high-top basketball shoes, then get the low-tops but I would add a tri-lock brace, which will help prevent re-injury. Bioskin tri-lock brace is the best and you should be able to get this through your local podaitrist.

In my book, soreness is pain. If you are still feeling soreness then you are not completely healed. Check out my article 'My feet hurt! Top 10 things to do to alleviate foot pain today' for more information on what you need to do. It is not just about protecting your feet on the basketball court, you have to be comprehensive and make all of the changes to get the full benefits.

My dad was a high school basketball coach at Salem High School in New Jersey and he led the team to win the State Championships in the 1980's. It was HUGE as Salem is a tiny little town and they were up against teams across the river from Philly and NY! They put the whole team and the coachs on fire-engines and drove them around the town in an impromtu parade. I have great respect for the game of basketball and for athletes - so take care of your feet, my friend!

Thanks for reading the blog and I hope this was helpful.
Best wishes and Happy New Year!
Cathy
:)

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

Hi Becky B,
Sorry for the delayed response! I'm glad to hear that you have the Rx Crocs and NB 928 on order!
The tri-lock brace is the Bioskin tri-lock brace and I added a picture of it on the blog (on the right side) that takes you to Amazon where you can purchase it. If you get it, you have to watch the YouTube video for instructions on how to put it on as it is tricky! Make sure that you pull the white strip to the side of the foot that hurts -- with 3rd metatarsal, you will most likely be pulling it to the outside of you ankle. Make sure that you follow up with your PCP for treatment of the osteoporosis because 58 is young!
Thanks for reading and I hope you have a happy New Year!
Cathy
:)

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

Hi Swacker,
Love the name!
Sorry for the delayed response. And now I understand why Roxanne was calling me Swacker! I thought I had a cool new nickname!!

The Rx Crocs are fabulous and work for about 95% of patients, but not everybody. The only times I have had problems with the Crocs grabbing the floor and causing tripping is if the patient is very old, has neurological issues (dropfoot or Charcot-Marie Tooth disease, ect) or they are in the wrong size Croc or they are in the wrong type of Croc (not Rx).
If you have any issues with the Rx Crocs and if they do not work for you - then you can try the Vionix Relax Slipper (does not have rearfoot control so it is not as good as a Rx Croc) or a Birkenstock sandal with a strap to the back.
I hope that was helpful and thank you for reading!
Happy New Year!
Cathy
:)

Unknown said...

I always found worth content here,Would like to visit your blog again.Keep posting interesting articles like this..

Anonymous said...

I fell two days two days after Christmas while taking decorations down. I was on a step, turned and missed a step, breaking my left wrist and sprained my left foot with an avulsion fracture. I went to the hospital ER, who took xrays to determine the above diagonis. I was put into a boot and since they were concerned about my wrist, they said to go see an orthopedic surgeon. Plus when I got home, there was nothing about how to deal with my sprained foot or boot. I did go to a wrist orthopedic surgeon, who also told me to see a foot orthopedic surgeon, which I did the next week. With the Christmas holidays, most doctors were out of town. My foot doctor took xrays and said as the ER did, I had a middle foot sprain with an avulsion fracture. I was wearing my boot, which he said there was nothing he can do because it will heal on its own. He even told me that I did not have to wear the boot and can walk normal. My foot was hurting, swollen and very sensitive with bruises, so I stayed in the boot. I am a little past 5 weeks from my fall and my left foot is still swollen. After searching Google for help, I found that I was supposed to put ice on my foot until swelling went away...no one told me that! Also discovered that I had to keep my foot elevated as well. After my swelling went down last week, since the doctor did make one comment while I was in his office...many patients said that Epsom salt foot baths help...not anything about ice. Due to that I did Epsom salt baths a couple of days. Wrong...since swelling came back. I then began cold water foot baths twice a day which has begun to get swelling back down. Last week I was able to get a high top boot on for a couple of days, until the warm water made my foot swell again. Two days ago I was able to get some loafers on my foot. I wore the ER boot for 4 weeks, and was trying to get out of ut due to the unevenness os the two legs making my right hip hurt at times. This week I have walked at home barefooted, which I found out is wrong. I found your site this morning when doing a Google search for what shoes to wear after a sprain. Since my doctor did not tell me very much to helo, plus he released me, so I do not have to go back to him. The shoes you have mentioned, do I have to have a prescription to purchase them? I want to get well so that I can take my duties back at home. My sweet husband has not complained, however I know he must be counting the days cooking and doing laundry. I can stand and walk without as much discomfort now, however my foot does still swell after walking. I have had to sleep on my back for the past 5 weeks, with my left arm sticking straight up and then learning to elevate my legs on pillows at night. I want to do whatever I can to get my Nirmal life back again. Being lazy us not fun for an extended amount if time. I am so far behind on everything! Any advice you can give me is greatly appreciated. Should I stay in the ER walking boot longer or get tge shoes you have mentioned? The discomfort I feel is on the left side of foot where I hit it and fractured it. I will get my wrist splint cast off next week, and had thought that my foot would have progressed quicker.

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

Hello Anonymous,
I'm sorry to hear about you injuries! If you have an avulsion fracture of the foot, then you will need to be in a below the knee walking boot for at least 6 weeks. I would highly recommend that you make an appointment with a podiatrist! You need to elevate and rest your foot as much as possible and you need to be in the boot for at least six weeks. After you are healed (which can sometimes take longer then 6 weeks and will be determined by your podiatrist) you will be eased out of the boot and into an excellent walking shoe such as the New Balance 928 or a men's New Balance 1540. Absolutely no barefoot walking! You need the Rx Crocs Relief or ultimate Cloud as a bedroom slipper.
Please see a podiatrist to get more specialized care for your foot issues!
Best of luck and please let me know how you are doing,
Cathy
:)

Bonnie said...

This blog is extremely helpful but I haven't read about a problem like mine. I hurt my rt foot this summer and walked around New York on it. I went to orthPedic dr who ultra sounded bottom and said it was plantar fasciitis get an orthotic and stretch. I did but the stretching hurt so much I went to pod. He took another ultrasound and it showed bone chips in my rt ankle. He ordered me custom orthotics and I got 928s but stretching hurts all the way from ankle bone to little toe on top of my foot. My pod says keep stretching (hands against wall and bend knee) but I feel like something could be wrong Any advice? Thank you. I can hardly walk sometimes the top of my foot aches so much

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

Hi Bonnie,
I am sorry for the delayed response! I highly recommend that you get a second opinion from another podiatrist and that you request x-rays and an MRI (of the foot and the ankle) to confirm a diagnosis. If you are having pain in your ankle and the 5th toe, you have more going on that plantar fasciitis! If you are in that much pain, ask your podiatrist if he/she can place you in a below the knee walking boot. This should greatly help with the pain.
Best wishes and let me know how it works out!
Cathy
:)

Anonymous said...

Hello Doctor McCarthy. I appreciate your informative blog. I especially admire your desire to help people suffering from former foot injuries and pain. I really need your help please. I received a lisfranc injury on February 5 2015 during a mixed martial arts sparring match. My sparring partner stomped on my left foot as hard as he could during our match and that is how I received my lisfranc injury. He is 5 feet 8 inches tall and 145 pounds and I am 5 feet 3 inches tall and 130 pounds. Sometimes it is so annoying to be such a scrawny small framed petite woman! I fought hard for three months to finally get treatment for it. I admit I was walking on it too much just hoping it would get better but it never did. I didn't even know ho bad it really was. I was put in a cast during May 2015 and a hard custom orthotic afterward. I was even in a wheelchair for about five months when the cast and hard orthotic failed. I am doing my third session of physical therapy now. I also have gel custom arch support orthotics and hiking boots. My hiking boots are Vigor Dr. Comfort Lyrica Velcro Strap Hiking Boots. But my left foot still hurts so very bad! I don't know why either! Could it be the custom arch supports? Or the fact that the insoles bend way to easily?! Please help me find out what the problem is here. I need to know so I can talk to my orthopedic surgeon about other foot care and shoe options. This lisfranc injury has costed me way too much pain, suffering, and money! Not to mention emotional pain and suffering to boot! I was told by my surgeon, chiropractor, and physical therapist that I would never be able to train m.m.a. again or be able to run again! Plus all the mocking I received from my sparring partner and others at the gym. I was even made fun of by my own mother because of this! This is literally adding insult to injury! At this point I just want to walk pain free again if that is even possible. This injury left me with arthritis and complex regional pain syndrome! I am only 29! I deserve to walk pain free! I am starting to think that everyone is right. I will never be able to train or run again! My m.m.a. career is over. I never wanted pity just comfort and mobility! Please help me find the right foot care products to talk to my orthopedic surgeon about?! I just wish he was more informative and easy to talk to. I get panick attacks before appointments with him and nervous before I have to call his office. Oh well I need to be able to walk comfortably again. He wants to perform the fusion surgery on me! Hope to read from you soon! I look forward to your response. FRUSTRATING!

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

Hello Anonymous,
I am so upset that you have been put through so much pain and suffering! I am really sorry that all of this has happened to you. Lisfranc's injury can be very serious and having CRPS and arthritis at such a young age is challenging. The people in your life who are not being supportive have no idea what kind of foot pain that you are dealing with and I hope they never find out. And if they do find out, they will look back and probably sincerely regret how horribly they treated you.

Do not get the fusion yet. The reason surgeons do the joint fusion is because if the joint hurts, then they fuse the joint so that there is no more motion and it stops hurting. Instead of getting the surgery, I want you to focus on making sure that your feet are absolutely 100% of the time in perfect shoes and inserts whenever you are standing or walking. Perfect shoes mean that you are ALWAYS wearing shoes that have a thick, rigid and non-flexible sole with a wide base, wide toebox and rearfoot control. The only time you can be barefoot and standing is in the shower. Stopping all motion through the injured joint will enable it to heal and, after it is healed, you will be able to ease back into your activities. For the rest of your life, you MUST wear proper shoes and inserts. You will be able to get back into sports after you heal, but you will always have to wear excellent shoes, inserts and maybe even a tri-lock brace for certain activites. Please don't be depressed at that -- it is actually very good news and I tell ALL of my patients the same thing!

This is what I recommend:

1. Your bedroom slipper is Rx Crocs Relief or Ultimate Cloud or a Birkenstock sandal and all of them need to have the strap in the back. Use the slippers only to get up to go to the bathroom and putter around the house. As soon as possible, get into better shoes.

2. Go to a New Balance store and get the NB 928 or the men's NB 1540. Double check and make sure that the sole of the shoes do not bend or flex at all! If the sole is bending then it is defective and ask to try another NB 928 or men's NB 1540 from the stockroom.

3. You need a functional custom-molded insert, which has a rigid base with cushion over it. It should be full length and replace the insert that some with the NB shoe. You don't need a soft insert that bends and can be squished down. You need an insert that is rigid and inflexble so that it supports your Lisfranc's joint, and then there is cushion on top of it for more comfort.

4. If you are still having discomfort, ask your doctor to dispense (or you can purchase online) a Bioskin Tri-Lock brace (pull the white strap to whichever side of the foot hurts the most).

(Continued!!)

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

Continued letter to Anonymous MMA,

Ask your doctor about getting a bone growth stimulator, which is often covered by insurances for non-healing fractures. Did you get MRI's to evaluate the full extent of the damage?

After making these shoe changes, if your pain is still over 4 (on a scale of zero/no pain to ten/horrible pain) then you need to follow up with your doctor and requests a MRI (if you haven't already gotten one) and you should go back into a brand new full length (to below the knee) CAM walker and use the Roll-About so that you can be non-weight bearing for at least another 4 weeks.

If you are feeling pretty good in the NB shoes with inserts and the brace (pain less than 3/10) -- just remember that you are still in the healing process and you should be elevating your foot whenever you are at rest and you should be icing (if your doctor recommends it for you) for 10 minutes 2-4 x day.

The Lisfranc's fusion is not all it's cracked up to be. Whether you do the surgery or not, you must follow all of the above rules with shoes and inserts. Please try conservative treatment first. Just remember, for the rest of your life, if you wear any shoes that allow motion through the bottom of your foot -- the pain will never stop. The pain will only transfer around to other joints as you learn how to compensate and limp, which can lead to other joint problems.

The good news is that you should heal! And you should be able to return to most of you sports activites. Don't worry about MMA right now. You need to heal first and then EASE back into your sports. Doing MMA barefoot is not recommended and, in fact, would be a disaster but, with proper shoes and inserts, you should be able to get back into a walking and even a running program.
You're young and you're healthy and, if you make the right choices with shoes and inserts and give your body time to heal (with rest and elevation) you will heal!

I am shocked that your sparring partner stomped on your foot. Isn't that illegal in MMA?
Next time someone says something mean to you, look them straight in the eye and (without raising your voice) say to them in a perfectly calm voice, "That is so mean." Then be quiet (don't say a word! Remain silent!) and listen to what they have to say. They usually turn red and back-peddle and make excuses for themselves or try to laugh it off, but what I find is that it helps them realize that what they just said was mean.

Good luck and let me know how it is going!
Best wishes,
Cathy
:)

Anonymous said...


Thank you Doctor McCarthy. Just one post from you was 100 x more informative than my multiple face to face appointments with my Orthopedic Surgeon! Please excuse my other questions.
1. I have screws in my fourth toes from a hammer toe surgery so would a m.r.i. be okay to have on my lisfranc sprain?
2.Is there any other place I could purchase the New Balance Shoes you reccomend? There is no new balance store in my town and I don't have my drivers license. There is a Big 5 sporting goods store here and a Payless shoe store though.
3. Is the N.B. 928 a women's shoe? I wear a size 7 women so what size would I need in the men's N.B. 1540? My feet are tiny and even women's size 7 is sometimes too big for me.
4. Where would I be able to purchase the RX Crocks Relief, or Ultimate Cloud, or Brickenstock Sandal and Trilock Brace?
5. What powders, or creams, or sprays do you recommend I use on my feet to protect them from having to wear shoes all day and night long?
6. How do I clean my shoes, house foot wear and inserts?
7. Do I need to have my orthotist custom make my inserts for me?
8. What type of diabetic socks should I wear to protect and comfort my feet?
I WILL make sure that my soles do NOT bend! Thank you for that critical tip! I am greatful you informed me about that! The bottom of my boots do bend way to easily even under the arch! I did not know that was a problem!
9. Are heat pads or hot soaks okay for me? Or should I just stick with the ice?
Sorry for my many questions. I just really need to know how to help myself better. Please let me know all the answers to my questions so that I can make a thorough list to talk to my doctor about. I really appreciate your concern for my feet and comfort.
Yes foot stomping is perfectly legal in m.m.a ; but purposely injuring your sparring partner is against the rules of the gym, but my sparring partner didn't care. No one in the gym seemed to care either not even my trainer. Those men are scary and I'm glad that the gym shut down and my trainer and his wife moved. I hope my trainer and his wife never own and operate a gym again and that my sparring partner never wins another fight in his m.m.a. career. I just hope that I can be able to box again?! Boxers must wear shoes and no foot stomping is allowed in the boxing ring at least! Again thank you so much for all your help Doctor McCarthy. I wish you could teach my orthopedic surgeon about feet and ankles. I'm not trying to offend my orthopedic surgeon but he is not a podiatrist like you are! So that's why I want to check with you first. I hope to read from you soon!
I am still hopeful and stronger willed than ever.
Take care Dr.
:-)

Angkay07 said...

I first want to say I understand what "anonymous is saying from 4/18/16. I feel the same way, I am not an MMA fighter but a mother of 5 which for years felt like the same thing. <:) My Lisfranc fracture dislocation injury is also from January but of 2008. I was in an auto accident and yes needed emergency surgery. My foot was a ball.. literally was a round ball. I've had pain but this was over the top. So today- I have a question because I have not moved much passed new balance and I know I can't wear much anymore. It's ok I'm getting old but the choices are small and the prices can be unaffordable most of the time. I've tried on the sandal shoe from LL Bean, with all the straps that you talk about, but even the straps laying across the top of my foot hurt. My knees have taken a beaten and my hips too because of this foot, and like anonymous stated that everyone's outlook on this was poor at best. Even my surgeon & podiatrist told me that this will always be a sore subject.(literally) I don't know if anyone knows about Fibro but since this accident I've lived with constant pain all over and have had to stop so much of my life. Regardless of all of this do you have any suggestions on how to deal with and/or remove some of this top foot pain, & outside of foot wear as I looked through your list, I see that I am very familiar with most of these shoes and do try to buy on clearance and sales, but to know avail from pain And I've gone down the opioid road. Not for me Thank you so much Angela

Unknown said...

Hi, Dr. McCarthy,

I broke my fifth metatarsal shaft, about an inch or two from my toe, after twisting my foot on a hike; the fracture looks a bit like a wishbone. I was given a walking boot for "at least" four weeks; the orthopedist said that he'd be focused on the absence of pain as an indicator of healing. The break was on 4/17, and my orthopedist had it x-rayed this past Monday -- it shows evidence, though typically faint, of soft callus formation -- and said that I could wean myself from the walking boot and into a supportive sneaker over the next two weeks because the swelling is gone and I have no pain when he squeezes the edge of my foot or when I walk in the boot (except in my ankle, which gets very stiff from the restriction of the boot). However, the orthopedist also told me that "even if there was a nonunion," he would not keep me in the boot forever as long as my foot didn't hurt. This statement caused me concern. I'd be THRILLED to get out of the boot as quickly as possible, but I want the bone to heal, so I don't want to ditch the boot prematurely if doing so under these circumstances will prevent the bone from healing. Can I safely wean myself from the boot (walking without it doesn't hurt)? If so, what's the best way to do that?

Shelley Smith

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

Hi Anonymous,
I will do my best to answer these questions. However, please remember that I have never treated you as a patient and you need to discuss any concerns, ect with your current doctor.

1. I have screws in my fourth toes from a hammer toe surgery so would a m.r.i. be okay to have on my lisfranc sprain?
**The MRI is going to distort the image in that area. It might be an issue.

2.Is there any other place I could purchase the New Balance Shoes you reccomend? There is no new balance store in my town and I don't have my drivers license. There is a Big 5 sporting goods store here and a Payless shoe store though.
**I would purchase them online. Get your foot properly measured so you know what size to order. Your foot is more swollen and has probably gone up 1/2 to one whole size.

3. Is the N.B. 928 a women's shoe? I wear a size 7 women so what size would I need in the men's N.B. 1540? My feet are tiny and even women's size 7 is sometimes too big for me.
**NB 928 -- you can purchase in a woman's size. Get the proper fit.

4. Where would I be able to purchase the RX Crocks Relief, or Ultimate Cloud, or Brickenstock Sandal and Trilock Brace?
**Online. You can watch the Youtube video for how to properly put it on. Pull the white strap to the outside of the ankle of whiche ever side of your foot hurts the most -- you will understand after you watch the video.

5. What powders, or creams, or sprays do you recommend I use on my feet to protect them from having to wear shoes all day and night long?
**Clean Sweep $15, which you can purchase from a podiatrist's office.

6. How do I clean my shoes, house foot wear and inserts?
** Read the shoe manufacturer's recommendations.

7. Do I need to have my orthotist custom make my inserts for me?
If possible, custom molded orthotics are the best. The second best option is the Powerstep insert, which you can purchase online.

8. What type of diabetic socks should I wear to protect and comfort my feet?
**Any diabetic socks, preferrably ones approved by the APMA.

9. Are heat pads or hot soaks okay for me? Or should I just stick with the ice?
**You can soak feet in luke warm water with Epsom salt for 20 minutes (not hot) but afterwards you need to elevate and rest your feet and, if your doctor approves it, you can ice your feet with a bag of frozen peas for 10 minutes on and off -- at least 2x day if not more. Never ice longer than 20 min as it can cause tendon and nerve damage.

Sorry for the delayed response!! Lots of stuff keeping me super busy and I am thrilled to have a quiet day today.
Wishing you the best!
Cathy
:)

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

Hi Angela,
I am so sorry to hear about your Lisfranc's injury! I treat many Fibro patients who suffer with chronic pain as well as the added pain of friends and family who simply do not understand what they are suffering through. Most people simply can't comprehend how debilitating chronic foot pain is until they actually experience it - and I would not wish foot pain on anyone!

Obviously, for you, the basics are:
1. Only New Balance 928. Use a custom-molded orthotics or an OTC insert like Powersteps.
2. Maybe -- try the rocker bottom Sketcher Shape-Ups. Try them on at a store and if you like them they may work for you. If you have any history of an Achilles tendon injury or issues -- do not try this shoe. A more expensive version is the MBT, which might be a good investment for you IF the Sketcher Shape-Ups work for you.
3. Rx Crocs Relief or the Ultimate Cloud as a bedroom slipper.
3. Birkenstock sandals with a strap to the back.

**Remember: it's not about how many straps a shoe has -- it is about the sole of the shoe, which must be thick, rigid and completely non-flexible with a wide base. If the sole of a shoe has ANY flexibility at all - then it is cranking motion through your Lisfranc's joint, which will cause more pain and progression of degenerative joint changes.

Other things that help with pain:
1. Topical Pain Creams -- Biofreeze, Traumeel and even Rx Lidoderm patches to use as needed.
2. Elevate and Rest your feet above heart level if possible.
3. Anti-Inflammatories or Tylenol as needed. I do not like Opioids because they take away the pain and then you do to much and it is easy to over-do activities and pay for it later OR it makes you clumsy and you fall and injury yourself. Not to mention the addiction issues!

Ultimately, any shoe you get MUST have:
1. Thick, rigid and completely non-flexible sole with a wide base (this is the most important thing to remember and this trumps every other piece of advice that you will ever get about your feet!!!!)
2. Wide toebox
3. Rearfoot control
4. Arch Support.

**Also, skip a lace over the painful area on top of your foot to relieve pressure on that area.

I hope this was helpful and I am wishing you tons of good luck!!!
Cathy
:)


pm4 said...

Hi, Dr. McCarthy, I see a lot of the recommendations for shoes seem to be for women and I am wondering if they are the same for men. I am a 46 yr/old guy who is in the process of differentiating between sesamoiditis or an actual sesamoid fracture. First podiatrist said xray shoes fracture in left foot sesamoid. 2nd podiatrist says fracture is far from certain (new xrays) but that the sesamoid bones are bent over to the side. 3rd podiatrist (who I will probably stick with) is unconvinced that there is a fracture and thinks it might be sesamoiditis.

I am pretty active and walk a lot and never had problems with my feet before, but this all happened because I stupidly started doing heavy squats in the gym with barbells and my form was bad, so I kept rolling onto the balls of my feet. I was also doing these in barefeet since some schools of thought say barefoot squats are the best. Well I'm sorry now.

Anyway, MRI Is next, but I am on the hunt for footwear to at least prevent things from getting worse. My questions are...

1. Crocs RX Relief are all sold out in black on their site, so I was wondering if the Cloud were basically as effective for sesamoid issues?

2. Can Croc's be work outside for the same kind of protection, or are they meant only for indoors for sesamoid? They look ridiculous on some people but I don't really care.

3. I see you recommend the NB 928 for women but does that come in a Men's shoe or should a man go for the 1540? This would be for when I am walking to the NYC Subway every day for work - if they don't put me in a boot, and eventually for going to the gym to ONLY (for now) do upper body stuff while seated. I don't think I'll ever trust myself to do squats again which is devastating.

4. For a men's office shoe, is there something in the Dansko line or another good line you would recommend? I am aware of your list of general shoe rules, but you seem so knowledgable I thought you might have a specific mens office shoe you like to recommend.

I GREALY appreciate your blog here and for you time if you were to be so kind as to indulge my questions. Also, I am fully aware that you are not my doctor and cannot and would not specifically prescribe actual medical treatment for me since you are not treating me. I am only looking for suggestions or advice.

Thank you!

Mick

Manish Batra said...

Hey, very nice site. I came across this on Google, and I am stoked that I did. I will definitely be coming back here more often. Wish I could add to the conversation and bring a bit more to the table, but am just taking in as much info as I can at the moment. Thanks for sharing.
Cast Shoe

Keep Posting:)

Unknown said...

Hi, I starting reading your blog and almost cried because it's obvious you know your stuff. I deal with teeth grinding foot pain daily for the past 2 years since I broke all the way thru the middle bone that goes to the middle toe. I'm told by my podiatrist I have to by $400 orthotics to not be I pain because that bone shortened so much it keeps tearing tissue from the toe next to it. I can't afford expensive insoles. I have found a shoe for work I can be in for along time which are Korks. They are a Plato strap type shoe that does not bend and I think the kork offers alot of shock absorption. Problem is they are not tennis shoes. I just want to be able to take long walks again without crippling pain. Suggestions for an affordable orthotic or shoe that will work for me? Or can this be surgically fixed. Any info I can tactfully share with my not very helpful podiatrist? Thank you, Debbie K in San Diego

Unknown said...

Hi, I starting reading your blog and almost cried because it's obvious you know your stuff. I deal with teeth grinding foot pain daily for the past 2 years since I broke all the way thru the middle bone that goes to the middle toe. I'm told by my podiatrist I have to by $400 orthotics to not be I pain because that bone shortened so much it keeps tearing tissue from the toe next to it. I can't afford expensive insoles. I have found a shoe for work I can be in for along time which are Korks. They are a Plato strap type shoe that does not bend and I think the kork offers alot of shock absorption. Problem is they are not tennis shoes. I just want to be able to take long walks again without crippling pain. Suggestions for an affordable orthotic or shoe that will work for me? Or can this be surgically fixed. Any info I can tactfully share with my not very helpful podiatrist? Thank you, Debbie K in San Diego

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

Hi Debbie,
So sorry to hear about your foot injury!
Have you tried the Sketcher Shape-Up with a Rocker Bottom sole? This is a fabulous shoe for off-loaded the forefoot area. (If you have a history of Achilles Tendonitis - don't get this shoe). The Shape-Ups are available online and at some stores for under $100. Payless Shoes sometimes has Rocker-Bottom soled shoes for even less.
As far as inserts, I would get the Powerstep insert and use that to replace the insert that comes with the Sketcher Shape-Ups. If all of that works for you, ask your podiatrist if he/she can place a cookie pad on top of the insert which will further off-load the painful forefoot/toe area.
Also, try the over-the-counter pain creams like Biofreeze to help take the edge off of the pain at the end of the day or before a walk. You can get some microfiber socks with extra cushioning in the toe area (online or from Wal-Mart or Target, ect) and this really helps with the pain.
Don't forget good old rest and elevation of your feet at the end of the day.
For sandals, I would try a Birkenstock sandal with rearfoot control. You can find less expensive knock-offs of the real Birk online in other stores.
I hope this works for you and good luck!
Cathy
:)

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

Hi Mick,
Sorry to hear about your foot pain!
Here are answers to your questions:
1. I just found out this past week that the Rx Crocs are being phased out. Ugh! The Croc that I am recommending (if you can't find the Rx Relief Croc is the Specialist (not the vented one as it is not as strong). The Rx Croc Cloud is also appropriate for using as a bedroom slipper.
2. Crocs are only meant to be worn as a bedroom slipper and for puttering around the house. When you are 90 years old and not as active, then you can wear Crocs all day! But, if you are able to wear Crocs all day with no pain - go for it. Otherwise, they are supposed to be limited to bedroom slippers.
3. You can get the NB 928 or the 1540 in men's which are both good for your condition. Before you purchase them, make sure that they are not bending or flexing through the forefoot area. If they are bending then they are defective and you need to aske the salepeople to get you another NB 928 from the stockroom. They will look at you like you are crazy, but just stick to your guns. Any motion through the forefoot area will set back your healing and more pain. Have you tried the MBT or a Sketcher Shape-up? Unless you have a history of a Achilles Tendonitis issue, then one of these should be perfect for off-loading the seamoids which will facilitate healing and off-load the painful area. If you are in an amazing shoe with inserts and you are healed and having no pain, then you can ease back into doing squats. Squats are fine -- as long as your feet are protected with proper shoegear!
4. If your budget allows, the absolute BEST men's dress shoe is the Alden by J. Crew. It is very expensive but the sole is rigid enough to treat a toe fracture. Second best option is to get a black men's dress shoe with a Rocker Bottom shoe (google it and hit the 'image' button to see all your choices) and then go to the store to try them on and see if they work for you. As far as Dansko men's shoes are concerned, some are good and some aren't. Find the Dansko with the most rigid, non-flexible sole (have you tried the Dansko Professional with rearfoot control?). My husband likes the Dansko Wayne, but I have to replace it within 8-10 months because the sole starts to flex too much in the forefoot area.
Thanks for reading the blog and I hope this proves helpful!
Cathy
:)

pm4 said...

Thank you Dr. McCarthy, your blog is excellent and I really appreciate your responses. Disappointing about Crocs but at least they still have the Specialist. I am currently wearing the New Balance 928 as per your recommendations and I have to say they are, when worn with the gel dancer's pad, probably the most comfortable shoe I have ever worn and I really feel like they help a lot with the sesamoid issues. I am also going to try the MBT and the Sketchers just for the sake of it.

I have tried the Dansko Men's Professional Clog but I had to return them because I really felt like even with the shoe having a back, I didn't have enough rearfoot control (and I tried on and spent time in many sizes, this was definitely my size). My heel raises too far out of that shoe, and my toes are constantly gripping. I will look into the Alden and the Wayne, keeping in mind what you said about individual shoes. I have become obsessed with trying to (discreetly) bend shoes I find in shoe stores!

One follow-up question I do have, is (and this is related to men's dress shoes and rigid soles)... you mentioned inserts, what kinds of inserts do you usually recommend for sesamoid? I am using the dancers pad, and probably need some sort of arch support (that was one thing about the Danskos, even though it didn't feel right with my heel coming out, the arch support felt amazing, though arch support isn't anything I thought about prior to this injury), BUT what about inserts to make the shoe more rigid in the soles? Wouldn't this somewhat negate the need to shop all over looking for the elusive rigid men's shoes? I know they exist (like that Carbon thing), but I don't know if professionals such as yourself recommend them. If you aren't against trying them, are there certain brands? I don't know if they are all the same or if they come in levels of rigidity, and maybe some levels are better than others?

Anyway, THANK YOU for your blog and for indulging the sometimes frantic desperate sounding questions from those of us who are suffering and feeling clueless.

Anonymous said...

Thank you Doctor McCarthy. I will follow all of your recommendations. I am relieved I finally get to see a Podiatrist in August. My orthopedic surgeon is no foot and ankle specialist. I need to have new inserts made next month. I am hoping Big 5 has the shoes you recommend so I can test weather or not they bend. My boots bend, so OUCH! I ordered them by magazine. I will also make a list of questions and concerns for my podiatrist. I am hoping to take up boxing again in the future. At least shoes are required in boxing! :-) A local former boxer and trainer told me that I can have my boxing shoes or wrestling shoes custom made. No kicking or foot stomping either! I was able to take her self defense class recently. No pain because I did not kick or stomp. I also took a naproxen and drank a full packet of gelatin before and after class. I took extra calcium and vitamin d 3 that day, with more protein. I believe boxing may be doable. I hope so, it's my favourite sport. I miss sparring badly too! I will need to be medically cleared before she will let me box though. Again thank you Dr. I bet you have many satisfied patients. I wish you were my podiatrist.

Angie said...

Dr Mc Carty could you recommend a shoe for someone recovering from a dislocated 4th toe. Happened yesterday and fixed. I can put just a tiny bit of weight on it as long as my foot is flat and use my cane. It maybe necessary for me to go back to work before I feel completely recovered. Is there a brace I could wear temporarily and then a good shoe. I like the sketches shape ups but I feel that is not going to work now due to the rocking of the hill

Unknown said...

I am so happy I stumbled across this blog. I have never had any major injuries in my life and reading about PTTD and tendinitis, which I was just diagnosed with, is causing me great sadness.

I am obese and recently joined a gym and started walking on the treadmill daily for about two weeks. The pain was so severe after several hours post workout, that I finally decided something must be seriously wrong.

I was given a shot with b12 and other things in it. Given a 15 day prescription for an anti inflammatory, and I'm due back to my pod in two weeks for my first physical therapy session and then a reassessment with my pod afterwards.

I suppose I shouldn't have googled my condition. I am terrified that I'll never be able to go back to the gym and saddened that my attempt to lose weight is being completely halted by the pain that I'm in.

What's worse is that I just spent a lot of money on a brand new pair of Nike Airknit Flymax shoes and my pod told me they'd be no good. I am taking the shoes in for him to inspect Tuesday because they pass all the tests on the informational pamphlet and since I threw the box for the shoes away, I will have tossed a sizeable chunk of money down the drain if they will be no good for me.

My question is, what are your recommendations for shoes that I can wear around the house and out for daily activities? I have been barefoot my whole life, so I want to be sure I can find a comfortable shoe that will not tempt me to go to my preferred comfort of no shoes or socks. On the list of recommended sandals he gave me, Birkenstock was listed but with no specific information about what styles would be permissible.

And may I have your opinion on whether or not I'll be able to work out again? And are there any gym related exercises I should avoid....or that I can do in the future once I'm allowed. He currently has me on two weeks of no exercise whatsoever, but the thought of permanently being banned from any good cardio that would help me lose weight has me feeling very bleak, indeed. Thank you so much in advance.

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