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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:

«Oldest   ‹Older   201 – 279 of 279
Doctor of Podiatry Discusses and Recommends Shoes. said...

Hello pm4,
Sorry for the delayed response!
The best thing to add to a men's dress shoe is a dress custom-molded orthotic, which you can get from your podiatrist. They are thinner and go in most dress shoes.
I recommend and even carry the carbon-fiber removable shanks in our office ($199 per pair). They offer some excellent advantages but they have drawbacks. The idea of a shank is to transform a good shoe into a better shoe. The shanks will not work in shoes that are flimsy or super flexible soles. The shanks are only as good as the shoe that you put them into, which means that there is nothing better than just purchasing an amazing shoe that has a sole that doesn't bend or flex through the sole! If you have a decent shoe with mild bend through the sole, the shanks will help - but they do not work for everyone. They also take up room in the shoe and it is important that you have a full-length insole placed over the shank or they will be very uncomfortable. How's that for muddying the waters?
The reason I don't talk more about shanks is that they are not my first line of defense in treating patients. Once patients have gotten proper shoes and healing, then they can start using shanks so that they can broaden their shoe wardrobe choices. I can't stress this enough -- purchasing shoes that meet the 4 criteria are absolutely essential. Too many people try to use the shanks as a 'cheat' in bad shoes when the real purpose is to have the shank be icing on the cake and turning a good shoe into a better shoe.
I hope that was helpful and thank you for reading!!
Cathy
:)

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

Dear Anonymous,
Thank you for the kind words! Glad to hear that you may be able to return to sparring!!
Thank you for reading,
Cathy
:)

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

Hi Angie,
Sorry for the delayed response! After a dislocated 4th toe that has been reset - I would place you in a below the knee walking boot for at least 1-2 weeks so that there is facilitated healing. After that, the NB 928 or 1540V2 as a walking shoe and the Rx Crocs Specialist (non-vented) or a Birkenstock sandals for bedroom slippers.
I hope all is well and if it has not improved or still hurts, I would recommend a follow up with your podiatrist for repeat x-rays or even MRI.
Hope all is well!
Thanks for reading the blog,
Cathy
:)

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

Hi Anna,
Sorry about the delayed response!
You'll be able to return to working out - you will just have to biomechanically control and protect your foot to prevent further injury and to keep your foot feeling good.
Copy and paste these two articles into your search bar for more info on what you need to do:

http://podiatryshoereview.blogspot.com/2012/05/my-feet-hurt-top-ten-things-relieve.html

http://podiatryshoereview.blogspot.com/2012/04/podiatrist-shoe-recommendations-for.html

Also, talk to your podiatrist about getting a quality brace to wear as you return to your workout routine. Hang in there and EASE back into your gym routine.

Thanks for reading and best of luck!
Cathy
:)

Anonymous said...

Hi. My name is Dorthea and I have been recovering from a Pilon fracture. I went back to work about a month ago after my accident in April. I stand at work making food all day and my foot and back end up hurting really bad. My ankle swells up and I elevate it when I get home. I need to know what kind of shoes would be great for my feet. I just got a pair of Sketchers but haven't tried them at work yet. Can somebody help with advise?

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

Hello Dorthea,
The Pilon fracture is pretty serious. For work, I would place you in a New Balance 928 with a brace. You should be able to get a brace recommendation from the podiatrist or ortho who has been treating you. Depending on the severity of the Pilon fracture, you may need a custom-molded AFO, which you should discuss with your doctor also. I would also highly recommend that you discuss orthotics or at least and excellent OTC insert to put in the NB 928. Make sure you get the Croc (non-vented) Specialist clog to wear as a bedroom slipper around the house. Of course, check all this with your doctor!
Best wishes,
Cathy
:)

Anonymous said...

Hi - just fractured my 5th metatarsal in a mechanical fall. Have a boot (Ossur) but am looking for a shoe only to sleep with for the first few weeks (since when the boot is off - the foot hurts more but when it is on - very hard to sleep!). Also wondering if there is a shoe (or boot) that I can get in the pool and do some water exercises and/or easier to get on the exercise bike - did this with the boot last night and very bulky. I was supposed to run the NYC marathon - that's out - but still want to stay in shape. Many super many thanks!

Julie said...

Hi there,
I'm writing to you from the Laurentian Mountains, north of Montreal, Canada. Your blog, both questions and answers are fascinating! From twisting my foot the wrong way, while going down a grassy slope, I fractured the middle of my right 5th metatarsal on the day I left for a 5-week beachside vacation in Florida. There wasn't much pain or swelling, in fact, I didn't realize that I had injured my foot, till I tried to walk through deep sand to the ocean the day after the injury. In fact, never having had a fracture, in my 64 yrs, I thought it was a sprain and did the RICE thing for 2 weeks and avoided the sand. Because I was planning to go on a bus tour of Italy in the fall, I decided to get my foot x-rayed and that's when I found out about the fracture. It's in the middle of the 5th metatarsal, kind of a v shaped on the extreme right, reducing to a hairline traversal fracture right across the bone. In Florida, I was put in a CAM boot with the air pump mechanism for 3 weeks and told NOT to walk on the sand, nor try to go into the ocean (even with a wheel chair with large wheels), not to drive, and not to go to Italy. I was limited to the pool that had a lift. A walker was recommended, but I used a cane for 3 weeks until I headed home (where I have a walker.) I have to say that I did hobble around barefoot in the bathroom several times a day, so maybe I did further damage. Not sure how the healing process works. For those 3 weeks I did put weight on the boot, as I thought it was a "walking boot" and I could do so. Once back in Quebec, after seeing some healing on a 2nd x-ray, my Montreal orthopedic surgeon recommended staying in the boot for another 6 weeks, but keeping the weight off as much a possible. He said if I needed to walk a little, to only use my heel. I live alone, and find it very difficult to prepare dinner, etc., while keeping the weight off of it. I got no further suggestions. I saw a kneewalker on line, but I did NOT want to try it, as I am obese, only 4'11'' and have a torn meniscus on the leg with the injured foot, and a deteriorating meniscus on the supporting leg. My physio therapist said I could cause my knees further damage with a knee walker. My questions are: 1.) Do I re-fracture my foot every time I put weight on it? 2.) Can I use a ortho wedge surgical shoe that keeps the weight on the heel, instead of the CAM boot? I know I should ask my own doctor, but I won't see him for 6 weeks, and he works out of a hospital and don't know how to reach him. Why do I want to substitute the ortho wedge shoe for the boot? I find the boot very heavy for my back and my knees. How am I keeping the weight off the foot? I sit on the walker and push myself around backwards. The Montreal doctor did say that I could drive short distances, (in a regular shoe) because the weight is on my butt, and the motion is up and down. What do you feel about the ortho wedge shoe? and how diligent do I have to be about not weight bearing? Thanks for any advice. Julie

Joan said...

Dr McCarthy,
I broke my second metatarsal near the foot last September. Ortho put me in the CAM and bone stimulator. It did not heal. I had surgery on it in June, did non weight bearing for 6 wks and transitioned to CAM boot then shoe. I had my 3 month post-op appointment and they said it was healing slowly. I asked if there was anything else I could do and they said take more vit D (5000 IU). I'm taking Vit C, Ca, and Vit D. I'm concerned that it's still not healing as fast as it should be. The X-ray looked no different to me than my 6 week X-ray. I just got the 928 for women (they are no longer carried in stores), crocs rx (on line), and abeo inserts. Is it too late to impact healing 3 months post-op? Is there anything else I can do? I'm still in a lot of pain 6/10 most days. I'm a professor so I'm on my feet all day and I'm a caregiver to a chair bound parent. I do not help him up yet. What can I expect for healing time and getting back to walking/hiking/yoga? Will it ever heal? Ortho said reevaluate in 3 months. I'm concerned.

JeanZ said...

Hi. Thank you For the educational article I am Recovering from broken medial maleolus (plate and 4 screws) surg 8/3/16. Just got the OK for full wgt bearing. What is your opinion on Orthoheel (Vionic) slippers for around the house ? Also, I work with horses and am outside in the barn Most of the day (when I get back to normal that is). Do you have any recommendations for an outdoor work boot or shoe? I like the idea of crocs as they seem comfy and easy to clean. A lot of people actually wear them for daily chores and such for that reason, just not sure if they would be appropriate after such an injury. Also I think putting on an ankle length boot might be a bit tough for a while due to swelling. Thank you.

Anonymous said...

I fell and injured bottom of foot between big toe and second toe. The second toe was overlapping and swollen...I had surgery to fix bunion and straighten 2nd toe. The pin did not hold second toe straight and had a second surgery to fix 2nd toe again. I am at point now where I am gradually coming out of boot...I bought crocs and the are great. I bought new balance shoes today. Had a question on why New balance 928 shoe is getting bad reviews since NB made v2. Are there any other shoes to go into if we cannot find the NB you recommended ....

June

Alexandria B said...

First off, thank you for sharing this blog!

14 months ago I had lisfranc fracture/dislocation injury. Fractured 2 metatar., shattered 2 midfoot.

My surgeon did amazing! But I stand 8hrs 5d/week.
My stiff foot pops loud every morning.

I need to prevent arthritis!

Looking forward to trying the shoes you recommended!

-Alexandria
26yrs Seattle, WA

Brooke said...

Dr. Cathleen, Hello! I was diagnosed with a lis franc injury in May of 2014, after a car wreck where the brakes gave out on me, and I was pressing the brakes so hard when I hit a tree it broke all of my mega tarsals and popped a ligament. I went straight to the hospital, in the worst pain of my life. They quickly scheduled me to see an orthopedic surgeon the next business day. I had never had any type of broken bone or surgery so I was freaked out and totally depressed but I was very impressed with the dr. He seemed to know what he was talking about. He preceded to inform me that I needed surgery where a "fixature" would be put in and left for around two months, then I would have another surgery to remove the metal that was on the outside of my foot. During the surgery he used a plate and several screws to put my foot back together. Between surgeries I was "good" I stayed off my feet and feed my boardom...I ended up gaining 40 pounds. I went from 140 to 180 in two months. So that would be another problem when I got back on my feet(the additional weight gain). After the surgery my foot looked so almost deformed with a huge lump on the inside of my foot. I would go back to the orthopedic dr at least twice a month. He told me it was healing perfectly, and the lump on the side was completely normal BC that was where the plate was located. But I was doing absolutely everything wrong...the week after my surgery I was walking around in flip flops, horrible bedroom shoes, and mostly barefoot. I didn't know this was wrong BC he was telling me everything looked awesome. I would be in constant pain.... Omg I don't have another experience to compare it to. I was hurting and still hurt badly if I'm on it longer than 5 minutes and the swelling is unbelievable! Since then I have been back to see him once, just for him to check my foot out. He didn't do any xrays BC I have no insurance and had already wracked up $100,000 just in hospital bills from the surgeries. I am and have been filing for disability since BC in addition to the foot injury, I also suffer from PTSD from the wreck. I don't drive and have a hard time riding BC I get so scared. Well turns out that my big toe joint has pretty much popped out of place...so he is recommended another surgery. I have since lost the weight that I gained durning the two month period I was totally out of commission. But it hasn't helped much...I don't think. I have, since the wreck experienced more body pain than I can imagine. The disability dr constantly ask me what I take for pain and I tell them just ibphefen for the swelling and they can't believe I'm dealing with all this pain I am experiencing. I have had scoliosis since childhood and this injury had made it completely unbearable...I mean I sleep on a heating pad every night! My left calf is twice as big as my right BC of the injury. I wish I had found your blogg two years ago. I am 31 feeling like I'm 60. This accident has affected my whole life! I used to be so outgoing and healthy...I worked out, loved to walk or run, that had all changed. The reason I was looking for some info is BC I need some good tennis shoes that are gonna help. Your blog is wonderful. Anyone that ever had this injury should read this asap...I feel asif I have hurt my body more than anything BC I didn't realize how to take care of my foot in the beginning. So for anyone who has had this injury recently... Live by the information she had outlined in her blog. This is wonderful info! Thanks dr!

Brooke said...

Dr Cathleen....I was reading on this page about how a Dr could write a prescription for these shoes to get a tax write off. Is there anyway you could write me a prescription for the shoes you think I need and the Crocs RX also...it would help out a lot. As you know, and in my previous post I said that this injury can get expensive...with surgeries, medicine, shoe inserts...etc. Please let me know. Thanks so much! This blogg is awesome and has helped me understand so much more about this injury! U are awesome!!! (brookepoole200@gmail.com)

Unknown said...

Great blog!And very helpful site"casual shoes for men"

Unknown said...

Dr. Hi, I love your blog and wanted to ask your recommendations for a right heel fracture that I received at work after having to jump off a ladder. I had surgery with 2 screws and healing. With PT 2x wk for 12 visitis. What shoes do you recommend for a size 12 man and I need steel toed shoes for my work as a mechanic in a truck shop. Many thanks, Aubrey Brown

Anonymous said...

Hi. I am a physician and I must give you credit for responding to all of these questions. Wow! Yes, I have one, also. 9 weeks ago I fractured (non disjointed) the proximal base of my 5th metatarsal. (zone I). First 3 weeks- non weight bearing. Past 6 weeks, Air cast select short walker (boot). Now, my ortho foot/ankle doctor; has told me to advance from the boot to a "hard-soled" shoe. I called his office, for a specific example; and was told, "Just a regular shoe" ("not flip-flops or sandals"). This can't be right. So: I'm trying to find a "hard-soled" shoe.
Tonight, I tried on the Dansko XP Pro clog, which had a hard sole (and felt great); except, as a clog it had no "rear foot control". I was told by the salesman it is supposed to have a slip heel.
Thus I'm at a loss. I ordered the shoe you recommended, "John Fluevog Chief". I just hope it fits (as only came in a few sizes).

Any specific "hard-sole" shoe recommendations?
Most appreciated.
S.T
Louisville, KY

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Kathleen said...

Hi there.

I'm recovering from a Lisfranc sprain, inter-metatarsal bursitis and a bone bruise on my navicular bone on my right foot. I finally had a MRI on week 10. It's been about 14 weeks post impact (someone threw a Christmas tree on my foot). I spent 2 weeks on crutches before I saw my podiatrist (emergency room said nothing was wrong with my foot) and then 6 weeks in a boot.

My problem is that I can't seem to find any shoes that don't bother my foot. They still swell and throb with pain almost daily and I can't tolerate anything on top of my midfoot.

I know that I need arch support for the sprain. Do you have any recommendations? Mary Janes and clogs are not an option right now. I probably need a different size for my right foot due to the swelling. I work in a professional office. I've been wearing a pair of flats that are about 2 sizes too big to accommodate swelling.

I also was wondering how long the swelling/pain would last.

Thank you.

I feel like such a wuss.

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Elmlou79 said...

Hi was involved in a car accident and suffered a oblique calcaneal fracture. I live in Scotland, UK so been reading your blog in the U.S. Been NWB for 5 weeks have been advised by my Consultant could be NWB for up to 8-12 weeks. No longer have to take painkillers which has been a positive step forward and wearing a backcast which I can take on and off. Been exercising my ankle up and down but not much movement side to side. Could you recommend footwear when I start to weight bear. Was looking at lace up Dr Martens which you get in the UK. Trying to be positive as read so many different stories about how long it takes to recover from these injuries. Any helpful suggestions would be much appreciated.

Roxanne said...

Elmlou79, I am 3 years out from shattering my calcaneus into 7 pieces. There IS light at the end of the tunnel. If you want to email me at roxannebernard68@gmail.com, I'd be happy to talk with you about my experience. I'm American but descended from Clan McGregor!

weezer said...

Dr. McCarthy,

I just stumbled across this post looking for good running shoes after a Lisfranc injury. I injured my foot over 5 years ago. Originally had one screw in place, it backed out so I had it removed. I am active duty military, so I had to deploy like that until I could get it fused a year later with 6 screws. I have picked up running and have done pretty well with Asics Kayanos. I tried going to Sole to Soul to be fit and they gave me Hoka's. Unfortunately, they really hurt my knees (from what I have read due to too much support). Before my injury I had tried New Balances and had similar results with knew pain so I reluctant to try them again. I would like to continue running and am curious if you think the New Balances are worth trying again or is there something else worth looking into? Thank you!

Matt said...

Dr. McCarthy, like everyone else after hours of searching I found this! On 1/16 I slipped on ice while carrying oranges. The oranges swung in my hand and I launched them out causing me to spin completely around but my other foot was on dry pavement it did not move. Tri-Malsculus fracture(broke the three ankle bones) and fractured the fibula in multiple places lower and upper, also causing the tearing of soft tissue(shown in an mri) the dislocation of tarsal joint and the shin bone. So four surgeries later, (1. putting everything back in place with screws and hardware, 2. installing a halo, 3. removing the halo, removing some more screws,4. removing plates) and another looming to shave down bone spurs I am walking! Reading some of these injuries makes me envious. I sometimes where a hard brace (DonJoy), but always have some kind of support from a soft brace when i walk. My old shoes are beat up from walking in the brace (Merrels with good support) but they are done for and i am looking at getting into some new balance with the roll bar (MW847v2) and looking for the crocs rx for house walking and nightly trips to the bathroom. I am currently walking with a peg leg when I go, yeah not the smartest, but I will fix that. I worry about the pool this summer what would you recommend? I fear that the Teva's will cause my ankle to roll. Thank you so much for this blog.
Matt

Unknown said...

Excellent advice for healing after foot surgery. Shoe choice is important even if you've had a partial knee replacement. Your joints need full support starting at the feet. You should wear the proper shoes, especially during physical therapy sessions. Our hospital has a full team of physical therapists to help with joint replacement in Webster, Texas.

Lindsey M said...

Hello Dr. McCarthy,


This is an incredible blog. I am in my early 40s. I had severe PT tendonitis 12 years ago and was casted and then in a walking boot and on crutches for nearly a year. I developed Achilles tendonitis and plantar fascitis too. It took about 8 years for me to walk more than a block or two without bad pain. The only shoes I have been able to tolerate are Birkenstocks (in the summer and as a house shoe), Dansko clogs (at work) and running shoes. For awhile I could not wear a shoe with a back because of my Achilles tendonitis, but backless sandals aggravated the PTT pain. I have been sustaining with these shoes for several years and I am not complaining -- I am happy to wear these shoes, and to be walking at all -- but now I am starting to have pain again because I do not feel that the shoes "hold" my ankle well. I also swear that Dansko is making their clogs wider. Until recently, I have been been able to walk 1 mile or 2 with my orthotics and running shoes with very little pain.

I found this amazing blog and immediately tried to buy some of the shoes that might work for my PTTD but found they were no longer being available (I think the styles were discontinued). I am wondering if you plan to update your list of dress shoes at any point. I also was wondering if you ever do paid phone consultations about shoes for long distance patients. My long-time pod retired and I have not found another who knows much about shoes and cares to help patients actually find a shoe that is a good match like he did and like you obviously do.

I have worn these same 3 pairs of shoes for nearly 5 years. I would love to have just one shoe with a back that I could wear to work that is not a sneaker.

Thank you so much, Lindsey

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Anonymous said...

Thank you SO much for your blog, it has been a life saver. I broke my 2nd and 3rd metatarsals, with the 3rd being displaced. My podiatrist decided it wasn't displaced ENOUGH for surgery. Here I am, 4 and a half months later in terrible pain. I'm doing all the right things shoe wise....crocs, inflexible new balance, Birkenstocks, prescription insoles, and I'm still limping severely and suffering with pain. What can I do?

Stephanie

Anonymous said...

Do you know anything about the Protalus line of orthopeadic inserts? I've considered purchasing them for recovery from calcaneus surgery (my husband) and for recovery of fracture to the long foot bone on the right side of right foot (for myself). By the way, your blog has been very helpful in educating us about footwear. Thanks!

Anonymous said...

Hello

my husband got a soccer injury on july 2017, we thought it should be ok and thought it will heal its own, even he said it is getting better, well after all he walks around in filp flops, barefoot etc, then we went to canada and after much walking his foot started hurting and may be slight swollen not sure... so we straight went to see an orthopedist, didn't know much about podiatrist until I see this blog, so orthopedist took 3 view foot xrays and he came in point blank and said my husband needed surgery, he said my husband got the lisfranc injury today, but I believe no fracture though, just torn ligament, the doc was vague not sure he said it partially torn or fully torn. but wen I looked at it or the ER physician who works at the hospital I work looked at it, we didn't feel surgery but still not confident, the ER doc is not confident either since orthopedist said surgery, but we don't want surgery so what if the lisfranc is fully torn but no fracture will there be a recovery possible without surgery? I would have even posted that xray, but I guess no upload option :(. Please let me know, we are devastated. we live in texas otherwise I would have been already running to ur office

Anonymous said...

Dr. McCarty, I am desperate for some answers! My boyfriend shattered his left foot in high school when he was skateboarding down a hill and fell. He has had 4 or 5 surgeries on it and has had his bones fused together and plates and screws put into his foot. He has been in pain for years and he is now 24 and still has no relief. I don't know what to do for him and I hate seeing him in immense pain everyday. He usually wears boots on a daily basis, so if you have any suggestions on a great pair of boots, then I am all ears. I will take any suggestions for his foot because right now it's not getting any better and I don't know how to ease his pain in any way. Please Help!

missmilobiscuit said...

Dear Doctor, I'm so glad to find your blog. I fractured my 5th metatarsal in july and am healing very slowly. I am a 45 year old female. I have been barefoot in my house all this time after i got off the airboot which I wore for about 6 weeks. After that i have been wearing slip-on Sketchers. My ortho says that it is delayed healing and to take more calcium. nothing else. any advice please.

Most gratefully,
Radhia

Unknown said...

I am recovering from a sessamoid stress fracture. I have been in a boot since the first of December and on crutches. I was already in a boot over the summer, still walking on it, and it did not heal. When I get out of this boot, do you have a recommendation for a tennis shoe brand that supports well?

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Brooke said...

Hey Dr.
Love your blog...ive had alot of problems finding info on lis franc fracture and your blog has really been very educational to me. Wish i would have found it earlier.In midyear of 2014, I had a wreck were the brakes totally gave out on me and I ended up hitting a tree, completely shaddering my foot, where I was trying to press the brake so hard. Went to er and was referred to an exellent pod. Underwent two surgeries. One to input fixation device in my right foot, this was completely devastating to me. After the 1st surgery I had the fixation piece removed and a plate with 6 pins in it. I have the boot but did not wear it long enough...Now almost 4 years later my foot looks almost deformed. I didn't take the injury as seriously as I should have,but in my defense i was young and didnt really understand all the repercussions of not following the Drs orders. I HATE SHOES! I have went bare foot, just socks and flippers constantly!!!! Currently I am definatley feeling the effects of my stupidity. Because I hit the tree with such force, my hip was "jammed" up about two inches higher than the opposite leg. These injuries have added up and I now cant work, walk for more than 2 minutes without being in absolute chronic pain not only in my foot my back and in my hips. Mentally and physically this injury has got me pretty down and out. I am now struggling with horrid back pain, sciatica, foot pain and I already have arthritis in the joints in my foot. I can see where my toes are curling up to support my body when I walk. I'm only 33 and I feel so much older bc of these effects on my body. Basically all the advice in your blog, I did the opposite and I wanted to share my story so your readers will take this break more seriously. I'm considering having the hardware in my foot removed bc it hurts and looks like the pins and plate are shifting, almost like my foot is rejecting the hardware. I have NO arch in my foot and before the wreck I was flat footed anyway. I have discussed this with my pod but he wants to fuse the bones, DO you think this is a good option for me? Really appriecate your opinion on this! As for my back pain I have been to chiropractor and had multiple XRAYS to see the damage in my back, I have considered back surgery but I am terrified of that, bc I've only heard bad stuff from ppl that have had them. Thanks for you advise and good luck to all the ppl reading this and suffering with the same problems I am. FOLLOW DR'S ORDERS! I wished I had!

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


Thank you Thank you THANK YOU, Dr. McCarthy! I had 4, count ‘em FOUR metatarsal/lis franc fractures in my left foot (plus a broken right ankle) from stepping in a “washout” on the golf course in crappy shors May 21, 2015. (I was wearing $80 “orthopedic” flip flops at the time 😳 -duh!) I managed to avoid surgery, as the bones were not displaced, I healed well and quickly for an old gal, wore stiff “rocker bottom” shoes after cast removal and a stint in the boot and recovered pretty well. Once I decided to wear “normal” shoes again, though (a.k.a. crappy shoes) the foot pain and limping ensued. UNTIL a week ago, that is, when I found your blog by the grace of God!!! Thank you!!! I now own Croc Specialists for slippers, Spira “wave spring” athletic shoes AND a lovely pair of Dansko sandals for church -all recommended by my new long-distance podiatrist: Dr. McCarthy!! Best of all, my foot is VIRTUALLY PAIN FREE!!
I can’t tell you what a new lease on life you have given me, and I thank you from the bottom of my heart!! God bless you and your most wonderful work!!

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Very informative!

Hairline Fracture/Stress Fracture – Everything You Need to Know

Ahne SD said...

Great post. Very helpful.

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Anonymous said...

I have a fractured foot and broken bone in the foot. Once it heals can I ever wear a steel toe shoe again or do I need special show? Feel free to Email me answers at brianchesslottery#yahoo.com

Ahne SD said...
This comment has been removed by the author.
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Great post. Thank you for sharing

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Isabela Mills McCabe said...

Do you have any recommendations of work shoes for someone coming out of a 2nd metatarsal stress fracture? Doctor had given me a hard insole to wear on my sneakers, but my work is a bit formal and I wouldn't be able to wear that.

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Henry Chamberlain said...

I am so glad to find your blog. I am taking your advice and I bought a pair of Crocs to wear around the house as I heal from a pinky toe fracture to the right foot. My general practitioner concluded from my x-ray that I have a minor fracture. In his opinion, I probably just need to use buddy tape. And, in a number of weeks, I should be good as new. I can also get another opinion from a podiatrist in person but I'm leaning towards not doing it. I might but, based on the information I now have, it does seems like a manageable situation on my own. I fell from a last step to the stairs. That was two weeks ago. In another two weeks, I am set for a trip to NYC, which will need to be very limited due to this fracture. I could cancel my trip altogether but I would prefer not to. Any general suggestions on a minor fracture to a pinky toe?

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Glenn said...

Thank you for this page. It is very informative.

I have Charcot Foot due to Peripheral Nueropathy. I have a slight rocker foot. Can you recommend an alternative to that dang CROW Boot. It's black, and in this summer heat, it gets incredibly hot.

Anonymous said...

Hi Dr. Mc Carty, WoW!!! Thank you for sharing all of your information. This is very helpful. Wondering if this can help me.

I have bilateral lisfranc sprains with post tramatic arthritis. I have been in and out of the cam boot and can finally tolerate a hard sole post op shoe. I use a walker and my mobility is very limited due to this injury from 2 years ago.
-Will theses shoes help me? Will the trilock brace add support?

Per my dr my next step is a good wide based sneaker ( brooks or hoka) with a steel plate to help stabilize my foot. I am desperate to find a hard sole shoe that will provide the support I need. Please help! Thanks!

David 9 R / 26 V said...

I recently had ORIF of a 5th met fx due to non-union. Six weeks post op and still wearing boot. Using EBI bone stimulator for at least 8 hrs a day. I read with great interest your suggestions for footwear during/after boot is discontinued. At present I am wearing ECCO hiking shoes (was wearing when bone just broke while walking in airport). I use prescription orthotic in the shoes. Of course I am NOT wearing shoes on effected foot. So questions:
1. When sitting around house can I wear rubber soles slippers on fractured foot and wear EBI coil over top?

2. Should I follow your suggestions for Lisfranc fractures - Croc Rx, New Balance Shoes, no barefoot (even when going to bathroom at night and NOT bending ankle)?

In the blog I mostly found comments from women on shoes, types, etc. Not many male comments. Should I follow same suggestions? I guess I should buy my athletic shoes at store specializing in professional fitting.

Thanks in advance for ANY suggestions you may provide. My email is dwsgasser@gmail.com

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Unknown said...

Hi Dr.McCarthy,
So my mom fractured(basically shattered) her ankle and she has been out of a boot for a while and she still does not have a special orthopedic shoe to wear to improve her chances of her ankle healing properly. Her doctor told her the type of shoe for her to get but she doesn't remember the name and can't get ahold of that doctor now. If you could recommend a type of shoe for a post ankle fracture I would really appreciate it. I have been looking and looking and just want to get one that will work. Also, my mom likes to wear slip on shoes, like clogs. She doesn't prefer tennis shoes so any recommendations you can give us would really be a huge help!

Unknown said...

Hello Dr Mccarthy.

I am 12 weeks post op from a lisfranc fracture, a bad one apparently. I have read through all the comments of your blog and am trying lots of different running shoes to see if I can find one that comfortably fits my foot.

Crocs RX are no longer available for homewear. Could you please recommend another home shoe? I literally have nothing other than my airboot to wear currently and am desperately looking for a shoe to wear at home as well as a shoe to keep up with my 3 year old. My foot is still very sore and I feel like my injured foot has become wider, I need something spacious I think, but all shoes I have found so far are a medium width. Thank you so much .

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

Hello Unknown,

Thank you for reading the blog. I would recommend that you wear New Balance 928 or 1540 for around the house. As a bedroom slipper, you can try Birkenstock sandals, Crocs, Vionic Relax slippers or the Orthofeet diabetic slippers, which you can purchase online.

Hope that was helpful and I hope you feel better soon,

Cathy McCarthy

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Unknown said...

Like so many others, I am glad I found your blog! My 5th metatarsal fractured (Jone's fracture) approximately 7 weeks ago and I will finally (HOPEFULLY) be taking this boot off next week - last time I went it still wasn't quite healed enough. Thus far my pod hasn't mentioned any specific shoes and when I started Googling I found you! I ordered a pair of NB 1540s which will arrive Friday and a pair of Croc's Specialist II, as I noticed in one of your other blogs you mention that style. I noticed in a more recent post you put Croc's without the style though, from earlier in the month. Is any Croc, with the strap on the back, good or are the other styles inferior? I am going to ask my pod about the brace but I do also see it on Amazon. If he doesn't give me one or doesn't think it is necessary, do you suggest I get it anyway? Another shoe question, I notice you don't typically recommend Nike and I know most of their shoes are pretty flimsy which is a bummer because I like the look and fit. Should I just be following your general guidelines when finding sneakers, that they cannot bend etc? I'll likely be going to physical therapy as well to safely start getting back into exercise as I am an avid waker, biker, hiker, etc etc and I don't want to rush into anything if my foot isn't ready.

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Cazzie!!! said...

Good day Dr McCarthy. My name is Carolyn and I am an ICU Registered Nurse. I fractured my base of 5th metatarsal due to rolling my ankle 4 weeks ago. I am in a camboot for another 2 weeks but my queries in regards to appropriate shoes once I progress from camboot to shoe wearing please? I have an ankle brace ready to go. Thankyou in advance. Carolyn

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NATASHA STEWART said...

Not sure if this is still an active blog. I am almost recovered from a broken foot and looking for shoes for after I am out of my walking boot. Al Crocs RX are phased out, what is recommended instead for around the house?

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Judiblue said...

I went to the ER after folding my foot in half.. xrayed and told no break and it was sprained.
I wore a boot for a couple months and after 5 months was able to get into see a podiatrist.
He said the ER dr missed that I had a Lisfranc injury and I had to deal with the pain or get surgery which would mean months of staying off my foot.
If I wear my hiking shoes I can manage a 2-3 mile hike..
I would love to get some mid calf western boots for hiking in rattlesnake areas…
I can get my foot into a wide width.. would they be an okay thing to get? They do have a firm sole… or will they be a waste of the $ they will cost… thanks

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