Question
Dear Doctor,

I sent you a question back in July 2009 concerning sore feet after pregnancy. About 6 weeks after my daughter was born I started suffering from sore feet (mainly the left foot), firstly in the area where the foot meets the leg and then in the area on the top of my left foot near the small toe. You advised that the hormone Elastin may be responsible for my problems and this should resolve itself in time. Well, my daughter is now 13 months old and I still suffer from foot pain. I had custom made orthotics made for my feet last July and had them adjusted twice. They helped with the pain a bit but seemed to have caused other problems, i.e ligament pain on the top of my foot (the ligaments that connect to my toes). I started physiotherapy couple of months ago and did all the exercises that the physiotherapist recommended but little, if anything has improved. The physiotherapist suggested that I take the orthotics out completely and see how I get on. I had no orthotics in my shoes for the past 4 days and I am only wearing trainers. The ligaments on top of my foot stopped aching but various muscles in my feet ache more now and I am really worried that I may get plantar fasciitis again (I suffered from this 2.5 yrs ago but it did resolve itself eventually with custom made orthotics). I now made an appointment with an orthopedic surgeon but the appointment is not until the end of March. I was just wondering what your opinion is on all this. Could something else be wrong with my feet? I would think that the hormone should be well out of my body by now? I had no injuries and I have lost all post pregnancy weight although I have to lift my daughter constantly. Also, I had an X-ray to rule out arthritis and all was clear. Many thanks for listening. Kind regards, Katarina

Answer
This Chicago & Elmhurst Podiatrist says.......

Dear Debra,

Sometimes there is a break in period of up to 1 month for orthotics.Usually they work better in some shoes and sometimes they only work on up to 80-90% of the patients. They may also need a redo. Try a shoe with a little bit of a heel-like a low wedge and maybe "mules" at home.These kinds of shoes take some pressure off the plantar fascia.
The stretching exercises will not work--unless they involve your calves and Achilles tendon.Sometimes ultrasound physical therapy helps.I'm pretty sure you have tight calves/Achilles-and so do stretching exercises of the calves-with the knee locked. Google the exercise for examples.
Also-if there is increased weight-that will work against you-because you are also more active.Continue to work with the weight if an issue-the physical activity will stay the same-since you have a baby.
Put the orthotics back in and see the podiatrist and explain that they are hurting the top.
If he/she is sympathetic and willing to work with you -stick with it.
If the doctor doesn't listen then.......
Skip the appointment with the orthopedic surgeon and go see another good Board Certified Podiatrist.
The training difference in the foot & ankle is HUGE.To be Board Certified in Surgery of the Foot & Ankle as a Podiatrist there are more than 75 cases sent in for the exam. The orthopedic surgeon may send in a Maximum of 12 case-usually less.
The orthopedic surgeon who has done a Foot & Ankle Fellowship has equivalent foot & ankle training as a board certified podiatrist
Hope This Helps
Good Luck!

Dr George Tsatsos & Svetlana Zats
Podiatrist Chicago 60618 & Elmhurst 60126 Podiatrists
Board Certified in Foot and Ankle Surgery & Orthopedics
New South Loop Location-Chicago 60661
AnkleNFoot.com
Runnersdoc.com
BabyFootDoc.com

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