Question
Hello Dr. Tabari,
I have had problems with my right foot for about 2 years.  It started when I noticed that I was walking on the outside edge of my foot and I would tear out the right outside edge of my right shoe within about 2-3 weeks of use.  The only shoe that I can wear long-term without wearing out are Crocs, because of their flexability and I wonder if the fact that they don't help keep my foot in a natural position is hurting me more.
I went to a speciality shoe store (called The Starting Block) and they evaluated me on a treadmill and a computer.  It showed just how severe the angle of my Supination was.  
I now have pain when I am on my foot for a long period of time and it pains me to try to walk with it in the normal position.  
I don't have health insurance as of yet (I should be getting on my fathers plan soon) and am not in a financial position to see a specialist.  
I am 34 yrs old and weigh 250Lbs.  I am working on losing weight because I know that getting some of the weight off my foot will help, though its a slow process.  
Do you have any suggestions about what I can do to help my walking (Pain management, Aids ie a cane or corrective shoes, etc)?  Will it get worse if I don't do anything?  Does it sound like Surgery is in my future?
I thank you for your time in helping me with my foot.  
Kim

Answer
Hi Kim,

It is very important for you to be evaluated by a podiatrist. You have to have an expert evaluate the nature of your gait and do a thorough biomechanical examination.

It is very well possible that a pair of well-made customized orthotics (insoles) may solve your problem. But before this can be done,  you have to see a specialist. Your feet and ankles have to be x-rayed and evaluated radiographically in order to determine the nature of your problem. Your problem may be confined to your foot and subtalar joint or it could be originating from the position of your knees, or any imbalances proximal to your knees.

It is very hard for me to determine if you are a surgical candidate or if your foot pain will get worse without having seen you in a clinical setting. Here are some of the things you can do until you see a doctor: continue to wear comfortable shoes, try to lose weight and if you experience pain in your foot after a certain type of activity, refrain from doing that activity.

In regards to your medical insurance situation, you can go to a reputable teaching hospital and apply for what's called Sliding Scale Program in which they will adjust the charges according to what your income may be.

Sincerely,

Isaac Tabari, DPM
Doctor of Podiatric Medicine
Diplomate, ABPOPPM
New York, NY
http://www.footdocnyc.com


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