Flat feet troubles

Hi there. I'm 27 and I've gone my whole life with flat feet and pronated ankles without orthotics until about 3 months ago. To start, my ankles and feet never really gave me problems. Last summer, I decided to start running. I loved it and managed to work my way up to 2 miles without stopping (I know, that's not much for actual runners, but for me it was great). My ankles started hurting a little bit, but I would just run through it. I bought a $100 pair of Brooks running shoes which helped the shock a little, but not the ankle pain. Eventually, my right ankle started having pain... felt like bone pain. So I went to a podiatrist who had me fit for orthotics and warned me not to run anymore because I was born with a "bad set of wheels." I've stopped running (the running period only lasted a few months of the summer).

Ever since getting the orthotics, they feel good when I walk, though my ankles now pop and crack in the morning for the first 10-20 steps. Additionally, I'll be sitting and I can feel a slight warmness in my left ankle and when I pop it, it feels better. Kinda like tendinitis or something.

Anyways, I'm not sure what I should do. I've been taking glucosamine/chrondroiton (sp?) and omega3 with fish oil pills for a month or two but they aren't healing. I'm wondering if I permanently damaged my ankles and have to look forward to continual degeneration of my ankles and arthritis and all that jazz. I work full time and am in college full time so my money is limited (the $500 orthotics killed me) and my time is limited, though if someone thinks I should go back and report my ankle condition, I will do what it takes. This all really bums me out because I'm in school to become a physicians assistant and plan to be on my feet and not in a wheelchair or whatever. I'd also like to get some cardiovascular activity back in my life as it keeps me sane in a lifestyle of all work and no play.

Can anyone offer any advice? Thanks for reading this.

(PS - I wear the orthotics in skate shoes. I bought the shoes before the orthotics, and my flat feet sorta broke down the arch and flattened the shoe. Now that I have orthotics, I'm wondering if I should be new shoes that are more conducive to better feet form, arch, etc?)

[FootDoc]

THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
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First of all, I am really saddened at the number of people who write in here who have gone to a podiatrist and the next thing they commonly say is that they were sold orthothics . . They mention no specific diagnosis, apparently have not been offered a treatment plan, and often have spent far too much money for something for which the doctor pays relatively little and often supplies no specific prescription other than submitting a cast to a lab, PERHAPS with the complaint of the patient. I'm not saying that orthotics don't have their place in the care of foot problems, but I have to wonder how many patients who come to these doctors leave with something other than an overprice orthotic and without a diagnosis or having the doctor enunciate a treatment plan or being given any knowledge of what, if anything, is being done for them. Apparently, go to a chiropractor and you get some bone cracked . . go to a podiatrist and you get orthotics. Actual studies generally conclude that glucosamine and its combinations are more placebo than treatment and omega3 fatty acids may do something for cardiovascular disease, but I doubt anything for joint pain, although you will find cult-like revulsion from some at such a statement. I can tell you that running is wear and tear on the joints of the lower extremities (you claim not to have the ankle problem before becoming a running enthusiast) and if one has such problems, stopping the running and not running through it is generally the answer. If you really wish to know if you have damaged your ankle joint structures, have the ankle examined, both physically and radiologically. I really cannot discern what your actual complaint is at this time and therefore have little to offer you other than my opinions stated above.

Hey there, thank you for the reply. When I went to have my feet looked at, the first portion involved taking an xray of both feet. I don't think (from what I got from the conversation) that my cartilage has worn to the bone or anything like that. But you're right, no real treatment plan was offered. I was supposed to be rechecked 30 days later, but never did, so maybe I need to get back in there. I'm guessing without x-rays, most people can't offer advice. I'm just curious if these kinda things take a long time to heal. With Christmas money, I bought a nice recumbent exercise bike, but I'm not even sure if I should be using it, or the stair climber at the gym. From your experience, do feet typically adjust to new orthotics in the form of popping and clicking and whatnot until the foot/ankle has become used to it's new form, or is this something that is not normal?

Thanks again for your help..

[FootDoc]

DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
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If you are talking about popping such as is heard when cracking knuckles, that is thought to be a sudden escape of gas from within the joint capsule. Generally, such sounds mean nothing ominous. If, on the other hand, you are describing "crepitus," that can portend something more serious. Neither are something that. in my experience, is generally associated with wearing orthotic, but orthotics, in general, especially if they are actually doing something, often take one time in which to become acclimated to them. I normally recommend to my patients that they should only be worn until any adverse symptoms arise, then remove them from the shoes and return them at a later time until anything untoward is felt again. I will see the patient at intervals to determine if their complaints, if any, are normally expected ones and should mitigate, or if some changes need to be made. To that end, the patient has to be able to offer reliable, understandable and consistent information. In my experience, many weight-bearing problems can generally be made temporarily better by just about anything I put into or add on the shoe, so don't think that just because an orthotic makes the feet feel initially better that the doctor has necessarily hit on something. But when a part of the body hurts, the first thing to do is to look at and evaluate THAT part, and not make assumptions that its cause is elsewhere.

What's funny about orthotics is that my feet now prefer to be in them, for when I wake up and take a shower and do whatever business I need to do without my shoes on, my feet are usually happier and more comfortable when I finally put my shoes / orthotics on. In fact, you could say I loathe not having my shoes on when walking around the house.

The popping feels similar to knuckle popping, so I guess that's good, although I don't especially enjoy the pressure that I feel in my ankle that is only relieved after popping them. When I work out (five minutes on stair climber / ten minutes on recumbent bike) my ankles don't pop at all for a while. It's certainly not uncomfortable to do such working out either, I'm just wondering if I should ride a wheelchair around for a month or two.

Well, thank you for the info. It sounds like I need to maybe have my ankles re-xrayed since the orthotics and maybe get some pointers about shoes, since I can't imagine all shoes are created equal in regards to orthotics...

[FootDoc]

DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
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It is not uncommon for orthotic wearers to become "addicted" to them even when they are no longer successfully treating whatever they were prescribed for. I did not intend for you to infer that the popping you were hearing is analogous to cracking knuckles or that it is of no consequence. I don't know why you are experiencing it.