Pre-Camino podiatrist visit

[SeñorJacques]

Just got back from seeing my podiatrist as part of my pre-Camino prep.

Some highlights, in the spirit of hopefully constructive oversharing :

• My previous visit three months ago was to address pain in my left foot due to heel bursitis + achilles tendonitis. Happy to say that a combination of PT exercises, weight loss, and wearing the 5mm cork heel lifts my podiatrist recommended for my Altras seems to have taken care of the tendonitis, while a cortisone shot completely knocked out the bursitis which had been bothering me on and off (mostly on) for a couple of years. I only wish I'd done it sooner.

• I was curious to see if another cortisone shot would be helpful as a preventative before my trip in case the bursitis made a comeback on the road. But my doctor is very much of the "if it ain't broke, don't fix it" school and did not recommend it, especially since said shots could have deleterious effects in the future if administered too often. Instead, he gave me a prescription for meloxicam (a stronger anti-inflammatory than over-the-counter ones like ipuprofen) in case my heel starts giving me problems again. And he reiterated his recommendation of Voltaran gel (which I understand is available in pharmacies in Spain) as helpful for foot and joint pain as well.

• Based on a reminder/recommendation I picked up on this forum, I wore the socks and shoes I will be wearing on my walk and am happy to report that both passed my podiatrist's inspection with flying colors. In particular, he was very impressed with the build quality of my Altra Olympus 4s, which he said he'd never seen "in the wild" before although he said he often recommends Altras to patients with toe and forefoot pain due to their wide toe box. (For what it's worth, however, he was wearing and said he "swears by" New Balances!) He said the additional padding on the Olympuses would be beneficial for a long walk over varied terrain, and that although the medical jury was still out over the supposed benefits/drawbacks of zero drop shoes they likely won't cause me problems with the heel lifts. So I can now say that my Camino footwear is officially podiatrst approved*! (*By my podiatrist anyway, which is good enough for me.)

• I also walked (or fairly skipped!) out of the office with a prescription for a round of antifungal medication to treat a slight but persistent case of what I thought was merely dry/chapped skin on the sole of my foot, but which was in fact an infection that could have become worse through long days of walking over a period of many weeks - not to mention encounters with less-than-salubrious albergue shower floors. Not exactly the sexiest information to share but I'm glad he caught it before it became a real problem.

All of which leads up to the main point of this post, which is that making an appointment to see a podiatrist should be part of everyone's Camino preparation! My visit not only reassured me that I'd made a sound footwear decision for myself but helped diagnose and treat some conditions that could have turned into more serious problems during my walk. Best $50 insurance co-pay I've spent in a while, and a more than a worthwhile expense on my Camino spreadsheet.

TL;dr: See a podiatrist before your Camino. You'll be glad you did!

 

[SeñorJacques]

PS - I also came home from the podiatrist to find the credential I'd requested from American Pilgrims on the Camino had arrived in the mail, pictured here with the New Orleans patch I bought on my way home this afternoon to go on my backpack. Some nice pre-Camino coincidence magic!

(By the way - this credential weighs almost half as much as the one issued by the Santiago cathedral and has space for half a dozen extra stamps ... maybe of interest to anyone looking to shave even more grams off their pack!)

 

[Former member 92300]

• Based on a reminder/recommendation I picked up on this forum, I wore the socks and shoes I will be wearing on my walk and am happy to report that both passed my podiatrist's inspection with flying colors. In particular, he was very impressed with the build quality of my Altra Olympus 4s, which he said he'd never seen "in the wild" before although he said he often recommends Altras to patients with toe and forefoot pain due to their wide toe box. (For what it's worth, however, he was wearing and said he "swears by" New Balances!) He said the additional padding on the Olympuses would be beneficial for a long walk over varied terrain, and that although the medical jury was still out over the supposed benefits/drawbacks of zero drop shoes they should be more than fine over the course of my walk. So I can now say that my Camino footwear is officially podiatrst approved*! (*By my podiatrist anyway, which is good enough for me.)

Glad to hear your doc approves of Altras! I have been wearing Lone Peak 4/5s. I don't get the forefoot pain - but before I started Altras with my injinji toe socks and darn tough or injinji merino wool socks - I always blistered both on my bunyon area and toe areas. Not a problem any more. SO TEMPTED - to try Olympus! But the price tag and I used my REI member coupon and member rewards on a lighter sleeping bag already. With my Altras I went through several insoles before I got the right cushioning.

Thanks for sharing!

The credential - I have 2 from Santiago - the regular one and a "Holy Year" one. I also have 1 from the US. I will have to look again - I thought the regular one from Santiago held the most stamps. It definitely has more than the Holy Year one... maybe I just compared sizes of the Santiago regular one and the US one and assumed? I dunno... gonna have to pull them out and compare later! I do like that the US one has my name and where I am from typed in so it looks pretty!

 

[SeñorJacques]

Yes, the price tag on the Olympuses gave me some initial sticker shock! But they do feel sturdier than my previous Lone Peaks, and the tread is much thicker, so I'm hoping the cost will be offset by the increased durability.

The US credential is definitely lighter - but now I'm second guessing the extra sello capacity (all those accordion folds got confusing after a while.) At any rate it was indeed a pleasant surprise to see my name and home town pre-printed on the inside cover in faux-calligraphic script. Definitely nicer than the chicken scrawl I would have written in the "blank" one I have from Santiago ...

 

[J Willhaus]

Yes, the price tag on the Olympuses gave me some initial sticker shock! But they do feel sturdier than my previous Lone Peaks, and the tread is much thicker, so I'm hoping the cost will be offset by the increased durability.

The US credential is definitely lighter - but now I'm second guessing the extra sello capacity (all those accordion folds got confusing after a while.) At any rate it was indeed a pleasant surprise to see my name and home town pre-printed on the inside cover in faux-calligraphic script. Definitely nicer than the chicken scrawl I would have written in the "blank" one I have from Santiago ...

Love the ones from American Pilgrims that are "personalized"! I also have a variety of credentials from along the way including one that was gifted to me from a hotel!

 

[annmte]

@SeñorJacques: Thank you for giving me this nudge. I have had a couple of niggling foot issues (Morton's toe/Greek toe, which I think is causing a bone spur on the top of my foot) that don't currently cause me serious pain. My fear was that a podiatrist might say that I shouldn't walk a Camino - but I think your advice is sound. It's more likely that he will give me tips that could actually improve my Camino and/or prevent worse problems along the way! Made an appointment for Tuesday, will bring my Altra Lone Peaks as you suggest - and hopefully I'll feel "cleared" as well!

 

[Anna Cameron]

Just got back from seeing my podiatrist as part of my pre-Camino prep.

Some highlights, in the spirit of hopefully constructive oversharing :

• My previous visit three months ago was to address pain in my left foot due to heel bursitis + achilles tendonitis. Happy to say that a combination of PT exercises, weight loss, and wearing the 5mm cork heel lifts my podiatrist recommended for my Altras seems to have taken care of the tendonitis, while a cortisone shot completely knocked out the bursitis which had been bothering me on and off (mostly on) for a couple of years. I only wish I'd done it sooner.

• I was curious to see if another cortisone shot would be helpful as a preventative before my trip in case the bursitis made a comeback on the road. But my doctor is very much of the "if it ain't broke, don't fix it" school and did not recommend it, especially since said shots could have deleterious effects in the future if administered too often. Instead, he gave me a prescription for meloxicam (a stronger anti-inflammatory than over-the-counter ones like ipuprofen) in case my heel starts giving me problems again. And he reiterated his recommendation of Voltaran gel (which I understand is available in pharmacies in Spain) as helpful for foot and joint pain as well.

• Based on a reminder/recommendation I picked up on this forum, I wore the socks and shoes I will be wearing on my walk and am happy to report that both passed my podiatrist's inspection with flying colors. In particular, he was very impressed with the build quality of my Altra Olympus 4s, which he said he'd never seen "in the wild" before although he said he often recommends Altras to patients with toe and forefoot pain due to their wide toe box. (For what it's worth, however, he was wearing and said he "swears by" New Balances!) He said the additional padding on the Olympuses would be beneficial for a long walk over varied terrain, and that although the medical jury was still out over the supposed benefits/drawbacks of zero drop shoes they likely won't cause me problems with the heel lifts. So I can now say that my Camino footwear is officially podiatrst approved*! (*By my podiatrist anyway, which is good enough for me.)

• I also walked (or fairly skipped!) out of the office with a prescription for a round of antifungal medication to treat a slight but persistent case of what I thought was merely dry/chapped skin on the sole of my foot, but which was in fact an infection that could have become worse through long days of walking over a period of many weeks - not to mention encounters with less-than-salubrious albergue shower floors. Not exactly the sexiest information to share but I'm glad he caught it before it became a real problem.

All of which leads up to the main point of this post, which is that making an appointment to see a podiatrist should be part of everyone's Camino preparation! My visit not only reassured me that I'd made a sound footwear decision for myself but helped diagnose and treat some conditions that could have turned into more serious problems during my walk. Best $50 insurance co-pay I've spent in a while, and a more than a worthwhile expense on my Camino spreadsheet.

TL;dr: See a podiatrist before your Camino. You'll be glad you did!

I second the recommendation for a pre-Camino visit to your podiatrist at home. I will also point out that, if you develop difficulties while walking, you can consult a local podiatrist - as I did on CF in 2018. The 2 blisters from my very first day out of St Jean Pied de Port were getting worse and preventing safe walking, so I googled "podiatrist near Estella bus station" and was amazed at the satisfactory outcome! I saw an excellent clinician who was thorough and skilled, she treated my feet and gave invaluable advice for avoiding further problems, and all for only €22!! I spoke minimal Spanish and she no English but with help from her younger assistant, my French and Latin and good will all around, we managed. Spain has excellent medical and Allied Health services.

 

[SeñorJacques]

I second the recommendation for a pre-Camino visit to your podiatrist at home. I will also point out that, if you develop difficulties while walking, you can consult a local podiatrist - as I did on CF in 2018.

I figured this would be the case (I bet podiatrists on any Camino do brisk business!) but it's good to know that they are easily available. Thank you for the confirmation!

 

[SeñorJacques]

@SeñorJacques: Thank you for giving me this nudge. I have had a couple of niggling foot issues (Morton's toe/Greek toe, which I think is causing a bone spur on the top of my foot) that don't currently cause me serious pain. My fear was that a podiatrist might say that I shouldn't walk a Camino - but I think your advice is sound. It's more likely that he will give me tips that could actually improve my Camino and/or prevent worse problems along the way! Made an appointment for Tuesday, will bring my Altra Lone Peaks as you suggest - and hopefully I'll feel "cleared" as well!

I hoped this post would provide such a nudge to anyone planning an upcoming Camino! Glad it was helpful. I too have one of those storied Greek toes which tends to blister at the joint, which is one reason I love Altras so much – whenever I try on a shoe with a more constricted toe area that is the first place I feel it. Wishing you a happy and pain-free journey!

 

[CA_Pilgrim]

I was curious to see if another cortisone shot would be helpful as a preventative before my trip in case the bursitis made a comeback on the road. But my doctor is very much of the "if it ain't broke, don't fix it" school and did not recommend it, especially since said shots could have deleterious effects in the future if administered too often.

Very much agree with your podiatrist regarding cortisone injections. It's best to get to the cause of the problem than to treat symptoms with cortisone injections. I went down that road with my plantar fasciitis before I got my first good pair on orthotics. The cortisone injections temporarily ended the pain and they lasted several months, but the problem came back I went through 2 rounds of injections and observed visible deterioration of the connective tissue near the site of the injections. It caused large dimples to form and it took years for them to fill back in completely. It probably also weakened the tendons in my foot and I was lucky not to rupture any.

That was about 12 years ago. Fortunately, I found a new podiatrist that made a good pair of orthotics that treated the source of the problem without further need for drugs.

FYI, not sure of your nationality, but there are 2 topical OTC agents that are very effective at treating symptoms of joint and tendon pain with minimal side-effects. In the USA, Diclofenac Gel (brand name Votaren Gel). In the EU, there is both Diclofenac Gel and Ibuprofen Gel (brand name Ibuleve Gel). I find that Ibuprofen Gel is more effective but continuous/overuse is can make the skin dry and flaky. I don't have this problem with Diclofenac Gel. I no longer need to use them because the custom orthotics are so effective but I'm glad to know that I can pick up a tube of the gel products if there is ever a need during my Camino.

 

[SeñorJacques]

FYI, not sure of your nationality, but there are 2 topical OTC agents that are very effective at treating symptoms of joint and tendon pain with minimal side-effects. In the USA, Diclofenac Gel (brand name Votaren Gel). In the EU, there is both Diclofenac Gel and Ibuprofen Gel (brand name Ibuleve Gel). I find that Ibuprofen Gel is more effective but continuous/overuse is can make the skin dry and flaky. I don't have this problem with Diclofenac Gel.

Thanks for sharing your own podiatrist experiences! Sorry to hear about how the cortisone shots affected you in the long term. That is exactly what I was fearful of and I'm glad my podiatrist dissuaded me from perusing them further as a treatment option. (In my case they helped relieve bursitis caused by a heel spur, so I don't think orthotics would have been effective. But I'm still grateful the one shot at least helped me get to the point where I was able to walk pain-free for the first time in years and gave me the confidence that the bursitis might not be as much of an issue on my Camino as I feared it would be.)

I'm in the U.S. and have used Voltaran (diclofenac) gel on the advice of my podiatrist, as I mentioned above - it seems to have helped relieve my tendonitis considerably. I will be taking a tube with me on my Camino and will keep my eye out for some Ibuleve in my travels per your suggestion. Cheers!

 

[J Willhaus]

You can also buy these topical medications in Spain if you don't want to carry the extra weight. I used the voltaran and it made my legs swell so I ended up giving it away to another pilgrim.

 

[WalkingLester]

More fun facts for the weight conscious pilgrim: I have bought both diclofenac and ibuprofen gel in Spain. The pharmacies always tell me that in Spain diclofenac only comes in 150 gm tubes. But, ibuprofen comes in a 50 gm tube. Ibuprofen is somewhat more expensive.

 

[Former member 92300]

FYI, not sure of your nationality, but there are 2 topical OTC agents that are very effective at treating symptoms of joint and tendon pain with minimal side-effects. In the USA, Diclofenac Gel (brand name Votaren Gel). In the EU, there is both Diclofenac Gel and Ibuprofen Gel (brand name Ibuleve Gel). I find that Ibuprofen Gel is more effective but continuous/overuse is can make the skin dry and flaky. I don't have this problem with Diclofenac Gel. I no longer need to use them because the custom orthotics are so effective but I'm glad to know that I can pick up a tube of the gel products if there is ever a need during my Camino.

These are both good meds and can be very helpful during a hike like the Camino. I used Diclofenac (prescribed for me) on my ankles regularly when they were inflamed, during my Camino. That said - always best to consult your physician. And if having any new injury - best to get it checked out by a doctor! Too often people start applying these meds for minor issues (no big deal - I do it too), but then when the problem persists and doesn't resolve they don't get it checked out until more damage is done. So - just be careful/mindful when using them!

So glad they finally put Diclofenac Gel in the over the counter meds section!

 

[Embee12]

@SeñorJacques Thank you for your thorough reportage. I've been reading all of the "wide toe box" threads as a person who loves Lone Peaks' toebox, etc., but who dislikes the zero drop (it seemed okay at first, but it's not - heel is hurting, hips are hurting as I train) - but everything else I tried, even the "wides," just didn't do it, were too constraining, somehow - more like sneakers than whatever this singular thing Lone Peaks are. Can you remind me what heel lift drop you recommend? And is there any more specifics about getting them than to purchase them off of Amazon? Like a certain brand or taper?

Thanks.

 

[SeñorJacques]

@SeñorJacques Thank you for your thorough reportage. I've been reading all of the "wide toe box" threads as a person who loves Lone Peaks' toebox, etc., but who dislikes the zero drop (it seemed okay at first, but it's not - heel is hurting, hips are hurting as I train) - but everything else I tried, even the "wides," just didn't do it, were too constraining, somehow - more like sneakers than whatever this singular thing Lone Peaks are. Can you remind me what heel lift drop you recommend? And is there any more specifics about getting them than to purchase them off of Amazon? Like a certain brand or taper?

Good to hear I'm not the only one who loves everything about Altras except the zero drop!

My podiatrist recommended simple 5mm cork heel lifts that go under the Altra insoles that come inside the shoe. Unfortunately Amazon was the easiest place for me to get them - I just did a search for "5mm cork heel lifts" and bought the most inexpensive pair, which happened to be made by a company called Prime-Med. I'm sure you can pop that search phrase or similar (like "heel lift inserts") into the search engine of your choice and find other places to buy them. They are about as low-tech as it is for something to be: they are simply heel-shaped pieces of cork that taper to a 5mm thickness.




Ignore the reviews that say they're not durable, which I have to assume were left by people who didn't realize they're meant to be worn under the insole. I've been wearing the same pair for almost four months and they are holding up fine. Buying a two-pack meant I will have a fresh pair for my Camino next month too.

All that said, the usual disclaimer: These are the heel lifts which were recommended by my podiatrist and which worked for me. Everyone should consult their own podiatrist to address any issues they are having with their feet, especially when they are causing pain in other parts of the body. I am not a podiatrist, nor do I play one on T.V. This information is provided for anecdotal purposes only. (Hope that serves to pre-empt the inevitable "you shouldn't take advice from strangers on an internet forum and should always consult your own doctor first!!1!" responses which always seem to follow a comment like this, no matter how strongly worded my disclaimers are )

 

[deborahbennett]

With my Altras I went through several insoles before I got the right cushioning.

Jeanine, I'm wondering which insoles you found that had the right cushioning for Altras?

I'm fairly happy with my Curex Hike Pro insoles for my Altra Lone Peak wides. I've given a personal thumbs down on the Superfeet Green and Sole moldable insoles that were too stiff and uncomfortable for me, and the Dr. Scholl's plantar fasciitis insoles because the more rubber-like material seemed to cause a lot of friction/heat.

I'm going to try the Altra Olympus shoes next time I'm in a city that has them in a store instead of having to buy them online and ship pairs back and forth to find the right size.

I currently switch off between my Lone Peaks with a pair of New Balance More Trail Fresh Foam extra wides for that added cushioning. But the toe box in the New Balance shoes isn't as wide as the Lone Peak wides. So far, switching off between the two pairs seems the best that I can do.

 

[Former member 92300]

Jeanine, I'm wondering which insoles you found that had the right cushioning for Altras?

I'm fairly happy with my Curex Hike Pro insoles for my Altra Lone Peak wides. I've given a personal thumbs down on the Superfeet Green and Sole moldable insoles that were too stiff and uncomfortable for me, and the Dr. Scholl's plantar fasciitis insoles because the more rubber-like material seemed to cause a lot of friction/heat.

I'm going to try the Altra Olympus shoes next time I'm in a city that has them in a store instead of having to buy them online and ship pairs back and forth to find the right size.

I currently switch off between my Lone Peaks with a pair of New Balance More Trail Fresh Foam extra wides for that added cushioning. But the toe box in the New Balance shoes isn't as wide as the Lone Peak wides. So far, switching off between the two pairs seems the best that I can do.

I have no idea! Haha... I had some I liked here in the US - but I did a long hike here (52 miles with a 45 pound pack) before heading to Spain and my feet were very sensitive after that so I picked up a cheap cushion insole in Madrid (the pharmacy I was at didn't have good ones). Then in SJPDP I went to an actual hiking store and picked up a better pair - but I didn't keep the container so I have no idea what they were.

I broke down a few hours ago and ordered a pair of Olympus - I stuck with the same size I wear in other Altras (and sized 1 1/2 sizes up for socks and swelling). I hope they are worth the big ticket price! I really like the Lone Peaks and tighten the laces to keep my heals snug. Hoping I can do the same with Olympus.

 

[SeñorJacques]

I broke down a few hours ago and ordered a pair of Olympus - I stuck with the same size I wear in other Altras (and sized 1 1/2 sizes up for socks and swelling). I hope they are worth the big ticket price! I really like the Lone Peaks and tighten the laces to keep my heals snug. Hoping I can do the same with Olympus.

Welcome to the Olympus club! You may want to consider picking up a pair of elastic lock laces to go with them, as I discussed in a previous thread. My own pair really “clicked” with my feet when I started wearing them with the elastic laces - not sure why, as regular laces were fine with my LPs, but the extra weight and lateral support on the Olympuses may have something to do with it. Looking forward to hearing what you think!

 

[Joodle]

Just got back from seeing my podiatrist as part of my pre-Camino prep.

Some highlights, in the spirit of hopefully constructive oversharing :

• My previous visit three months ago was to address pain in my left foot due to heel bursitis + achilles tendonitis. Happy to say that a combination of PT exercises, weight loss, and wearing the 5mm cork heel lifts my podiatrist recommended for my Altras seems to have taken care of the tendonitis, while a cortisone shot completely knocked out the bursitis which had been bothering me on and off (mostly on) for a couple of years. I only wish I'd done it sooner.

• I was curious to see if another cortisone shot would be helpful as a preventative before my trip in case the bursitis made a comeback on the road. But my doctor is very much of the "if it ain't broke, don't fix it" school and did not recommend it, especially since said shots could have deleterious effects in the future if administered too often. Instead, he gave me a prescription for meloxicam (a stronger anti-inflammatory than over-the-counter ones like ipuprofen) in case my heel starts giving me problems again. And he reiterated his recommendation of Voltaran gel (which I understand is available in pharmacies in Spain) as helpful for foot and joint pain as well.

• Based on a reminder/recommendation I picked up on this forum, I wore the socks and shoes I will be wearing on my walk and am happy to report that both passed my podiatrist's inspection with flying colors. In particular, he was very impressed with the build quality of my Altra Olympus 4s, which he said he'd never seen "in the wild" before although he said he often recommends Altras to patients with toe and forefoot pain due to their wide toe box. (For what it's worth, however, he was wearing and said he "swears by" New Balances!) He said the additional padding on the Olympuses would be beneficial for a long walk over varied terrain, and that although the medical jury was still out over the supposed benefits/drawbacks of zero drop shoes they likely won't cause me problems with the heel lifts. So I can now say that my Camino footwear is officially podiatrst approved*! (*By my podiatrist anyway, which is good enough for me.)

• I also walked (or fairly skipped!) out of the office with a prescription for a round of antifungal medication to treat a slight but persistent case of what I thought was merely dry/chapped skin on the sole of my foot, but which was in fact an infection that could have become worse through long days of walking over a period of many weeks - not to mention encounters with less-than-salubrious albergue shower floors. Not exactly the sexiest information to share but I'm glad he caught it before it became a real problem.

All of which leads up to the main point of this post, which is that making an appointment to see a podiatrist should be part of everyone's Camino preparation! My visit not only reassured me that I'd made a sound footwear decision for myself but helped diagnose and treat some conditions that could have turned into more serious problems during my walk. Best $50 insurance co-pay I've spent in a while, and a more than a worthwhile expense on my Camino spreadsheet.

TL;dr: See a podiatrist before your Camino. You'll be glad you did!

You have a Camino spreadsheet?? I am impressed! ( I did cut the tags out of my clothes to save weight. I am also a lover of Voltaren. I used it quite a bit my last Camino, as my good walking buddy, Canadian Katy brought me some from Canada. You can Now buy it at Costco! I’ve got mine ready for my next Camino in mid September. We’ll worth the carry weight!

 

[C clearly]

You have a Camino spreadsheet??

You don"t?

 

[Anna Cameron]

You don"t?

Why? do we need one?
I managed without, last time!
(Admittedly, things have changed somewhat since 2018).

 

[SeñorJacques]

Why? do we need one?
I managed without, last time!
(Admittedly, things have changed somewhat since 2018).

No one needs a spreadsheet!
But for those of us with borderline OCD tendencies who very much like the processes of trip planning and keeping track of things (especially expenses), organizing a spreadsheet is akin to a very pleasurable way of scratching a particular itch

 

[C clearly]

Why? do we need one?
I managed without, last time!
(Admittedly, things have changed somewhat since 2018).

Of course! They are compulsory!

No one needs a spreadsheet!

Whose side are you on anyway?

 

[Anna Cameron]

Of course! They are compulsory!


Whose side are you on anyway?

 

[J Willhaus]

No spreadsheet, but I do have a packing list.

 

[Embee12]

Good to hear I'm not the only one who loves everything about Altras except the zero drop!

My podiatrist recommended simple 5mm cork heel lifts that go under the Altra insoles that come inside the shoe. Unfortunately Amazon was the easiest place for me to get them - I just did a search for "5mm cork heel lifts" and bought the most inexpensive pair, which happened to be made by a company called Prime-Med. I'm sure you can pop that search phrase or similar (like "heel lift inserts") into the search engine of your choice and find other places to buy them. They are about as low-tech as it is for something to be: they are simply heel-shaped pieces of cork that taper to a 5mm thickness.


View attachment 122303

Ignore the reviews that say they're not durable, which I have to assume were left by people who didn't realize they're meant to be worn under the insole. I've been wearing the same pair for almost four months and they are holding up fine. Buying a two-pack meant I will have a fresh pair for my Camino next month too.

All that said, the usual disclaimer: These are the heel lifts which were recommended by my podiatrist and which worked for me. Everyone should consult their own podiatrist to address any issues they are having with their feet, especially when they are causing pain in other parts of the body. I am not a podiatrist, nor do I play one on T.V. This information is provided for anecdotal purposes only. (Hope that serves to pre-empt the inevitable "you shouldn't take advice from strangers on an internet forum and should always consult your own doctor first!!1!" responses which always seem to follow a comment like this, no matter how strongly worded my disclaimers are )

@SeñorJacques Thank you for this information including very clear image! I feel like I also need more cushioning in that of late the LPs seem to have started me on some Plantar Fasciatis, sadly. Heel and arch have been hurting since Tuesday when I last wore them. (I've walked with my comfortable dorky Skechers slip-ons since then.) So... what do I get? The simple cork lifts - would that help with the heel pain/budding PF? - then there's heel cups, inserts, cushioned inserts... and, while I'm at it, I've just realized that I might as well acknowledge my slight discrepancy in leg length and see if there's something to do about it since I've never walked 200 miles before. (I'm starting in Leon.) I am aware of this discrepancy at times, such as when I'm getting pants hemmed - but, more a propos of the walk, when I'm doing a particular leg machine in the gym, or standing quad stretches, coz my hips go wonky with the shorter side; I feel it when I walk, too, sometimes - not painful, really, just weird, and I wonder what it must be doing to my body to have my hips misaligned becuase of that. So what would I get to solve all that? It seems like the lifts alone wouldn't solve the Plantar Fasciatis and heel pain if it's not a heel cup... How do I combine all of those things? Sorry to get so granular... Maybe it's time for me to ... go to the podiatrist?

 

[C clearly]

Maybe it's time for me to ... go to the podiatrist?

Probably would be a good idea.

Also, consider how many miles you have put on your current shoes. I use very cushioned running shoes and at some point after 500 km or so, I start to notice that my feet feel more punished after a long walk. I seem to need that cushioning, which breaks down with time and impact.

 

[SeñorJacques]

Sorry to get so granular... Maybe it's time for me to ... go to the podiatrist?

Being a fellow Camino Forum member means never having to apologize for getting too granular

And yes, it sounds like a podiatrist visit is in order! My father-in-law has the same leg length discrepancy that you do and after trying various DIY fixes over the years recently got custom orthotics to correct it, which seems to have helped him enormously. Your podiatrist will likely be able to help you with those too.