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Sharing my visit to a podiatrist (orthotics)

CalgaryLynn

Active Member
Past OR future Camino
2021
I thought I would share the particulars of my recent visit with a podiatrist. I am new to this walking long distances repetitively and thought a podiatrist might have some insight for me. I walked on Friday for 8 miles during my training and came home with a big blister on my little toe to show him.

I had surrounded my blister with a moleskin and covered with a bandage and he said immediately "Why didn't you drain it". He promptly put a small sliver cut on the roof and said told me to always drain, smear with antibiotic cream and bandage up. OK! Done!

He gave me some stretching exercises (which I should be doing now to prevent plantar's fasciitis) and a small ball to use to massage my feet and lower back at the end of the day. He also said I should be soaking my feet after every walk in Epson salts. Easy to do!

I also got a prescription for a pain relief gel to be used whenever I get painful feet and back. It is a compounded gel with diclofenac, gabapentin and lidocaine which can be rubbed in. Better than the Ibuprofen pills that are hard on the stomach.

He also told me I had flat feet so suggested I get a custom orthotic. I have been thinking of this as when walking longer distances I do experience some lower back pain.

With all this, I am wondering if anyone else has had experience with orthotics on the Camino and whether or not it has been beneficial?
 
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Past OR future Camino
Frances/SJPP '15,'16,'18,'19,('20)
Way of St. Francis, Italy 2017
Portuguese/Finisterre 2018, 2019
Orthotics are a must in my opinion. Although, I am not sure that you need custom ones. I had some years ago and they were so hard I could never wear them. I do hear that they may be different now. I really like mine from The Walking Co. When I got them we had a store in town and they were able to determine which ones I needed.
 

Sirage

Member
Past OR future Camino
Le Puy to Santiago (2005), Porto to Santiago (2007), Vezelay for 200 kms (2009), From Seville, May (2015), Le Puy to Sangüesa (2016), Norte-Primitivo (Sep-Oct 2016)
With all this, I am wondering if anyone else has had experience with orthotics on the Camino and whether or not it has been beneficial?
I have walked quite a few Caminos - at a guess about 6,000 kms.

Getting the "right" insole was a game-changer and stopped me getting blisters, in conjunction with the "right" shoes and socks. Much money has been spent on shoes.

I didn't have luck with custom orthotics, but with up-market insoles.

And of course everyone is different so only your experience will find what works for your feet, with perhaps your experience based on ideas from this forum.
 
Past OR future Camino
Frances 2015, 2018, 2022
My custom orthotics were a game-changer for me. After my first two week stint on the Camino my feet hurt so badly I could hardly walk. When I got home, I tried several over-the-counter orthodics but they did nothing. I finally went to a podiatrist, who diagnosed high arches and fit me through some kind of 3-D technology. I have not had sore feet since. No foot problems at all when I returned to the Camino for my remaining 300 miles. Worth every cent.
 
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Anamiri

Veteran Member
Past OR future Camino
2016, 2017, 2019 Camino Frances
I thought I would share the particulars of my recent visit with a podiatrist. I am new to this walking long distances repetitively and thought a podiatrist might have some insight for me. I walked on Friday for 8 miles during my training and came home with a big blister on my little toe to show him.

I had surrounded my blister with a moleskin and covered with a bandage and he said immediately "Why didn't you drain it". He promptly put a small sliver cut on the roof and said told me to always drain, smear with antibiotic cream and bandage up. OK! Done!

He gave me some stretching exercises (which I should be doing now to prevent plantar's fasciitis) and a small ball to use to massage my feet and lower back at the end of the day. He also said I should be soaking my feet after every walk in Epson salts. Easy to do!

I also got a prescription for a pain relief gel to be used whenever I get painful feet and back. It is a compounded gel with diclofenac, gabapentin and lidocaine which can be rubbed in. Better than the Ibuprofen pills that are hard on the stomach.

He also told me I had flat feet so suggested I get a custom orthotic. I have been thinking of this as when walking longer distances I do experience some lower back pain.

With all this, I am wondering if anyone else has had experience with orthotics on the Camino and whether or not it has been beneficial?
I have problem feet, so custom orthotics are a must - however I force the podiatrist to make them both comfortable for me, and to fit my shoes. Otherwise you have to buy shoes that don't fit your foot, just to fit the orthotic.
They don't want to do that - saying it will ruin the structure of the orthotic.
However I get 2-3 years with the 'amended orthotic' before they fall apart so that works for me. If I didn't get them shaved down I wouldn't be able to wear them at all - so its not a difficult decision.
He grudging says I get good value considering the kms I put on them. I do more kms than most of his customers who don't make him amend them.
Don't know why they don't have more common sense, as with every new pair we have the same fight. I never complain about the price and I am a repeat customer -so it irks me that we have to go through the same argument each time, with him reluctantly making them usable. ($500)
It takes him about an hour to 'fix' them so they fit multiple shoes. An orthotic that doesnt fit anything is useless.
Thats my experience.

My husband just uses the ones from the sports store with some extra cushioning, and likes those. ($60)

For my grandson (13) who has flat feet, we used the type that are heated, put into the shoe, and you stand on them to mould them to your foot. ($85)
He used to get pain in his feet and knees at school running and paying rugby. So I thought the orthotics were worth trialing.
They were a miracle. Without them his feet hurt in an hour.
With them, (they fit all his sports shoes) he can run or walk all day. We did take him to a specialty sports shoe store, for a full consult, and purchased the best shoes for him that we could,
I was pleasantly surprised, as the inserts were way cheaper than the custom ones, and at that price, you can afford to keep getting more as feet grow.
They are a much better fit for the shoe as well, so I dont know why the custom ones cant be made with better material.
.
 

Albertagirl

Veteran Member
Past OR future Camino
Frances (2015); Aragones-Frances (2016); VdlP-Sanabres (2017); Madrid-Frances-Invierno (2019)Levante
I use custom orthotics and have for years. My new ones, for my pilgrimage on the Levante this fall, are different from previous models: thick and soft and trimmed to fit in my camino boots. Yesterday, I was out for a walk wearing the boots, and was amazed both at how comfortable they are with the othotics, now well broken in, and how fast and light I felt, walking. I am not afraid of the distance that I shall have to walk on tarmac, beginning the Levante. These boots, with the new orthotics, feel well designed for walking on a hard surface. The rest of my gear is being assembled, but comfortable and sturdy boots, with made-to-measure othotics, were my first item designed and assembled for a very long walk.
 
Past OR future Camino
2022
I wonder what opinions people had about the sport store higher end insoles, Superfeet come to mind, or the more expensive of the Dr Scholls insoles. Dr Scholls even has a machine system available in some areas that you stand on, and then an insole from a selection of about 18 is recommended.

TBH, I am almost always shocked when I take a pair of expensive runners or trail shoes and pull out the insole, to see how flimsy it is. I usually buy the Dr School "active" or "runners" insole to replace those.

Forum thoughts?
 

Anamiri

Veteran Member
Past OR future Camino
2016, 2017, 2019 Camino Frances
I wonder what opinions people had about the sport store higher end insoles, Superfeet come to mind, or the more expensive of the Dr Scholls insoles. Dr Scholls even has a machine system available in some areas that you stand on, and then an insole from a selection of about 18 is recommended.

TBH, I am almost always shocked when I take a pair of expensive runners or trail shoes and pull out the insole, to see how flimsy it is. I usually buy the Dr School "active" or "runners" insole to replace those.

Forum thoughts?
I agree, the insoles that come with shoes are really thin and offer next to nothing in the way of cushioning.
 
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Anamiri

Veteran Member
Past OR future Camino
2016, 2017, 2019 Camino Frances
I've never heard of those! That's great.
I dont remember what brand they are, they are blue in colour - we get them from specialty sports shoe shops, they heat them first, then slip them in your shoe hot, and you stand/walk in them for a while to mould them. He said they were very warm (he had socks on) but not too hot.
 
Past OR future Camino
V. Fran (2019) in progress
C. Primitivo (2019)
C. Frances - (2019) in progress
C. Finnisterre (2015)
I list my podiatrist as my PRIMARY CARE doc! Ha ha ha. He's been a life saver for me. Two months before my first Camino I developed achilles pain - PANIC!! I was fitted for orthodicts and referred for a bit of PT. Voila! Camino #1 (two weeks) was a success. I've since walked the TMB, parts of the Norte and Primitivo, and the last 250 km of the Via without any foot pain/issues. In fact, I'll be picking up my third pair of orthodicts next week (they last approx. 1 to 2 years depending on much walking or running one does. BTW, they are not inexpensive (several hundred USD) but I've not missed a day of walking, hiking or Pickleball in seven years. Hopefully, I'll be back on a Camino end of summer '21 or early Fall.
 

henrythedog

Loved and fed by David
Past OR future Camino
Frances 2017, 2018, 2019, Ingles 2018, (Madrid 2019 partial - retired hurt!) (more planned)
The first thing I do with new boots or shoes is to remove the manufacturers insoles. I have custom orthotics and use those or ‘superfeet green’ in everything apart from Birkenstock sandals.

When I first had custom orthotics they provided instant relief from foot pain, but then over the course of a few months I had progressive discomfort in my ankles, knees and hips as my lower body slowly realigned itself. It was worth the effort.

Sizing ‘off the shelf’ insoles is not quite as simple as buying the right size and trimming to fit. Best to see a trained fitter as your foot shape might benefit from a larger size, trimmed to fit - it depends on the shape and position of the arch of your foot.

I’m less convinced by the heat moulded versions - in my mind what they do is support your foot in its current possibly imperfect shape. Others views may differ.
 

Moorwalker

Active Member
Past OR future Camino
The Saint's Way, Cornwall
Nobody can really tell you whether orthotics would be beneficial for you, only if they were helpful for them.

Blisters are a matter of both opinion and position. I tend to drain them and then use a hydrocolloid dressing such as Compeed. Don't try to remove a Compeed type dressing or it will tear off the delicate skin over the blister, let them come off of their own accord.

That gel is serious stuff, gabapentin in particular has the potential for some nasty side effects and is usually prescribed only for serious nerve pain, not for just acheing feet. Lidocaine is a topical anaesthetic and again seems like a serious drug for a relatively minor problem. Unless you have serious structural foot problems I'd be asking why the podiatrist prescribed it.

Orthotics again are a totally individual thing. For some foot problems they are very useful, but because they change the way you move they can also cause problems with other joints, in particular your hips and lower back. Use them initially with care and awareness to see how you adapt to them. If they don't seem to suit, go back to the podiatrist and get them changed or adjusted. There are some very good off the shelf orthotics available if you just have moderate, simple flattened feet and I would ask the podiatrist about those before you spend a lot more money on customs. It may be that custom orthotics would work well for you but it's worth exploring the possibilities first.

Lower back pain is often greatly improved for doing exercises to improve your core strength. I'm a big fan of pilates for that, yoga often emphasises flexibility without the underlying strength needed to support that additional flexibility.

Overall I would be quizzing the podiatrist as to why they have prescribed a serious drug for nerve pain, why they recommend custom orthotics rather than off the shelf (could it be that they will make more profit?) and why they have not pointed you at exercises for both your feet and your core muscles since those are critical to comfortable walking.
 

GuyA

Active Member
Past OR future Camino
2022
I have walked quite a few Caminos - at a guess about 6,000 kms.

Getting the "right" insole was a game-changer and stopped me getting blisters, in conjunction with the "right" shoes and socks. Much money has been spent on shoes.

I didn't have luck with custom orthotics, but with up-market insoles.

And of course everyone is different so only your experience will find what works for your feet, with perhaps your experience based on ideas from this forum.
Sirage if you don’t mind sharing what type of insoles are you using? Would give me a good starting point. I have walked ~ 3,000 Camino kms however always on the lookout for improving equipment.

Thanks

Guy
 
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Becky 59

Active Member
Past OR future Camino
Camino Frances (May 2018)
Camino Ingles (Aug 2019)
I wonder what opinions people had about the sport store higher end insoles, Superfeet come to mind, or the more expensive of the Dr Scholls insoles. Dr Scholls even has a machine system available in some areas that you stand on, and then an insole from a selection of about 18 is recommended.

TBH, I am almost always shocked when I take a pair of expensive runners or trail shoes and pull out the insole, to see how flimsy it is. I usually buy the Dr School "active" or "runners" insole to replace those.

Forum thoughts?
I personally LOVE Superfeet, got them at REI in the US. They had 3 styles at that time (a few years ago), for high arch, medium arch, and low arch, and I tried each of them in the store to find the right "fit", then picked shoes to go with them. I do have high arches, but apparently my arches are "average" enough that a OTC insert worked well. I suspect inserts are as personal as picking which backpack and which shoe works best for an individual.
 

Albertagirl

Veteran Member
Past OR future Camino
Frances (2015); Aragones-Frances (2016); VdlP-Sanabres (2017); Madrid-Frances-Invierno (2019)Levante
To add to my previous post, my custom orthotics were suggested by the physiotherapist who treated me after my knee replacement surgery. The intention is to improve my mobility, and so far they have done very well. If you have had any surgery which affects your mobility, you might inquire afterwards whether prescription othotics would be desirable for you. If you have no major mobility issues, I do not see why over the counter orthotics, carefully chosen, could not also help.
 

JillGat

la tierra encantada
Past OR future Camino
2018
Anamiri: [[For my grandson (13) who has flat feet, we used the type that are heated, put into the shoe, and you stand on them to mould them to your foot. ($85)]]
Seems like an orthotic that molds to your foot might add some cushion, but it wouldn't provide any correction. The orthotics I got from my podiatrist corrected a problem in my feet (a raised section under the forefoot to prevent metatarsal pain). That being said, I still ended up wearing my chaco sandals on the Camino far more often than my shoes.
 

DyanTX

DyanTX
Past OR future Camino
CF Sept 22 - Nov 3, 2016
I wonder what opinions people had about the sport store higher end insoles, Superfeet come to mind, or the more expensive of the Dr Scholls insoles. Dr Scholls even has a machine system available in some areas that you stand on, and then an insole from a selection of about 18 is recommended.

TBH, I am almost always shocked when I take a pair of expensive runners or trail shoes and pull out the insole, to see how flimsy it is. I usually buy the Dr School "active" or "runners" insole to replace those.

Forum thoughts?
I agree that insoles that are sold in trail runners are lousy. I pull them out and put in SuperFeet insoles (berry or the newer trail type women specific). I have used SuperFeet for 20+ years in all my hiking shoes - first in the heavy backpacking boots I started with and now in trail runners - Altra Lone Peak 5.0 at the moment. They work perfectly for me. With proper fitting shoes, socks and use of Foot Glide - no blisters in years of walking/hiking.
 
Past OR future Camino
Frances 2016; Mansill de las Mulas to Finisterre/Muxia 2017; Aragones 2018; Suso/Yuso, Meseta 2019
We all have had varied experiences with our feet, with trial and error we most of us have found our individual solutions. My solution has been Darn Tough cushion socks, worn over Fox River liners, with Powerstep Pinnacle Plus insoles and Altra Timp trail runners. I order insoles from TheInsoleStore.com. The people there were able to suggest for my needs insoles that offered metatarsal support. The website has a large selection of products for various foot needs as well as lots of information about foot conditions.
 
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CalgaryLynn

Active Member
Past OR future Camino
2021
I have problem feet, so custom orthotics are a must - however I force the podiatrist to make them both comfortable for me, and to fit my shoes. Otherwise you have to buy shoes that don't fit your foot, just to fit the orthotic.
Thanks for that. He did say to bring in my boots and he would fit the orthotic to the boot. I asked him that question as I don't want to buy other boots. Mind are nicely broken in.
 

CalgaryLynn

Active Member
Past OR future Camino
2021
I use custom orthotics and have for years. My new ones, for my pilgrimage on the Levante this fall, are different from previous models: thick and soft and trimmed to fit in my camino boots. Yesterday, I was out for a walk wearing the boots, and was amazed both at how comfortable they are with the othotics, now well broken in, and how fast and light I felt, walking. I am not afraid of the distance that I shall have to walk on tarmac, beginning the Levante. These boots, with the new orthotics, feel well designed for walking on a hard surface. The rest of my gear is being assembled, but comfortable and sturdy boots, with made-to-measure othotics, were my first item designed and assembled for a very long walk.
Good to know being as you are from the same city and medical professionals tend to hang out together and influence each other. My podiatrist said he would fit the orthotics to the boots as well.
 

CalgaryLynn

Active Member
Past OR future Camino
2021
That gel is serious stuff, gabapentin in particular has the potential for some nasty side effects and is usually prescribed only for serious nerve pain, not for just acheing feet. Lidocaine is a topical anaesthetic and again seems like a serious drug for a relatively minor problem. Unless you have serious structural foot problems I'd be asking why the podiatrist prescribed it.
The gel is a compounded product made specifically for back and feet pain. Side effects are dependent on percentage of drug compounded in the gel. The amounts are on the lower end. I am comfortable with his suggestion.
Overall I would be quizzing the podiatrist as to why they have prescribed a serious drug for nerve pain, why they recommend custom orthotics rather than off the shelf (could it be that they will make more profit?) and why they have not pointed you at exercises for both your feet and your core muscles since those are critical to comfortable walking.
Thanks for that but we did discuss exercises and he gave me some exercise suggestions. I am a yoga enthusiast. The cost is certainly worth considering as they are not cheap but if I get something that helps with the lower back pain and will be fitted to my comfort level, it would be beneficial.
 

Eleonore

New Member
Past OR future Camino
Portuguese
Ingles
Nobody can really tell you whether orthotics would be beneficial for you, only if they were helpful for them.

Blisters are a matter of both opinion and position. I tend to drain them and then use a hydrocolloid dressing such as Compeed. Don't try to remove a Compeed type dressing or it will tear off the delicate skin over the blister, let them come off of their own accord.

That gel is serious stuff, gabapentin in particular has the potential for some nasty side effects and is usually prescribed only for serious nerve pain, not for just acheing feet. Lidocaine is a topical anaesthetic and again seems like a serious drug for a relatively minor problem. Unless you have serious structural foot problems I'd be asking why the podiatrist prescribed it.

Orthotics again are a totally individual thing. For some foot problems they are very useful, but because they change the way you move they can also cause problems with other joints, in particular your hips and lower back. Use them initially with care and awareness to see how you adapt to them. If they don't seem to suit, go back to the podiatrist and get them changed or adjusted. There are some very good off the shelf orthotics available if you just have moderate, simple flattened feet and I would ask the podiatrist about those before you spend a lot more money on customs. It may be that custom orthotics would work well for you but it's worth exploring the possibilities first.

Lower back pain is often greatly improved for doing exercises to improve your core strength. I'm a big fan of pilates for that, yoga often emphasises flexibility without the underlying strength needed to support that additional flexibility.

Overall I would be quizzing the podiatrist as to why they have prescribed a serious drug for nerve pain, why they recommend custom orthotics rather than off the shelf (could it be that they will make more profit?) and why they have not pointed you at exercises for both your feet and your core muscles since those are critical to comfortable walking.
I have been using Voltaren cream for years. It is now available in US without prescription. Do check with your physician before using.
 

C clearly

Moderator
Staff member
Past OR future Camino
Most years since 2012. Hoping now for 2022.
medical professionals tend to hang out together
Maybe. But there can be very great differences in approach and they don't all agree with each other!

I go to a "pedorthist" now, who has more of a kinesiology background and deals in equipment rather than medical matters. He needs to understand the biomechanics, and be aware of the rest of the body, but he doesn't do the medical stuff that podiatrists do. He works with nurses and other paramedicals who do. I am much happier with him providing this service of outfitting my feet, than I was with the podiatrist I used to see. However, I realize that is a case of me finding the particular service than I want and need, and every situation is different.

If I needed prescription painkillers for generalized foot pain (i.e. not from an identifiable injury) I would go to my family doctor.

I must say that I am convinced that custom orthotics have enabled me to continue long distance walking. Over recent years, I have 3 times developed a chronic pain in a foot that lasted months, but disappeared after a few weeks of new orthotics. I have very flexible feet, and think that as I age they need more and more precise support to keep everything lined up properly for the hard work.
 
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Moorwalker

Active Member
Past OR future Camino
The Saint's Way, Cornwall
I have been using Voltaren cream for years. It is now available in US without prescription. Do check with your physician before using.
But that mixture is not Voltaren cream where the active ingredient is diclofenac, it contains several very potent drugs. It may be appropriate for the person concerned but it's worth checking with the prescriber why they think that something like that is appropriate.

Edited for mis-spelling
 

davebugg

A Pilgrimage is time I spend praying with my feet
Past OR future Camino
2019
I noticed that definitions are getting kinda blurry for the terms 'Insole'/'Insert, vs 'Orthotic'. I thought it might help to tighten things up a bit so that we do not get tripped up by terminology.

Insoles, arch supports and molded inserts are pretty much the same thing as a category. You can usually find them over the counter at retailers from big box stores to athletic shops to outdoor recreation stores like REI. They are all over online shopping sites as well.

They provide additional cushioning and may also offer some level of minor support in your shoes, replacing the insole that came with the shoe.. Because the material is often soft and deforms easily, even if contains some plastics, evaluating them for wear and tear about every 4 to 6 months, at most, is a good idea. Beyond that and their functionality decreases.

Orthotics are found in shops that are specialized or medical offices. This can get a bit confusing because the term “orthotic” has been adopted into a more common usage as a generic term, like kleenex or windex to describe all sorts of shoe inserts.

An orthotic is generally a firm support. It is primarily made from some type of plastic material where the arch of your foot is located. Orthotics are made based on measurement and assessment of foot positions during exam. Frequently, there are x-ray examinations made of the foot/feet. hey are meant to provide some distinct level of arch support in order to reduce the risk of further structural damage of injury to the feet while walking or running.

As a result, orthotics are custom made. They cannot be pre-made or manufactured then placed on a store shelf waiting for a buyer. Your foot must to be evaluated, and that evaluation determines what and which type of orthotic you need. A mold is made of the foot/feet, the mold is then modified to deal with the foot's specific structural issue(s), and then the orthotic is fabricated (off site or on site) to precisely match that foot and its needed correction. Orthotics do not usually deform; therefore, they do not have to be replaced as nearly as frequently as over-the-counter insoles.

Superfeet models, for example, even though they have a plastic component, are NOT orthotics. Neither are Dr. Scholls products, or gel inserts, or silicone stuff that slips into a shoe. The same applies to heat molded insole products.

Some other personal observations:

Into this mix comes a sorta hybrid approach: specialty shops which are stand-alone, retail locations that one can pop into and have a mold taken, and a device produced.

The inserts produced are meant to act in the same manner as an orthotic, and many of these shops do indeed refer to their product as an orthotic insert. Here's the problem: the need for a physical exam and assessment has often been replaced with a robotic algorithm which attempts to deduce problems based on a foot's shape and visualized pressure points.

That is an imprecise way to try and determine an actual deformity or structural problem that NEEDS to be corrected, vs one which does NOT need correcting. They can work to help soreness, but they can also do nothing; or worse, exacerbate an underlying issue. As such, the insert devices produced may not solve the problem at all, and the customer later ends up still needing to visit a medical professional, which will cost even more money.

Keep in mind that the business of orthotics, even those which are custom made in a podiatrist's office, are a BUSINESS. There is a large debate, even in professional circles, about how to evaluate the need for an orthotic, whether they are needed, and even whether they produce the level of benefit which are promised to patients and consumers.

Anecdotally, there are many who find them a life saver. . . but also those who have found them to create harm.

I think there is an approach to dealing with foot issue which reveal themselves when distance walking which will allow for two things: 1. The ability of the person to make effective changes starting with the simplest corrections which are usually the least expensive. 2. If you find that nothing suggested is effective, you will have a more precise way of explaining your symptoms to a treatment specialist, like a Podiatrist.

1. Start first with the footwear itself. Not every shoe model can satisfy all the needs of every individual. Each brand of shoe will have a variety of different models within that brand, which incorporates varying levels of motion control and pronation control features, as well as cushioning. Those features range from neutral to very aggressive.

Whether Hoka One One, New Balance, Nike, Brooks, Asics, etc, you can find a model that is designed to more effectively deal with a deficiency.

2. If you find a shoe that is the most effective at helping to deal with you issue, but can still benefit from additional correction then try out various insoles and inserts which focus on the specific issues that you are concerned with: pronation, motion control, comfort, heel pain, metatarsal pain, etc.

Like shoes, there are many third party insoles and inserts, with each brand having a variety of models to try and address a number of foot related corrections. It can take time to find a good match; it is not as simple as taking the recommendations of other people and calling it good. Like shoes, what may be terrific for one person, may be medieval level torture to another.

It is a myth that it may take time for you to 'get used' to an insole or insert if the insert or insole is uncomfortable. Do not accept that. What can be true is that an insert or insole might feel 'odd', which will sort itself out quickly as you wear them. Discomfort = no.

3. If a solution isn't found, I would think about consulting with a Sports Podiatrist, not a general Podiatrist, to properly assess feet and ankles.

At any point if there is serious discomfort with knees and/or the lower back is involved that goes beyond your body normally adjusting to a new regimen of long distance walking, I recommend seeking consultation with an Orthopedic practitioner or surgeon who can more accurately assess you for specific musculoskeletal issues. The diagnosis may point to the need to address issues with the feet in order to solve the problem, but there can be other serious underlying explanations for the pain.

There are folks who will report that their symptoms were resolved using a variety of means. These are anecdotal reports. While they worked well for someone else, there are others for which they have failed.

So go conservatively, being cautious with any serious concerns regarding knees, lower legs, ankles and feet as you seek solutions. If someone suggests something that sounds appealing to try, go slowly as you try it out yourself.
 
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Anamiri

Veteran Member
Past OR future Camino
2016, 2017, 2019 Camino Frances
Seems like an orthotic that molds to your foot might add some cushion, but it wouldn't provide any correction. The orthotics I got from my podiatrist corrected a problem in my feet (a raised section under the forefoot to prevent metatarsal pain). That being said, I still ended up wearing my chaco sandals on the Camino far more often than my shoes.
I didnt have high expectations of them either. The guy in the shop asked us to go in the morning when they had more time, and they do a full gait analysis etc, and selected the best shoes for his feet. The whole process took ages.
We spent about a year getting him used to walking, carrying a pack etc as he came from a family of non walkers. During earlier walks in his old shoes (New Balance) that we bought earlier, he had complained afterwards of sore feet and knees after only walking for an hour - and I had doubts about taking him on Camino. Initially I didnt want to buy his actual Camino shoes until closer to the time as his feet were growing so fast, and he was tough on shoes as well.
But it worked and we were able to take him to Spain and he walked without any foot/knee pain - so the outcome was brilliant. It cost an additional $80 plus the Camino shoes were more expensive (Saucony) - in my opinion money well spent. Not wanting to be the grandmother causing pain to her grandson, I had been prepared to see a doctor and podiatrist if necessary, as he was so excited to be coming with us to Spain.
At 13, he had grown out of his shoes within months of coming back - its much easier when feet have stopped growing - they only fit him for 6 months.
We later found that the inserts fit his rugby boots, and he could play a full game without pain as well.

I have hard moulded orthotics, with a Mortons extension, to correct my big toe problem - expensive but necessary. I get them fitted to both my shoes and my sandals - in Spain I mainly wear sandals. I found some German made sandals that come in wide width, and have a removable insert for orthotic, and they work really well.
 
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Sirage

Member
Past OR future Camino
Le Puy to Santiago (2005), Porto to Santiago (2007), Vezelay for 200 kms (2009), From Seville, May (2015), Le Puy to Sangüesa (2016), Norte-Primitivo (Sep-Oct 2016)
Sirage if you don’t mind sharing what type of insoles are you using? Would give me a good starting point.
Formthotics - A New Zealand brand - NZ makes some good outdoor stuff.

A have tried both these types - there are more - I prefer the Red/Blue which is not as thick as the Blue/Green - a combination of fitting my shoes and thickness.

I use them every day, and I use my preferred Camino shoes (multiple pairs and a new pair ready for the next Camino) for my every day walking, and walk more km at home than on all my Caminos. Say 5 -15 km/day > ~ +/-3,000 km / yr. Along the beach, to the supermarket ... ... ... . My car's main role is being stationary.

Formthotics-Both.jpg
 

Frank Wortley

Member
Past OR future Camino
French Caminos - April/May 2013, March/April 2017 and (Sept/Oct 2018)
I have not used orthotics. However I did by an excellent pair of boots - with one problem: The sole kept disengaging from the upper (4 pairs). So I took the full length shank out, purchased a boot half the price and a half size bigger and put the shank under the insert in the boot. EXCELLENT!!!!

Someone mentioned blisters. I have always been a bush walker and my feet have toughened up - no longer a "tenderfoot" so I cannot remember they last blister I developed. I regularly travel multiple, long and rough terrain distances. So, as said in the Army "Train hard, fight easy!"
 
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Ronald Boivin

Member
Past OR future Camino
2021
I thought I would share the particulars of my recent visit with a podiatrist. I am new to this walking long distances repetitively and thought a podiatrist might have some insight for me. I walked on Friday for 8 miles during my training and came home with a big blister on my little toe to show him.

I had surrounded my blister with a moleskin and covered with a bandage and he said immediately "Why didn't you drain it". He promptly put a small sliver cut on the roof and said told me to always drain, smear with antibiotic cream and bandage up. OK! Done!

He gave me some stretching exercises (which I should be doing now to prevent plantar's fasciitis) and a small ball to use to massage my feet and lower back at the end of the day. He also said I should be soaking my feet after every walk in Epson salts. Easy to do!

I also got a prescription for a pain relief gel to be used whenever I get painful feet and back. It is a compounded gel with diclofenac, gabapentin and lidocaine which can be rubbed in. Better than the Ibuprofen pills that are hard on the stomach.

He also told me I had flat feet so suggested I get a custom orthotic. I have been thinking of this as when walking longer distances I do experience some lower back pain.

With all this, I am wondering if anyone else has had experience with orthotics on the Camino and whether or not it has been beneficial?
Personalized Orthotics are a must if prescribed by a podiatrist. I did two Caminos of about 1000 km each and wore my orthotics faithfully which helped prevent prevent certain kinds of foot problems. Scheduled REST DAYS are critical for foot healing. I had major problems with my feet ( Shin splints and infected blisters requiring antibiotics) on my first Camino (Frances). It’s only when your walking apparatus gives up on you that you value it. Right now, I’m preparing for a third Camino in September. Heel Spurs ( Plantar fasciitis injury ) are seriously threatening my ability to engage in this third Camino. I feel quite disheartened.
 

henrythedog

Loved and fed by David
Past OR future Camino
Frances 2017, 2018, 2019, Ingles 2018, (Madrid 2019 partial - retired hurt!) (more planned)
Personalized Orthotics are a must if prescribed by a podiatrist. I did two Caminos of about 1000 km each and wore my orthotics faithfully which helped prevent prevent certain kinds of foot problems. Scheduled REST DAYS are critical for foot healing. I had major problems with my feet ( Shin splints and infected blisters requiring antibiotics) on my first Camino (Frances). It’s only when your walking apparatus gives up on you that you value it. Right now, I’m preparing for a third Camino in September. Heel Spurs ( Plantar fasciitis injury ) are seriously threatening my ability to engage in this third Camino. I feel quite disheartened.

Have a search for PF on here - there is some excellent advice as many have been afflicted.

I’m less than 100% convinced that all custom orthotics are strictly necessary given the vast off-the-shelf range available these days. (I have and use both).

If one takes a car to any tyre/battery/exhaust outlet for one of their ‘free inspections’ a vanishingly small number get a ‘no action needed’ report.
 
Last edited:

NYSE

Member
Past OR future Camino
Camino Frances & Camino Finisterre/Muxia April 2019
I thought I would share the particulars of my recent visit with a podiatrist. I am new to this walking long distances repetitively and thought a podiatrist might have some insight for me. I walked on Friday for 8 miles during my training and came home with a big blister on my little toe to show him.

I had surrounded my blister with a moleskin and covered with a bandage and he said immediately "Why didn't you drain it". He promptly put a small sliver cut on the roof and said told me to always drain, smear with antibiotic cream and bandage up. OK! Done!

He gave me some stretching exercises (which I should be doing now to prevent plantar's fasciitis) and a small ball to use to massage my feet and lower back at the end of the day. He also said I should be soaking my feet after every walk in Epson salts. Easy to do!

I also got a prescription for a pain relief gel to be used whenever I get painful feet and back. It is a compounded gel with diclofenac, gabapentin and lidocaine which can be rubbed in. Better than the Ibuprofen pills that are hard on the stomach.

He also told me I had flat feet so suggested I get a custom orthotic. I have been thinking of this as when walking longer distances I do experience some lower back pain.

With all this, I am wondering if anyone else has had experience with orthotics on the Camino and whether or not it has been beneficial?
I have walked thousands of miles in Superfeet thin insoles (Multiple pairs...they last around 600 miles). They are incredible. I would highly recommend them. Im surprised your Dr. didnt prescribe a larger pair of shoes/boots to address the blister malady.
 

CalgaryLynn

Active Member
Past OR future Camino
2021
I have walked thousands of miles in Superfeet thin insoles (Multiple pairs...they last around 600 miles). They are incredible. I would highly recommend them. Im surprised your Dr. didnt prescribe a larger pair of shoes/boots to address the blister malady.
I have boots that are a size larger but when I put my foot down, with flat feet they expand. He did recommend "new balance" but I am very comfortable in my boots. Walking ahead of time is revealing my hotspots so I can take appropriate measures to protect those spots.
 
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C clearly

Moderator
Staff member
Past OR future Camino
Most years since 2012. Hoping now for 2022.
Walking ahead of time is revealing my hotspots so I can take appropriate measures to protect those spots.
I found that in previous footwear, I got blisters on my baby toes after a few days on the camino, even though they never appeared as hotspots during training, and I thought the shoes were perfectly comfortable. I now use a wider shoe which allows full wiggling and spreading. If you are prone to getting those baby toe blisters, you might want to tape the toes from day one - I always hoped that 'this time' I wouldn't get them, but I always did after several days with the narrower fit.
 
Past OR future Camino
2021
I thought I would share the particulars of my recent visit with a podiatrist. I am new to this walking long distances repetitively and thought a podiatrist might have some insight for me. I walked on Friday for 8 miles during my training and came home with a big blister on my little toe to show him.

I had surrounded my blister with a moleskin and covered with a bandage and he said immediately "Why didn't you drain it". He promptly put a small sliver cut on the roof and said told me to always drain, smear with antibiotic cream and bandage up. OK! Done!

He gave me some stretching exercises (which I should be doing now to prevent plantar's fasciitis) and a small ball to use to massage my feet and lower back at the end of the day. He also said I should be soaking my feet after every walk in Epson salts. Easy to do!

I also got a prescription for a pain relief gel to be used whenever I get painful feet and back. It is a compounded gel with diclofenac, gabapentin and lidocaine which can be rubbed in. Better than the Ibuprofen pills that are hard on the stomach.

He also told me I had flat feet so suggested I get a custom orthotic. I have been thinking of this as when walking longer distances I do experience some lower back pain.

With all this, I am wondering if anyone else has had experience with orthotics on the Camino and whether or not it has been beneficial?
I have been using Spenco inserts for years (more reasonable than custom). Spenco Original for every day use and MAX for hiking - https://spenco.implus.com/ Also available on Amazon. In addition, use an old tennis ball underfoot to stretch the plantar's fasciitis. And do Calve stretching exercises for the Achilles tendon.
 

CalgaryLynn

Active Member
Past OR future Camino
2021
I found that in previous footwear, I got blisters on my baby toes after a few days on the camino, even though they never appeared as hotspots during training, and I thought the shoes were perfectly comfortable. I now use a wider shoe which allows full wiggling and spreading. If you are prone to getting those baby toe blisters, you might want to tape the toes from day one - I always hoped that 'this time' I wouldn't get them, but I always did after several days with the narrower fit.
Yes, I walked today with tape on my baby toes and it made a big difference, also I redid the laces to expand the toe width. Much more comfortable walk with no blisters today.
 

CalgaryLynn

Active Member
Past OR future Camino
2021
I have been using Spenco inserts for years (more reasonable than custom). Spenco Original for every day use and MAX for hiking - https://spenco.implus.com/ Also available on Amazon. In addition, use an old tennis ball underfoot to stretch the plantar's fasciitis. And do Calve stretching exercises for the Achilles tendon.
I will have a look at those. Those are the two exercises my podiatrist suggested to me. Calf stretching and also bending the stretched leg to lift the heel to stretch the PF. I have a massage ball that I started using. Also I have been using the Epson salts for 20 minutes in hot water after every walk. Amazing on feet, takes away the inflammation and just feels really good after a soaking.

Every little suggestion helps. Thanks all!
 
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GeauxWalking

New Member
Past OR future Camino
2022
I thought I would share the particulars of my recent visit with a podiatrist. I am new to this walking long distances repetitively and thought a podiatrist might have some insight for me. I walked on Friday for 8 miles during my training and came home with a big blister on my little toe to show him.

I had surrounded my blister with a moleskin and covered with a bandage and he said immediately "Why didn't you drain it". He promptly put a small sliver cut on the roof and said told me to always drain, smear with antibiotic cream and bandage up. OK! Done!

He gave me some stretching exercises (which I should be doing now to prevent plantar's fasciitis) and a small ball to use to massage my feet and lower back at the end of the day. He also said I should be soaking my feet after every walk in Epson salts. Easy to do!

I also got a prescription for a pain relief gel to be used whenever I get painful feet and back. It is a compounded gel with diclofenac, gabapentin and lidocaine which can be rubbed in. Better than the Ibuprofen pills that are hard on the stomach.

He also told me I had flat feet so suggested I get a custom orthotic. I have been thinking of this as when walking longer distances I do experience some lower back pain.

With all this, I am wondering if anyone else has had experience with orthotics on the Camino and whether or not it has been beneficial?
Hey! Thank you for the information! I have an appointment in a few weeks with a podiatrist for custom orthodontics, I had a pair previously (over 10 years ago) and they were a huge help! Especially as my right foot causes me more issues than my left so the customs are built to each foot vs. the store bought ones. Of course they are not cheap so I tried some other options first. I was still having pain in my right foot so rather than stress it anymore, I am going to see about getting a new pair made. I think I will be happier in the long run. I suppose it depends on whether you can find a solution without having to have customs made. Unfortunately, I could not. Buen Camino.
 

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