Help for the flat-footed?

[HMS '05]

Hi, I'm a MSIII who just started clinical rotations. I'm really enjoying my time in the OR and definitely can see it as a possible career, but the experience is slightly tarnished by the really severe foot and back pain I experience around the 3rd hour of a case. In my current rotation, most of the operations thankfully don't last much longer than 3 hours (although we might have 3 cases in a day), but I worry about what will happen during the 6+ hour cases that surely lie ahead. I am extraordinarily flat-footed (so much so that shoe salesmen in the past have actually called over their colleagues to observe my apparently freakish absence of arches!), which no doubt compounds the problem. Do any of the veterans of this forum have any suggestions for footwear or other ideas that worked for them? I bought a pair of Dansko clogs (which several residents recommended), but their extremely stiff insoles and rather high arches are even more uncomfortable than the tennis shoes I was wearing. Please don't tell me that I'll have to go into Rads just because of flat feet ! Thanks by the way to forum posters like Kimberli Cox and DrOliver--I have been skulking through this forum for quite some time, and your posts are almost invariably informative and highly helpful!

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[scutking]

I wear Red Wing boots and they work great. No complaints. It's the predominant footwear of choice at my program. One thing that can work during a call night is to switch shoes in the middle of the night. That places pressure on different points of your foot and may relieve some of your discomfort. One of my fellow residents will wear clogs during the day, but switch to tennis shoes in the middle of the night.

 

[maxheadroom]

I never go to the OR in anything but my Dankso clogs or a pair of tennis shoes with "Super Feet" insoles. Actually, unless I'm in a clinic where I have to dress up, I'm always wearing either the Danskos or my New Balances with Super Feet. Hmmm . . .

 

[Docgeorge]

You might want to visit a podiatrist or an Orthodics and Prosthetics clinic and get your foot casted and some otrhodics made. I had pretty much the same problem but to a lesser degree and getting some custome insoles were a life saver. They will run you about 300 or so dollars but believe me once you've had them for a while it's hard to imagine life with out them.

 

[::Seabass::]

Originally posted by Docgeorge
You might want to visit a podiatrist or an Orthodics and Prosthetics clinic and get your foot casted and some otrhodics made. I had pretty much the same problem but to a lesser degree and getting some custome insoles were a life saver. They will run you about 300 or so dollars but believe me once you've had them for a while it's hard to imagine life with out them.

I completely agree. I have high arches and can't live without my orthotics, and they are worth every cent. I only wish they would fit in more women's shoes besides tennis shoes, but you sound maybe male, so you shouldn't have a problem.

 

[sacrament]

Originally posted by HMS '05
Hi, I'm a MSIII who just started clinical rotations. I'm really enjoying my time in the OR and definitely can see it as a possible career, but the experience is slightly tarnished by the really severe foot and back pain I experience around the 3rd hour of a case. In my current rotation, most of the operations thankfully don't last much longer than 3 hours (although we might have 3 cases in a day), but I worry about what will happen during the 6+ hour cases that surely lie ahead. I am extraordinarily flat-footed (so much so that shoe salesmen in the past have actually called over their colleagues to observe my apparently freakish absence of arches!), which no doubt compounds the problem. Do any of the veterans of this forum have any suggestions for footwear or other ideas that worked for them? I bought a pair of Dansko clogs (which several residents recommended), but their extremely stiff insoles and rather high arches are even more uncomfortable than the tennis shoes I was wearing. Please don't tell me that I'll have to go into Rads just because of flat feet ! Thanks by the way to forum posters like Kimberli Cox and DrOliver--I have been skulking through this forum for quite some time, and your posts are almost invariably informative and highly helpful!

I have the same problem and I'm actually quite terrified of my surgery rotation for this very reason. I cannot stand still on my feet for more than a couple of hours without severe pain--if I can walk around, that helps matters quite a bit, but there isn't much walking around during a surgical procedure. My recovery time is poor, too; it usually takes a full day before my feet are back to normal. The notion of doing this for weeks on end really has wondering how in the world I'm going to manage without being on painkillers. I bought some over-the-counter shoe inserts which did absolutely nothing for me. I suppose the next step is to see a podiatrist, but I'm feeling rather skeptical.

 

[Blade28]

I just bought a pair of Birkenstock Redmonds, and they feel great! Much better than wearing a pair of regular shoes.

 

[UI2003]

I too was born without appropriate arches (my plantar skin reaches up on the medial surface on my foot as if an arch *ought* to be there, weird) and I've stood through 8-12 hour TAA and Ao Arch Aneurysm surgury with no prob. I just make sure not to let all of my weight sit on any one area of my foot for > than 30 mins. Also, picking up each foot and rotating your ankle a few times an hour works well. My biggest problem strangely enough is my lower *back*. For this, I do all those back stretching exercises you learned in P.E. each morning before heading out to work. I tried using a back brace for a while (like the ones you see box-loaders wearing) but it didn't work. I keep meaning to get orthotics made but I'm holding out until I'm in the OR more regularly - procrastinator that I am...

 

[gims]

Tried em all..owned em all...Anywears...Danskos....etc...the absolute best hands-down, and a well-kept secret of many an attending here in the Northeast, are Troentorp (Bastad) Clogs from Sweden - you can get them online or find a Scandinavian store near you like I did and try them out. Like Danskos but solid WOOD (poly sole so you don't clomp around too much). Sounds uncomfortable until you try them....trust me on this one. Better than my Danskos....

And even 6 foot 200+ lb guys like myself don't feel like a wussy when I wear them...they look damn cool, actually been asked about them by many people...

Just my $0.02...

-gims

 

[Surgdude]

My wife has really flat feet and will be starting on rotation next month. About 3 weeks ago, whe went to the podiatrist and got fitted for some orthotics, which have worked wonderfully. On her foot XR's, she was already showing arthritis across some joints. The pods told her that there is a neurovascular bundle that runs through some space near the talus and calcaneus that has essentially no purpose except to give people with flat feet pain. Once she got the orthotics, she had to find lace-up shoes in which to put them. Most of the recommended brands could be found relatively easily. Dansko, Doc Martens, Ecco, Rockports, etc. Knowing how much standing one can do in the OR in a day, or when you do become a resident and have to be on your feet for 25 hours in a 24 hour period, you'll be thanking yourself for making the commitment to the orthotics.

One other thing--I "borrowed" a pair of Ted hose from the hospital to wear during longer cases/days when I would be on my fet a lot. Best thing that I ever did. Makes a huge difference by the end of a long shift. And strangely, it makes me feel sexy. Oh wait, that last part is when I cross-dress up in my fishnets and high heels. Damn, why don't I develop a better internal monologue?

 

[LaCirujana]

Originally posted by Surgdude
One other thing--I "borrowed" a pair of Ted hose from the hospital to wear during longer cases/days when I would be on my feet a lot. Best thing that I ever did. Makes a huge difference by the end of a long shift.

Oh, yeah!! definitely "borrow" the TED hose. I have "borrowed" several pairs, along with a couple a sympathetic PACU nurse handed me one evening after a particularly killer day on my feet. I can't quite bring myself to spring for the official Jobst stockings, although one of my vascular attendings claims that he wears 'em every day. He must like that sexy feeling....

 

[Apollyon]

Next up - the Unna's boot!

 

[Sachin]

I'm with you guys.. Dansko's rule.. In fact, I have a virtually new set (size 42, equiv to a 8 1/2 or 9 mens) for sale.. Those are black but I like Brown for myself.. they work great and with my flat feet, I'm able to survive the day (and night).. they took a little getting used to, but I can tell you that the low back pain is definitely improved with Danksos..

Sachin

 

[dpmdoc]

Of course, I'm going to tell you orthotics are great. Well they are, and they can be designed for almost any type of shoe. The Dansko's and Birkenstocks are good too. For the back pain and the flat feet the clogs wouldn't help someone as much as a custom orthotic. Orthotic may or may not help the back pain. Bottom line...get orthotics, your feet will appreciate it.

 

[entpa]

One thing that may keep your back from aching so much is to place a step where you can put one foot on...switch feet periodically. Works like the rail at the bar

 

[Minimalist M]

I have flat feet and Ecco's walking shoes plus a Dr Scholl's work day insole gel saved my feet.

 

[sacajaweha]

eccos are outstanding, my dress shoes are more comfortable than tennis shoes