During the early 1980s, I illustrated a book on running biomechanics that was authored by Dr. John Durkin (deceased) and famed running coach Joe Newton of York high school (also deceased). Durkin was a podiatrist to some world-class athletes including Sebastian Coe, the Olympic champion at 1500 meters. Coe had flat feet and kept getting injured. The man could leg-lift 700 pounds, but the force of his own body pounding along the track with a bad case of pronation was injuring his calf muscles. Newton was helping with Coe’s training leading up to an Olympic year, and he introduced him to Dr. Durkin to help with a chronic leg injury.

At that time that I met Coe at Durkin’s office, I was young enough that my feet weren’t giving me many problems. Thus I viewed Coe’s issues with a cold objectivity and was actually sworn to keep his flat feet a secret. This was pre-HIPPA laws I believe, but there are some aspects of privacy that are just plain common sense.

Truth be told, Sebastian Coe was not alone among world-class distance runners having injury problems. There were other top-flight athletes visiting Durkin for help. He specialized in making orthotics for runners and when runners experience success with any kind of treatment, word tends to get around.

Twinges

I’d had some twinges in legs and joints as early as high school. That’s when my dad fashioned a heel lift for my track spikes. He made it out of brush denim, a fashion favorite at the time. His engineering mind helped him structure the counterbalance in my shoe, and it worked. I was able to complete the season injury-free.

In college as a steeplechaser, there were plenty of times when my left calf would get injured from making that leap of twelve feet from the barrier to the water pit. But that injury was less about biomechanics and more about the extreme stresses of jumping from a 42″ barrier over water to land on an incline.

That injury would always heal up. Overall I was pretty lucky not to have many overuse injuries during the competitive years of my career.

And then I got older.

Chondromalacia strikes

Somewhere in my mid-30s, I started to notice a burning sensation under my left kneecap. It persisted for months. Finally, I bought this gadget called a Cho-pat knee strap that lifted the kneecap to keep the underlying cartilage from rubbing the wrong way beneath the patella. That worked for a while, but it was kind of annoying to run with that stupid strap on my knee all the time.

I finally visited Dr. John Durkin and got a set of orthotics. He was rather dismissive of my knee strap. “You’re not dealing with the source of the problem,” he told me. Durkin was a bit brusque in many ways.

The orthotics worked. My knee pain subsided and I actually increasing my running mileage for a while. Yet I was also a prisoner of sorts to the orthotics in my shoes. I could not go anywhere without them or the knee would start to ache under the patella.

No more sandals

That was a pretty profound lifestyle change in some ways. No longer could I wander around in summer sandals of any kind. I even wore the orthotics in my dress shoes. The problem with that strategy was the smell. The orthotics made by Durkin has an insole glued over the top of a plastic insert designed to keep my feet stable. All that running and sweat and confined spaces made those orthotics stink so bad they could kill small animals if I crossed their path.

I recall wearing them to a new job where I shared a space with another new employee during the first few weeks. The foot odor from my orthotics was so strong it was embarrassing. I tried everything from sprays to powders to keep it at bay. But all failed.

Round II & III

Finally, I went to see another podiatrist in 2002. He made some dress orthotics that had thin leather covers that never absorbed odor. Problem solved. I still have those orthotics and wear them daily. So I’ve certainly gotten my money’s worth out of them.

I even used them running for many years. That strategy worked until calf cramps took me down. Then I consorted with a pedorthist, Shelley Simmering, who built a new set of orthotics specifically for running. They are relatively thick and somewhat heavy, but they do the trick. I get them tweaked now and then.

Principles of orthotics

In case you are lucky enough not to need such devices, the basic premise of orthotics is simple: They put your foot into a neutral position so that your legs and knees do not have to compensate for the imbalances caused by structural faults in the bone and ligaments of your feet. While human bipedalism is a miracle of evolution, it is a far-from-perfect process. With 7 billion people in the world, the odds are plentiful that some of us will have feet that are either flawed from the start or develop problems over time.

Some medical doctors seem to scoff at the whole orthotic paradigm. A triathlon friend we call Dr. Joe has steadfastly refused to get orthotics even as his knees and hips give him problems. I also have a triathlete friend whose feet were aching. She tried orthotics for a while but then went into intensive physical therapy. That seems to have helped immensely. It was all about using strength training to compensate for the imbalances in her foot structure.

I rather admire those who refuse to go the orthotic route. Sometimes I look at the devices in my shoes as a ‘crutch’ of sorts, an affectation of purpose that is only necessary because I’m too lazy or busy or cheap to actually invest in the strength training that might cure the source of the problem.

Maybe so. But until then I’m grateful for the TEVA sandals that I own. They have a degree of arch support and I can wear them without typically sticking the orthotics inside the open banded sandals.

But good old flip-flops? Those don’t really work for me over any sort of distance or time. I can wear them in and out of the pool, or maybe to the beach. But the souls of those rubber floppers are largely safe from wear. In the game of sandals vs. orthotics, it is likely always the orthotics that will win.