7.22.2011

Self Merrell-cation

The worn tread under the big toe of my (formerly) beloved Via
Spiga boots shows evidence of years of over-pronating
.

I've mentioned my bad foot quite a bit on this blog, but I've never really explained how it came to be.

That is partially because I don't really know how it came to be. I know the day it started — it was in February, 2010, the week we got two blizzards here in the DC area. I hadn't been doing a lot of high impact exercise, and in fact I'd only left my condo building once the entire week. But one day I looked down, and my right foot was swollen.

Very, very swollen. It wouldn't fit in any shoes of mine aside from my trail runners, which were pretty roomy. After some of the snow had melted, I had to make an emergency trip to DSW, where I looked around for shoes that both fit and felt comfortable. I ended up landing on a pair of black Merrell clogs.

I saw my primary care physician. She thought I'd sprained it, but recommended going to see a podiatrist if it stayed swollen. It did, so I saw the podiatrist. There were x-rays, a soft cast, and then an air cast. The odd thing was, it didn't really hurt very much. But the bones in there went snap, crackle, pop when I walked, and it was disturbingly swollen.

The swelling lasted for weeks, as I wore the air cast but also tried a variety of home remedies. One — a poultice of sea salt, ginger powder, and honey (Trader Joe's Desert Mesquite, if you're curious) — made the swelling go down drastically after the first application. The podiatrist didn't believe me, but I swear, every subsequent application brought the swelling down a bit more. That brought with it a new set of problems, as there was even more snap, crackle, and pop, and the lower the swelling got, the more there was actual pain.

I did another round in the air cast, which made no progress. I got an MRI on my foot, which showed only some degeneration in my big toe joint, which the podiatrist pooh-poohed as not being a possible cause. Gradually, over the course of several months, the swelling went down to the point where you might think it was a normal-looking foot. That is, until you saw my other, lean and bony foot. The podiatrist referred me to a vascular specialist. The vascular specialist spent half an hour telling me I had chronic lymphedema, then looked at my MRI results and decided the problem was this degeneration in my big toe joint. So basically, the two doctors had gone around in a giant circle.

I went to see another podiatrist for a second opinion, this one affiliated with Johns Hopkins. He got my hopes up for awhile by thinking it was a rare problem with my lisfranc ligament that just wasn't showing up on the MRI. So I got a CT, and guess what, it didn't show up there, either. He also concluded it was lymphedema, and referred me to a lymphedema clinic.

But I wasn't buying it. Whatever happened to my foot, it happened quickly, and clearly only to one foot, and that didn't sound like chronic swelling due to failure of the lymph nodes to me. So before I committed to the lympedema clinic, I decided to find a really good lymphedema specialist, and scheduled an appointment with one at the Cleveland Clinic before the Thanksgiving holiday (my family lives in Ohio).

I discovered when I saw her why the Cleveland Clinic's doctors are so good — they take the time. She spent more than half an hour with me, going over my medical history and the history of my foot problem, and examining me. And her conclusion? It was probably likely that the swelling (edema) was secondary to a problem in the foot. She referred me to a foot and ankle orthopedist at the Clinic, who also spent a good half hour with me, and then came up with the most realistic conclusion: nobody might really ever know exactly what's going on in my foot.

By then the snap, crackle, pop symptoms had been overshadowed by serious stiffness and pain in my arch, and he recommended trying the logical thing — orthotic arch supports. But he also said something that really made me think, and that was that, even with the mystery swelling, I have good feet. I don't have funky arches, or plantar fasciitis, or anything like that. I nearly cried. For the first time in a long time, I felt some hope as it related to my feet.

And there was another cause for hope. I'd been wearing those Merrell clogs pretty much every day to work, so before I left for Thanksgiving, I'd ordered some new shoes from Zappos. I chose a couple brands, but ordered heavily Merrell on the success of the clogs. One pair, Merrell's Brios, probably changed my life.

Merrell uses something they call Q-Form in women's shoes. The idea is that women's hips are wider, so our legs don't go down straight, like men's. This makes us walk differently, and badly, as far as our feet are concerned. Q-Form compensates for this with a shock-absorbing air cushion in the heel, build-up on the sides of the feet, and varying densities throughout the rest of the foot. Essentially, it stabilizes your foot throughout the whole stride, keeping you from pronating or supinating. There was Q-Form in my clogs, but because your feet tend to move around a little in clogs, I didn't feel it as much.

I sure felt it in the Brios, though. All of a sudden my arch was well-supported and my foot was completely stabilized. Gradually, all of the pain and stiffness left my arch. I began to realize that I had been over-pronating for many years — essentially pulling myself along with my big toe as I walked. I began to understand how I was supposed to be walking. And when I tried on some of my old shoes — Skechers especially, but even my New Balances weren't innocent — I saw how they had in fact been contributing to all of this over-pronation.

I started buying more Merrells. Not every pair felt as good as the Brios, and there were quite a few pairs that went back to Zappos. But when I found a pair that worked for me, they really worked. By December, the arch pain was gone, and replaced with some pain and cracking in my big toe when I was barefoot. FINALLY, the thing that was actually a problem was showing its symptoms. And as long as I wore my Merrells, the toe didn't hurt.

I procrastinated getting the orthotics, but finally did order them. When they came, they were a disappointment — they didn't feel nearly as good as the standard Merrell insoles, and the big toe joint cracked away when I walked in them. At this point, I decided to bail on medical science as far as the foot was concerned. The doctor had only recommended them as something worth trying, and while trying the orthotics had been a disaster, trying the Merrells was a rousing success. I stopped trying to find a "cure" and started accepting that this was the way my foot was going to be now. I put the orthotics on the shelf and bought even more Merrells.

My foot has gradually gotten better this year. It's still a bit swollen, and probably always will be. But I decided to follow the doctor's statement that my feet were essentially good feet, and stop letting it be a concern. No more only riding the exercise bike because it was low impact. I started walking more, and nothing bad happened. I got to the point where I could walk 5 miles without any problems. I bought a pair of Merrell barefoot shoes, and although they didn't have Q-Form in them, now that I'd learned to walk properly, they felt good too, because there were no messed-up shoe-ey bits getting in the way. I gradually built up the strength of my feet by walking and even running a bit in the barefoot shoes. A few weeks ago, I walked a full 10 miles in the barefoot shoes, and nothing bad happened to my foot.

After I posted a negative review about them on Yelp (this had more to do with billing issues, but also I felt the orthotics did not fit well), the manager of the orthotics place asked me to come back and have a fitting with him, at no extra cost. I did, and he was impressed by my Merrell sandals, going so far as to say he was going to recommend them along with his usual recommendation of Birkenstocks for sandals (which obviously can't hold orthotics). He wanted to try me in a cork rather than a plastic orthotic, so he took a new mold of my feet.

Merrell insoles on the top, orthotics on the bottom. Almost the
same shape, but the Merrell insoles are thinner and don't dip where
the big toe joint goes, which caused the cracking in the orthotics.

After he did, he looked between the red foam shapes of my foot, and my Merrell sandals. Wow, he said, they're the same shape as the sandals. Orthotics, he said, make shoes that don't fit your feet work for your feet. But what I'd done was go out and find shoes that fit my feet. It's possible that Merrells just happened to be exactly the right shape for my feet. But judging by the number of other people I see leaving shoe reviews who say they only wear Merrells now, my feet aren't the only ones they're perfect for.

I don't worry about my feet anymore. After spending much of last year wondering if I'd ever be able to walk more than a mile again, that's something I don't take for granted. And I did take my feet for granted before this happened. My main judge of shoe success was not causing blisters, regardless of what they were doing to my foot innards. I put them in $20 shoes from Target, and Skechers, and all manner of high heels. If the mystery swelling hadn't happened when it did, I'd probably have bought a pair of Skechers shape-ups, and right now I'd be wrecking everything from my hips to my feet.

Merrell insoles on the top, Skechers insoles on the bottom. You can see the
giant dip in the Skechers' big toe joint area, which caused my over-pronation.

I can't get back all of the years I spent over-pronating in bad shoes, but at least now that I've had to pay the consequences, I know that I have to put my feet in good shoes. Merrell dominates my shoe racks these days, and most of what's left are shoes I just can't quite bring myself to get rid of yet.

So if you read this blog and wonder why I'm such a Merrell fanatic, well, that's why. My feet are stronger than ever, and I'm back to walking when I want, as far as I want, and that's because of Merrell.

2 comments:

Christina said...

I just happened on your post looking for relief for my very tender swollen heel. Please tell me what Merrell's work in additon to the Brio.
Chri

Carrie G said...

Hi Christina,

Anything that's labeled as having Q Form should have the air cushion in the heel. I've done a series of reviews of different shoes in other blog posts here, as well, where I try to walk five miles in them and see what happens.