Wednesday, June 23, 2010

An Opportunity Missed?

Twenty years ago, soon after I moved up to Nashua, someone recommended to me that I visit a podiatrist named Howard Dananberg. He was noted to be a top notch podiatrist and I was having terrible back problems from my 5 years in triathlons. I went for an initial visit, but it was going to cost over $1000 dollars further and I could not afford the price. I went to a local podiatrist instead who refurbished the old pair of orthotics I had used off and on with no success for about 5 years. They still didn't do much for me after that.

I recall Dr. Dananberg telling me something was wrong with my forefoot, but I can't recall what it was. He taped up my feet in a special way and I ran great for a couple of runs until the tape fell off. Still, I could not imagine how the front of my feet and the way they lined up could possibly affect my left lower back (and no way to research online either). I have since seen Dr. Dananberg's name repeatedly over the years in all sorts of studies and references. He is a very well-known podiatrist. I have often wondered what would have happened if I could have afforded those orthotics and recieved his care those 20 years ago.

I tried orthotics again a little over 10 years ago. That did not go well either. While they were comfortable, they seemed to make my "supposed" leg-length difference worse. Even a local chiropracter was speechless when he tried to x-ray me with and without the orthotics. When I put a heel lift in my right shoe under the orthotic, the x-rays showed the right leg getting shorter. He could not figure it out. Two months into wearing the orthotics, I ran the Cape Cod Marathon. My legs felt balanced only when I added a heel lift to the right shoe, and by then I had over 1/2 inch of extra lift under the right orthotic, and my back couldn't handle the stress. I was holding my right lower back rigid and tight the first 16 miles of the race. Then I grabbed a drink of water and relaxed, immediately my back went into severe spasms and I was out of the race and running for many days. That was the end of wearing those orthotics!

I have tried the minimalism thing for the past few years, but there is still something wrong with my feet, hips, and back. When I first went to Dr. Baroody (the ART doctor)last week, he said that both my feet have "functional hallux limitis" and my left foot has an inverted heel. I have been trying to research both of these issues. I can't find much on the inverted heel, but there is a lot on functional hallux limitis. The other day I googled Dr. Dananberg's name to see if he still practiced in the area and found out that...

"Howard Dananberg, is renowned worldwide for development of
the concepts of Functional Hallux Limitus and the relationship of
gait style to Chronic Lower Back Pain

I found a very recent video where Dr. Dananberg describes this condition in an easy to understand way.

I also noticed that there is an insole which is named after him that is supposed to manage the condition (see video). I decided to call his office to see if they sell the insole "off the rack". I explained that I had been in 20 years earlier and the price I was quoted (that I could not afford). I was told that at that time Dr. Dannanberg probably wanted a specific and costly gait analysis done and that he doesn't need to do that anymore. When I asked about current pricing, it was like $120 for an initial visit (comparable to 20 years ago)and that the insoles would be about $150 unless I needed some posting done. Different orthotics would be about $480. That is not much more than the orthotics I had 10+ years ago from a no longer remembered podiatrist. Well, I missed the opportunity 20 years ago and I am not going to do that again when I have one of the most well-regarded and innovatice doctors in the field just miles down the road. I have an appointment set for next Tuesday.

I am still getting ART treatment. Dr. Baroody viewed my videos and saw "lots" of things. Well that wasn't hard to do. He has worked on my tight hip flexors and has now started working on my tight glutes and hamstrings. The funny thing is, I keep reading how ART treatment is supposed to hurt. Just like with the last ART doctor I went to, I barely feel anything but the pressure of fingers. There is no pain and I was watching Dr. Baroody as he kept looking at me in surprise. He was sure I would feel something on some of those muscles, but there was no pain at all. Oh well, that is fine with me!

I did cut out a section of under the first metatarsal on a pair of Dr. Scholls generic plastic insolesas Dr. Baroody suggested. I ran in them Friday for 8 miles as soon as I cut them out (probably not good- I know) and they changed my stride some and fatigued the hip in a different place, but I did not like the high arch on the insoles. I ran 8 miles the next two days, and they made me run slow and I felt real awkward. I stopped wearing them as my whole left side was now messed up and it felt like something was pinching. I ran the Mine Falls race Monday night without them and my left hip was stuck. I ran 20:24. After an ART visit Tuesday morning things felt better. I ran with the insoles in my light Puma K Street shoes in the Lowell race. That felt a bit better and I ran 19:33 for an easier course. My hip wasn't stuck, but muscles were not balanced properly.

Here are some of Dr. Dananberg's artices that relate to Functional Hallix Limitis from the Vasyli Think Tank™ and the insole company.

Here is a Carson Boddicker article on "Mobilizing the Big Toe" and a video.

Here is a Gary Moller video on mobilizing the big toe. He is the older brother of Lorraine Moller, one of the great female marathoners (Olympic medal, BAA Marathon win, ect.)

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