When your feet tire quickly and changing shoes doesn't help

What follows combines several patients' visits into one composite story. It is not about any one person, and anything that could identify someone has been removed.

How do patients usually come to us?

Patients tell us their soles feel heavy after walking just a little. Thinking the shoes were the problem, they've tried several pairs, but nothing changed.

They also say their lower back feels heavy the day after a light walk. They assumed it was just low stamina.

Pain patches and massage help for a while, but within a few days it comes back, again and again.

Why doesn't changing shoes help?

Shoes only wrap around the foot; they don't hold up a collapsed arch for you. A comfortable shoe and a supportive shoe are two different things.

A cushioned sole feels nice the moment you step down. But it doesn't stop the arch from sinking. So the more you walk, the more strain builds up in the same spot.

Pain patches and massage are the same. They loosen what's stiff for a while, but the structure that makes it stiffen again stays as it is.

What do we look at?

We have you stand barefoot and see how much of the arch is left. Then we measure where pressure concentrates on the soles of your feet.

We also look at where calluses have formed. They form where weight has rested for a long time, so their location tells us the shape of your walk.

We look at the soles of the shoes you came in. We can see which side wore down first.

How do we treat it?

We make custom insoles that support the arch. Unlike store-bought ones, we decide which spots to support and by how much, based on the shape of your foot right now.

For the painful spot, we first treat the inflammation with acupuncture and pharmacopuncture (herbal acupuncture). If it hurts too much to walk, you can't move on to the next step.

We also guide you in stretching tight calves and soles and in using the small muscles inside the foot. Support alone doesn't last long.

How did things go?

The first thing people tell us is that their feet feel lighter. Less pressure on the lower back, even after standing a long time, comes next.

The insoles may feel a bit strange for the first few days. We tell you this in advance and have you gradually increase the time you wear them.

What are the limits of this approach?

Support doesn't rebuild the arch to how it once was. It's about changing how weight is spread when you walk, to ease the strain.

If your foot is swollen and warm, if you're losing sensation, or if you have diabetes, foot wounds can progress differently, so it's best to see the appropriate specialist first.

To people with the same symptoms

1. A comfortable shoe and a supportive shoe are two different things.
2. A cushioned sole doesn't stop the arch from sinking.
3. Where your calluses are tells us the shape of your walk.
4. Support alone doesn't last — stretching and using the muscles go along with it.
5. If your foot is swollen and warm or you're losing sensation, see that specialist first.

We look at the whole chain, from the feet up through the knees and lower back. If you only treat the spot that hurts, it comes back a few days later.

If your first steps in the morning hurt, or nothing changes even after switching shoes, come see us once. We don't look only at the feet; we follow the chain up through the knees and lower back.

There are many possible causes, so the same treatment can lead to different courses for each person.