Custom orthotic insoles are for indestructible badasses, right?

Posted by Al Boyle
On November 5, 2023

“You know, I’m still standing better than I ever did
Looking like a true survivor, feeling like a little kid”


Elton John
Album: Too Low For Zero (1983)

Custom orthotic insoles weren’t on my radar.

In a September 2023 post series (the 3rd, 10th, and 17th, if you’re newer to this newsletter), I described the experiences that led to three back surgeries: where I failed, where I succeeded, and the steps I’m taking to avoid a fourth. As with the first experience, pain from the most recent forced me to alter my gait. The normal range of motion associated with taking a step sent lightning bolts down my leg and into my foot.

The late-February surgery brought immediate relief. Woohoo!

Fast forward a month–D’oh!–and I’m experiencing a radiating pain in my left foot.

It’s sharp. It starts near the outside of the foot and travels in. It disrupts my sleep.

And it alarms me, because I’ve only experienced nerve pain post-surgery when I’ve herniated another disk. Do I have anything left to herniate??

“Remain calm! All is well!…ALL IS WELL!!


Chip Diller, pleading with the panicked, fleeing crowd amidst the parade chaos
Animal House (1978)

I shove Panic back into my mental closet, slam the door, deadbolt it, and ignore its demonic laughter. I log into my neurosurgeon’s patient portal to explain what I’m experiencing.

“I didn’t do it, nobody saw me do it, there’s no way they can prove anything!”


Bart Simpson’s emphatic, paranoid, and therefore, questionable denial of wrongdoing
The Simpsons, Season 1: Moaning Lisa

He says it’s not related to my surgery and recommends I follow up with primary care. Well, I know how that movie ends: I’m either taking medication, getting a prescription, or getting a referral to my podiatrist.

Since I already have a podiatrist, I pass go and he collects my co-insurance. Why do I have a podiatrist? Well, I had a benign alien thingy in my right foot years ago. I call it my alien thingy. Good times.

My podiatrist tells me my altered gait from my last disk injury left me with a parting gift: foot tendonitis and metatarsalgia. Meta-whatta?

According to Wikipedia, it’s also known as a stone bruise.  I’ve stepped on a few stones barefoot in my time, and that pain subsided in a moment or two. This pain refuses to comply with its eviction notice. Still, I’m relieved my lumbar spine isn’t a Jenga game gone bad.

My treatment plan calls for:

  • A prescription painkiller
  • A recommendation for a topical cream called Voltaren
  • A recommendation to scale back on activities that aggravate my symptoms
  • A referral to physical therapy to stretch and strengthen the support structures
  • A prescription for iontophoresis treatments to dispense dexamethasone into the injured area

We also discuss new sneakers and custom orthotic insoles. New territory for me.

Sneakers tend to last me a year or two, or maybe that’s only what I’ve believed all along. He recommends new sneakers every six months, and I’m on board. I also like the idea of custom orthotic inserts. What could be better than something designed for my feet?

Besides a foot rub.

In the next newsletter, I’ll cover the orthotic design process, how treatment went, and where I stand (ha!) now.




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