Poster: A snowHead
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Background:
I am a female with large calves and a joint disorder called Ehlers Danlos Syndrome. The shape of my feet has been described as pes cavus by my orthotist, and I have a high instep. Eight of my toes are naturally curled but do flatten when weight bearing.
Despite several visits to CEM I still continue to be really unfortunate with my boots. The most recent alterations (to try to accomodate my calves) were carried out a month ago at Solutions4feet and while I was excited to try out the boots at the snowdome, I was disappointed to find out that the same pain came back after an hour. The pain is always in my right foot, centred around the ball of the foot and the second/third/fourth toes. I already wear custom orthotics with metastarsal pads due to a high instep and my Ehlers-Danlos Syndrome (hypermobility type), and my most recent trip to Bicester involved moulding the liners with these insoles inside. The advice from CEM's new colleague was to try physiotherapy for tight calves, as they've done about as much as they can with the boot.
I had a 60 minute sports massage on Tuesday, with most of the time being spent on my calves. Additionally this afternoon I went to see my usual physiotherapist, who happens to have worked three seasons in the Alps so understands a lot about skiing. She has also worked in a rheumatology department, giving her experience with EDS. Her advice was that it's probably a nerve issue and no amount of calf stretching will fix nerve damage. She suspects that the pain may be caused by nerve damage in the inside of the ankle, and her advice was to experiment with buckling the boots looser than normal to see if it helps. I already make sure the buckles are fairly loose so I'm not sure if this will make any difference.
My next trip is in three weeks and I will be with a large group of friends so I would really like to be able to ski with them, without having to stop all the time, but I feel at a loss of what to do now. I do intend to have one or two further sports massages, use my foam roller and keep up a routine of ski specific physio exercises in the weeks running up to my trip which may help. However after what my physiotherapist said, I am really nervous about having yet another trip ruined by unbearable pain in my feet. It is frustrating because skiing is something I am determined to continue doing despite the joint disorder, but my last trip resulted in me sobbing at the side of the piste with my boots off on multiple occasions. Not what you hope for when you spend c. £1000 on a holiday.
CEM and the team at Solutions4feet have been incredibly helpful so far, but I thought I would also post here to see if any snowheads have had a similar issue and managed to overcome it.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Your pain sounds a bit like Mortons Neuroma. I suffer from that though not normally in ski boots. My GP referred me to the local hospital and I've now had two lots of steroid injections between toes 2-3 and 3-4. They have helped quite a bit.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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Your pain sounds a bit like Mortons Neuroma. I suffer from that though not normally in ski boots. My GP referred me to the local hospital and I've now had two lots of steroid injections between toes 2-3 and 3-4. They have helped quite a bit.
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You need to Login to know who's really who.
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Your pain sounds horrendous and I'm hugely admiring of your spirit and determination. I'm one of the lucky ones without much in the way of feet problems but I suspect it might be worth visiting your GP and getting referred to a specialist as Pam W has. This probably won't be in time for your next trip though.
One thing I do wonder about is whether you might like to try snowboarding on your next trip. You might get on better with snowboard boots and that would allow you to continue to enjoy your time on the slope with your friends.
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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Can you get a referral to a good foot surgeon? Feet are mightily complex things so I think it might be good to get the full range of opinion. I was referred to Mark Tagoe who apparently has a very good reputation in the world of feet.
I've had a lot of foot pain for a number of years, initially diagnosed as Morton's Neuroma and I was being lined up for surgery as no amount of steroid injections (apparently I've had my limit of these) seemed to resolve the problem. But after further x-rays, ultrasound and MRI scans the foot surgeon I was referred to decided that the small neuromas around the nerves leading to toes 2 and 3 could not cause the level of pain I was experiencing. The eventual conclusion was that I have unusual geometry to my foot bones which means that any pressure going through the forefoot gets focused on the joint between the 2nd metatarsal and phalange (foot bone and toe bone), and consequent inflammation and pain. There's not a surgical solution for that, so I've had to change slightly where I put pressure through my foot (less on the forefoot, more through the middle of the foot). This has significantly reduced the pain, but not eliminated it entirely.
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You'll need to Register first of course.
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@calbris, commiserations
It's miserable, been there.
As @pam w, and @rob@rar say it could be Mortons. I'm another one who's had that.
What helped me:
Consultant foot specialist, Ultrasound scan and cortisone injections.
Physio - foam roller and medidyne calf stretcher
Podiatrist - orthotics in my street shoes
Boot fitting - sure CEM team will have done this but my modifications included a metatarsal bar under my footbed and getting really flat in my boot so as to have the weight evenly distributed over the foot and no loading on the ball of the foot.
And also..... If you are overweight, consider losing weight, I lost 3 stones and the Mortons doesn't niggle at all now.
Good luck!!
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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@calbris, a very salient point was made by @rob@rar, the foot is complex so best to see a foot specialist and get some scans done to see what's causing the pain since it's hard to tell from your description what the issue is.
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I am absolutely not an expert on Mortons Neuroma but if you don't get any pain when snowboarding then if it were me that's what I'd do. Let's be fair, the fun is in going downhill on frozen water and engaging edges and carving turns. I'm an old windsurfing wave sailor who last year switched to kite surfing and had a pretty tough learning curve to go through. But same sensation, sliding over the water using wind power, and going downhill on water. Same as skiing and boarding. Good luck.
Last edited by Ski the Net with snowHeads on Sat 9-01-16 20:47; edited 1 time in total
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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Dies not take much to get a diagnosis .. But injections and surgery are not usally succesfull ... You could also try bowen and acupuncture, both have been known to help all nerve ailments..
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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Hi. As a chronic pain sufferer with nerve damage that affects my toes (They point up, I have limited feeling but sometimes they burn) I do appreciate how frustrating it is to be constantly plagued by recurring pain when you are doing something you love (I mean it never happens while I'm ironing FFS!)
Once you have exhausted the podiatrist/orthopod/surgeon route, if you still have got nowhere it might be worth considering the last resort of the drug route via the pain clinic, I use pregabelin (every day)to inhibit the nerves sending pain messages, voltarol for inflammation(only when skiing or if I have a flare up), codeine for the pain(only skiing/flare) and a TENS machine to confuse the nerves further(most days). I know little about ED syndrome so if this is inappropriate I apologise, I'm not a DR so I'm not advising that these drugs are the ones you would be prescribed, I hesitated to post at all on the subject but as your symptoms and frustrations struck a chord with me I thought I'd mention another possibility. I hate taking meds but I'd rather do that than not ski again. Good luck x
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@yorkshirelad, injections and surgery can be successful, though. I've successfully had a neuroma surgically removed from one foot.
While there is evidence that acupuncture can be effective for pain relief (I've had it myself), there is no clinical evidence that bowen is effective in any way other than in a placebo effect. Recommending bowen is like recommending homeopathic remedies.
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You know it makes sense.
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Surgery was not recomended for me.. And the injections had limited effect... Re bowen though...If you are not aware of how bowen works i suggest you look into it more, im married to a practitioner and having seen the effects first hand and the number if people helped by it im amazed, also please check premier league football teams and premier league rugby, all use bowen as a quick cure whilst still on the pitch... Have you not wondered why so many are treated on the pitch rather than off it...?? . If it is a placibo how does it work on horses ( where it what origanlly meant for) .. If you have not tried it i strongly suggest you do before taking drugs or having surgery.. Both have higher risks ..
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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Bowen works. Give it a go. I encouraged so many people from work to give it a go and they haven't had a day off with a bad back since...
It can't do everything, nor is it for everybody, but if you are in pain/discomfort, give it a go.
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Poster: A snowHead
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Apparently Ten years ago or so they did not know bowen iworked, but after extensive tests and research coupled with dissections they found out that it was fascial release that was the trick... Muscle problems have recently been found to be caused not by the muscle its self but by the " facial covering" or thin skin holding the muscle together.. Its bcoming a very research based therapy.So its Not at all quackery. For further info look in the FAQ On wwwthebowentechnique.com web site, its interesting !!
With my mortons nuroma i tried all sorts, by the time id found my "cure" i then discovered bowen ..
Acupuncture worked wonders on my trapped nerve from skiing, never had it before so was very sceptical.
I would rather first spend £2 for a silicon footpad or £30 for a complimentry session before drugs or surgery, but each to their own i suppose ..
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Dealing with problems in the fascia is certainly effective but not confined to Bowens.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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I did look up bowen and could find no peer reviewed studies by scientists/medics proving its effectiveness.
Myofascial release is definitely effective. And if that is what bowen is, I can't see how it would work on a foot neuroma, which is basically fibrous scar tissue formed around a nerve that has been ground between bones.
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You need to Login to know who's really who.
You need to Login to know who's really who.
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I did not say it worked on mortons nuroma, but could be worth a try, !! It can work on areas that maybe causing similar symptoms (read about spanish golfer Jose ozlathabal ..) . a peer review is not what you may think, having knowledge of testing and results that they can and do give, i am always amazed the fall back onto peer reviewing.
As no two injuires are identical, it is impossible to select a "test group" .. That is the problem, but it also gives other bodies the justification to make sure we pay for surgery, drugs and injections etc.. They dont always work, as your doctor/surgen will point out before treatment whilst also warning you of side effects and surgical related problems...
As i and many on snowheads will testify to is that it works.. As do the horses that cant speak, again it is everyones option to take a road of treatment, but i would ask people to prove it does not work . .. Now thats a challange lol
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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Quote: |
surgery, drugs and injections
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Modern medicine is a business - if people were cured they would be out of a job.
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You'll need to Register first of course.
You'll need to Register first of course.
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This is for information for those new to bowen abd this thread, sorry if its gone off track from the possible neuroma ..
This is just one bit of research done.. Independantly, there are more,
Research carried out at University of Lancaster By Dr. Bernie Carter,
Principal Lecturer in Children’s Nursing – The Clinical Nursing Practice Research Unit
of this study was to evaluate Bowen Technique in the treatment of frozen shoulder.
A mixed method, case study (Stake, 1995) approach was adopted as the best means of generating appropriate data. Quantitative data was generated in relation to physical functioning, mobility, levels of pain experienced, past medical history and specific shoulder pain history. Qualitative data was generated in relation to individual clients' experiences of Bowen therapy and their responsiveness, or otherwise, to the therapy. Data was collected through specially developed consultation sheets, self-report pain diaries, self-complete questionnaires and semi-structured interviews with clients at specific stages within their treatment.
20 participants.
OUTCOMES
A high level of satisfaction with the therapy, a commitment to using Bowen in the future should they require it for another episode of frozen shoulder or other condition, and the intention to recommend the therapy and therapist to friends and family.
A significant improvement in shoulder mobility and associated function for all participants, with 70% of participants regaining full mobility (equal to the non-affected side) by the end of the treatment.
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Sub_Zero_G wrote: |
I did look up bowen and could find no peer reviewed studies by scientists/medics proving its effectiveness.
Myofascial release is definitely effective. And if that is what bowen is, I can't see how it would work on a foot neuroma, which is basically fibrous scar tissue formed around a nerve that has been ground between bones. |
From what little I know of Bowen I think you are right in saying there are no peer reviewed studies or decent evidence to support its effectiveness. Quackwatch lists it as a 'questionable treatment' along with all sorts of other dodgy things (homeopathy, aromatherapy, ion foot baths, and Bach flower remedies). Personally, I think it's utter nonsense with zero science behind it, but my wife swears by Bach's 'Rescue Remedy', so what do I know!
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Dr Rock wrote: |
Quote: |
surgery, drugs and injections
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Modern medicine is a business - if people were cured they would be out of a job. |
Actually, if people weren't cured they would be out of a job even quicker. If modern medicine cures people they will simply live long enough to contract the next illness/injury that modern medicine will then try and cure too.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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@foxtrotzulu, a lot of what is being discussed on this page can fall within the quackery definition, including acupuncture (I've tried it and it provided a few hours of pain relief in an inflamed knee on the first occasion but not on subsequent occasions) and myofascial release, which is nothing more than massage that relieves muscle tightness in the same way that sports massage does.
As someone who usually exercises/participates in sport six days a week, I get a weekly sports massage, which does help to alleviate some of the muscle tightness I experience. It does not cure ailments, enhance my performance, nor even alleviate all of the muscle tightness. Every now and then my massage therapist says she needs to apply myofascial release, which feels exactly like the sports massage she usually gives me, with the same results.
The thing that annoys me is when practitioners of alternative therapies become evangelical, point fingers at big pharma and proven medicine, or play the persecution card, all while preying on vulnerable people who have chronic illness or chronic pain and who are so desperate to feel better that they part with good sense and good money.
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I'd say sports massage is the same thing as myo-fascial release also trigger point therapy. If your problem is caused by muscle tightness its highly effective. But not otherwise. I have a good self-treatment book on trigger and I now know that a niggling pain in my upper right arm is referred from the scalene muscles of the neck. When I successfully get the right spot I can feel the pain down the arm. After a while, and some discomfort, the problem is solved. Till the next time. Possibly caused my using a mouse.
Trigger points in the vastus medialis can cause knee pain and sometimes the knee to "give way".
But no therapy is a panacea and the author of my trigger point book loses me when he suggests that trigger points in the head and neck might give rise to dyslexia.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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Sorry in advance for brief replies, I am at work and trying to be coy.
pam w wrote: |
Your pain sounds a bit like Mortons Neuroma. I suffer from that though not normally in ski boots. My GP referred me to the local hospital and I've now had two lots of steroid injections between toes 2-3 and 3-4. They have helped quite a bit. |
Thanks for your reply. Physio suggested Mortons Neuroma then said that since I don't have constant pain in the area, it's unlikely to be that.
olderscot wrote: |
Your pain sounds horrendous and I'm hugely admiring of your spirit and determination. I'm one of the lucky ones without much in the way of feet problems but I suspect it might be worth visiting your GP and getting referred to a specialist as Pam W has. This probably won't be in time for your next trip though.
One thing I do wonder about is whether you might like to try snowboarding on your next trip. You might get on better with snowboard boots and that would allow you to continue to enjoy your time on the slope with your friends. |
Thank you. I may give snowboarding a go in future but I'm really keen to persevere with skiing at the moment. It probably sounds weird but having never tried it, I can't imagine the idea of having both my feet fastened in to one board! You're right though, the boots do look a lot more comfortable.
rob@rar wrote: |
Can you get a referral to a good foot surgeon? Feet are mightily complex things so I think it might be good to get the full range of opinion. I was referred to Mark Tagoe who apparently has a very good reputation in the world of feet.
I've had a lot of foot pain for a number of years, initially diagnosed as Morton's Neuroma and I was being lined up for surgery as no amount of steroid injections (apparently I've had my limit of these) seemed to resolve the problem. But after further x-rays, ultrasound and MRI scans the foot surgeon I was referred to decided that the small neuromas around the nerves leading to toes 2 and 3 could not cause the level of pain I was experiencing. The eventual conclusion was that I have unusual geometry to my foot bones which means that any pressure going through the forefoot gets focused on the joint between the 2nd metatarsal and phalange (foot bone and toe bone), and consequent inflammation and pain. There's not a surgical solution for that, so I've had to change slightly where I put pressure through my foot (less on the forefoot, more through the middle of the foot). This has significantly reduced the pain, but not eliminated it entirely. |
Thanks Rob, it's really interesting to hear about your experiences with foot pain. How did you change the area you place pressure on? Do you have custom orthotics?
sarah wrote: |
@calbris, commiserations
It's miserable, been there.
As @pam w, and @rob@rar say it could be Mortons. I'm another one who's had that.
What helped me:
Consultant foot specialist, Ultrasound scan and cortisone injections.
Physio - foam roller and medidyne calf stretcher
Podiatrist - orthotics in my street shoes
Boot fitting - sure CEM team will have done this but my modifications included a metatarsal bar under my footbed and getting really flat in my boot so as to have the weight evenly distributed over the foot and no loading on the ball of the foot.
And also..... If you are overweight, consider losing weight, I lost 3 stones and the Mortons doesn't niggle at all now.
Good luck!! |
Thank you for your advice. Which out of those things did you feel was the most helpful?
I fear that weight loss may be the key, but I'm probably not going to make a significant change before my trip. Unless I deliberately give myself food poisoning...
Thank you. I shall definitely look into these! I'd never heard of them before.
Sub_Zero_G wrote: |
@calbris, a very salient point was made by @rob@rar, the foot is complex so best to see a foot specialist and get some scans done to see what's causing the pain since it's hard to tell from your description what the issue is. |
Thanks. Do you know whether the NHS is likely to give any support for issues like these, or is it a matter I'd have to address privately?
lilywhite wrote: |
Hi. As a chronic pain sufferer with nerve damage that affects my toes (They point up, I have limited feeling but sometimes they burn) I do appreciate how frustrating it is to be constantly plagued by recurring pain when you are doing something you love (I mean it never happens while I'm ironing FFS!)
Once you have exhausted the podiatrist/orthopod/surgeon route, if you still have got nowhere it might be worth considering the last resort of the drug route via the pain clinic, I use pregabelin (every day)to inhibit the nerves sending pain messages, voltarol for inflammation(only when skiing or if I have a flare up), codeine for the pain(only skiing/flare) and a TENS machine to confuse the nerves further(most days). I know little about ED syndrome so if this is inappropriate I apologise, I'm not a DR so I'm not advising that these drugs are the ones you would be prescribed, I hesitated to post at all on the subject but as your symptoms and frustrations struck a chord with me I thought I'd mention another possibility. I hate taking meds but I'd rather do that than not ski again. Good luck x |
Thank you for your post, it's good to hear that you managed to find a way to keep skiing even if it's not ideal to be taking so many meds. Do you take pregabelin and voltarol regularly outside of snowsports? I try really hard to limit my painkiller use except in the event of flare ups, but I do rely on NSAIDS and dihydrocodeine to survive some days...
yorkshirelad wrote: |
Apparently Ten years ago or so they did not know bowen iworked, but after extensive tests and research coupled with dissections they found out that it was fascial release that was the trick... Muscle problems have recently been found to be caused not by the muscle its self but by the " facial covering" or thin skin holding the muscle together.. Its bcoming a very research based therapy.So its Not at all quackery. For further info look in the FAQ On wwwthebowentechnique.com web site, its interesting !!
With my mortons nuroma i tried all sorts, by the time id found my "cure" i then discovered bowen ..
Acupuncture worked wonders on my trapped nerve from skiing, never had it before so was very sceptical.
I would rather first spend £2 for a silicon footpad or £30 for a complimentry session before drugs or surgery, but each to their own i suppose .. |
Thank you. I don't know much about Bowen but I already practice mindulness and do pilates stretches to help with my joint pain. I will do a bit of reading to see whether it could help in addition to my sports massages.
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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calbris wrote: |
Thanks Rob, it's really interesting to hear about your experiences with foot pain. How did you change the area you place pressure on? Do you have custom orthotics? |
Yes, I do have custom orthotics, which are designed to stabilise the foot in the boot. I didn't realise that I put a lot of pressure through my forefoot until I did a training course where we spent some time skiing very slowly with our eyes closed. It was quite a shock to discover that at the beginning of each turn my fore/aft balance was quite forward, and it almost felt like I was getting up on my tippy toes! After that it was a conscious effort to make sure the movements I made didn't project my centre of mass too far forwards at the start of the turn. It was a small, subtle change, and not easy to do, but it did help me manage the pain to more acceptable levels. I will often get my feet out of the boots (coffee break, lunchtime) for a little massage and this also helps manage the pain.
calbris wrote: |
Do you know whether the NHS is likely to give any support for issues like these, or is it a matter I'd have to address privately? |
I was referred to the foot surgeon at my local NHS hospital (West Middlesex University Hospital) by my GP. It was good fortune that my local hospital has a well-regarded foot Dr there, but I see no reason why you shouldn't be referred, especially as you have already consulted a good bootfitter, physio, etc.
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Yes, NHS also helped me, through the GP as usual. Perhaps I get along OK in ski boots precisely because I don't get the weight forward soon enough in the turn?
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You know it makes sense.
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@calbris. I regularly take the Pregabelin, they take a while to take effect and you gradually up the dose until it works for you, some people get side effects from coming off them too quickly so for me the more sensible choice is to take them regularly or I will end up overdosing or underdosing(if there is such a thing). The voltarol I only take when I'm either having a flare up or if I know I'm going to overdo it at work or doing sport.
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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This is why I like snowheads . I hate going to the doctors! Had problems like all listed above and now realised I have Morton's Neuroma, so GP here I come for a referral.
Think it all stems back to 20 odd years of wearing Army boots and having to walk/tab/run and do everything else in them, these have not been kind to my feet.! Always had an issue when running more than an hour and also finding the right boot for skiing (should have gone to a boot fitter, I know, kicking myself now). But thanks to all of the above and the post by @calbris, . Sympathise with you.
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Poster: A snowHead
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@calbris, my Mortons was improved by all the things I mentioned. However since the weight loss I'd say it disappeared.
Good luck getting a solution.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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@calbris, very sorry to hear of your illness - sounds like a right pain in the posterior as well as the foot. Fair play for maintaining a positive outlook. It's not a condition I've come across before so I've done a bit of reading on it to try to understand and it seems that joint instability/dislocation/subluxation is the major issue for your type. I can definitely sympathise with that as I've dislocated my shoulders 32 times.
By all means dismiss this as quackery but I have also had severe pain issues in ski boots for the last 5-7 years, particularly in my right foot. I also have a theoretically osteoarthritic right knee. My foot pains are definitely caused by a lack of blood circulation and nerve damage (possibly in my hip) but in the past I have skied with my boots completely undone and my foot was still numb. I've been known to take my boots off and throw them across lift stations out of frustration as well as have ridiculously large stretches done on the boot to improve circulation with no improvement. I've also had a "met-dome" put in my orthotics in case it was Morton's Neuroma which made no difference.
I have done two things recently that have helped:
1/ I changed my boot liners to the latest Zipfits. It took 12 days of hard skiing, some extra cork lining injections and some manipulation to get them right but eventually I could ski all day with around 90% circulation in my right foot and minimal discomfort. This is extreme for Zipfits because most people say they fit perfectly after 48 hours. So they may help if you believe the pain issue is related to circulation and foot shape rather than being purely skeletal. My issue seems to be a particularly predominant vein on the outside of my ankle that is getting compressed so it may or not be relevant.
2/ (This is the quackery ) I have been taking high quality magnesium glycinate supplements for the last 3-4 months. They have transformed my life. Magnesium is known to have profound effects on cell structure, especially bone cells and brain cells, as well as controlling 350+ enzymic reactions elsewhere in the body. I know that my natural diet doesn't contain much magnesium and there are plenty of estimates out there that say that 60%+ of the western world probably has a magnesium deficiency due to modern farming methods.
Personally, I feel 20 years younger mentally because my general fatigue has gone. I am laughing at things that would have made me angry or suicidal before. I've re-become the phlegmatic character I used to be. I don't need a "power-nap" in the middle of the day anymore. Most importantly, I have NO bone-on-bone pain in my 'osteoarthritic' knee anymore and I feel that the dead nerves in my right toes are growing back. I've also got feeling in one of the two dead fingers in my left hand (from nerve damage in the shoulder from multiple dislocations).
A quick search on google says magnesium may well help your hypermobility condition by improving the cell structure. I hope it does but if not, maybe my testament helps someone else. BTW, I had a headache for three weeks when I started taking magnesium. It's not unusual for people to get a headache when they first take it but three weeks is considerably more than most. The epicenter of the pain though, was exactly the impact point of where I was knocked unconscious 11 years ago in a skiing accident...
Good luck and I wish you well.
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