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2 ::  J. M.
This is a young man, who at this writing is 29 years old. As a child his feet were normal, but in his teen years he developed high arches (cavus feet). As his growth continued he developed a curve in the lower part of his legs, becoming bow-legged (tibial varum).

In compensation the first ray of his feet (essentially the big toe joint) dropped (plantarflexed first). You can see this in the photo. All of this is probably related to a congenital narrowing of his spinal column.

We have not observed any change for several years—however this abnormal condition causes his foot and heel to work at a funny angle, and without orthotics creates an odd twist in his legs as he walks which is painful in his hips. Just as odd is that even though this man has broad shoulders and hips — his feet are narrow. A “B” width.

In this case orthotics alone will not solve the problem, as he tips “off-the-shelf” boots over to the outside with a few days wearing. Also stock boots do not offer sufficient depth to accommodate the aggressive orthotics needed.

So, I have been making custom boots for this fellow for years. Much of the time he works as a wildland firefighter. In the picture you see a new pair of fireboots I have made. This fellow is a hard driving individual — always going
and going hard. He will destroy a pair of factory boots in 45-60 days. A pair of my boots will last him 2 to 3 years.

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