Testimonials & Results

Case Studies

Fused Heel with custom orthotic

Archie

Archie Turner had been seriously injured while in the service 23 years before I met him. The bones of his right lower leg, ankle and foot had been shattered in an accident. Because of the extent of the injury the bones of the ankle and mid-foot needed to be fused-his ankle would no longer flex. Additionally because of the severity of the injury he had lost about 2 inches of length in his Tibia/Fibula, so the plan was to fuse the ankle with a built in 2" heel height so that, theoretically, he would walk with his pelvis level. (His footwear would need to have a 2" heel.)

Unfortunately, something went awry in the surgery and he ended up with a 3 ½" fused heel height. This created several problems: a) Archie now carried a great deal of weight on the ball of his right foot, and over time developed a callous that was about ½" thick. b)The foot became very unstable, and he would "run the boots over" at the heel. Within four to six weeks the heels of new boots would be tipped over to the point that they were not wearable (These were custom boots provided by the VA for which, I am told, they paid about $700/pr.) c)His left leg was now functionally 1 ½" shorter than the right, creating low back pain and dysfunction in the feet, and various other pains.

When I first saw Archie, he was managing a gated mobile home community, but he had great difficulty working more than 5 hrs/day due to feet problems.

The VA was not pleased with my quote, but they had a responsibility to Archie and were out of ideas of their own.

This is what I did: I cast his right foot and leg and created an "anatomical last" with the 3 ½" heel height. Over this last I built an orthotic with the correct heel height and a very, very strong lateral flare so that he would now have heel strike (lessening the pressure on the ball) and creating stability in the foot so that the boot was no longer tipping out. Over all of this I designed, patterned, and built a special boot that would support the foot/ankle/leg to increase the stability and laced firmly so that his foot did not slide into the toe area of the boot. I finished off the boot with a rocker bottom sole to improve the fluidity of his gait and additionally decrease the force against the ball of the right foot. For the left foot we made a boot that looked as much like the right, except with a 1 ½" leg length accommodation and an orthotic to correct for excessive pronation, and to give this foot as much benefit as possible, as it was quite overworked.

Everything worked as planned. Within several weeks the callous on the right ball was gone! Where previously there had been a ½" callous, the skin looked like that of a child. His first pair of boots (the only footwear worn) was still going strong after 14 months when he ordered a second pair for dress. Eighty to ninety percent of the pain Archie had suffered in his feet, ankles, legs, hips, and back was gone. One evening Archie plopped in a chair in his kitchen and exclaimed to his wife that he was tired. Lori looked at the clock and replied "No wonder, you have been going non-stop for 13 hrs."

P.S. Let's play with $'s for a minute - Archie told me that the VA paid $700/pr for the boots they provided him (and had been for 23 years) and that the boots would only last 4-6 weeks. The first pair of boots I built him was the only thing that he wore for the first 14 months, when he ordered a dress pair (the first pair were still going strong) at that 14 month point, assuming that the figures given me were accurate and giving the benefit of 6 weeks/pr. The VA saved over $5000.00 for that 14 month period of time.

Injured foot with custom orthotic and boots
 

Jim

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.

Custom Boots wiht Orthotic
 

Mike

A logger, Mike lives on an island a 1000 miles north of Vancouver B.C. Canada. Several years ago, he had an accident as he was falling a large tree resulting in significant injuries. His left femur was fractured and he lost a significant part of his quadricep. Although his knee was not damaged, his left tibia was fractured, and he had lost much of the calf muscle. Fortunately, his ankle and foot were not injured. The surgeons did a marvelous job reassembling his leg but as he healed, the posterior compartment of his left leg contracted: his heel could no longer reach the ground.

Prior to the accident, Mike had excessive bilateral pronation. Because he was young, active, and healthy, he got along just fine. Following the accident, with his leg being compensated, this became an issue. With the contracture on the left, he, functionally, has a short right leg by more than an inch.

All in all Mike's feet hurt, he had knee pain, and his hips hurt. Previously work had been a joy-now it was miserable.

From her home in Southern California, Mike's mother launched a telephone campaign to find someone to help him out; her search brought her to me.

When she made his appointment she told me just to "fix him up" and send her the bill. Though skeptical, Mike kept his appointment.

During his first visit he stayed three days while I made orthotics and boots that were carefully tuned to the exact heel height so that he finally had left heel strike and which resolved the leg length discrepancy.

Once again Mike had a normal gait. When he first put the boots on he was just like a kid on Christmas morning-he beamed.

Since making that first pair of packer boots, I have made a pair of calked (spiked) logging boots, slip-on mules, elastic-sided Australian stockman's boots (or high heeled Romeo's) and a couple more pairs of packers. Needless to say, Mike is no longer skeptical.

Injured Leg with Custom Orthotic
 

Brian

February of ’04 Brian was on a snowmobile one dark evening with friends—headed up Vail Pass for some backcountry skiing. As they passed a large snow grooming machine something went wrong and Brian ended up in the path of the groomer—and was run over. The groomer was towing an implement that is essentially a monster roto-tiller to munch the snow up, then lay it out flat again.

In this case Brian’s lower left leg got munched. You can see the photos. He had some great medical help, and 9 months later when he came to me I could see that they had done a wonderful job making the best of a tough situation.

But, Brian’s foot now had moderately serious swelling, limited range of motion, the calcaneous (the heel bone) was now peaked toward the back so it hurt in a normal shoe, the foot was turned at an odd angle in relation to the floor, and the leg was a little short compared to the other.

All in all it made walking laborious, and at times painful, and normal shoes would not work.

Previously, Brian had been a very active fellow: biking, hiking, snowboarding, climbing, kayaking, and served on a mountain search and rescue team. We started to work with Brian on a Monday morning. We spent about 3 hours for me to understand everything that was going on with his feet, carefully understanding the recommendations for orthotics and footwear from his Physical Therapist, and making a plan of action.

I then made a cast of the left foot and measured both feet.

While I was making custom lasts—I sent Brian to town shopping for a pair of below-the-ankle athletic or hiking shoes. We finished out the day fabricating an appliance that slips into the left shoe making a proper interface between his foot and the ground---and accommodates the “peakedness” of his heel bone without rubbing or pain. The sole of the left shoe was “rockered” giving the shoe more motion to accommodate the limited range of motion, and raised to accommodate the short leg. Plus, an orthotic for the right foot. Brian was estatic—he thought that he would never wear a pair of stock shoes again!

The next morning we went to work on hiking boots, starting with custom patterns. You can see from the photos that even given the differences between his feet, the boots look remarkably the same. You can see Brian trying on the new boots. By Thursday mid-day I had him on the way home. He still has a long way to go with Physical Therapy, but we were both delighted with the outcome at this point.

Comparisons

Without Orthotics

with and without orthotics

With Orthotics

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Without Orthotics

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With Orthotics

with and without orthotics

Without Orthotics

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With Orthotics

with and without orthotics
 
 
Milo Orthotics Comparison

“What a different these orthotics have made for Milo. Aligning the feet, controls the rest of the body. Helping everything feel better. ”

- Milo B.

 

“Hattie has suffered from not being able to be a kid because her feet hurt so much. Plantar Fasciitis was a big pain for her until we received the orthotics from Merrell FootLab. Look at the difference between before and after Hattie walks. Notice the knees being more straight and the feet not crashing, with the orthotics.”

- Hattie B.

Milo Orthotics Comparison
 
Milo Orthotics Comparison

“I’m 63 years old and have experienced 40 years of foot problems. At times the pain became extreme, chronic and debilitating. One orthopedic foot doctor once told me my feet were 1 in 10,000. I experienced multiple surgeries and used various orthotics with varying degrees of success. At least 12 practitioners have worked on my feet. I quickly went from being an active backpacker and distance runner to taking up exercises that did not involve using my feet. I knew of Randy and considered the idea of seeing him more than once but never made the investment of time and money. Finally I decided to see him for a pair of custom orthotics. Four days later I took my first hike of 4 1/2 miles in 40 years over rough terrain. The selfies I sent home showed a guy with the smile so big you would think I did something illegal. My family could not believe it. This is defiantly a game changer for me.”

- Kevin