Correcting problems with gait/walking technique - does anybody know anything?

[NomDeOrdinateur]

There's a long history of prematurely dodgy knees, hips, and ankles on my mother's side of the family, which I seem destined to become part of. I've had (painful) clunky ankles and worn my shoes down very unevenly since I was a child, and have been prone to tripping and overbalancing since my late teens. I'm now nearly 23, and I'd like to do what I can to avoid needing joint replacements in the future but I have no idea what help to look for.

I swapped my pretty shoes for Dr Martens boots about a year ago, which made a huge improvement to my balance and ankle pain. However, I still wear shoes down very unevenly (the sole is very worn on the instep of the foot which is attached to my "bad" ankle) and get pain if I wear any other shoes or go barefoot for very long. I'm also noticing knee pain in the "bad" leg for the first time, since I started wearing sandals a couple of weeks ago. I also can't stand for long or walk very far without pain, especially in the "bad" side.

Does anybody know whether any help in correcting gait problems is likely to be available to me via the NHS (or privately, if not too expensive)? Nothing comes up when I search, but I'm not really sure what I'm looking for. I'd love to do something about it now rather than waiting for it to become debilitating, especially since I know I'm unlikely to be able to wear Dr Marten 8 eyelet boots or similar throughout my lifetime (even if just due to employers' dress codes) and I have no other ideas of how to mitigate the problem!

Thanks in advance for any advice :)

[raisah]

I am not a health specialist but my ds has various issues regarding balance due to prematurity & I can pass on the advice given by physios to us.

1 - swimming is brilliant for strengthening your muscles in your legs & generally. It also relieves weight & tension off your legs.

2- be assessed properly by your G.P. So that you
can access NHS services such as physiotherapy

1. Improve your diet, increase calcium & take supplements.
   

1. If appropriate, lose weight as increased body weight puts pressure on the joints and knees.

[Bluestocking]

I'm no expert, but I know that my niece had a very asymmetrical gait as a child and was referred by the family GP to a physio for exercises to help her balance the way she used each side of her body. She also had orthotics although I don't know if she still uses them now - she's in her late teens. Both these interventions seemed to help a lot; she's a tidy cross-country runner which you would never have imagined possible seeing her wobble about as a little girl.

[MrsSnow]

I would ask your GP to refer you to a podiatrist who will be able to asses the way you walk and give you tailor made insoles which will stop the uneven wearing down of soles, stop tripping up etc. it wasn't until I fractured my foot that I was referred to a podiatrist who could not understand how I had survived for so long.

[tobiasfunke]

Orthotics. Take yourself off to a podiatrist who specialises in bio-mechanics and get assessed. Orthotics are amazing- a bit of stuff in your shoe can solve allsorts of leg and hip pain.

[NomDeOrdinateur]

Thank you PolterGoose (great name, BTW)! I'll find out whether I can self-refer, it would be great if so.

Is there a possibility that the generic orthotic insoles could cause harm? If not, I'll probably buy some of those for the sake of getting started quickly and only get custom made ones if I really need to.

[flybynight]

Again with the podiatrist and orthotics I got mine this week at the age of 42. If I had got them at your age, I would have avoided a lot of degeneration and discomfort. Podiatrist! Quick!

[NomDeOrdinateur]

I'm sorry to hear that, flybynight - I hope the treatment helps to mitigate the damage, and thank you for your advice!

I'm definitely going to start sorting this out now - my poor DM has had 2 knees replaced and needs at least 1 ankle replacement (all have been necessary for about 15 years but the doctors considered her to be too young), so I know now that I can't ignore it.

If you don't mind me asking: did you see your podiatrist through the NHS, and (if so) how long did you have to wait in order to be seen and have the orthotics made?

[NomDeOrdinateur]

Oooh, missed some replies above - will go back and read! Sorry!

[valiumredhead]

Physio definitely!

[flybynight]

I did it privately, nom. NHS wouldn't do anything custom made here. It cost £300 including all of the follow up care. The podiatrist (a GENIUS) reckons they are a one off purchase. The cost is part of the reason I took 20 yrs to get around to it.

I'm hoping it can help me avoid your mums problems.

[NomDeOrdinateur]

Thank you all for replies - it's very encouraging to hear that so much can be done, and it definitely sounds like orthotics will be the way to go! I'll try some of the Scholl inserts that PolterGoose recommends until I can get to a podiatrist.

Thanks also for the more general advice, Raisah - I'll make sure I don't get overweight (my mum's problems have been worse since she put on a stone), and I could definitely benefit from swimming more regularly and upping my calcium intake.

[NomDeOrdinateur]

Wow flybynight, I expected that private treatment would be much more expensive than £300, so that's a relief! It's not an insignificant amount of money, by any means, but I agree that it's more than worthwhile if it will prevent serious joint problems. Watching my mum gradually recover from the pain of the knee replacement surgery and still not gain much increased mobility has really bothered me - I feel so sorry for her, and I'd hate to be in that position.

I hope the orthotics work for you - will you be wearing them for life, and do they work with most "structured" shoes? (Also, if you're in driving distance of West Mids or Hampshire I'd be very grateful for the name of your podiatrist, in case I can't get NHS treatment!)

[Mabelface]

My physio referred me to a podiatrist and the difference is brilliant. No longer do my knees twinge very painfully when I walk up the stairs, no more painful hip or back. I discovered that, instead of flat feet like I thought, I have an underdeveloped muscle on the side of my lower leg and also my Achilles tendons are too tight, causing my foot to roll in and giving me bunions. A mixture of physio and orthotics has really changed things for me. Contrary to flybynight's reply, my orthotics ARE custom made by the NHS and it cost me nothing.

[NomDeOrdinateur]

That's great to hear, Madlizzy - it's amazing to think about how complex the act of walking really is, and how much can go wrong! I really hope I can get NHS treatment, as I'm still on a student budget. I'd definitely find the money if I needed to, but if I can get NHS orthotics and treatment then hopefully I can replace my unevenly worn boots at the same time and have a fresh start at walking properly.

[flybynight]

The orthotics have worked almost instantly! I have slim(ish) ankles for the first time ever as my ankle bones now fit into my feet!

They work in lace up/ buckle up type shoes. Anything that grips the foot and has a deep enough heel cup. Converse with the spongy liner taken out, for example. Much easier to manage in winter than in 26 degree heat, I imagine.

The NHS may well offer this service in your area. Ask your GP.

[OnFoot]

Podiatrist. If your GP won't refer you, then do the initial consult privately and get info/letter to take back to your GP saying you need a referral.

[Mabelface]

Yes, agree about the type of shoes. Mine are in my doc martens which I wear for work, as that's when I'm on my feet the most. They don't quite fit my Vans though.

[trashcanjunkie]

are you hyper-mobile? I discovered that I was and have had to entirely learn how to walk properly, as I used to just throw my legs out from my hip and hope for the best. Being extremely mindful whilst power walking three to four times a week has really helped, as did climbing or bouldering at a local centre.

[NomDeOrdinateur]

That's fantastic, flybynight - I'm going to make appointment with my GP tomorrow! Good to hear that they'll work with DMs and Converse - that will suit me perfectly.

Trashcanjunkie: I don't think I'm hypermobile in general but you may be onto something, thank you for suggesting it - my ankles are definitely more flexible than they should be and my feet kind of "roll inwards" sometimes so that I fall or hurt myself. That started happening in my very early teens and I remember having to learn to walk differently as a result.

[Scorchio]

If you go private, use this to check that the podiatrist is registered (and therefore has recognised qualifications and training).

[Mabelface]

Oh yes, I used to turn my ankles on a regular basis and that's improved too.

[stayathomegardener]

Where are you based OP?

[joanofarchitrave]

Orthotics are definitely available on the NHS in some areas (my ds has just had some made, no more leg pain when he's running :)) so worth probing a bit if your GP says no initially, to see if you can be referred elsewhere, or the reasons why you don't meet the criteria.