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Nonoperative resources

The first line treatment for most foot and ankle problems is non-operative.

Information about off-the-shelf products and tools that are doctor-recommended for common conditions.

Shoes

  • The Hoka brand shoe provides excellent support and cushioning. It helps individuals with arch problems, heel pain and limited ankle or great toe range of motion. There is a “wide” option for a roomier toebox. These are very sturdy, comfortable shoes for anyone standing and walking for long periods.

    The Bondi 7 and Bondi 8 shoe models have great support and a “rocker-bottom” sole design that helps propel you forward with each step. You may add an insole for extra support.

    Find online (www.hoka.com) or try out at your local footwear store/REI/select running stores. Retails $140-170.

  • New Balance is a trusted footwear brand for those with pre-existing foot problems. There are many different shoe models, materials and designs. The 928 has a toe rocker design that is especially helpful for those that have great toe pain (hallux rigidus) and require a shoe that redistributes the pressure while walking.

    Retails $100-150.

Orthotics

  • Superfeet orthotics are pre-made inserts designed to provide different levels of arch support for those with mild-moderate flat feet. They are an inexpensive option and a good way to try out what feels comfortable to you. The inserts are thin and can be used with most sneakers and casual shoes. However, they are less durable than custom inserts and will need to be replaced more often, typically every 3-6 months.

    These are available through Amazon or the Superfeet (https://www.superfeet.com) website. Orange and Green provide the best arch support. Retails $50-60/pair.

  • Aetrex makes off-the-shelf orthotics to provide support and pain relief. The L400 model is appropriate for patients with mild-moderate flat feet. They are an inexpensive option and a good way to try out what feels comfortable to you. The inserts are thin and can be used with most sneakers and casual shoes. However, they are less durable than custom inserts and will need to be replaced more often, typically every 3-6 months.

    Men/women versions are available online https://www.aetrex.com/ according to shoe size. Retails $65.

  • A Morton’s extension orthotic is made of a stiff, lightweight material like carbon graphite or carbon fiber. When placed into your shoe, they make the sole stiffer and take the pressure off painful joints like the big toe metatarsophalangeal (MTP) joint or the midfoot joints. This is a good nonoperative treatment for arthritis in these areas. It is especially effective with a “rocker-bottom” shoe from Hoka or New Balance to help you walk efficiently.

    Place the insert underneath the insole layer of your shoe or you may use another orthotic on top of it.

    Find it on Amazon according to shoe size. Retails ~$60

Braces/sleeves

  • The Ankle Stabilization Orthosis (ASO) is a low-profile brace for supporting and protecting the ankle. It can be used when recovering from an ankle sprain or used preventatively when playing sports. The ASO is typically made from a nylon fabric with Velcro and lace components that wrap the ankle snuggly. A big plus is that they fit into most athletic shoes and are not obvious with long pants.

    The ASO can be used as needed and removed when resting. It should not be worn for sleep.

    Generic and brand name products available online or at local drugstores. Typically $30-50 each. Can be worn on either ankle. Measure your ankle (including heel) to find the appropriate size.

  • Some gentle compression around the ankle may help with mild symptoms of swelling and pain. The Compro sleeve is an elastic sock-like device that may be easier to use than compression stockings or an ankle brace. It can be worn with or without socks and fits into most shoes.

    Remember to put this on in the morning before you start your activities. It is used as needed and should be removed for sleep. The goal is to provide some snug compression and gentle support around your ankle. If you notice a lot of swelling at your toes or above the ankle at the end of the day, you may need a different device.

    Find online. Retails $12-30.

  • For managing plantar fasciitis, the key is to stretch out the calf muscle (gastrocnemius) and the plantar fascia of the foot. Symptoms are particularly severe in the morning allowing these structures to get tight while sleeping. Night splints help to keep the foot stretched, but may be bulky and hard to sleep in. The Strassburg sock is a knee-high sock that has a strap from toe to shin. This accomplishes the same goal and may be easier to get used to.

    Find online or medical supply store. Retails $20-40.

Toe/heel devices

  • A metatarsal pad is a simple over-the-counter device to relieve pressure from the ball of your foot. It is typically an oval-shaped foam or felt material with an adhesive side that can be stuck inside any shoe. It is key to put the metatarsal pad in the right position for it to be effective! The pad should sit mostly in the arch of your foot, rather than directly under the bony prominences of the forefoot. I recommend these simple steps to get the right fit:

    1) Put a small transferrable mark on the spot on your foot that hurts (a dab of lipstick works great)

    2) Put on your shoes (without socks) and take a few steps

    3) Remove your shoe and you should see the mark transferred to the insole.

    4) Insert the metatarsal pad before the pad, use a piece of tape to temporarily secure it

    5) Walk around and check the feel

    6) If this feels comfortable, you can remove the backing and stick it permanently.

    Find in drugstore or online. Retails $5-15.

  • The Budin splint is an over-the-counter device for hammertoes. It has a pad under the foot and straps that loop over the toe(s) to keep it straight. This will decrease irritation on the knuckle and tips of your toes. If worn regularly, may keep the hammertoe from becoming worse.

    They are available with single or double straps depending on how many toes need to be treated. Apply and then wear shoes and socks as normal.

    Available in most drugstores or online. <$10.

  • A heel cup made of silicone, gel or foam can be inserted into any pair of closed shoes. They cushion the heel from pain around the Achilles tendon or plantar fascia. These should be low-profile, 1/4”-1/2” thick.

    Find at the local drugstore or online. Retails ~$5-15.

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