First, I would track down a book by Dr. Murray F. Weisenfeld titled "THe Runners' Repair Manual"
(St. Martin's Press, 1980
). Not only does this have many pages on unusual foot problems, but Dr. W. provides all sorts of creative padding techniques that may work as well as orthotics at about a zillionth the cost. I think I've seen this book recently at stores such as Borders and Barnes and Noble, and I'm sure copies could be had through Amazon and other similar operations.
another thing you might want to try are the metatarsal pads sold through Road Runner Sports. These are small pads that have an adhesive backing which can be removed so that they stick to the insoles. They stick very tenaciously, but can be remnoved easily without damaging the insole/sockliner.
I wonder if what you have is a dropped metatarsal head. I had mine drop early in '99, and it still creates problems. It has now been exacerbated by a neuroma, which sends nerve jolts to the end of your toes. If this happens to you, you can get relief through a corticosteroid injection.
As for the dropped met. head idea, what worked for me
(htis is from the above book
) is to take a piece of felt boot liner and cut it so that a felt "platform" sits under my big toe joint and the joints of my other toes, but NOT under the affected toe
(for me it's the second toe, the "index" toe
). What this does is keep the toe's met head from pounding with each footfall; it is sort of suspended there above a gap I've cut in the felt. The whole felt piece, by the way, is small, maybe only three inches in length. I tape it onto my sockliner with paper medical tape. I haven't needed to use this for quite some time, but for long runs and long races I have carried a pad with a small bit of the tape in a baggy in the pocket of my running shorts
(De Soto
), or the side pocket of my race top
(also De Soto; good pockets in both items.
)
Finally, if you can't find the Weisenfeld book, PM me and I'll photocopy the pertinent pages and send them to you.
Good luck with this. It's one of those "stealth" injuries!