Foot stress fractures and boot fit

[sk8dreamzzzz]

Hi Skaters,

I wonder if you can help with a dilemma. I keep getting recurrent stress fractures in my feet. It never happened until 2020 and since then I've had several. I've changed skates and sizes several times. I also roller skate and have gone through a few different boots trying to find something with more toe room without being too long. I've also had my current ones punched out twice to try and maximise toe box space.

I've recently been fitted for custom skating (hockey, but skate specific so no metatarsal pad) insoles. My feet were scanned and there were 2 fitting sessions of about 1 hour each. They struggled to get the insoles into my ice skates, but they do get into my roller skates OK. Our rink closes in the summer so I only just got to try them out in my ice skates last week. I immediately felt my toes are crammed into the skates now and after 2 sessions felt the start of a stress fracture. The pain got worse in the next sessions and I've now taken a break from skating and walking for the last two days.

Now I wonder if the insole is taking up valuable space in my skate. They are made out of a special shock absorbing material and the arch and shape is custom to my foot. I wonder if it's worth getting a 1/2 size bigger boot to accommodate the special insole or if I should take the insole out a return to skating on a regular one. That would mean time and money was wasted on that custom insole, but the ultimate goal is to prevent my bones from breaking.

Does anyone have experience with insoles affecting skate sizing?

Thank you!

 

[Coach Aimee]

If you wear custom orthotics, it’s recommended that you get fitted for your skates with them.

That said, many orthopedic insoles are not intended for skating. It’s best that you go to a podiatrist that is well versed in skating.

The right physician can also provide you with insight as to why you repetitively suffer with stress fractures as it could also be related to low bone density.

 

[sk8dreamzzzz]

If you wear custom orthotics, it’s recommended that you get fitted for your skates with them.

That said, many orthopedic insoles are not intended for skating. It’s best that you go to a podiatrist that is well versed in skating.

The right physician can also provide you with insight as to why you repetitively suffer with stress fractures as it could also be related to low bone density.

Thanks for your response, Aimee. I follow your YouTube channel and it's great.

These are prescription insoles by a specialist and are made for skating. They took a very long time to order and I had to pay a handsome fee for them on top of what my insurance covered. I've been to several doctors and specialists since 2020. I'm still undergoing tests because it's not clear why I keep getting stress fractures. My bone density and vitamin levels were normal. I've had about 4 by now on different metatarsals and feet.

 

[tstop4me]

Hi Skaters,

I wonder if you can help with a dilemma. I keep getting recurrent stress fractures in my feet. It never happened until 2020 and since then I've had several. I've changed skates and sizes several times. I also roller skate and have gone through a few different boots trying to find something with more toe room without being too long. I've also had my current ones punched out twice to try and maximise toe box space.

I've recently been fitted for custom skating (hockey, but skate specific so no metatarsal pad) insoles. My feet were scanned and there were 2 fitting sessions of about 1 hour each. They struggled to get the insoles into my ice skates, but they do get into my roller skates OK. Our rink closes in the summer so I only just got to try them out in my ice skates last week. I immediately felt my toes are crammed into the skates now and after 2 sessions felt the start of a stress fracture. The pain got worse in the next sessions and I've now taken a break from skating and walking for the last two days.

Now I wonder if the insole is taking up valuable space in my skate. They are made out of a special shock absorbing material and the arch and shape is custom to my foot. I wonder if it's worth getting a 1/2 size bigger boot to accommodate the special insole or if I should take the insole out a return to skating on a regular one. That would mean time and money was wasted on that custom insole, but the ultimate goal is to prevent my bones from breaking.

Does anyone have experience with insoles affecting skate sizing?

Thank you!

Did you bring your skates to the podiatrist when you were fitted with prescription orthotics? I have two sets of prescription orthotics: one for regular street shoes (in my instance, ankle-height work boots) and one for running shoes. The orthotics are configured differently and fabricated from different materials, depending on the application (walking or running) and on the particular shoe (the running shoe has less volume than the work boot, and requires a 'low-volume' orthotic). My podiatrist didn't have any experience with figure skates, so I ended making my own. But since your podiatrist does have experience with figure skates, I would have thought the orthotics would have been designed to fit properly into your skate boots (or you should have been told that there is not sufficient room in your skates to provide the correction you need).

 

[sk8dreamzzzz]

Did you bring your skates to the podiatrist when you were fitted with prescription orthotics? I have two sets of prescription orthotics: one for regular street shoes (in my instance, ankle-height work boots) and one for running shoes. The orthotics are configured differently and fabricated from different materials, depending on the application (walking or running) and on the particular shoe (the running shoe has less volume than the work boot, and requires a 'low-volume' orthotic). My podiatrist didn't have any experience with figure skates, so I ended making my own. But since your podiatrist does have experience with figure skates, I would have thought the orthotics would have been designed to fit properly into your skate boots (or you should have been told that there is not sufficient room in your skates to provide the correction you need).

I brought my skates to the orthopaedic shoe making meister. I'm in Germany, so it's called an Orthopädie-Schuhmacher-Meister, someone who specialises in making custom orthopaedic shoes and inserts. After scanning my feet and talking to me, that person has made these custom insoles for hockey players and they are made of special shock absorbing material. They are much thinner than the ones you would wear in normal shoes and do not have the metatarsal pad like I have in my normal daily shoe inserts. However, they are thicker than say, a Risport or Edea stock insole. The last step was having them fit into my existing skates. It was a real struggle and they were sanded many times. Despite all this, it feels like I lost some valuable toe space in the boot.

The orthopaedic doctors that dealt with the fractures did not want to see my skates, despite me bringing them and taking them out of the bag. So to clarify, the podiatrist (or here, orthopaedic doctor) doesn't make the inserts, they just prescribe them to me and I go to the person who makes them. I chose a place that was recommended by my skate tech/shop as being the only place around that can make a custom skating insole.

I'm not sure if I should remove the insoles and go back to stock ones, an immediate solution, or buy bigger skates to accommodate the insoles. I have paid for training for the next 2 weeks straight and don't think anyone has boots in stock in my size right now.

Can I ask how you made your own?

 

[icewhite]

I brought my skates to the orthopaedic shoe making meister. I'm in Germany, so it's called an Orthopädie-Schuhmacher-Meister, someone who specialises in making custom orthopaedic shoes and inserts. After scanning my feet and talking to me, that person has made these custom insoles for hockey players and they are made of special shock absorbing material. They are much thinner than the ones you would wear in normal shoes and do not have the metatarsal pad like I have in my normal daily shoe inserts. However, they are thicker than say, a Risport or Edea stock insole. The last step was having them fit into my existing skates. It was a real struggle and they were sanded many times. Despite all this, it feels like I lost some valuable toe space in the boot.

The orthopaedic doctors that dealt with the fractures did not want to see my skates, despite me bringing them and taking them out of the bag. So to clarify, the podiatrist (or here, orthopaedic doctor) doesn't make the inserts, they just prescribe them to me and I go to the person who makes them. I chose a place that was recommended by my skate tech/shop as being the only place around that can make a custom skating insole.

I'm not sure if I should remove the insoles and go back to stock ones, an immediate solution, or buy bigger skates to accommodate the insoles. I have paid for training for the next 2 weeks straight and don't think anyone has boots in stock in my size right now.

Can I ask how you made your own?

I have no experience, so likely not very helpful, but... I would definitely go back to the Schuhmacher and tell them it's not the right size for your skates. Maybe ask your insurance about this as well (=claim) So that maybe you will get kind of a refund or another fitting. After all these insoles obviously don't do the job if you can't fit them into your normal figure skates. So what was paid for wasn't "delivered".

 

[tstop4me]

I brought my skates to the orthopaedic shoe making meister. I'm in Germany, so it's called an Orthopädie-Schuhmacher-Meister, someone who specialises in making custom orthopaedic shoes and inserts. After scanning my feet and talking to me, that person has made these custom insoles for hockey players and they are made of special shock absorbing material. They are much thinner than the ones you would wear in normal shoes and do not have the metatarsal pad like I have in my normal daily shoe inserts. However, they are thicker than say, a Risport or Edea stock insole. The last step was having them fit into my existing skates. It was a real struggle and they were sanded many times. Despite all this, it feels like I lost some valuable toe space in the boot.

The orthopaedic doctors that dealt with the fractures did not want to see my skates, despite me bringing them and taking them out of the bag. So to clarify, the podiatrist (or here, orthopaedic doctor) doesn't make the inserts, they just prescribe them to me and I go to the person who makes them. I chose a place that was recommended by my skate tech/shop as being the only place around that can make a custom skating insole.

I'm not sure if I should remove the insoles and go back to stock ones, an immediate solution, or buy bigger skates to accommodate the insoles. I have paid for training for the next 2 weeks straight and don't think anyone has boots in stock in my size right now.

Can I ask how you made your own?

(1) I'm in the US. Here, a podiatrist diagnoses and treats medical conditions related to the feet. If they decide orthotics are a proper device for treatment, they take a cast or scan of the feet, inspect the footwear of the patient, and prescribe specific orthotics, taking into account the specific footwear and intended use (walking, running, or other). The podiatrist then sends specifications to an orthotics laboratory, which fabricates the orthotics. The podiatrist can make minor adjustments (such as trimming), but, often, one or more iterations are needed after the patient tries them out, and the podiatrist sends the orthotics back to the laboratory for modifications as needed. Here one person has end-to-end responsibility for treatment.

(2) What boots are you wearing? I wear Jackson boots that are fully heat moldable (baked in an oven). Orthotics generally can't be baked. But after baking the boots (with stock insoles removed), my tech inserted my orthotics into the heated boots; and the boots were then heat molded to my feet. After heat molding, I had him further punch out the toeboxes for extra room (the toebox is locally heated during the punching process for better results).

(3) Since you have problems with fractures, I would NOT recommend making your own orthotics; at least not until those problems are definitively resolved (and then only if you can't get satisfactory resolution from your doctor and meister). But since I've already posted instructions previously, I'll refer you to them purely for background information at this point: https://www.goldenskate.com/forum/threads/jackson-skate-insoles-arch-supports.95667/ (Reply #6). For the base flat insoles, you can cut some from thin Poron foam sheet (1/8"/~3 mm thick); they tend to be more durable and thinner than many commercial flat insoles. Since you are in Germany, I highly recommend the Pedag (https://www.pedag.com/de/de) components that can be attached to or used with the flat insoles (arch supports, heel wedges, metatarsal pads).

 

[Coach Aimee]

These are prescription insoles by a specialist and are made for skating. They took a very long time to order and I had to pay a handsome fee for them on top of what my insurance covered. I've been to several doctors and specialists since 2020. I'm still undergoing tests because it's not clear why I keep getting stress fractures. My bone density and vitamin levels were normal. I've had about 4 by now on different metatarsals and feet.

I'm so sorry to hear of your struggles. I hope you find the reason soon!

 

[sk8dreamzzzz]

I went to a skate fitter yesterday and he was convinced my skates are too small for my fee. (Jackson 6.5W in Risport I am 250 and have been skating in those sizes for the last 3 years). He put me in a Risport 255 and 260 and decided on the 255. He only had one boot in stock in that size, a men's RF3. My orthotic insole fits fine in the boot, the toes feel roomier. I went ahead a bought it because I was hoping it would stop the foot pain so my money on the next 2 weeks of training won't be wasted. I figured it was possible my foot length changed since I quit ballet in the winter when I had a foot injury. It's possible my arch muscles have flattened out and increased my foot length. They've definitely gotten wider since last winter which was also medically confirmed as "foot splaying" when I was offered surgery.

The boot was heat molded (ouch! The laces pressure aggravated my metatarsal pain), my current freestyle blades were mounted onto it (CA, one size too long for my taste but I'm not ready to drop more money on blades when these are practically new) and he put it on the boot stretcher for 7 hrs to punch out the toe areas.

I had a class that night so I got to try them out and the verdict is...

They feel too big! My heel slips so I tightened the laces quite a bit over the ankle flex area (just before the hooks), but left them loose over the metatarsal area because of the pain. My toes were numb on both feet after 30 mins. This was not ideal, not comfortable. Also, the left blade is not aligned as before so I am skidding braking and falling to the inside when I think I am on the rocker on the left foot. Metatarsal pain still there. I was lucky enough to get an appointment with a doctor before traveling next week for a skate camp (!). At this point, if the change in footwear hasn't helped, it is likely a stress fracture again and I may have no choice but to stop for another few months.

Long story short, bigger skates means I now have previous pain + heel slip. I just added problems to my problems. I'm going back to the shop today for blade alignment and hoping they can help with heel slip.

 

[Ic3Rabbit]

I went to a skate fitter yesterday and he was convinced my skates are too small for my fee. (Jackson 6.5W in Risport I am 250 and have been skating in those sizes for the last 3 years). He put me in a Risport 255 and 260 and decided on the 255. He only had one boot in stock in that size, a men's RF3. My orthotic insole fits fine in the boot, the toes feel roomier. I went ahead a bought it because I was hoping it would stop the foot pain so my money on the next 2 weeks of training won't be wasted. I figured it was possible my foot length changed since I quit ballet in the winter when I had a foot injury. It's possible my arch muscles have flattened out and increased my foot length. They've definitely gotten wider since last winter which was also medically confirmed as "foot splaying" when I was offered surgery.

The boot was heat molded (ouch! The laces pressure aggravated my metatarsal pain), my current freestyle blades were mounted onto it (CA, one size too long for my taste but I'm not ready to drop more money on blades when these are practically new) and he put it on the boot stretcher for 7 hrs to punch out the toe areas.

I had a class that night so I got to try them out and the verdict is...

They feel too big! My heel slips so I tightened the laces quite a bit over the ankle flex area (just before the hooks), but left them loose over the metatarsal area because of the pain. My toes were numb on both feet after 30 mins. This was not ideal, not comfortable. Also, the left blade is not aligned as before so I am skidding braking and falling to the inside when I think I am on the rocker on the left foot. Metatarsal pain still there. I was lucky enough to get an appointment with a doctor before traveling next week for a skate camp (!). At this point, if the change in footwear hasn't helped, it is likely a stress fracture again and I may have no choice but to stop for another few months.

Long story short, bigger skates means I now have previous pain + heel slip. I just added problems to my problems. I'm going back to the shop today for blade alignment and hoping they can help with heel slip.

You may want to give up on stock boots and go for a semi-custom/rapid custom or full custom. I hope your pain goes away and it's not another stress fracture. Good luck!

 

[tstop4me]

My heel slips so I tightened the laces quite a bit over the ankle flex area (just before the hooks), but left them loose over the metatarsal area because of the pain.

This approach is guaranteed to fail. Unless you do something special to maintain differential tension, if part of your laces are loose and part of your laces are tight at the start, as you skate, the tension will even out.

 

[sk8dreamzzzz]

This approach is guaranteed to fail. Unless you do something special to maintain differential tension, if part of your laces are loose and part of your laces are tight at the start, as you skate, the tension will even out.

I returned to the shop, they adjusted the blade and said exactly what you said here about the lacing. I was afraid to tighten over my metatarsals, but since I can't return the boots now I went ahead and laced them up snugly everywhere. This time I removed all my silicon stuff from the ankle and top of the foot. Well, what do you know? The boot is very roomy actually well padded so it didn't press on my metatarsals. At some point toward the end of the session, it felt like the tongue started to press that area. The boot frame or part over the metatarsals seems to be higher than the top of my foot, if that makes sense. It's higher up than on my previous skates. No heel slip yesterday! The slight blade alignment adjustment was enough. It feels "normal" now.

I'm still adjusting to it feeling a bit longer, but yesterday's session was much better. I plan to give it a month and see how I feel after that. I'll see a doctor tomorrow. I'm hoping I haven't injured the foot to the point of another stress fracture and maybe it is *just* pain from the tight boots. I can't imagine they could give me an MRI in the same day, but that would be amazing.

As for future bootage, I am beginning to think @Ic3Rabbit is right about custom boots. I wonder if you have any good recommendations for customs in Europe? I say in the future because I'm debating surgery for my tailor's bunions and that may influence boot fit.

Edited for typos

 

[Ic3Rabbit]

I returned to the shop, they adjusted the blade and said exactly what you said here about the lacing. I was afraid to tighten over my metatarsals, but since I can't return the boots now I went ahead and laced them up snugly everywhere. This time I removed all my silicon stuff from the ankle and top of the foot. Well, what do you know? The boot is very roomy actually well padded so it didn't press on my metatarsals. At some point toward the end of the session, it felt like the tongue started to press that area. The boot frame or part over the metatarsals seems to be higher than the top of my foot, if that makes sense. It's higher up than on my previous skates. No heel slip yesterday! The slight blade alignment adjustment was enough. It feels "normal" now.

I'm still adjusting to it feeling a bit longer, but yesterday's session was much better. I plan to give it a month and see how I feel after that. I'll see a doctor tomorrow. I'm hoping I haven't injured the foot to the point of another stress fracture and maybe it is *just* pain from the tight boots. I can't imagine they could give me an MRI in the same day, but that would be amazing.

As for future bootage, I am beginning to think @Ic3Rabbit is right about custom boots. I wonder if you have any good recommendations for customs in Europe? I say in the future because I'm debating surgery for my tailor's bunions and that may influence boot fit.

Edited for typos

Yes, just PM when you are ready.

 

[sk8dreamzzzz]

Just an update - The boots seem OK so far. They do feel too roomy in the forefoot, but with Bunga pads on my ankles, I don't have heel slip. I did see a doctor before leaving for the skate camp. He used an ultrasound machine to determine there was no visible stress fracture, but let me know that I might still have a level 1 or stress reaction which isn't yet visible. He said as long as I am reducing the intensity of my trainings, it should heal without taking a complete break from skating. He said if there is pain, reduce activity immediately. Then he reminded me of my low vitamin D and C levels.

So I went to skate camp, took a bunch of vitamin D and C regularly and began adding citrus to my water bottle. I had on and off pain for 6 days, sometimes limping before the camp began. I refrained from jumping activities and walked/stepped my way through the off ice training. The coaches were very accommodating. Midway through the camp, my muscles were so sore that I had to take a break for a day. The following day all my pain disappeared and my cycle started. I remembered having food the night before with very high iron content (oysters, mussels, clams) and somehow this made sense! I was able to take part in all the activities like normal on the last day, including my tiny jumps.

I don't know how much is related to the boot size and I wish I knew more about this, but for now am very happy to not be in pain and will continue with vitamins and shellfish.

 

[sk8dreamzzzz]

Just another update almost 6 months later. I have no forefoot pain in the new boots and no pinkie toe swelling. After skating on them a while and beginning jumping again, they have loosened a bit and I am back to heel slip and general feeling that they are too big.

I won't make any changes this season, but am really wondering if I should have tried an RF3 250 instead of 255 with lots of punching out of the toe area... or even custom (though terribly afraid of the cost)

 

[Ic3Rabbit]

Just another update almost 6 months later. I have no forefoot pain in the new boots and no pinkie toe swelling. After skating on them a while and beginning jumping again, they have loosened a bit and I am back to heel slip and general feeling that they are too big.

I won't make any changes this season, but am really wondering if I should have tried an RF3 250 instead of 255 with lots of punching out of the toe area... or even custom (though terribly afraid of the cost)

If it's Risport, you'd have to go to Italy to get the custom and then it would require back and forth travel until they are correct.
Not worth it.

 

[WednesdayMarch]

Feet change, especially when we have health issues, so it may be that now your stress fractures are healed you could return to a smaller boot. This is something you should ask your foot doctor about before trying it, though! Over the past 6 years, I've gone from a Risport 240/SP-Teri 5.5 through various Grafs (don't ask), Risport 245 and right now Jackson 6.5W. I would not be surprised to return to a 245 or 6 now that the medication issues I had are being resolved. Skating equipment is a constant drain on the finances!

 

[bostonskaterguy86]

Just another update almost 6 months later. I have no forefoot pain in the new boots and no pinkie toe swelling. After skating on them a while and beginning jumping again, they have loosened a bit and I am back to heel slip and general feeling that they are too big.

I won't make any changes this season, but am really wondering if I should have tried an RF3 250 instead of 255 with lots of punching out of the toe area... or even custom (though terribly afraid of the cost)

Hmm - just a thought based on my own experience, because it sounds like you and I might have similar feet (wide forefoot, narrow-ish heel, some foot splaying), but did you try on the Risport Royal Pro when you were fitted, by any chance?

I ask because when I was fitted a couple weeks ago, I tried on both the RF3 Pro and the Royal Pro, and I found that the Royal Pro had a noticeably better shape for my foot. The toebox is a bit more rounded / less tapered than the RF3, so I was able to get a snug heel fit and still have enough room in the forefoot. I'm wondering if the Royal Pro in a 250 might fit you better than the RF3 255.

 

[sk8dreamzzzz]

Hmm - just a thought based on my own experience, because it sounds like you and I might have similar feet (wide forefoot, narrow-ish heel, some foot splaying), but did you try on the Risport Royal Pro when you were fitted, by any chance?

I ask because when I was fitted a couple weeks ago, I tried on both the RF3 Pro and the Royal Pro, and I found that the Royal Pro had a noticeably better shape for my foot. The toebox is a bit more rounded / less tapered than the RF3, so I was able to get a snug heel fit and still have enough room in the forefoot. I'm wondering if the Royal Pro in a 250 might fit you better than the RF3 255.

I had Royal Elite (looks like the same toe box shape as the pro) 250 and was totally happy in it for about 10 months until my little toe started swelling. I remember it was always red when I took them off. I had it punched out twice when my toe turned blue, but that was probably too late. Put them back on in August for a week and got forefoot pain. I still have the boots although I have taken the blades off to try and sell them. I'm debating trying them again. I'm terrified of an injury before my first competition. I will probably wait until the end of the season.

I've realised 2 things
1. My little toe is longer than most everyone's I've seen. It's only slightly shorter that the 4th toe. The tapering of even the roundest Jackson toe box doesn't work for that shape. No idea what does other than a rectangle...
2. My feet and legs get mildly swollen based on what I eat. I have celiac and a milk allergy, both of which went undiagnosed my whole life. It would seem the issue is solved now and I could go back to my smaller size, but you'd be surprised how many times I accidentally ingest those ingredients because of improper labelling or cross contamination and swell for days or weeks.