OK guys, I need some objective advice on a nagging problem. I alluded to this yesterday in Byron's boot thread (now moved to the boot fit sticky in the Gear Garage), and this speaks to Dan's comments on posted vs. non-posted footbeds.
My 14 year old daughter has recently developed swelling and pain in the forefoot area. The swelling is in the center of the foot, and was initially directly below the metatarsals, and now appears to be mainly between the metatarsals and the toes. She is in a pair of Salomon Instinct boots - 98mm last; 90 flex; custom shell heat molded; liners heat molded. She has been in these since December 2011, and did not have these problems until I put a new pair of footbeds in. The first beds were off the shelf Conformable Volcano, thin, with moderate arch support. The second pair were slightly thicker, and with much more pronounced arch support; also off the shelf non-custom. Her first two ski days this season were still with the new pair, then I swapped them for the old pair, and the pain has lessened significantly but is still present.
Shell fit a couple of days ago showed a slight contact between baby toe on the right foot, indicating a punch out is needed there; but decent wiggle room at the left baby toe side. Pain is worse on the right foot, but still present on the left side. Other shell fit parameters look fine (length, width, instep height, etc.).
Boots have a rather pronounced forward lean.
Foot shape is narrow forefoot and heel, high arches, moderate instep (in my judgement). She does pronate. She is also very slightly knock-kneed, which the Salomon boots sorted out nicely right out of the box.
FYI, she also has this problem in her cycling shoes (SPD pedals), which is another issue to be fixed somehow. She does not have this problem in her other sports footwear -- she plays competitive soccer (6 hrs./week training and game time), as well as school sports (volleyball, field hockey). It seems that pressure on the metatarsals is the common factor, given the cycling shoe problem.
In light of that, I have removed some widgets from the heel area inside her ski boots that were tightening the heel pocket but also increasing the ramp angle. Also, I have been paying more attention to how she buckles her boots - looser over the toes and instep, tighter at the cuff. Both of these seem to have helped as well.
Sorry for the long-winded preamble....
Next steps: in addition to the shell punch-out, I want to get her a new pair of footbeds to properly support the arches and the metatarsals. My brief chat on the phone with the shop bootfitter showed that his preference is a custom footbed, posted, to lock the foot in place. So, further to Dan's comments, I have some questions about proper selection:
-- What are the advantages/disadvantages of posted vs. non-posted? Specifically in this context - high arches; pronation; forefoot support; metatarsal pain.
-- Is a custom footbed even appropriate for a growing teenager? Her feet have not grown in the past 18 months, but they may change their shape (as evidenced by the rt. foot baby toe contact, which was not present at first bootfit session. Therefore I am reluctant to get custom footbeds, only to have to replace them every season until she is an adult. I am thinking a semi-custom like an A-Line or Footbalance, with an added metatarsal pad, may be OK. However, if custom is the way to go to avoid chronic permanent problems, then it's worth the money.
Any other suggestions or insight, non-footbed related, would of course be most welcome as well. BTW, we will also have her checked out by a podiatrist to ensure that there is nothing structurally wrong there. She has had several bad ankle sprains from soccer which may be contributing to the problem. Well worth looking at.... Finally, if the Instinct is fundamentally the wrong boot for her, then we will get her into something more anatomically suitable, but we're not at that point yet.
Thanks in advance.... Looking forward to your feedback.
Svend