Bev Combs: Putting Her Best Foot Forward

[caption id="" align="alignnone" width="250"] Combs models her custom shoes. Photographs courtesy of Bev Combs.[/caption] If the shoe fits, wear it. Not many people understand this statement as well as Bev Combs. For most of her life, she had been relegated to wearing black, orthopedic oxford-style shoes because they fit, they were comfortable, and without them, she says, the muscles in her feet and legs strained and felt like they might collapse underneath her. Without those shoes, it's "like there [was] no support whatsoever—I limped badly," Combs says. "When your feet hurt... it affects everything—your legs and knees and your hips and your back." Combs, 64, experiences chronic foot and leg pain and strain. She was born with bilateral club feet and has undergone many corrective surgeries from her infancy to well into her 40s. To ease the pain and help correct the tendency for her feet to turn inward, she attended physical therapy and wore various leg and foot braces. She also attempted to wear various types of shoes, including custom-made, corrective, and off-the-shelf, all the while searching for styles that were more fashionable. In the end, orthopedic oxford shoes provided the most support and the best fit, especially with the double-upright AFO she has worn on her left leg since 1993, she says. All that changed in 2003 when Combs was presented with another option from her pedorthist—a prototype he had designed that met her needs for custom-support as well as her aesthetic preferences. Feet First [caption id="" align="alignnone" width="350"] Combs as a child with the post-surgical cast used to correct her club feet.[/caption] Combs describes the bones in her feet as being "gnarled and twisted" when she was born. Her left foot turned in so much that it was perpendicular to her right leg. Her right foot also turned in, but not as much as the left. Her parents were referred to a well-known orthopedic surgeon, Charles Burbacher, MD, who performed the first of her 17 surgeries when she was just three and a half months old, according to Combs. Among other surgeries, she underwent an arthrodesis and a triple arthrodesis in which the subtalar, calcaneocuboid, and talonavicular joints were fused together to relieve pain in the rear portion of her left foot. She underwent more surgeries in her early 20s to lengthen the ligaments at the back of her left foot and calf because up until then she walked on the ball of her foot and was unable to touch her heel to the ground, regardless of whether she was walking barefoot or wearing shoes. Her last surgery, she says, was in 1994 to reset the bones in her right foot for a second time because it was progressively turning perpendicular to her left leg. Although her orthopedic surgeons were able to straighten and reset the bones in her feet, Combs says the multiple surgeries left her feet weak, and to this day she experiences pain and strain while she walks because her feet still pull to turn inward. Wearing orthopedic shoes alleviates the strain somewhat, and the double-upright AFO on her left leg provides additional support, she says. Despite contending with chronic foot pain, Combs says she is thankful for her childhood and growing up in a supportive environment with her parents, maternal grandparents, and aunt under one roof in their Miami, Florida, home. "We were a team," she says. And that team banded together to care for her and made sure she always received the proper foot care and wore the proper footwear, even though the family budget was tight. Combs never let her foot problems prevent her from pursuing activities. She played on basketball and volleyball teams throughout junior high and high school and also tried tennis, golf, and the 50-yard dash in track. The twisting foot motions required to play tennis and golf, along with having to wear sneakers instead of her orthopedic oxfords, caused her extreme pain, she says. In fact, she recalls that after playing sports she would come home limping. Her father applied ice to her feet until they went numb and stiff, and her mother massaged her feet and legs to relieve the strained muscles. Combs worked hard to not let the pain interfere with her participation in activities and sports, but there was one sought-after activity that remained out of her reach. Miami Edison Senior High School, which Combs attended, had a nationally recognized precision drill team called the Cadettes. The Cadettes marched in parades and participated in social events, and Combs says she had dreamed of becoming a Cadette since she was in elementary school. Although she maintained the required 4.0 grade point average and community service record, she experienced so much pain while marching that she was unable to keep the tears at bay. Still, she begged the sponsoring teacher to allow her to continue. Despite her pleas, Combs was dismissed from the team after the first week because her limp prevented her from staying in step with the other Cadettes, which affected the appearance of the precise lines of marchers. "I was very upset about that," she recalls. "I certainly understood... but it was really disappointing. I thought...somehow I could make [it as a Cadette], but it was impossible." Putting Her Best Foot Forward After moving to Atlanta, Georgia, in 1985 in her 30s, Combs needed to find a local specialist to assist her with her foot care and footwear. With a prescription for orthopedic shoes in hand, Combs went to see Don Rogers, CPed, upon the recommendation of an acquaintance. Rogers, the owner of Star Shoes, Lawrenceville, Georgia, says he continued to fit Combs with the familiar black orthopedic oxford-style shoes. However, she often expressed her desire for "a dressier-looking shoe than the leather-soled oxford that she had grown up wearing," Rogers says. He had been fitting Combs with footwear from the Apis Mt. Emey line of therapeutic and orthopedic shoes since 1995. Rogers individually modified each shoe to accommodate the different needs of her right and left foot. "Clubbed feet are pretty much of a challenge, but in [Combs'] case, she [also] needed a wider width, which so many shoes don't come in," he says. "Apis shoes come in a wider width." In 2003, Rogers was finally able to meet Combs' desire for a more stylish shoe while accommodating her specific foot care needs. He took a low-heeled, pump-style shoe and added lace stays to pull the feet back and hold them in the heel of the shoes while still having plenty of support to hold her AFO, he explains. The custom-support system that Rogers designed and added to Combs' shoes—which incorporates a counter and cradle system for the back of the foot and around the heel to provide more stability and support while maintaining a dressy look—is now used by Apis, El Monte, California, per a joint agreement between the two parties. Rogers says one feature that works well for Combs is that the inside seams in the shoes are positioned on either side of her Achilles tendon to prevent irritation. Combs says her Mt. Emey shoes loosely resemble pointe ballet slippers with laces. They hold her feet in a more comfortable position than the orthopedic oxfords did, completely relieve her strained muscles, and allow her left heel to lightly brush against the ground, which is the closest it ever has come to having full ground contact. Combs is so pleased with the fit, function, and fashion of these shoes that they are her footwear of choice. She says she wears them to church, out to lunch and dinner, to the grocery store, and even to work in the garden. She says she still wears the oxfords, but mainly for going out in inclement weather. "[My feet] feel like they're tied up like little packages and [are] comfortable...," Combs says. "The oxfords were good at doing what they did, but they didn't go far enough. They didn't have all the particular modifications that Don put into these shoes." Combs says she is glad to have found a more comfortable and nicer looking pair of orthopedic shoes that fit and properly support her feet, adding that she feels like her feet are "on a good foundation." Editor's note: Sarah Walker contributed to the writing and research of this article.

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