When Bigfoot Books an Appointment: A Podiatrist’s Field Guide

Every year, just an hour outside of Asheville, Marion, NC transforms into Bigfoot central, celebrating our region’s most famous (and camera-shy) resident. While the festival is all fun and folklore, I couldn’t help but think: what if Bigfoot actually booked a podiatry appointment? What would the chart look like? What diagnoses would I make? And—most importantly—what treatment options could possibly hold up against a 700-pound biped?

The New Patient Intake

Name: S. Quatch (prefers “Bigfoot”)
Age: Unknown (estimates range anywhere from 40 to 400 years)
Occupation: Professional Hide-and-Seek Champion
Insurance: Out of network (obviously)
Chief Complaint: “Doc, my dogs are barking worse than actual dogs.”

Clinical Examination: What We Can Learn From the Evidence

We don’t have an actual clinic visit to go on, but we do have footprints, film, and biomechanics research to extrapolate from.

The Numbers Don’t Lie

According to Journal of Biomechanics, ground reaction forces equal about 1.2 times body weight during walking and up to 3–4 times during running.¹ If our cryptid weighs roughly 700 pounds:

• Walking force per foot: ~840 pounds

• Running force per foot: ~2,800 pounds

• Comparison: That’s like balancing a grand piano on each foot with every running stride

Anatomical Features from Footprints

• Flat arch profile – Tracks show absent medial longitudinal arches (pes planus)

• Wide forefoot – 7–8 inches, nearly double human averages

• Midtarsal break – Flexibility point in the midfoot absent in modern humans

• Modified gait – Lacks a typical heel-toe pattern, suggesting compensations under extreme load

Differential Diagnosis

From a podiatric standpoint, these findings point toward several likely pathologies:

1. Chronic plantar fasciitis
Degeneration and thickening of the plantar fascia under repetitive overload.²

🦶 Want to know how plantar fasciitis actually affects humans (and why mornings can feel so painful)? Read my full guide here: Podiatrist’s Plantar Fasciitis Treatment Guide .

2. Stage III posterior tibial tendon dysfunction (PTTD)
Flatfoot collapse plus excessive mass = severe tendon failure and ligament compromise.³

3. Forefoot stress injuries
With widened stance and massive load, metatarsal stress fractures and sesamoiditis would be expected.⁴

4. Onychomycosis (fungal nails)
Warm, moist forest environments increase risk significantly—think “ideal fungal lab.”

🧴 Living in damp environments like Bigfoot? That’s a recipe for fungal toenails. Learn more about causes and treatments in my post: Toenail Fungus: A Podiatrist’s Guide .

Treatment Protocol

Conservative (Weeks 0–12)

Custom Orthotic Therapy

• Standard materials max out at ~300 pounds

• Bigfoot’s version: industrial-grade carbon fiber with titanium reinforcement

• Evidence: systematic reviews show ~70% reduction in pain with orthotics²

Physical Therapy

• Eccentric calf strengthening

• Intrinsic muscle activation

• Proprioception drills (fallen logs double as balance beams)

Medical Management

• NSAIDs at weight-based dosing

• Antifungals (probably in 55-gallon drums)

• Corticosteroid injections (veterinary-sized syringes required)

Surgical (If Conservative Fails)

Following McGlamry’s reconstructive protocols, adapted to Sasquatch scale:

• Medial displacement calcaneal osteotomy (~15 mm translation)

• FDL tendon transfer with graft augmentation

• Spring ligament reconstruction using heavy suture (#5 FiberWire)

• Cotton osteotomy for forefoot correction

Recovery: 6 weeks non-weightbearing (theoretical only), progressive loading in bracing from 6–12 weeks, return to “forest activity” at ~6 months.

What This Means for Humans

The humor aside, Bigfoot’s “case” reflects the same conditions I see in clinic daily:

1. Body weight matters – Every 10 pounds lost relieves ~40 pounds of force per step¹

2. Flat feet need support – Untreated PTTD often progresses to arthritis and deformity³

3. Catch it early – Stage I PTTD responds to orthotics and PT; Stage III often requires surgery

4. Fungal prevention is simple – Rotate shoes, change socks daily, keep feet dry

Prognosis for Sasquatch

Based on published outcomes and a bit of imagination:

• Pain relief: 60–80% at 3 months²

• Return to function: ~85% of baseline at 6 months

• Recurrence: 20% if orthotic compliance maintained

Bigfoot FAQ

How big are his feet?

Casts show 15–24 inches. That’s size 22–26 shoes. Shaq wears a 22—Bigfoot makes him look like a kid in Payless.

Could he really get plantar fasciitis?

Yes. Imagine your morning heel pain multiplied by 500 pounds.

What shoes would you recommend?

Reinforced hiking boots in size 26 EEE. Nike “Air Sasquatch” has a nice ring to it.

Would orthotics help?

Definitely. The lab might need to subcontract NASA for production.

Could he run a marathon?

Possible, but stress fractures would likely end it by mile 10.

Would insurance cover treatment?

Doubtful—he has no Social Security number and probably hasn’t met his deductible.

Feet Made Simple Resource Box

These are my go-to products for patients dealing with flat feet, heel pain, or high-pressure loading. (Humans only—Sasquatch would need industrial versions.)

• Footwear: Brooks Ghost Max – maximum cushioning for heavy strikers
  Topo Ultrafly 4 – wide toe box with stable arch support
• Orthotics: Powerstep Pinnacle Maxx – my top pick for reliable arch control
• Skin & Nail Care: Urea 40% Cream – softens thick calluses and heels
  Diabetic Socks – moisture-wicking to help prevent fungus and friction

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