Plantar Faciitis

[tommy]

As refered by my PCP last week, I visited the Podiatrist this morning. X-rays and long consultation confirms a mild case of PF. Slight arthritis in the ankle without pain. A bunion as well. Mild pain in the (fallen) arch. No pain in the heel, although it is inflammed. We caught it early.

I got a lesson in the structure of the foot and the interconnections of the ligaments that hold it all together. It's rather complex, but logical and intriguing. The Podiatrist was excellent and spent a lot of time explaining stuff.

Running per se is not the culprit. This condition started after taking a couple of months off from running. My everyday shoes were a very bad choice. I never noticed how little support they gave me. They were very comfy (I've been gellin' like a fellon). Some of the stretching exercises (standard stuff) that I have been doing made things worse. The leg presses and calf presses at the gym also made things worse. The running shoes were okay, but once injured, they are not supportive enough now either.

So, I will wear a heel cushion for a while, replace my shoes, replace my running shoes, do a specific stretching exercise, change my exercise routine (cardio and strenght training), ice massage my arch at night, always wear shoes - even getting out of bed. More cycling, more swimming and more eliptical machines - no treadmill. Some of these instructions and changes are temporary to facilitate healing. Some will be permanent.

I'll be a bit crabby about being on the sidelines and about making some of the changes (like wearing shoes in the house), but I'm counting my blessings. The prognosis for full recovery is good. There are three more steps that can be taken if this round doesn't entirely do the trick. The next would be an orthotic insert in my shoe. The next would be medication. The last would be surgery. I really don't think that we will get as far as surgery, and I doubt that I would go for that anyway unless necessary for everyday life. The stretching exercise this evening gave me instant relief. That is very encouraging.

Follow up appointment in 2 weeks. Off to massage my arch with ice.......Thanks for listening.

 

[Raverlaw]

Tom,

What a let down that must be. Your plan to keep up the cardio workouts is the right way to go. Does your gym have a rower? At the risk of sounding like a broken record, it is a great all-around cardio and strength exercise with no impacts to the knees or feet.

Here's a link to the manufacturer if you'd rather get one for home - it's about the same as a year's membership at a nice gym.

Concept 2 Rowing Machine

Good luck! ( I hope this doesn't put you out of the Pike's Peak walk this year)

 

[BillCobit]

More cycling, more swimming....

Tom, so sorry to learn of your injuries. Sounds, though, like you are getting some competent treatment. And just maybe, creating the seed crystal for triathlon obsession

I had a painful foot condition 10+ years ago - hallux limitus = painful arthritic condition similar to bunion that was gradually destroying my joints. I had limited range of motion, could not run at all and could not walk w/o pain. The first attempt at surgical intervention by an orthopaedic surgeon was a disaster - very long and painful recovery, and left me no better off. As the condition got worse, I decided to consult a podiatrist that had a very good reputation. He reviewed x-rays w/ me and explained biomechanics. He advocated surgical intervention that included shortening foot bones, re-aligninment by cutting notches in bone & closing the notches w/ screws, plus some joint remodeling. My first reaction was that this guy was a kook who would REALLY screw me up. But I went to the university med library (back in the day before web resources existed) and found corroborating references for his diagnosis and exactly the treatment he described. And since prognosis was not good w/o corrective action, I decided to give him a try.

Although much more complicated, his surgery lasted a fraction of the time the orho's hack job took. And remarkably little pain after the operation. I've got one really good joint now, and one that is a little problematic due to effects fo the pre-surg disease state. Also, feet that are slightly different in size and shape, making it difficult to find running shoes that fit But hey, I'm running! Well, shuffling...but not cuz of my feet!

Best wishes for a speedy recovery, Tom! Meanwhile check out http://www.trifind.net/nf/tx.html

 

[tommy]

Bill and Bill,

Thanks for the encouragement! I'll get through this okay.

BillC
Wow, you have been through the ringer. Your experience gives me great hope. My goal is a local sprint tri in the fall - McKinney with a friend (that is doing Austin in a couple of weeks).

BillR
My gym has a rowing machine in the weight room, but not a rower as you use. Keep after me about rowing. Maybe someday........ Pikes Peak 2005 - we'll see. Actually, Im thinking of Longs Peak in 2006.

BTW, the guy that manages my running store was wearing a tee shirt from the 1996 Pikes "Assent" 1/2 marathon running up the same trail I hiked. His wife ran the marathon the next day. 13.1 up and 13.1 down. Yikes!

Off to buy new shoes!

 

[Nancy]

Had that for a while also. Changed to Birkenstocks for everyday use, and after another while, it disappeared. I gradually shifted myself to other more attractive footwear and now can wear just about everything, for a little while, at least.

 

[Marguerite53]

sorry to hear you're off your stride

sorry to hear you're off your stride

Hi. Just wanted to chime in that orthotics are VERY helpful. My husband has had nagging back problems, a neighbor had your condition exactly (she's an avid golfer) and a young woman my daughter's age (18) brought on problems with volleyball and track. All 3 have benefited enormously from the orthotics. My husband and I wear Birkenstocks alot. He actually was given the name of a place who will take the Birkenstocks and rebuild them with your carefully produced orthotic device. He also has inserts for his dress shoes and weekend shoes.

Be advised, they can make noise -- squeeky. All you need to do is put a wee bit of talcum powder in the shoe and you'll be noise free!

If you need the name of the company who rebuilds shoes, let me know. I suspect it's a national company.

Good luck.

Marguerite

 

[hensylee]

Tom, I had that, too. went to local podiatrist who ordered (at my choice, but you do anything to help alleviate the pain) insertable arche supports for my shoes - they poured some 'concrete' like a cast to fit my foot, sent it off to get the arch support made. Cost $300 because insurance didn't cover it. I wore the things for awhile, found that local stores also had supports that looked just like the one I bought. It took a LONG time, but eventually the foot healed itself. Yours will, too.

 

[tommy]

Thanks, girls. Your stories of eventually healing are encouraging. I'll look into the Birkenstocks. A quick Internet search shows several Birkenstock dealers and repair shops in my area. I also like the idea of portable inserts. They should make shoe selection easier, because the insert does the work. I'll talk to the doc about the over-the-counter varieties. They are available everywhere - even the grocery store.

Injuries have a way of getting me down. I know on the scale of calamities, PF is pretty low. My pain is slight. The hassle is moderate. Change is a pain. I worked out yesterday afternoon and felt a lot better. I'm avoiding heavy walking, running, and the treadmill until my next appointment.

I'm counting my blessings. You and this board are several of them.

Thanks again.

 

[Nancy]

Here's a link for Spenco OTC orthotics. They have been recommended by a couple of doctors for the problems you're talking about. Joe and I have both used them and they helped. I got them at the shoe repair place, but I believe sports stores carry them or similar ones as well. They're well made.

http://www.spenco.com/prod_footcare_greenarsup.html

 

[csutherland]

I had your condition in my foot 3 years ago. I saw a podiatrist who put me on--well, can't think of the name of it, but it's now off the market. I took it for a month or so and it helped some. It's an anti-inflammatory. Then she wrapped my arch & heel very tightly with tape for 2 weeks. Felt great while it was on but didn't last. Then she gave me a corisone shot in the heel. Ouch, ouch! That lasted about 2 weeks.
Finally I was complaining to my beautician about my sore foot and she said to take large doses of ibuprofen, 4 or 5 at a time instead of the 2 listed on the bottle. I was afraid to do that and called my pharmicist. He said it was fine for relatively short periods of time. My pain was starting to travel all the way up to my knee. The beautician explained that was because I was walking funny to keep the pressure off my heel and it was throwing my knee out of whack. She said to get some good walking shoes with a broad heel base to keep me from rotating the foot. All this really did it! I now wear no other shoes except for short periods of time such as church, funerals, etc. Appearance is no longer a factor!
In my experience this condition is lurking all the time just waiting for a chance to come back. If my ankle, heel or arch have the slightest twinge I pop a few ibuprofen as it's an anti-inflammatory Of course if you are using coumadin you can't do that.

 

[Jean]

Tom, when I first read your post I was all set to launch into my praise of Birkenstocks too. But then I saw others did too. Just want to add my two cents. I too had heal spurs about 8 years ago. Did a lot of research on it and tried Birkenstocks and they stopped the pain within the week. Since I have worn mainly Birkenstocks. They have very nice styles now...men and women. Good luck.

 

[tommy]

Update

Update

I had to cancel my podiatrist follow-up due to "bigger fish to fry" . Coumadin thread has those details.

I did play some softball one night and wrapped my foot. It seemed to help, or at least avoided making things worse.

On the lighter side, when I was wheeled into the colonoscopy room with my clothing on a tray at the bottom of the guerney (sp?), my new size 14 Brooks Beasts were a topic of discussion . Those shoes have a huge platform. "Beast" is an appropriate name. I was wearing my White Rock Marathon shirt as a reminder that obstacles are meant to be overcome. It also has long sleeves. They keep those medical facilities cold.

My running days are farther away than I would like . I will skip my annual local 5k for the 2nd time in 6 years . I have done some cycling and swimming, but nothing lately. I'll get there. One step at a time.

Thanks for all the tips and encouragement.

 

[tommy]

Finally got back in to see the podiatrist. He wrapped (taped) my foot and gave me another exercise to do. The wrap really helps. It's only around the bottom of the foot. It keeps the plantar facia and arch supported. Don't know if I can tape it myself, but will try.

Next visit 2 weeks will likely get fitted for custom orthotic.

 

[KAJ]

Night splints help plantar fascitis

Night splints help plantar fascitis

I just had to respond to this. I had a very bad bout of PF several years ago and had read an article on the internet about using night splints. My podiatrist had never said anything about this treatment, but I was able to get him to order some for me. It took just a little getting used to wearing them at night, but what a difference!! The very first night I wore them I could tell a huge improvement-- stood up in the morning and had no pain whatsoever for the first time in months. I wore them every night for about a year, which was probably a lot longer than really necessary (I was paranoid about the PF coming back). Now I just have to be really careful about what shoes I wear, and always wear shoes in the house instead of going barefoot.

As I remember it, the principal behind the splints is that when you sleep, your feet relax and the tendons tighten up. Then when you stand you have pain from microtears in the tendons. The splints keep your feet in a flexed position, therefore avoiding the tearing.

By the way, a lot of places now sell foot splints much cheaper than what you would have to pay through the podiatrist. Try footsmart.com.

Hope this helps- Susan Jaeger (wife of Karl, AVR replacement/aneurysm repair March 2005)

 

[tommy]

Susan,

Thanks....very helpful.

My doc dicussed the night splints. Said that when the ligament relaxes overnight, it builds fluid. The fluid is what causes the pain in the morning.

I'll check out footsmart.com.

Thanks again.

 

[hensylee]

you might want to ask prices before you go getting the custom job. Mine cost $300 and that was years ago. Insurance won't cover (at least it didn't then). Actually, I found that Dr Scholl's was exactly as good. Nancy also mentioned one.

It's going to take time to heal this thing, but it will happen. My cousin went the same route as me (the orthotic ones made by the podiatrist) and found that eventually her foot cleared up same as mine. It's just going to take you some time.

Think I must have injured my foot somehow walking for hours and hours as a tourist in Boston. Hard sidewalks and mostly uphill. Are you still wanting to run when you get better? Might re-consider that.

 

[tommy]

Yes, I'm considering running after healing. That leads me to consider the custom molded orthotic. Will I ever run another marathon? Who know, but I would love to do shorter runs, if possible. One thing at a time. My next goal is to be pain free for 3 weeks. Then I can walk for exercise.

 

[Nancy]

Here's a website that has all kinds of "foot" remedies, including night splints.

www.footsmart.com