Plantar fasciitis...anyone familiar with this?

[Nanker]

Pooj, it sounds to me like you have an injury. Do yourself a favor and seek out a sports medicine orthopedic surgeon that specializes in foot and ankle injuries. I'd bypass the podiatrists. JMHO, but I don't think they're very sharp.

There are lots of good surgeons at U Penn. Went there myself a number of years back to have a procedure done on one of my shoulders by Dr. Gerald Williams. He's pretty much a shoulder guy. You need someone like him for feet.

 

Do it.

Edited February 3, 2013 by Nanker

[Zackry00]

I've been battling PF for the past 2 years. I was the the Pediotrist probably 10 times last year for checks, cortisone shots, shoe insert fittings, followups, etc. I finally had a good cortisone shot that kept for a bit. Until the last 3 weeks. It seems to have worn off and now I have another appointment on Monday to see if there is any alternative treatment. I've read about two different treatments if your case is as bad as mine.

 

One is called ESWT- Extracorporeal Shockwave Therapy http://en.wikipedia.org/wiki/Extracorporeal_shockwave_therapy

The other is PRP - Platelet Rich Plasma http://en.wikipedia.org/wiki/Platelet-rich_plasma

 

Both are not covered by my insurance, but in reviewing these treatments, it seems that they work better than the cortisone shots and are more permanent, just not justified by a long enough patient trials. The out of pocket was quoted to me at about $500 for these treatments, but for me that seems worth it to be able to sleep without a night splint and be in pain in the mornings and evenings.

 

Hope this helps.

[Shamrock]

I know it has been in the news alot via eli manning etc....i may be 'suffering' from it and have been for a couple months...recently got back to trying jogging, trying to work through the pain...i have been also trying to do more stretching excersizes directed at that part of the foot and lower leg....am i doing damage by jogging, or will this kind of help in the stretching...i am not jogging any distance at all as i am just getting used to it....someone has mentioned a tennis ball under the arch and stretching it that way....my main concern is giving up the jogging as i really want to stick with it in hopes of doing a 10K in april....if anyone has any personal expertise i would appreciate it...i have looked on line for info, just want to hear from those that may have gone through it...thanks in advance

 

I'm a podiatrist, see in the vicinity of 2 /day, over a long period.

Main thing is to get accurate diagnosis.

There's plenty of "anatomy" in that area for it to actually be many other things too.

Imaging, physical assessment, including your history (running shoes, running mileage included, work etc. etc.).

Could go on for hours with what we see that's not plantar fasciitis but was called plantar fasciitis.

Edited February 6, 2013 by Shamrock

[Shamrock]

Pooj, it sounds to me like you have an injury. Do yourself a favor and seek out a sports medicine orthopedic surgeon that specializes in foot and ankle injuries. I'd bypass the podiatrists. JMHO, but I don't think they're very sharp.

There are lots of good surgeons at U Penn. Went there myself a number of years back to have a procedure done on one of my shoulders by Dr. Gerald Williams. He's pretty much a shoulder guy. You need someone like him for feet.

 

Do it.

 

Ouch!

[The Poojer]

Pretty sure he meant present company excluded...but I went the cortisone, insole, night splints...xray(did show maybe some indication of spurs)...tried to get me to do 6-8 sessions of pt/month..but the expense was too much for me, even with insurance.. I know my weight doesn't help but the pain is too discouraging at times so its a vicious cycle....just not sure why the flare up and why its so severe for the first time ever...still as bad as it was Sunday...

 

 

 

 

Ouch!

[Nanker]

LOL. You beat me to it Pooj. Yes, present company excluded.

I've just had bad results with Podiatrists, and that's all anecdotal of course.

I'm sure there are plenty of them that don't smell their hands after caressing your feet.

[Shamrock]

Pretty sure he meant present company excluded...but I went the cortisone, insole, night splints...xray(did show maybe some indication of spurs)...tried to get me to do 6-8 sessions of pt/month..but the expense was too much for me, even with insurance.. I know my weight doesn't help but the pain is too discouraging at times so its a vicious cycle....just not sure why the flare up and why its so severe for the first time ever...still as bad as it was Sunday...

 

X-ray did show, maybe... ... Hmmmm.

From the film, does it look like its emanating from the facial insert or perhaps higher up on the tubercle representing Abductor digiti minimi or perhaps even Flexor digitorum brevis... ...

Any chance they're "in stance" view films too. Did they X-RAY whilst the foot was weight loaded or unloaded?

Have you had an diagnostic Ultrasound, cheap as chips too.

If its a tear, how substantive is that tear? Where in the fascia did it fail- the enthesis, the belly, the med/ lat chord- where?

So something has fatigued the fascia into tearing.

The fasia's in a stalemate of acute injury and now becoming chronic.

What's changed and perhaps hasn't changed in your history.

What's overloaded the fascia?

Structural, functional, restorative, footwear, training regime, recovery, medically...

Insoles or orthotics, there's a difference in correcting the foot posture. Or was it just an insole to mange impact?

Correct stretching technique, there's a difference between good and bad technique. Stretching of tendo Achilles is very beneficial but typically poorly done.

 

I'm all about accurate diagnosis, treatment can then be realistically guided rather guessed, compare precision guided munitions now to WW2. Sure area bombing was considered a success if it was within 5 miles of the target, but really...

 

 

[The Poojer]

tbanks for that list of questions...i may need to go get another xray and have all of them answered...the one guy i went to took the xray and gave me the shot, insole and splints...i appreciate the feedback

 

X-ray did show, maybe... ... Hmmmm.

From the film, does it look like its emanating from the facial insert or perhaps higher up on the tubercle representing Abductor digiti minimi or perhaps even Flexor digitorum brevis... ...

Any chance they're "in stance" view films too. Did they X-RAY whilst the foot was weight loaded or unloaded?

Have you had an diagnostic Ultrasound, cheap as chips too.

If its a tear, how substantive is that tear? Where in the fascia did it fail- the enthesis, the belly, the med/ lat chord- where?

So something has fatigued the fascia into tearing.

The fasia's in a stalemate of acute injury and now becoming chronic.

What's changed and perhaps hasn't changed in your history.

What's overloaded the fascia?

Structural, functional, restorative, footwear, training regime, recovery, medically...

Insoles or orthotics, there's a difference in correcting the foot posture. Or was it just an insole to mange impact?

Correct stretching technique, there's a difference between good and bad technique. Stretching of tendo Achilles is very beneficial but typically poorly done.

 

I'm all about accurate diagnosis, treatment can then be realistically guided rather guessed, compare precision guided munitions now to WW2. Sure area bombing was considered a success if it was within 5 miles of the target, but really...

[birdog1960]

i've see many more cases of this in the last 5 years and i'm pretty certain it's due to the obesity epidemic. usually try injections and anti-inflammatories and then refer to ortho or podiatry but honestly don't see their treatments being much more effective, unfortunately. people get very frustrated...again, i think much of the problem is the pounding the feet get from carrying around much more than they were designed to and treaments sometimes can't overcome this basic issue. besides weight loss a few other basics: good shoes. i started a thread on recommendations for them that garnered little interest but they're really important for foot and back health. i ended up with merrill's that look like birkenstocks with backs. some PT's recommend dansko clogs (too high an arch for me). the major thing is a rigid sole. avoid crocks and flip flops like the plague. and while you're healing, avoid running. try something else that doesn't pound your heels like swimming, rowing machine or spinning. from what i've read there's really no carefully conducted, large, impressive studies on treatment of this very common conditon so recommendations or mostly empirical. maybe the resident podiatrist can steer us towards some but i think, given it's prevelance, those studies are needed.

Edited February 6, 2013 by birdog1960

[birdog1960]

http://emedicine.med...6143-medicationa nice detailed reference on the subject. maybe more than you need or want but lots of good info here.

[whateverdude]

Stop running, stop stretching for 3 months. Start wearing New Balance walkers from the min you wake up to the min you go to bed.....this is the only thing that will fix you up. Oh and lose weight

[The Poojer]

up until this week, while i didn't do it religiously, i would jog/walk a couple miles a day and i could just walk it out for about 10 steps...but sunday i just cannot bend my foot at the ankle 'upwards'...it is getting a bit better but it is by far the worst flare up i have had and i had'nt done anything to cause it to be so bad....

 

i've see many more cases of this in the last 5 years and i'm pretty certain it's due to the obesity epidemic. usually try injections and anti-inflammatories and then refer to ortho or podiatry but honestly don't see their treatments being much more effective, unfortunately. people get very frustrated...again, i think much of the problem is the pounding the feet get from carrying around much more than they were designed to and treaments sometimes can't overcome this basic issue. besides weight loss a few other basics: good shoes. i started a thread on recommendations for them that garnered little interest but they're really important for foot and back health. i ended up with merrill's that look like birkenstocks with backs. some PT's recommend dansko clogs (too high an arch for me). the major thing is a rigid sole. avoid crocks and flip flops like the plague. and while you're healing, avoid running. try something else that doesn't pound your heels like swimming, rowing machine or spinning. from what i've read there's really no carefully conducted, large, impressive studies on treatment of this very common conditon so recommendations or mostly empirical. maybe the resident podiatrist can steer us towards some but i think, given it's prevelance, those studies are needed.

[birdog1960]

i've only had this once. walked outside barefoot and was sure i'd stepped on a nail...but nope. had worn tight, stylish but uncomfortable shoes for a few days at work prior. that's when i started my quest for the perfect shoe...and it made all the difference. but yours are chronically inflammed and will take more time and effort. hope you can see the link i gave but it might require a sign in to medscape which you may or may not be able to do - don't know. at any rate, the more aggressive treatment options dicussed there will need to be ordered and monitored by a doc.

[Shamrock]

3 today. 1 in a T2DM with a Hallucal amputation & torn medial chord subsequent, 1 kid as Birdog suggested with BMI of 32 with both parents saying their kid was big boned like them... I'm trying not to imagine Cartman & 1 lady who was definitely not overweight but in 6inch heels working as a domestic- hard work, her son described her as having typical European woman work ethic! All different, all different management. For a small area, it's actually pretty interesting for me

[The Poojer]

Pain finally gone today...can bend my foot normally...didn't even take my normal 10-12 steps to loosen things up...very strange

[tennesseeboy]

I got it fifteen years ago ater running the Gasparilla 15k. The prescription then was rest and ice and I had a neat exercise I got from my brother who is a high school track coach which involved freezing a soda can and rolling it. Took a long time to heal and actually was the last straw to my racing career. Never really got into it again.

[BillsFanM.D.]

I got it fifteen years ago ater running the Gasparilla 15k. The prescription then was rest and ice and I had a neat exercise I got from my brother who is a high school track coach which involved freezing a soda can and rolling it. Took a long time to heal and actually was the last straw to my racing career. Never really got into it again.

 

Better to freeze a disposable water bottle....just in case you forget it in the freezer.

[NoSaint]

i've only had this once. walked outside barefoot and was sure i'd stepped on a nail...but nope. had worn tight, stylish but uncomfortable shoes for a few days at work prior. that's when i started my quest for the perfect shoe...and it made all the difference. but yours are chronically inflammed and will take more time and effort. hope you can see the link i gave but it might require a sign in to medscape which you may or may not be able to do - don't know. at any rate, the more aggressive treatment options dicussed there will need to be ordered and monitored by a doc.

 

thats why you should save the high heels for special events and not day to day use at work....

[birdog1960]

thats why you should save the high heels for special events and not day to day use at work....

yup. the merrell's and clogs just don't have the same effect. but seriously, i need to stop getting esquire: my current shoes just seem so inadequate...

[The Poojer]

how strange...this morning i get a twitter follower request from a dr. seigerman, podiatrist....i wonder if that is pure coincidence or if i left a trail of cookies and they were able to find me that way...pretty weird....