PDA

View Full Version : Recalcitrant Plantar Fasciitis


Axe
08-12-2010, 07:43
**I have done searches for plantar fasciitis, plantar, and heel spur here. I have done my due diligence in searching other internet sites and Pubmed as well.

Please excuse the drawn out story here. I figured it is better to lay everything out to make it easier for anyone who reads this who might have suggestions as to what I should do next.

I am a 41 y/o male, 6'00". was 235 lbs, am now 250 due to lack of exercise. I am having issues with Recalcitrant Plantar Fasciitis.

For a number of years, I walked 3-6 miles per day. I walked on asphalt road surfaces during snow season and on soft ground when the snow wasn't covering the ground.

I did not run, nor did I ruck. I have had an ACDF, and could use a laminectomy as well, but am trying to avoid it if possible, so I avoid jarring or strong weight hanging from my back/neck/shoulders.

In April 2009, I started developing very minor (1/10) pain bilaterally in my dorsal calcaneal region that was present only during exercise. I was already taking Mobic 15 for the neck and a right ankle which has minor OA.

I reduced my walking to 1-2 miles per day,began icing and elevating after activity, and started doing some minor stretching.


By July 2009, despite the measures I was taking, my pain was at 5-6/10 when walking, 4/10 at rest 24-48 hrs following any necessary walking of more than 1/8 of a mile. I began to notice that standing for more than 6 hours caused pain equivalent to the pain caused by ambulation.

I stopped walking for exercise and avoided other walking and unnecessary standing except when absolutely necessary. I continued icing, elevating, and stretching. I also then developed s/s of minor Achilles Tendonitis in my left ankle.

I made a visit to one of the best Orthopods in the area in January (Team Doc for the Packers). He gave me pain medication to get me through the SHOT Show, gave me a Medrol Dose Pack to be followed with Voltaren in place of Mobic, and Rxed Physical Therapy. The Medrol pack helped for the time I was on it, but then lost its efficacy.

I did physical therapy, which consisted of stretching and ultrasound treatment on the heels. The ultrasound made a huge difference for 24-48 hours, relieving pain completely. By the next appointment, necessary daily walking would cause the pain to recur, and the ultrasound treatment would remove it again.

The PT stretching relieved the Achilles Tendonitis, and I gained flexibility in the foot, soleus, gastro, and other muscles/tendons of the ankle, but did not achieve relief of the plantar fasciitis pain issues.

At this point, walking more than 1/8 mile or standing for more than one hour caused pain 7-8/10. The ultrasound was like a magic wand, but wouldn't last past two days of minor activity.

I underwent Cortisone injections in both heels in late May 2010, which gave significant (roughly 99%) relief of pain, allowing normal ambulation. I avoided any serious walking, but was able to handle being Scoutmaster at Boy Scout camp in July (1-2 miles per day walking at a fairly slower pace), get a mile or so of normal up and down office work ambulation weekdays and outdoor chores on weekends, and able to remain standing for more than 4-6 hours without extreme discomfort. I was able to remain standing without severe pain well enough to cut up and split 3 cords of wood, which was my major chore goal for the summer, and get my son through his Eagle Scout project ( 4 days X 12 hrs per day of standing/walking.)

About a week ago, I needed to walk approximately one mile on soft ground. 48 hours later, I was at a 8/10 pain level when walking, 6/10 pain level standing, and an intermittent 4-5/10 pain level when at rest. I am back to no activity, ice, elevation, stretching.

I visited the Orthopod 2 days ago. He is confounded at the lack of improvement. He did not want to do more Cortisone injections because of the pf rupture risk. He wrote me another script for PT, a script for night splints, and wrote me a script for painkillers for my upcoming family vacation to Yellowstone next week.

I have tried different shoes, and different OTC orthotic inserts. Nothing has really worked. I have pretty much exhausted the options I can think of short of surgery, which I know is a last resort and beset with morbidity issues all its own. My Orthopod strongly recommends against it as well since it causes so many arch issues.

I have read some research about a technique called dry needling, which involves repeated jabbing of the plantar fascia followed by ultrasound-guided injection of Cortisone. The reported results sound promising, but I can find little detailed information on the procedure studies and protocols. (I can only read abstracts on Medline as I do not have an account). I also can not find a lot of people who perform the procedure using internet searches, which leaves me questioning the true efficacy of the procedure. My Orthopod had never heard of it.

I would like to regain the ability to ambulate for normal daily activity. I would also like to be able to exercise by walking. I am willing to travel for treatment if I need to see someone with special expertise.

Does anyone have any suggestions as to how I should proceed? I am running out of ideas.

Boomer-61
08-12-2010, 10:47
Axe,
Sorry to hear about your problems. I had it in both for 9 months.
I have very little experience with the needling, I have one pt who has had it done with limited success. Kind of like the ultrasound, she had to have multiple treatments and none gave her lasting relief.
As for the traditional treatments, it sounds like you've done most: icing, stretching etc. Did you try night splints? What helped me was to get rid of all my shoes and buy Ortho recommended shoes and orthotics which were professionally made. The only other thing I would recommend is weight loss. You're ideal body weight should be around 185 or so. You can exercise in a pool or on a stationary bike without exaccerbating your feet. Reduce your caloric intake by about 500 per week and the weight will come off a pound at a time. Yes it will take time but it will work and you are less likely to rebound. I truly believe that if you reduce the load/stress on your feet, i.e. weight loss, and support your feet with good shoes and orthotics you will get relief. I would avoid surgery. I haven't been bothered with it in 15 years but I still stretch two and three times a day. I don't ever want it to recurr. I sympathize with you 100%. I wish I had a quick and easy cure for you but I don' know of one.
Good luck.

Blitzzz (RIP)
08-21-2010, 19:38
What you've tried is understandable, but obviously not done the trick.
First, the Plantar Fascia will shorten over time and not be painful until it's late. Not to late though. The heel spur comes much later as a result of the extra tension on the calcaneous at the anchor point of the Plantar Fascia.
The fix will be aggressive stretching of the Plantar Fascia. this can be done with a "Pro Stretch" or by standing at the kitchen sink with doors open, placing your toes on the bottom shelf (about 3" from the floor), then stand straight legged until you feel the stretch.
You can PM me for better explanation. Dave.

Eagle5US
08-21-2010, 21:07
Caution when using medical terminology if you aren't exactly certain what it is you are saying. I am going to separate the following statements for clarity:

Your post is very confusing....
Recalcitrant Plantar Fasciitis? Or RECURRENT / REFRACTORY Plantar Fasciitis?

You mention considerable pain in the DORSAL (top) part of your calcaneous...if it were also POSTERIOR (to the BACK) that would be Achilles Tendonitis.

Pain to the inferior (bottom) anterior (front) of your calcaneous could be plantar fasciitis.

You stated you had Achilles Tendonitis in your ANKLE - Achilles Tendonitis does not occur in the ankle, it occurs on the POSTERIOR (BACK) of the foot.

You mention Ultrasound Tx of your heels...I am assuming you are talking about TENS or UltraSONIC treatments? Ultrasound has no effect on relieving inflammation.

A few clinical questions...
-Have you had any imaging done? X-Ray will probably demonstrate significant heel spurs to the anterior portion of your calcaneous in the event of Plantar Fasciitis and/or to the posterior portion of your calcaneous with Achiiles Tendonitis.

-Do you wear splints at night when you sleep?

-Is your pain THE WORST when you first step on the floor (first episode of weight bearing) in the morning, getting better throughout the day unless you sit down for an extended period?

-Is your pain on the BOTTOM of your foot, or the BACK of your foot.

Once you can clarify the above questions...they may lead to more questions, but I can probably provide some additional guidance for Tx and palliative therapy. For either / both conditions if refractory (Plantar Fasciitis and Achiiles Tendonitis with associated spurs...) after failure of more conservative measures, Podiatrists often can surgically shave the spurs and provide significant relief of symptoms.

Eagle

guinness18er
08-22-2010, 11:07
Hello everyone, I hope I'm not double tapping this issue. While Plantar Fasciitis is the topic of discussion I would like to present my case and ask a couple questions to the QP's who have possibly been in a similar situation to mine.

First, here is the short version of the injury history. February 2008, after combatives practice I had a sharp pain in the ball of my foot, and some slight swelling. At the time I was working on some kicks, pivoting a bare foot on the floor of a basketball court. Drove on without seeking any medical attention and the pain gradually wore off. May of 2008 attended and graduated the Sapper Leader Course. Put the ruck down for a couple weeks, then began train up for SFAS. After ruck marches, and runs on pavement the ball of my foot would be aching so bad, that my form was falling apart and I would run/walk on the very outside edge to keep pressure off the ball. After training events the pain would subside and I could walk as normal. Through out the train up and leading into SFAS the pain moved from the ball of my foot, through my arch and to the point just behind where my arch meets the heel. One week into SFAS the pain was excrutiating, and I was losing mobility in the foot/ankle, and couldn't walk without a limp, and could barely run.

This was my demise in SFAS, and I should have pushed it back, but I thought I could suck it up for 2 weeks. After returning from selection and licking my wounds for a while, I went to a Podiatrist, at the time on Fort Leonard Wood. X-Rays showed a small fracture in one of the metatarsal heads (the one next to my big toe), which in her opinion, led to a small case of arthritis, which caused me to change the way my foot struck the ground when running or rucking. The change in my form, led to Plantar Fasciitis to develop.

Initial treatment was 2 weeks rest, stretching, and insoles with a lot of arch support. After 2 weeks, I ran, at the time I was a BNCOC instructor and running with students so I could not fall out when the pain came back. Went back to the Podiatrist, this time treatment was the same, but with 1 month rest. After one month the same thing happened. Back to the Podiatrist, this time, a steroid shot in the foot, and another month rest. First run back after 6 weeks, it comes back.

At that time I was on orders for Fort Bragg, and to a unit I knew was about to deploy. I got to Fort Bragg and did an 8 mile BN run which left me limping bad for 2 days, however I completed it with my platoon. From there, we deployed, have been deployed for 8 months and conducting dismounted route clearance for 5-10km 5 days a week. The only way I have been pain free is by taking 1600-3200mg of Ibuprofen a day, wearing ym night splint, and wrapping my foot with 2" tape (before applying 2" tape I wrap my foot in Pre-Wrap so the duct tape doesn't take the skin off). I'm getting by, but the condition is not going to heal until I can rest it for a long time. A little more info about me, I'm 6'0, 190, bodyfat ranges from 6-10%, I'm a Crossfit fanatic and take my fitness very serious. I also run in the POSE Technique, and before injury had 2 mile times in the 11 min. range, 4 miles in 24 min., and rucking 18 miles in 4.5 hours. I would primarily run in cross country racing flats on trails and gravel.

I can get through the deployment fine, but here are my questions:
First, will wrapping my foot in duct tape when I do a dismounted patrol or run ultimately lead to a weak arch that won't support me in the future, or some type of deficiency?
2nd, I know this won't heal until I can rest for a few months. I start PSYOPS school in January, and am hoping to be able to rest it during the language phase which should be 4-6 months. Can anyone tell me if it is reasonable to be able to do PT on your own during the language phase of PSYOP Qual Course, or should I just push the school back, and attempt to rest at the 27th ENG BN while I'm a PSG?

Lastly, I'm a huge Crossfitter and do a lot of heavy Olympic lifts. All though these lifts do not involve running, jumping, or any type of shock trauma, due to the heavy weight of squatting, deadlifting etc, am I continuing to damage the Fascia?

I know this was long winded, and I hope I'm not wasting anyones time here. Just wanted to get as many facts out as possible in order for more timely and sound advice. The Army, and my own mentality is to suck it up and it will pass. However, I have goals to achieve, which include going to the Ranger Regiment PSYOPS Detachment and then to Selection again in a couple years. I don't want to be walking with a limp in 10 years when I'm 40, but I also have a job to do, and simply can't rest at this time. Thanks for all your help in advance, and if necessary I will refer to the 18D posting which takes you to the Vagisil web page. Have a good one.
Also, just remembered, I have a golf ball and baseball which I roll my foot on, I also massage it nightly. When my foot is taped, I'm taking 1600-3200mg Ibuprofen, wearing my SOF or Superfeet Insoles, and wearing my nightsplint, I can run about 2 miles, or patrol app. 5km and remain pain free. Anything less as far as treatments go and I run 1/2 mi. or do a short patrol and I'm at a 4-5/10 in pain.

Eagle5US
08-22-2010, 11:24
The most important point of your post s the fact that you are taking 1600-3200mg of IBU daily.

1. Your body can only absorb so much IBU (2400mg) in a 24 hour period
2. By doing this for long periods of time, you place yourself at SIGNIFICANT risk for a GI Bleed. Believe me, I know.

As far as your foot goes, it was injured. It was injured in a bad place that doesn't get much of a "rest" unless you are in a wheelchair and you may need to consider changing your activities and future plans secondary to your injury and chronic pain.

Lastly, your case does not sound primarily like "Plantar Fasciitis" as much as it does (as your podiatrist mentioned) a metatarsal arthritis with an associated fasciitis.
Welcome to the world of chronic, activity dependent, pain.

Understand also, that any weights you lift transfers that energy to the platform you are lifting it on...in this case your feet. Your , no longer perfect, feet.

If you need to wrap your feet with tape to meet mission, by all means do so. The tape does take some of the responsibility for supporting structures from the natural formation of the foot (or ankle / wrist / elbow / digit / whatever body part is taped). In the realm of sports medicine this is designed to be an activity specific (i.e. TEMPORARY) utilization of additional support mechanisms to prevent injury in the event of extreme stressors OR to assist in support of an injured area.

HTH

Eagle

Pocket NCO
08-22-2010, 21:36
To Axe:

I will assume that the MD's have properly diagnosed you. With that said, there are a couple of different treatments that you should talk to your PT and MD about. The first is graston. It is a deep tissue technique that encourages the inflammatory process (which your body need to heal). Info can be found here: http://www.grastontechnique.com/

Sometimes the anti-inflammatory drugs that you take prohibit the body from healing on its own leading to increased dysfunction and weakness of a tendon or ligament (or fascia). The ultrasound worked because it was providing heat to the area which allowed the connective tissue to become more elastic and have increased blood flow (which helps the inflammatory process). There is a complex balancing act between beneficial and harmful inflammation, but the bottom line is your body needs it to repair.

The second treatment I would suggest discussing is barefoot walking progressing into very limited barefoot running. Barefoot walking/running allows you foot to move naturally so it self stretches (and self corrects). It also strengthens the intrinsic muscles of the foot and allows for a stronger arch. Some orthotics cause more of a problems than they solve because they allow the arch to weaken due to over support and create an unnatural gait. Again, discuss this with your PT and/or MD. Overdoing it without specific guidance on amount and technique can just exacerbate the problem.

The last thing I would discuss is self stretching and massage. It seems that you are doing the right things with the night splint and stretches but one of the biggest relief techniques I've seen with plantar fasciitis is to stretch and massage "wide". What I mean by this is that you should try to stretch/massage the foot medial to lateral especially along the arch. you will probably feel adhesions along the tissue on the bottom of your foot. The goal is to break those up allowing the fascia to expand some.

I have seen many different athletes and Soldiers achieve lasting relief with these techniques so don't be afraid to ask your PT and/or MD about them and get a second opinion if they want to keep pumping you full of meds without effective therapy. I've never heard of a pill that can truly correct an orthopedic problem.

guinness18er
08-22-2010, 22:58
Thank you much Eagle 5. A doc here on Shank did say that it could be a permanent problem due to the mis-alignment caused from the metatarsel fracture. Also, for what it's worth I don't stay on Ibuprofen or Naproxen for more than 2-3 weeks depending on mission, then I take an equal amount of time off, and start the cycle over again. I wish I knew if the Fascia is actually tearing off my heel bone, or just inflamed, and if the NSAID's are just masking the pain, or if their actually taking the inflamation away. Lastly, in most cases of Plantar Fasciitis I have read that the pain starts out bad in the morning, then gradually tapers off. My pain gets worse with activity, and is located where the Arch meets the heel, or just at the beginning of the heel. Thanks again, I will keep the Ibuprofen use in mind.

Eagle5US
08-22-2010, 23:07
Lastly, in most cases of Plantar Fasciitis I have read that the pain starts out bad in the morning, then gradually tapers off. My pain gets worse with activity, and is located where the Arch meets the heel, or just at the beginning of the heel. Thanks again, I will keep the Ibuprofen use in mind.
Being that this is the case, I would be money that if you had lateral views taken of your feet / foot that there would be a prominent spur extending from your heel towards your midfoot.

Traditional PF is worse in the morning because the foot draws up at night while not under weight. Hence, the use of night splints, stretching and massage prior to first morning weight bearing.

As your conditions worsens with activity - it may indicate a mechanical irritation caused by a chronic pulling of the plantar fascia (PF) on the attachment point to the heel bone. This chronic pulling then creates osteoblastic activity (i.e. bone formation) where it shouldn't be and you develop a spike or "spur". Specifically in the area extending into where your PF attaches. So, every time you take a step, you are moving tissue across a hardened structure that isn't supposed to be there. After conservative treatment fails, the next step is to remove the offending "spike" (heel spur)

I hope that makes sense....

Eagle

Blitzzz (RIP)
08-23-2010, 15:58
Mostly good stuff here.
I give a big thumbs up to Bare foot walking and running as there has been much research in that direction lately, with good results.
In 18 years of Physical Therapy I'd have to say Stretching the Plantar Fascia relieved the Heel pain. Stretching the Fascia releases the tension on the heel and allows the body to remove the additional calcium from that attachment.
Check with a good PT , and try to get some Myofascial release done to that tendon system.
Lastley as stated, one just decides what one can endure and drives on. Good luck to you.

Axe
09-03-2010, 21:18
Caution when using medical terminology if you aren't exactly certain what it is you are saying. I am going to separate the following statements for clarity:

Your post is very confusing....
Recalcitrant Plantar Fasciitis? Or RECURRENT / REFRACTORY Plantar Fasciitis?

You mention considerable pain in the DORSAL (top) part of your calcaneous...if it were also POSTERIOR (to the BACK) that would be Achilles Tendonitis.

Pain to the inferior (bottom) anterior (front) of your calcaneous could be plantar fasciitis.

You stated you had Achilles Tendonitis in your ANKLE - Achilles Tendonitis does not occur in the ankle, it occurs on the POSTERIOR (BACK) of the foot.

You mention Ultrasound Tx of your heels...I am assuming you are talking about TENS or UltraSONIC treatments? Ultrasound has no effect on relieving inflammation.

A few clinical questions...
-Have you had any imaging done? X-Ray will probably demonstrate significant heel spurs to the anterior portion of your calcaneous in the event of Plantar Fasciitis and/or to the posterior portion of your calcaneous with Achiiles Tendonitis.

-Do you wear splints at night when you sleep?

-Is your pain THE WORST when you first step on the floor (first episode of weight bearing) in the morning, getting better throughout the day unless you sit down for an extended period?

-Is your pain on the BOTTOM of your foot, or the BACK of your foot.

Once you can clarify the above questions...they may lead to more questions, but I can probably provide some additional guidance for Tx and palliative therapy. For either / both conditions if refractory (Plantar Fasciitis and Achiiles Tendonitis with associated spurs...) after failure of more conservative measures, Podiatrists often can surgically shave the spurs and provide significant relief of symptoms.

Eagle

Eagle,

The Physical Therapy Script from the Orthopedic Surgeon said Recalcitrant Plantar Fasciitis.

The PF has not gotten better since the onset a year and a half ago. I have not been able to exercise without pain. The pain is ameliorated by rest, but returns during and following standing and walking activity. The Orthopedic Surgeon said he uses Recalcitrant and Refractory interchangeably to describe a non-resolving soft tissue condition. He said that in his opinion my PF is not recurrent as it has never resolved.



I meant to say plantar, not dorsal--Sorry. Pain on bottom of feet, underside of the heels, worst pain back part of bottom of heel. The pain is usually distributed in a horseshoe pattern around the outside edge of the bottom of the heel, as well as the center of the bottom of the heel. The pain will extend to encompass the midsole area of the feet as well when I push exercise.


There was Achilles Tendonitis. I felt the pain/tightness in the at about the level of the malleoli, hence I thought of it as the ankle.

It was Ultrasonic treatment of the heels, not Ultrasound.

I apologize for my errors. I generally try to avoid typing faster than my brain can think, but I failed with my original post.

In answer to the clinical questions:

Xrays showed bilateral heel spurs May 2009. May 2010 Xrays do not show significant change to the spurs (ambulation-related pain has increased however).

The pain had been worst when standing or when my heel struck the ground when walking, after prolonged standing and walking.

If I had done a good job of resting for a few days, I could sometimes walk relatively short distances without pain for a day. 24-48 hours following walking, however, the pain would develop with any heel contact and would hurt at rest as well.

For the past month the pain has changed to be the worst when I first get up and after resting. I have been on a car vacation with the family the past three weeks. When I got out of the car to walk at our destinations and for rest breaks, I looked like an 80 year-old man trying to walk initially , then as the foot stretched, the pain and tightness improved and I then could walk normally. (The more I walk, the higher the price I will pay later painwise, however)

I do not currently have night splints as the Orthopod/PT did not think I needed them in January 2010. I now have a script for them and will be getting them.

The pain is on the bottom of both feet, not at the back of the feet.

Thank you for taking the time to respond to my post.

Axe
09-03-2010, 21:28
Axe,
Sorry to hear about your problems. I had it in both for 9 months.
I have very little experience with the needling, I have one pt who has had it done with limited success. Kind of like the ultrasound, she had to have multiple treatments and none gave her lasting relief.
As for the traditional treatments, it sounds like you've done most: icing, stretching etc. Did you try night splints? What helped me was to get rid of all my shoes and buy Ortho recommended shoes and orthotics which were professionally made. The only other thing I would recommend is weight loss. You're ideal body weight should be around 185 or so. You can exercise in a pool or on a stationary bike without exaccerbating your feet. Reduce your caloric intake by about 500 per week and the weight will come off a pound at a time. Yes it will take time but it will work and you are less likely to rebound. I truly believe that if you reduce the load/stress on your feet, i.e. weight loss, and support your feet with good shoes and orthotics you will get relief. I would avoid surgery. I haven't been bothered with it in 15 years but I still stretch two and three times a day. I don't ever want it to recurr. I sympathize with you 100%. I wish I had a quick and easy cure for you but I don' know of one.
Good luck.

Boomer,

Thanks. I will check into professional Orthotics.

I do need to lose the weight. I have been waiting for the PF to resolve so I could resolve walking. I need to move on and pick a different activity for now, however.

Axe
05-01-2011, 12:49
I figured I'd leave an update in case it will be of benefit to someone else out there.

After continuing PT with no definitive benefit for several months, I contacted Dr. Lev Nazarian at Thomas Jefferson University in Philadelphia in January, 2011 to discuss Dry Needling. Nazarian is an interventional Radiologist and a Professor at Jefferson University.

I checked into Dry Needling as the other alternatives such as ECSW Therapy and Platelet-Rich Infusion were deemed experimental and not covered by my insurance.

I left a message for Dr. Nazarian, expecting a staff member to return my call. To my surprise, the Dr actually called me back and spoke with me personally. He spoke with me for about 30 minutes describing the Dry Needling procedure. He said there was a 90% efficacy rate, almost-immediate return to weight-bearing ability, and next to no risk of morbidity.

That made the decision between traditional surgery (significant morbidity risk and downtime) and Dry Needling a no-brainer to me.

I made an appointment and went to Philadelphia on Feb 17, 2011 to have the procedure done.

After a physical exam and view of the plantar fascia using ultrasound, Nazarian gave me a posterior tibial block and then inserted a 3 1/2" needle in the back of the heel. Nazarian then worked the needle in and out throughout the plantar fascia using a sawing motion to break up scar tissue and adhesions.

The procedure was done in an exam room, and took less than 20 minutes.

Nazarian said he can feel the scar tissue as well as visualize it on the ultrasound, as penetrating the scar tissue feels like trying to puncture a rubber ball with the needle.

Following the procedure, I was instructed to remain non-weight-bearing for 24 hours, then walk as tolerated, do PT for 4-6 weeks, and avoid anti-inflammatories for a few months.

To my surprise, I was able to tolerate walking immediately after the 24 hour rest period, though the foot was stiff and painful. The post-procedural pain was MUCH less than I was expecting however. I was in far less pain than I had been in following Cortisone injections.

I had a slowly-progressing recovery that resulted in a complete elimination of pain when at the 8 week point, about two weeks ago. I have been able to start walking again without pain.

If I had the traditional surgery, I'd be getting out of my cast and maybe starting to walk now. With Dry Needling, I was able to stay ambulatory, with far less risk of adverse effects, and am confident that I have made as complete of a recovery as is possible.

I walked 2 miles the other day and didn't have any pain during or after. It doesn't get much better than that after having been on invalid status for almost two years. I wish I had undergone this procedure a long time ago!

I'd strongly recommend Dry Needling to anyone suffering from recurrent/recalcitrant Plantar Fasciitis looking for alternatives to traditional Plantar Fascia release surgery.

Boomer-61
05-01-2011, 18:38
Axe,
It just doesn't get much better than that. Thanks for the update.

prof.tomjohnson
05-30-2011, 10:05
As one who went to Primary Care, Orhto, Podiatry and even PT to no avail. I tried stretching daily using the yoga face-down-dog. Over two weeks, I had positive results. I continue to do this stretch daily (with occasional missed days) the 'spuring" resolved and has not returned. Just as another message posted, stretching works where drugs fail.
TJ

hoot72
06-10-2011, 00:19
I just about recovered from this and all I can say is this is absolute torture for those who have it.

I went to a podotrist (foot specialist?) who figured out in part why I was having problems and made some suggestions which have ultimately proved extremely beneficial.

1. I had over pronating feet which meant I had to change the type of running shoes I used for ultra marathons (100k-250k races) and every day use. I am now using Asics Nimbus Gel running shoes which are fantastic on the feet.

2. I do some very basic stretching exercises for the feet when the pain hit in the mornings and nights which helped a lot.

3. I had to lose weight and it meant off loading 15kg which has helped.

4. Had to do more stretching exercises for the achilles and calf muscles before training and a proper warm down after training.

5. I use 2XU calf support tights to race with and 2XU long tights to sleep in to help with blood circulation. I think it MAYBE helps 3%-5% so don't expect miracles but for me, I find I wake up the next day feeling much better rather than sore. I can't say if the 2XU stuff is making the difference but I think a combination of all 4 things above plus sleeping with the compression tights do help blood circulation in the feet.

If you are using combat boots or standard trekking boots, you need to get insoles customed made for your feet and/or to give more cushioning for your heel and mid-foot.

Hope it helps someone.

My PF problems also coincided with lower back problems I have suffered so it's possible several things have brought this about.

Axe
06-10-2011, 06:15
I'm walking 4-6 miles a day now. I am able to stay on my feet 12+ hours without pain. I am having no issues and consider my PF to have completely resolved, knock on wood. I am slowly and gradually starting to lose the weight I had put on during the three years I was hobbled up.

I am incredibly grateful to be able to stand for more than 1/2 hour at a time and be able to walk farther than 1/8 of a mile again! Until I went through this and lost my mobility, I had no idea just how much it incredibly sucks.

I feel like I have gotten my life back.

MtnGoat
06-10-2011, 08:48
Great Tread!!!!!!!! :lifter

I have had Plantar Fasciitis for about 4 years now. Done the stretches, exercises and OTC and Cushion inserts. Nothing really has worked. Iím taking a great made now but donít have the bottle with me now. I will post later on what meds it is. This really has been the only thing to help me. It also runs in my family. My sister is a avid runner and devolved it four years ago and after some stretching she got rid of it.

Iím 5í10Ē and was 210ish with about 14% to 16% BF. Since getting Plantar Fasciitis I seem not to break 220 and run as best as I can. Weight has jumped up to 250 before when Iím in shit ton of pain. I flout around 225 to 240 for the last year. For anyone try swimming if you have a pool to get into. It helps out, you just have to work harder and swim harder to lose the weight. Treadmills run on a 3% incline so you get something out of it. I do intervals for 20 to 30 mins on a mill. At 40 y/o and 41 y/o I beat or did better on my AFPT then some of my team mates of <33 y/o. So donít let it hold you back, you have to learn to work through the pain and BS of Plantar Fasciitis.

Otherwise good luck,

ezrida
06-16-2011, 13:11
Hi
For me it all started with plantar fasciitis. The best cardio exercise for someone with plantar fasciitis is swimming and riding a bicycle. I used to run and I got plantar fasciitis so I started to swim and cycle. Today Iím better with my PF so I ended up as a triathlete. I have finished my first olympic triathlon race a month ago.
There are many things you can do to treat your PF although I understood that treatment efficiency is very individual. If something works for one it will not necessarily work for the other.
I have found taping very useful. Taping will keep your foot from getting injured again and will help you get through your daily routine and exercises.
I found a very informative website in:
http://www.plantar-fasciitis-elrofeet.com
Take care & Good luck

Doctor Porkchop
06-22-2011, 20:58
Plantar fasciitis has been with me for four years now, up until last year I had about six months of without s/s then 4 to 6 month flare ups, until last summer when it really hit me, tried everything from custom made orthotics to cortisone shots, nothing worked, did a lot of research and stumbled on several articles on PF and barefoot/minimal shoe running, I had nothing else to lose so i gave it a shot. First month was extremely painful but kept going, by the middle of the second month I was able to run without problems for about four miles, fast forward a year later I have no pain while walking/running/Rucking, I still have some pain but only if you put a lot of pressure on the affected area, I have used the Nike frees ever since and would not try other shoe for running, it works so good that I'm even training for a marathon later this year, if anyone is interested pm me or google PF and barefoot running so you can understand the theory behind this approach, I know several individuals that have tried it and it has worked so far

1stindoor
06-23-2011, 08:33
My .02 cents.
I've had Plantar Fascitis for several years now. It comes and goes in severity depending on how much I'm pounding the pavement. At it's worst I've been able to lower the pain/discomfort level considerably by stretching at night before going to bed. This helps probably more than anything else when I first get up in the morning.

I've also all but eliminated running from my normal PT activities. I walk and bike normally now for cardio and it's made a world of difference.

This was probably the best advice for dealing with it over the long haul..."one just decides what one can endure and drives on."

Boxer99
12-26-2011, 12:40
Disclaimer: I'll of course add in the initial caveat that I am not a Dr., but I did want to provide my story as it might spark some ideas, etc. I sought out a CHEK Level-IV practitioner with whom I have worked with in the past for another issue. Though the original topic was posted last year, I figured that I'd share some info from my personal experience with a PF issue and add it to the vaults.

My PF Experience: After having been hit with 2 bouts of PF this year, I have learned a lot regarding some potentially very helpful ways of at least managing the issue. My PF issue I believe was caused by an opposite side hip issue which caused a shift in weight to the unaffected side, which then took up more body weight when running, longer ground contact time, etc., and then the resulting PF from bearing too much impact. As another caveat, the first bout was in doing something training-wise which was just stupid. I deviated from my normal training, tried an approach I'd never taken before and got hit with PF. The issue never was really treated, just stretching, and it came back with a vengeance!

A Few Potential Causes: This actually leads to one way at looking at PF, as many times an imbalance issue, not just an overuse issue; especially if it is occurring only on 1 side.
http://charlieweingroff.com/pdf/TheTop10TriggerPoints.pdf

In the doc above, I believe that Dr. Nickelston mentions that you could probably bet on opposite side hip issues. (and I also recommend checking out Weingroff's site, he is MARSOC's lead PT....please don't hammer me on the MARSOC reference ;-)
I just pretty much know in hindsight this was my issue.

Whether the issue is due to hip issues is not something anyone on the internet could actually diagnose. I'd recommend someone like a CHEK Level IV practitioner or someone to start looking at any left/right strength/muscle imbalances. That being said, if you want to go back to hips as a potential culprit, many cases of PF have been traced back to overpronation which also can be the result of improper hip rotation in the form of anterior hip rotation. Tight rectus femoris (and other hip flexors TFL, ITB), illiopsoas (also a hip flexor), lumbar erectors,and lats too can all be culprits in the causing this anterior hip rotation which then can translate in lower extremity compensations such as overpronation. However, folks that run a lot, and even those that are just the opposite and sit on their butts all day likely have tight rectus femoris, hip flexors, etc. and would likely benefit from dedicated work on keeping these muscles stretched well as sedentary folks also get hit with these same muscled becoming overly tight and the resulting postural shifts.

What worked for me at least: As far as what helped me from a treatment end....deep soft tissue work. I use the rounded but still somewhat pointed back end of a screwdriver. I simply didn't want to wait for the order of an NMT tool to come in to give this a go; it worked almost immediately and I kept on using it. Basically I did a lot of very deep strokes all along the bottom of my heel, calcaneus, and even along the bottom of my foot. I did this in multiple directions and get in pretty deep and slow into the heel area tissue., but not on the achilles. I'll do this when squatting and shifting my weight to one foot while in a plantar-flexed position, as well as then sitting on my butt and just pulling my feet back into dorsiflexion and doing the same series of massaging. Typically I really hit the sore and tight areas a little extra in the fascia, but because the fascia lines from the bottom of the foot near the toes all up through the achilles and into the gastroc/soleus area I treat that area as well. In the gastroc/soleus and areas above the achilles I use my thumbs to get in and do the massage work. Basically put my two thumbs together like an arrow point, and run multiple slow deep lines down the gastroc/soleus muscles, and all of the way down to the area right to and above the achilles. The work higher up in the leg is good in case the issue lies there in form of a trigger point and also just in case any resulting overcompensation has started causing trauma which might not be manifesting itself yet.

The old rolling on a golf ball did absolutely nothing for me. For me the deep and direct tissue work is what it took.

Finally, I like some very long fascial stretches of the gastroc/soleus area, in the form of both straight leg and bent knee stretches. I use an angled surface to basically wedge my feet upon, you don't want to try these hanging off of the edge of steps, etc. I go for 3 minutes each side, in both of the two positions. If you are trying these for the first time, you might want to do them in 30 and 60 second holds, alternating sides, as a gradual build-up until you are ready for the longer 3 minute holds. You definitely want to be cautious in not overstretching the first time you do this in the form of putting your foot in too extreme of a stretch position. Where you will have to be cautious is if you get hit with pain especially in the form of extreme tension in the PF area. When I was first doing this after the onset of PF, it was paaaaiiinful. It is also why I'd recommend trying to do the soft tissue work before the stretching as it really takes a lot of tension out of the fascia as well as warming it up.

If you do this, I've always been advised to do all of this on the opposite foot, even if it is not affected. You then run the risk of treating one side and getting better and then getting f*ed on on the other side of the body. Part of massage, NMT, etc., is to provide feedback to the body as well as literally causing some tissue and adhesion breakup. You do this to one side only and it has the potential to cause issues if not balanced out.

Also, go back and forth on both feet/calves, etc. You don't want to beet for minutes upon minutes at a time. The body needs some chance to respond to the stimulus of the massage as well as giving the tissue a break. Don't go overboard the first time you try it.

Personal results: I went from being where I couldn't run for a week due to PF setting in so badly that after that week off, I was stopped cold 5 minutes into a run. Two weeks later I was getting back to some "tempo" effort in some of my runs. A month later I was running 5-6 days per week again. 2 months later I am now back running every day, 2 running workouts per week (10 miles w/ w/u & c/d) and a long run of 12 miles.

Some Extras: What I still do as a precautionary measure if my PF feels a little tweaked is to use a 9V or 6V battery and take electrodes attached to each side and apply them above and below any tight areas in the PF area, for 5 minutes before running. This helps calm area before running if I need it.

This has not been an immediate cure-all and it is something that I still tend to daily. But I am running again and running well. Running specifically (and being Capt. Obvious here) can be a hard activity and very few people want to be told that they will have to do the extras such as which I have to do, to keep running. My PF issue gets better and better and my training is ramping up again. It just comes down to what one really loves doing, I love running and so the extra time staying healthy is worth it to me. (Don't tell this to the general public though, who get an injury and then just give it up and chalk it up to age, or some other excuse). I didn't want to go to a regular Dr. and definitely didn't want to get a cortisone shot as I've read of experiences of some sort of compromising of the fascial tissue quality after the shot. I understand that the shot is for healing but also didn't want to be completely numbed from the pain as it is a signal to me whether something is going wrong, or in the absence of pain, likely a sign of getting better.

Even very elite runners have suffered from PF so I don't view it as age-related, etc. I'd rather have not had the PF issue to begin with. But I do like knowing that I have the knowledge to deal with it while allowing me to carry on.

Anyways, just some info of what has helped me.

greenberetTFS
12-26-2011, 15:40
Boxer99

Where is your profile?..........:rolleyes:

Big Teddy :munchin

Boxer99
12-26-2011, 20:05
I think it is viewable now.

As I was scrolling back through the previous posts, Doctor Porkchop made a comment to which I can also relate. I've never been one to run in very heavy trainers/running shoes. But in the past month have gone back to doing most of my running in a lightweight training/racing flat and this has also helped the issue more. I believe that the increased proprioception helps get a better feel, as well as allowing for some slight adjustments in my stride to and to simply react faster. I also believe that with a more minimal shoe, there is less give or play due to less sole and cushion material that would allow more movement and give in the foot.

In fact I also used to run exclusively in Free's but didnt like some of the changes Nike started making to the line. It didn't take me too long either to get back to more of a training flat for most of my running.

hoot72
12-27-2011, 02:55
I think it is viewable now.

As I was scrolling back through the previous posts, Doctor Porkchop made a comment to which I can also relate. I've never been one to run in very heavy trainers/running shoes. But in the past month have gone back to doing most of my running in a lightweight training/racing flat and this has also helped the issue more. I believe that the increased proprioception helps get a better feel, as well as allowing for some slight adjustments in my stride to and to simply react faster. I also believe that with a more minimal shoe, there is less give or play due to less sole and cushion material that would allow more movement and give in the foot.

In fact I also used to run exclusively in Free's but didnt like some of the changes Nike started making to the line. It didn't take me too long either to get back to more of a training flat for most of my running.


I am using a pair of New Balance barefoot style trail shoes and they are fantastic to wear but a totally different feel from wearing normal running shoes. BUT, they are simply not for people with PF or arthritis of the feet. Maybe it's a case of different strokes for different people perhaps?

Anyways...my PF has subsided..it's the arthirities that's killing me..and I am not touching pain killers or meds to bring down the swelling....just trying hard not to over do things.

It's really a issue with body weight more than anything and putting our feet/ankles through a lot over the years.

Wonder what the soldiers in World War Two had to put up as they aged..i.e. shin splints, busted knee's, ankles, PF, arthirities...etc.

Boxer99
12-27-2011, 11:59
Very true in regards to different strokes.

I am not saying that any of this is the case as I am not qualified to make any diagnosis, but from what I've learned in picking the brain of more qualified folks, one way of looking at some of what you mentioned and the possible relationship between your PF and your back pain, along with carrying extra weight (in other words a combination of factors even).

Lets look at one possibility in that an anteriorly rotated/tilted pelvis was causing overcompensations further down the kinteic chaing in the form of overpronation and leading to the PF. If the pelvic rotation was due to overly tight hip flexors, this usually coincides with inhibited glute muscles. When the glutes aren't firing propery and are essentially shut off, a lot of the support could easily be taken up by the hamstrings and also the lower back. Many really good PTs will look at the area with the symptoms and then also start checking above and below the kinetic chain. The lower back issues could be a symptom of this.

Again, I'm not saying this is the case, but it is a fairly common occurance and sequence of events from what I understand.

Heck, there could be a lack of scapular stability leading to a rounding of the shoulders. The body's primary instint is to maintain the balance of the noggin' in its position over the body, and this could have then caused gradual pelvic shifts on down. I've even been advised of cases of people having had PF treated by working on the tonus of the cervical extensor muscles because of these connections through the fascial chain.

Really amazing how the body works.

I have also wondered myself about the long-term effects others have had to deal with from continued movement and running in heavy leather boots over the course of a career as compared to modern days. Working in boots is just a part of the job, but there have obviously been huge strides in the mobility and articulation modern boots allow.

hoot72
12-28-2011, 00:06
I am a firm believer your body weight also plays a part in what happens with your hips, knees and feet...not that I am an expert by any stretch of the imagination. All I know is it's brutally painful having PF and it's something I wouldn't wish on anyone.

Bishop
04-24-2012, 05:34
The pain is usually distributed in a horseshoe pattern around the outside edge of the bottom of the heel, as well as the center of the bottom of the heel. The pain will extend to encompass the midsole area of the feet as well when I push exercise.

I have similar pain on my left foot and only my left foot. After my 6-7mile run I just couldn't support my weight while walking (running was out of question) and pretty much made me limp. I can however stand up and stay up without any pain, it only comes when I maneuver on my left foot. The pain is as you describe it, a horseshoe formed pain or a half horseshoe, where it goes from the bottom of heel to the outter part of the sole (pain stops midways on plantar fascia)

I am 6'1 and 178,5 pounds.

I've used some anti-inflammatory gel (Voltaren, 11,6 mg/g Gel) and tried some foot stretching it seems to ease the pain, I have yet to talk to my doc.

MtnGoat
04-24-2012, 10:30
I have tried just about everything. Inserts, custom inserts, got molds, x-rays, shots. Never cut on, never would.

I'm glad this thread got bumped. Friday I got high intensity Shock-wave therapy for my plantar fasciitis. I had it in both feet. I have not had any pain since. This had been hands down the best thing for my treatment. My Doctor had been telling me to do it. But with it being so new in the military I was skeptical.

My .02 do it, if you have planters fasciatus.

For all of the Docs on the broad. One issues I did have happen wad I had rotator surgery back in 2006. Friday evening that shoulder started to hurry just like I a rotator cuff injury. It is pretty much gone now, some minor discomfort. Wondering how I can find out if it is from the shock wave treatment. Yes I have called my Doctor his nurse told me they have never heard of that. Just waiting now on the great Army appt system.

VVVV
04-24-2012, 12:27
My latest battle with PF was ongoing for about 3 months and getting more debilitating. Two thing that are helping.

1. Orthera Orthotic Inserts...Purchased at Costco 2 pairs ( 1 active, 1 dress) for $30. I now have 6 pairs!

http://www.orthera.com/orthotic-footwear-inserts-orthera-active/

http://www.orthera.com/orthotic-inserts-orthera-dress/.

2. Ace Night Splint...purchased at Walgreens for $33. Later found the same thing (different brand -3M) at Publix (Supermarket) Pharmacy for $25.

http://www.diyhomenetwork.net/free-home-design-software/landscape.html


The night splint worked wonders for me......morning pain was almost gone after the first night.

greenberetTFS
04-26-2012, 12:37
Have you tried SynVisc ?........It works for me but they claim you're only aloud 1 shot every 6 months,in between those shote I get cortisone......;)

Big Teddy :munchin

Oldrotorhead
04-26-2012, 14:08
My wife and a Doc. in town have found that wearing Crocs around the house and in place of flip flops when very informal is OK. They never go bare foot. They both claim the Crocs help a lot, I don't have any medical evidence of this, but for $25 it may be worth trying.

VVVV
04-26-2012, 15:11
My wife and a Doc. in town have found that wearing Crocs around the house and in place of flip flops when very informal is OK. They never go bare foot. They both claim the Crocs help a lot, I don't have any medical evidence of this, but for $25 it may be worth trying.


There are a lot of people who would disagree with that recommendation.

http://www.thebackpacker.com/trailtalk/thread/49221,-1.php

BTW as someone in that link mentioned.....try a pair a Merrell sandals! Expensive by darn well worth it!!! My wife has various foot ailments and her podiatrist recommended them (that's [and Asics running shoes] all she's been wearing the last 3 years...it changed her life!!

VVVV
04-26-2012, 16:56
Plantar Fasciitis Treatment & Management

http://emedicine.medscape.com/article/86143-treatment

Oldrotorhead
04-26-2012, 18:43
Here is some info on Crocs and foot pain. Again I have no first hand experiencewith this but my wife has one less thing to complain about.


http://diabetes.webmd.com/features/crocs-healthy-shoes-just-comfy



Crocs are certified by the U.S. Ergonomics Council and the American Podiatric Medical Association. Hanson says that what Crocs lack in aesthetic value, they make up in therapeutic benefits. The company created what it calls an Rx line of models specifically with healthy feet in mind: Croc Relief, Croc Cloud, and Croc Silver Cloud.

"These shoes were designed specifically to eliminate plantar pain and achy feet," says Hanson. "They also help people with injured feet, bunions, and diabetes. You've got a lot of inner support, heel cups and massaging heel nubs, and arch support. They're ideal for people with foot problems.

Hernando
02-27-2013, 20:41
I've got a dilemma that I could use some advice on. I'm currently a little less than 60 days from shipping active duty for 18X. I've been in the Guard for six years and I'm already an 11B so I'll just be going to Airborne, SOPC, and then Selection.

In the start of December I came down with plantar fasciitis. For about the first week it hurt bad in the morning and I had the typical symptoms. Currently it barely bothers me at all. At most it's nothing but a dull ache in my arch. Sometimes it doesn't bother me when running and rucking, and other times it does.

I stretch my foot daily, I use moist warm heat, I've bought insoles, and I use the calf massager daily as well.

My biggest issue is that because of this I've very much been limiting my ruck marching hoping to heal this. My cardio has suffered some but not much because I've maintained high intensity workouts thru crossfit. Being though that I'm two months from shipping and roughly four months from selection limiting my ruck marching and running isn't an option for me anymore.

My biggest concern is that I push thru it now but durning selection it flares up and becomes a major issue.

So I seek advice on how to proceed from here.

hoot72
02-28-2013, 00:15
I have found the Salomon RX Break sandals as a good sandal to use in doors and outdoors for PF.

I also have reverted to using nike ACG sandals day to day and not using leather office shoes and have no PF problems.

Also, when I do get the pf pains, the golf ball works brilliantly in solving the issues in a couple of minutes after pushing down the heel on the golf ball and rubbing it forward and back for a couple of minutes at night and in the mornings when the pain is at it's worst.

Hernando
02-28-2013, 16:20
I have found the Salomon RX Break sandals as a good sandal to use in doors and outdoors for PF.

I also have reverted to using nike ACG sandals day to day and not using leather office shoes and have no PF problems.

Also, when I do get the pf pains, the golf ball works brilliantly in solving the issues in a couple of minutes after pushing down the heel on the golf ball and rubbing it forward and back for a couple of minutes at night and in the mornings when the pain is at it's worst.

That is something I haven't done yet is get flip flops to wear around the house and such. I need to make a trip to the store and pick some up. I'm bad about walking around the house barefoot sometimes. I tried the golf ball this morning as well. That seems to work better than using the massage roller on my arch. Is able to get a deeper massage out of it.

Speaking from experience, and as someone who treats this condition regularly, and I've stayed at a Holiday Inn Express:

You may have bought insoles, but are they top of the line for shock absorption and support purposes? If so, and you're still having PF issues, its time to see someone who can make a set of custom orthotics. (And not a damn Dr. Scholl's store.)

Do you massage your feet after every run and ruck?

Are you dropping pack and elevating your feet during ruckmarch halts longer than a couple of minutes? Are you taking halts at all?

If you're still having PF issues, you may need to use a strassburg sock.


Are you willing to spend the money to see a physician who treats this condition? If your best efforts still come up short, this may be the best COA.


Be advised: These comments in no way constitute a diagnosis, treatment plan or prognosis. Good luck.

What would you consider top of the line? Currently for running and crossfit I use the Superfeet blue inserts. For rucking and everyday wear I use the Superfeet DMP inserts.

I usually don't massage my feet except in the morning and evening but I'll start adding that in after runs and rucks as well.

As of now the only halts I take when I ruck are for stretching, and usually if I stop at all for that it'll be at the very beginning. Usually though I've try to go the entire length of my ruck without a halt. I'll start adding in halts and elevate my feet while doing so.

I've got a strassburg sock but I usually don't wear that unless I don't have inserts in the current shoes I'm wearing.

Honestly I'm not concerned about the money. My biggest concern is simply getting my foot back to a 100% before I arrive at selection.

hoot72
03-01-2013, 01:05
That is something I haven't done yet is get flip flops to wear around the house and such. I need to make a trip to the store and pick some up. I'm bad about walking around the house barefoot sometimes. I tried the golf ball this morning as well. That seems to work better than using the massage roller on my arch. Is able to get a deeper massage out of it.

.


Yes, I find when you use the golf ball, it really 'gets in there' and helps with the inflamation of the tendons (i think) and generally is a great help in easing the pains in the mornings and nights.

Someone else suggested it to me..can't recall who though.

MtnGoat
03-02-2013, 00:01
I have Plantar Fascitis since 2007. I have had Shockwave treat and it worked on one foot. I wear all kinds of inserts, some work and some didn;t. They best thing I have found to help me out is lower (Calf) stretching exercises. I had a PT tell me this is what is the root cause of the inflamation of the tendons.

One leg forward and one back. Front leg bent a bit and lean into a wall supporting yourself with your hands on the wall. You MUST stretch for over one minute. Try working yourself up to 5 mintues for each leg. Longer the better, I even do this just standing around talking to people through out the day. I has really help me with my pain.

Hernando
03-02-2013, 20:54
Yes, I find when you use the golf ball, it really 'gets in there' and helps with the inflamation of the tendons (i think) and generally is a great help in easing the pains in the mornings and nights.

Someone else suggested it to me..can't recall who though.

I've started using the golf ball and I can already tell it's doing more for me than the massage roller was. Like ya said, it just gets in there and does a great job of hitting the right spots. Appreciate the good advice.

I have Plantar Fascitis since 2007. I have had Shockwave treat and it worked on one foot. I wear all kinds of inserts, some work and some didn;t. They best thing I have found to help me out is lower (Calf) stretching exercises. I had a PT tell me this is what is the root cause of the inflamation of the tendons.

One leg forward and one back. Front leg bent a bit and lean into a wall supporting yourself with your hands on the wall. You MUST stretch for over one minute. Try working yourself up to 5 mintues for each leg. Longer the better, I even do this just standing around talking to people through out the day. I has really help me with my pain.

I will have to add this to my stretching routine. I've been doing a lot of stretching but nothing that long. I was just doing your typical 15-20 seconds several times a session. One of the things that started making a big difference for me was using the massage roller on my calf. Stretching for that long should just help all the more.

Dusty
03-20-2013, 08:18
I developed a case after I had a lisfranc dislocation. Running in sand barefoot and wearing flipflops helped for some reason.

Hernando
03-21-2013, 19:16
I developed a case after I had a lisfranc dislocation. Running in sand barefoot and wearing flipflops helped for some reason.

I may have to see if I can track down some sand to run in, sadly not much to go around here.

I've been wearing some superfeet flip flops and they have seemed to help improve it some.

VVVV
03-21-2013, 22:44
My latest battle with PF was ongoing for about 3 months and getting more debilitating. Two thing that are helping.

1. Orthera Orthotic Inserts...Purchased at Costco 2 pairs ( 1 active, 1 dress) for $30. I now have 6 pairs!

http://www.orthera.com/orthotic-footwear-inserts-orthera-active/

http://www.orthera.com/orthotic-inserts-orthera-dress/.

2. Ace Night Splint...purchased at Walgreens for $33. Later found the same thing (different brand -3M) at Publix (Supermarket) Pharmacy for $25.

http://www.diyhomenetwork.net/free-home-design-software/landscape.html


The night splint worked wonders for me......morning pain was almost gone after the first night.

11 months later...I'm free from plantar pain. I still were the orthotics in all my shoes, and the night splints while sleeping. :D:D

Bortz
07-31-2013, 15:58
deleted

hoepoe
01-19-2014, 09:41
I had a bout with PF for just under a year.

Treated it with rolling a frozen soda bottle (plastic) under my feet, rolling a hard bouncing ball (gold ball size) under my feet when at my desk but that didn't seem to help

Then i changed to minimalist shoes, and walked in them (didn't run due to the PF), used a baking roller to "push out" my calves, slept with a PF specific brace and started stretching my calves every day.

I don't know what the actual solution was, but i respect the PF and how much of a nuisance it can be.

For me it seemed that the source was the tight calves. I still stretch them multiple times per day, especially on days that i run.

I pronate and was running in very cushioned, very supportive shoes when the PF started - that's what sent me to minimalist. I know use a "light" version (4mm drop) of minimalist shoes to run in and they're great. The extreme minimalist shoes (0mm drop) created other issues when running more than 3miles.

H