Plantar Fasciitis

[UMP25]

Originally Posted by Texas Aggie

I don't have PF (achilles tendonitis, instead) but my wife had PF. The cortizone shots do work long term, though short term for her, they were burning and otherwise painful. The doctor told her that happened in the minority of cases, but if you are going to get a shot (not a bad idea, btw), do it a couple of months before the season -- at least.

The shot hurt like hell when it was administered (and I do very well with shots, too), and my foot hurt for about 2-3 days, but afterward, it was fine.

[finnref]

Some tid bits from a retired ref and orthopedic surgeon. Option 1 is surgery. FORGET IT. Option 2 is cortisone injections. They work sometimes. But in my experience they did not work if not accompanied by rest. Therefore option 3 is rest. I call it relative rest because no one can stay off the foot. Ways to rest. Do not walk or run as much. Refs do not wish to do this. Therefore, space your games. Wear well cushioned shoes even off the court. Insert some well cushioned sport orthotics which may be $60 a pair. You do not need expensive custom made ones. The orthotics should have an arch support. It should be modified so that it is slightly more towards the heel of the foot and not well forward under the arch. By having it adjusted more to the rear it tilts the rear heel of the foot to the outside and takes pressure off the inside of the heel where the plantar fascia attaches to the bone. You can do this without moving the arch support. Just take some firm foam rubber or felt and tape it under the orthotic on the inside of the foot as an extension of the arch support to the rear. Some call this a medial heel wedge.This will not cure immediately. It will take 3 to 8 weeks depending on the severity and how well you can give it RELATIVE REST. It gets better usually in stages. First some good days, then bad etc. You are not cured till you are pain free for 3 weeks. Then keep wearing the cushioned orthotics when you ref. Hope this helps.

[Robert Goodman]

A number of years ago I had a case much milder than yours and had a friend give me an acupuncture rx. I can't tell whether it made a difference (I got over it fairly fast), and I got only one treatment, and she said it would take several treatments to really work. (The real story was that I was dating her. An acupuncture date -- top that one for unusual, huh?) Just thought you'd like to know that the treatment exists, maybe someone else knows better how well it works.

Right now I'm laid up following plantar wart removals from both feet. One on my left foot had gotten to silver dollar size. It's been 5 weeks for the big wound to heal, and more to come. I can walk, but with enough difficulty that I stay off my feet as much as possible, and many days don't even get dressed. A depressing summer, had to quit football coaching.

Robert

[rainmaker]

Originally Posted by Robert Goodman

(The real story was that I was dating her. An acupuncture date -- top that one for unusual, huh?)

No, please DON'T top that!

[Mark Dexter]

Originally Posted by finnref

Some tid bits from a retired ref and orthopedic surgeon.

Are you the retired ref and orthopaedist? If so, can you send me a PM? I have a few questions.

[Mountaineer]

Originally Posted by Texas Aggie

I don't have PF (achilles tendonitis, instead) but my wife had PF. The cortizone shots do work long term, though short term for her, they were burning and otherwise painful. The doctor told her that happened in the minority of cases, but if you are going to get a shot (not a bad idea, btw), do it a couple of months before the season -- at least.

OK, there are a couple who recommend the cortizone shots - let me weigh-in on the other side: DO NOT DO IT! If you get one and it help and the pain doesn't come back - great. If it does come back do not - DO NOT get more shots. I had some problems with PF and eventually achilles tendonitis. I've had a good bit of shots (2 or 3 per year). Everytime I would get one the doc would say that these are not good long term because they cause the soft tissue to weaken. But they still shot me every time.

I remember the day that my achilles tendon snapped - I was umpiring a college softball game and it wasn't pretty. It was April 29, 2006 and I'm back in therapy to get some strength back. I can officiate but I still have some physical problems. My first basketball game after the injury was horrible! You do not want to risk this type of injury.

That's my 2 cents . . .

[Jimgolf]

See a good reflexologist. It may not cure you, but it feels pretty good anyway. And the metaphysical mumbo jumbo can be very entertaining.

[refprof]

This is my experience with PF.
Cortisone shot. Try once. If it brings relief (with icing, rest and streching) you are lucky.
Acupunture. I tried #1 and after 3 more months of discomfort, i tried acupunture. After 3 treatments, is was gone for good.

Shoe inserts. I used them for 18 months. worked with my foot, but threw my hip out of wack. In the past week, I discarded the inserts and my hip is getting better.

[RefAHallic]

I sort of self diagnosed my PF two years ago after researching online, etc. The morning after a game my first steps I resembled walking like Frankenstein. Anyway, the remedy that worked for me were stretching/flexing the foot with a towel (looped around the foot just below the toes) before getting out of bed. It wasn't long before the pain was gone. I've been pain free since. However, one of our officials who is a physical therapist told me there will be a re-occurence.

[ranjo]

My PF came and went for a number of years while I was putting in a lot of running on the roads to train for long distance running events. Two years ago I thought I was going to have to give up running and officiating basketball altogether because of the pain. I went to a sports medicine specialist who offered the "silver bullet" (cortizone shot) and gave me a catalog of different appliances to look at. I borrowed a night splint from a friend who swore by it and gave me instructions on how to use it.

It was very uncomfortable to wear all night and many times I would have to take it off before morning. I wore it every night for about three weeks. By the end of the three weeks the pain was gone and I haven't had a recurrence for over a year and a half.

Don't know if it will work for everybody, but it sure did the trick for me. A website I found to get good information is www.heelspur.com

[Jimgolf]

Ironically, yesterday I read an article about a study on non-surgical treatment of plantar fasciitis, an excerpt of which follows:

A new stretch is proving quite effective to help treat and potentially cure plantar fasciitis, a condition that affects nearly 2.5 million Americans each year. In a study recently published in Journal of Bone and Joint Surgery, researchers found that patients suffering from the painful heel spur syndrome had a 75 percent chance of having no pain and returning to full activity within three to six months of performing the stretch. In addition, patients have about a 75 percent chance of needing no further treatment.

The study is a two-year follow-up on 82 patients with plantar fasciitis, all of whom were part of an original clinical trial of 101 patients in 2003. The patients were taught a new stretch that specifically targets the plantar fascia developed by Benedict DiGiovanni, M.D., associate professor of orthopaedic surgery at the University of Rochester and author of the study, and Deborah Nawoczenski, P.T., Ph.D., professor of physical therapy at Ithaca College.

The stretch requires patients to sit with one leg crossed over the other, and stretch the arch of the foot by taking one hand and pulling the toes back toward the shin for a count of 10. The exercise must be repeated 10 times, and performed at least three times a day, including before taking the first step in the morning and before standing after a prolonged period of sitting. More than 90 percent of the patients were totally satisfied or satisfied with minor reservations, and noted distinct decrease in pain and activity limitations.

The complete article is at http://www.urmc.rochester.edu/pr/news/story.cfm?id=1275

[jmaellis]

Thanks for all the great advice. I saw my PCP the other day and thankfully she referred me directly to a podiatrist. Unfortunately, my appointment with him isn't for another two weeks. While I'm waiting I think I will try some of the strategies suggested in this thread.

Thanks again!

[fitump56]

Originally Posted by jmaellis

Thanks for all the great advice. I saw my PCP the other day and thankfully she referred me directly to a podiatrist. Unfortunately, my appointment with him isn't for another two weeks. While I'm waiting I think I will try some of the strategies suggested in this thread.

Thanks again!

Do no such thing. PF is symptomatic to overuse. Stay off, rest, ice as much as possible.

[Ref_in_Rehab]

I pay the camp tuition fees by working as a physical therapist....here goes

1. Stretch your calves like crazy--- loop a towel around your foot and pull back to get a good stretch before getting out of bed in the morning, find a stair during the day, prop your foot up against a wall and lean forward, etc, etc, etc. Seriously, you should be stretching at least 4-6 times a day- don't make it hurt, just get a good stretch out of it, hold it for 20-30 seconds, and repeat, repeat, repeat.

2. Get good shoes with a good arch supporting insole. There really isn't a difference between the $400 custom orthotic the podiatrist will try and sell you vs. the $20 arch support from the sporting goods store. I recommend a full length support, not one that ends just past the arch. If you're working on your 2nd or 3rd season in the same pair of shoes, get a new pair.

On this note, if you have flat feet a good tape job can be helpful in a fix---find a trainer to do this for you because it's difficult to do yourself and not get wrinkles in the tape job which may cause blisters and only add to your suffering.

3. Ice, ice, ice. Ice after you do anything like running or walking. A frozen water bottle works great so you can sit down and massage the sole of your foot while working the bottle back and forth.

4. Exercises like massaging the sole of your foot with a golf ball before you run, and picking up marbles or scrunching a towel up with your toes can help loosen and strengthen your arch.

For really severe cases night splints (to stretch your foot all night long), cortisone injections (can also break tissue down, so can't be done too often), and surgery (don't go there) are options.

The best thing to do of course is prevent it---make sure you're in shape before the season begins, stretch, lose a few pounds, etc.

Sorry for rambling...hope it helps

[Mark Dexter]

Not about plantar fasciitis, per se, but a good short article about choice of proper running shoes.

http://www.cnn.com/2007/HEALTH/07/23...oes/index.html