Plantar Fasciitis

[onekgguy]

Does anybody have any experience with this? I used to have heel spurs as a kid and I don't remember doing anything for them other than walking with my heel raised. I developed the pain a few days ago. I find that when I'm on my bike I experience no pain at all. Walking is another story. Is there a particular shoe insert which helps? Stretches? If rest is the answer, how long do I need to stay off my feet? I've got an appointment this afternoon with a nurse practitioner and I'll go from there. I thought I'd post something here to get a better understanding from a rider's perspective. Thanks.

Kevin

[JohnS]

I had it pretty bad a few years ago. My first 10 steps in the morning were very painful. I hobbled like an old man. I went to a podiatrist and he gave me cortisone shots in the front of my heels. I started wearing
Superfeet in all of my shoes (I'd only worn in some previously) and haven't had a problem since...your results may vary! :)

[lemondsteel]

I agree with the cortizone shot. I too experienced no pain riding but walking hurt like the devil. Be prepared....... The shot is one of the most painful you'll ever have. At least mine was. They inject it real slow and I made the doc hold my leg down or I guarantee I would have jumped off the table. A few explisitives were hollered and all was fine. When I stood up from the table it was amazing. Almost no pain. I also have the benign tumors in my arch (very high arches) and they too benifitted fron the shot. I was riding the next day and really didn't give it any rest. I did use some alternating heat and cold treatment for 3 days. GOOD LUCK!

[onekgguy]

Oh, the cortizone shot sounds like great fun! Thanks for the warning, Lemondsteel.

John...any particular brand of Superfeet? I see they've got several styles. Thanks again,

Kevin

[toaster]

I once had problems with this condition. It hurt really bad in the morning with the first steps out of bed.

The best thing for me, I found, was to do lots of repetitions of seated and standing calf raises with light weights. This and alot of stretching of the affected area. Also, there's another exercise where you crunch a towel on the floor with your toes.

The idea of exercise and therapy helps with blood flow which is going to be the trick to getting past this.

[rePhil]

Doc surprised me by saying he wanted to treat it "aggresively". After ultrasound that confirmed it He gave me a Cortisone shot and wrapped it.He advised rest,ice and to always wear shoes. Went back in five days for another wrap. Also gave me a silly looking plastic heel cup that really helps. He advised custom orthotics, but at over $300 I passed. Strangely, my (and others)insurance will not cover orthotics. I picked up a pair of Dr Scholls. I have been fine since but if it flairs up I will pony up for the orthotics.
Interestly my pain was at it's worst wearing my cycling shoes and stopped at a light etc, or just sitting around the house barefoot.
Ironically during my visit the MD pointed out and I saw a young cyclist maybe 16 or so getting orthotics for his cycling shoes.

[Cinci Jim]

I had quite bad pain in the morning and then I switched to Dansko clogs for my everyday shoes and it went away in about a week or two.

[JohnS]

John...any particular brand of Superfeet? I see they've got several styles. Thanks again,

KevinThe grey ones for my cycling shoes and the lime green for my runners and hikers.

[Larry8]

Had it on one foot pretty bad, saw a podiatrist and got custom orthotics made. It doesn't hurt when you bike because your stretching out the heel when pedaling.
I limit walking barefoot and wear birkenstocks around the house to keep my arches supported. They do make splints that hold your foot flexed and lets you avoid tearing the heel any more. Never had andy cortisone shots. Good luck,

Larry

[Tailwinds]

Here's what I've heard from several people I know who have the same problem:

Stretching, stretching, stretching, and more stretching.

Also, getting massages regularly can help. When you're not receiving a massage from someone else, do it yourself.

Only wear GOOD, supportive shoes.

[dbrk]

A regime of well-considered therapeutic yoga directed at the problem will do more in the long run than anything else other than _always_ wearing proper, comfortable shoes. For this you need a well-trained yoga teacher and those are not easy to come by, despite all the folks bearing their own credentials. Write to me, perhaps I can recommend someone nearby.

I have this condition chronically and likely a neuroma (nerve damage) as well. In my case it may never fully heal due to the degree of damage. Let us hope yours progresses for the better.

The first few steps in the morning are crucial. DO NOT put all your weight on it before stretching and pulling apart the toes gently. The foot contracts and atrophies from the absence of pressure as you sleep. Putting weight upon it immediately is a sure way to aggravate the problem. So, as inconvenient as it is, stretch your foot with your hands before getting out of bed. This may make your day considerably better. I feel for you. Foot problems have changed my life and my cycling. In the day, I would leave early in the morning, bring lunch, ride all the day, and come home just after dark to use the lamp on my bike. Now I don't think more than four or five hours is good for my feet, no matter the shoes, orthodics, etc.

Good luck!

dbrk

[531Aussie]

The first few steps in the morning are crucial. exactlyamundo!! The trick is to NEVER walk bare foot when you've been off your feet for a period of time, especially in the morning.

This means putting shoes on before you take your first steps, even if you're just getting up for a piss in the middle of the night.

This is how I got rid of mine.

I was about to spend big money on orthotics, then it dawned on me that the worst time was those first few steps in the morning. The only time I stood without shoes was in the shower.

[Ken Robb]

I developed this problem by playing 9 sets of tennis in a row on a hard court--you know just like hoops--winners stay until beaten. I thought it was a stone bruise and kept playing. Oh the pain later!

I tried custom orthotics and they helped but the problem didn't go away completely. The ultimate solution for me was the dreaded cortisone shots and yes the are painful. It took a week or so after them before my pain subsided. My doc said it was about getting the inflamation under control so my body could heal.

Before getting the shots I sat between two orthopedic surgeons after we played tennis and listened to their contrasting opinions on how to best treat the problem. One said to just sever the plantar fascia from the heel and the problem would be fixed, albeit with some loss of "spring" in the arch. The other guy thought the shots were worth a try. Doc #1 said that the cortisone weakened the tissue and often led to a tear that then might need to be finished by surgery though sometimes the tear would be complete and surgery not required.

Doc #2 agreed but reasoned why not try the shots: if they worked great and if a tear developed and surgery was then required you weren't any worse off than if you had the surgery to begin with.

Good supportive shoes are very important and maybe you will need to have orthotics that you can move/use among all of your shoes. Resting the injured area after treatment long enough that you don't re-inflame the area is also critical.

Mine got so bad that I did develop heel spurs visible on x-rays. I think they have mostly disolved since I got rid of the pain. My understanding is that the body's response to the constant irritation of plantar faciitis is to build up calcium deposits at the site where the fascia attaches to the heel and that makes the pain worse and harder to treat so get it fixed ASAP.

I've had no symptoms for years.

[malcolm]

Get a golf ball and put it under your foot apply gentle pressure and roll the ball around with the sole of your foot (back and forth and round and round). Do this about three times a day while taking nsaid of choice. Give it a week and if it has not helped consider injections, best a concotion of steroid of choice and some version of lidocaine. The golf ball and advil will usually do it unless it is just too inflammed.

[wdlewis]

Here's a variation of the golf ball trearment.

While you're watching TV, roll an old fashion thick glass Coke bottle back and forth under your arch. Put some pressure on the bottle, but just enough to stretch the tendon that runs under your arch. You will feel some pain as you are doing this. That pain is the tendon stretching. Don't put so much pressure on the bottle as to break it.

Any cylinder about the diameter of a Coke bottle will work as long as the material won't shatter and cut you. Beer bottles are too thin and will shatter.

I did this for a week and my pain evaporated.

[slowgoing]

Old style Adidas Countrys. Best arch support ever.

http://www.zappos.com/n/p/p/7205938/c/5255.html

[Frustration]

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WWW.ESOLES.COM


The secret treat of Floyd Landis...


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[shumanmo]

I gotta go with the stretching crowd. I had it bad last year. Rested the winter, did a little stretching, deep massage and ice. Started running and biking again in the spring and it came back. Then I got serious about stretching - 3 - 5 times a day, at least 30 seconds per session. I do the lean against a wall and stretch one calf at a time method. It took a couple of weeks but that seemed to do the trick. I'm doing serious biking and running now with little pain.

[itsalldark]

Want to get rid of this problem? Do not waste your money on a custom pair of inserts---what a huge scam! A good pair of off the shelf inserts such brands as SOLE or the Spenco orthotic arch supports. Super Feet will also work, but the Sole brand is best for sure. No bare feet--not ever. After work out roll a can of frozen juice under you arch for a while---works great! Getting a shot is a really extreme way to go and temporary. Getting your arch back up into a neutral position is the key to the fix. Heel pain is the symptom---the arch is the issue--treat the problem not the symptom or it will never go away.

[Kane]

Want to get rid of this problem? Do not waste your money on a custom pair of inserts---what a huge scam! A good pair of off the shelf inserts such brands as SOLE or the Spenco orthotic arch supports. Super Feet will also work, but the Sole brand is best for sure. No bare feet--not ever. After work out roll a can of frozen juice under you arch for a while---works great! Getting a shot is a really extreme way to go and temporary. Getting your arch back up into a neutral position is the key to the fix. Heel pain is the symptom---the arch is the issue--treat the problem not the symptom or it will never go away.

I read all your responses, and this guy gave the worst advice about the inserts and the best advice about avoiding the cortisone!

Go to footdoc@wellfeet.com and read Dr. Erhenberg's (Doug E.) advice regarding plantar fascitis. Doug has worked on many of my patients over the years and a Who's Who of the cycling world including: Lance.

People with significant or painfull bunions, toe deviation, history of fracture, diabetes should see a Podiatrist. Before you ask for a cortisone shot, google cortisone and side effects.

Feet are complicated and each foot needs to be analyzed to determine the best approach. As a chiropractor, I recommend that you avoid letting chiropractors make 'custom' orthotics for you. Chiropractors are generally capable of mobilizing stiff feet, but as you suspect a podiatrist is much better at diagnosing and treating plantar fascitis and other serious foot problems.

One of my patient's had a severe case of plantar fascitis. This condition finally resolved when she started wearing sandals with arch supports at home. She used to be 'barefoot' in the kitchen, which had a hard tile floor. Wearing the orthotic/sandals made a huge difference in her condition.

If your symptoms persist you need to commit to dumping the shoes that orthotics won't fit in or which are not made to be supportive. Prada Italian loafers are a great example of an expensive shoe which works poorly with orthotics. Expect that the condition will resolve slowly and not all feet can be well managed.

good luck


Kane

[outdoorguy]

Hey all. I am an osteopath who practices manipulation from Indiana. I have had a good deal of experience treating (and curing for most) plantar fasciitis. In my experience it does not require injections. It does not require orthotics - a properly functioning foot is self supportive. What I think actually happens is that the medial (the one toward the inside) arch and the ligaments that help support it get injured. This lets the arch "fall" a bit and the plantar fascia is there to stop the spreading of the arch beyond a certain point. When the plantar fascia gets stretched because the arch has "fallen"- pain is the result. It usually takes me 2 to 3 treatments to alleviate the pain and restore the arch to its pre injury state.

If I can be of assistance to anyone, please write me directly (I don't make it to the message board often) outdoorguy@juno.com

Best of luck in getting it resolved,
Charlie

[onekgguy]

Charlie, thanks. I've sent you an email. Thanks to everyone for your suggestions. I went out and bought a new pair of running shoes last night and I'm keeping them on while I'm walking around the house. I also ordered a couple pair of Superfeet (http://www.allegromedical.com/browse/browseProducts.do;jsessionid=8CBA8A78BCD1D2EB941C9 692B44139A7?searchPhrase=superfeet) for both my regular shoes and my bike shoes. The pain isn't as bad as it was yesterday and I think I'll take a few days off my bike so as not to aggravate the condition. That's okay because there's always a bunch of stuff which needs doing around home.

Kevin

[itsalldark]

Kane, I have news for you====I just gave the best advice period! We have been treating these cases for over 20 years. I suspect we have a really strong handle on how to deal with this issue! If you need some advice let me know.

[JohnS]

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WWW.ESOLES.COM


The secret treat of Floyd Landis...


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Naw, I think it's something else! :D

[abscar]

After having a Orthopod inject me the pain intensified. About twenty years later a FP doc injected my foot and I did gain relief but it was temporary. I then injected myself and once again the pain eventually returned. In frustration I walked down the hall and spoke with a Orthopod who recommended daily whole body stretching which I never read about. I didn't stretch the way he recommended, but I did start single speeding on my mountain bike which requires a lot of body english.

Ta dah!!... minimal pain. So I'm in the whole body stretching camp. And the trail running (cross training) camp, steroid camp, and the over the counter prior to custom orthotic camp. I haven't practiced 20 years, but I've seen results with all treatments. I do think I'm a neccesary evil. I would rather not throw medication at a problem if there is a chance of more conservative measures working.

Now the really bad news. I'm meeting stiff resistence on the home front about my NEED for a Serotta.

[Sean Soucheray]

Excellent answers; I got to bookmark them, though I'd heard variations of some of them at least;

Let me contribute;

1. ) now, there are specialty shoe stores, foot solutions and the like, don't be eager to part with your money but maybe keep them in mind.

2.) A book for runners is out there, the Runners repair manual; this discusses many feet problems in depth; and is still in print, despite coming out some 25 years ago.

3.) A culprit of feet problems can be pedallng with soft soles/shoes of all things, watch out for this one. I never suspected it before. We know, we want cycling shoes to be hard bottomed for more power but I did not suspect that there was also a major drawback to pedalling in tennis shoes and such.