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Plantar Faciitis

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  • #41
    I've had it for about 4 years now. Mine isn't crippling, but it is uncomfortable, and it's never really gone away. My Dr. said to never ever wear anything but tennis shoes. That didn't happen. I do LOVE my boot. I wear it before I know I am going to be on my feet for a while, and after I am on my feet for a while. It makes a huge difference. Sleeping in it is not great, but I can live with it because it offers so much relief.

    My Dr. also said to roll a tennis ball under my foot (like the idea of the frozen juice cans).

    I did a few rounds of cortisone shots and the last one i had crystallized and I will never have another cortisone shot. I couldn't do anything but cry for two days it hurt so bad. It took years for the purple mark on foot to go away.


    • #42
      I had it also, I think it was a combo of wearing crocs all the time and starting to ride more often than I had done previously. What worked for me since the pf braces are so expensive is an ankle wrap I picked up at cvs and wrapped my foot tightly at night. I also got the under knee tendon brace pulled it tight so that the pressure was on the arc of my foot and wore this out and about with good tennis shoes. It hurt like hell at first but started to ease the more I wore it, after a month or so of these it was gone. I took my braces with me when we went to Disney world simply because of the massive amounts of walking and wrapped at night as a precaution and it didn't come back. Worked for me don't know why but thought I'd throw it out there.


      • #43
        Does your insurance cover the shock wave treatment? Mine doesn't & it's really expensive !

        Do you all have heel spurs, also?

        Me- about 6 yrs of PF, on & off, more on than off, about 10 sets of injections, heel spurs have doubled in size in the past 3 yrs. (I walk for a living, too.) Always use orthotics & Spenco hard arch supports (very good), best shoes have been Sketchers Shape-ups.

        Doctor is talking about cutting some of the PF to release the pull on it when I walk and removing bone spurs. Anyone else?


        • #44
          The first time I had PF I did the excercise and wore a Q-Ray bracelet and that got rid of it plus when I could find someone doing acuscope at a horse show I'd have them work on my feet...poof it's gone. May has it come back with a vengence the second time. The excersice didn't help at all but I have found an acupuncturest and after the third treatment all my tenderness is gone. I'm not going once a month to keep it at bay.


          • Original Poster

            No insurance coverage of the Shock Wave...but the way my foot was hurting when it became an option I didn't even ask what it was costing. I will not show for a while to cover the cost ....I still have pain every step, but it is bearable and I am not straining every other ligament in my leg like I was when it was so painful.
            "Over the Hill?? What Hill, Where?? I don't remember any hill!!!" Favorite Tee Shirt


            • #46
              Thanks Claudius. I'd also be OK to pay for it, if I thought it would work for me. I read it has a 50 percent success rate. Some of you seem to like it, so great, though. But, with my significant heel spurs, I'm concerned that the spurs will just always aggravate the PF and shock wave would be for naught.

              Sometimes, when they are horrible, my chiropractor (he's awesome) will do therapeutic ultrasound on my PF. It works quite well.


              • #47
                Bump this subject back up...

                Does anyone find a brand of paddock boots that offer enough arch support and a nice enough heel cup to be wearable with out an insert?

                What about other barn appropriate foot apparel?

                I have found my Birkenstock sandals make my feet pretty darn happy. I just can not wear them to the barn or to do my barn chores.


                • #48
                  My paddock boots are old Ariat's and they are pretty good on the bad feet.

                  I got a pair of Ariat Fat Baby's (western cowboy) for general wear and put a pair of Spenco hard arch supports in them. They are great and look so cool.


                  • #49
                    Just had to add my 2cents here. Member of the Orthopaedic Foot and Ankle Society.

                    Classic symptoms of PF are heel pain that is severe in the morning getting out of bed, gets a little better with movement, then is worse at the end of the day and is painful when getting up out of a chair (or out of the car, etc) after sitting for a time. We think that the reason the symptoms follow this pattern is that the PF shortens when we are non-weightbearing.

                    Plantar fasciitis is incredibly common- at any one point over 60 MILLION people have it. No one knows the specific cause. If you do MRI's on everyone (and this study has been done) sometimes you see nothing, sometimes inflammation, sometimes a tear, sometimes bone irritation, but often nothing. People have biopsied the PF with the same results, some have inflammation, many nothing. No one knows why this happens, no one knows the trigger. I have seen it in hundreds of patients, from 90# to 350#, people who sit all day, people who stand all day, runners, couch potatoes, etc. I see it in people who pronate, who have high arches, who have flat feet, etc. No common denominator other than almost all are over 25, and there probably some correlation with tightness of the achilles. (If one sees this problem in very young patients, one thinks of other things such as some of the auto-immune inflammatory diseases.)

                    PF is NEVER DUE TO A SPUR! The spur is an old concept that has been disproven as the source of the problem. If you x-ray all who have PF, some have spurs, some not. We used to cut out the spurs, but found that this did not make people better. The spur is a normal aging change of bone and is not the source of pain. It is not a thorn sticking into the heel!

                    Research by the Orthopaedic Foot and Ankle Society has shown 4 things that are statistically significant in helping plantar fasciitis and lots of things that do not help.

                    Things that did not show statistical significance (did not help nor "cure" PF
                    1. orthotics- a large study had several hundred patients, half the group did stretches no orthotics, the other half orthotics, the stretching group was much better

                    2. cortisone injection- no evidence for long term benefit

                    3. medication- might help pain a little, but will not make the PF go away

                    4. ice, heat, rolling foot on ball or frozen bottle, etc- again might help the pain a bit, but will not "cure" the problem

                    5. different shoes- no statistical significance. Interestingly, wearing a high heel (or high heeled cowboy boot) can make it feel better temporarily because this lets the PF shorten- but it thus perpetuates the problem

                    6. surgery- very limited benefit much of the time, most studies indicate only 60% of patients will improve. (versus 90% of patients who improve with bunion surgery, or meniscal tear surgery)

                    Things that are statistically significant:

                    1. Three stretching exercises and a night splint. It takes about 4 months to improve. The three stretches are a. "the toe pull" pics are on line- sit with one foot crossed up over the other knee (half of "Indian" style) take the hand on the same side, and pull the toes up toward the shin. Hold 5-10sec, repeat 5 reps, 6-8 times per day. This is the most important stretch. b. runners stretch- classic against wall or desk c. stand on stair and drop heel down. All stretches should be done 5 reps, 6-8 times per day but if one gets lazy, the toe pull is the most useful. It should be done before getting out of bed, any time sitting down, before getting out of the car, etc. Night splints can be found on line, they can either go on top or on the back of the leg. They are a must. If one has pain both sides, I tell patients to get one splint and alternate legs.

                    2. a cast- a short leg fiberglass cast (a walking cast) worn for 6 weeks can be highly effective, it probably works by putting the PF on stretch at all times

                    3. Platelet rich plasma injection- only if above fail, should be in a tall walking boot for at least 6 weeks after the injection

                    4. Shock wave- the high intensity type has been the only one to be useful, it requires anesthesia (Ossatron is the brand of machine) and a boot for 6 weeks. Again however, only if 1&2 fail.


                    • #50
                      I have had my feet arches injected many many times, custom orthotics, boots/splints to wear in bed, and many physical therapies,a (T.E.N.S.) (?) and it got so bad had tendonities up both legs and was threatend to be put in leg casts to keep me off my feet. MRI's, ultrasounds,x-rays and the thing where they stick needles w/ electrodes in you?
                      NSAID regular round the clock, soak feet in tub of water and ice several times a day. Find a good pair of lace up paddock boots and live in them. I swear by Ariat. When not in them try to find a shoe with a 2inch heel it will take the pressure off your heels/arches and put to ball of foot. THe ankle wrap that criss crosses under your arches..so amazing loved it. Better than the tap wraping I got from foot specailits.
                      Riding was my best therapy stretching down my heels.
                      Surpass can become your best friend, and I got Myofacsia release and massages to feet and lower legs..Finally I am pain/symptom free, also when ever you can even if for 5 minutes put your feet up, as in lay down and prop up on sofa arm!!!


                      • #51

                        Thanks so much for all the educated info.

                        Q: What do you think of heel spurs that have doubled in size in the past three years? I'm on my feet, walking for a living (have been for a long time). Do the heel spurs keep getting bigger or when do they stop?

                        My favorite shoes are the Sketchers Shape-ups, with either custom orthotics or hard arch Spencos in them. Which shoes do your patients like?

                        Dansko clogs were nice, but too unstable (tipping over) so I had to give those up.



                        • #52
                          Originally posted by sonomacounty View Post

                          Thanks so much for all the educated info.

                          Q: What do you think of heel spurs that have doubled in size in the past three years? I'm on my feet, walking for a living (have been for a long time). Do the heel spurs keep getting bigger or when do they stop?

                          My favorite shoes are the Sketchers Shape-ups, with either custom orthotics or hard arch Spencos in them. Which shoes do your patients like?

                          Dansko clogs were nice, but too unstable (tipping over) so I had to give those up.


                          The "spur" is just an x-ray finding, it means nothing. Shoes are whatever is comfortable, patients are all over the map. I tell them that any shoe except a leather soled shoe or a high heel is fine as long as it is comfortable, the shoe will not fix the PF- unfortunately. It would make life (including mine) so much easier if there were one shoe or one gizmo, or one pill that would cure this. Stretching is the most reliable method, but requires more effort on the patient's part, and people are often very impatient.


                          • #53
                            Thanks Mickey D.

                            surgery- very limited benefit much of the time, most studies indicate only 60% of patients will improve.

                            Now, my podiatrist spoke of something like cutting the PF so it doesn't pull anymore. Is that the surgery you are speaking about above? She also spoke of removing the bone spurs at that time.

                            What does it mean when heel injection "crystalizes"?

                            Oh, is PF much more common in fibromyalgia patients?

                            Tx again !


                            • Original Poster

                              Just thought I would update as I am the OP. I might have mentioned earlier that I had shock wave treatments...three a week apart. I stretch, use the brace at night and I threw out all my shoes and got good ones and use an orthotic with a bump in front of the arch....all is working. It still hurts...most after sitting...but I walk without limping and CHOSE to walk here and there...I had noticed the amount of denial I had been in as I would 'consider' whether it was REALLY necessary to go get the mail/bring in my horse/walk across the room!!! I am functional now...not pain free....but very managable. The turning point was definitely the shock wave!!
                              "Over the Hill?? What Hill, Where?? I don't remember any hill!!!" Favorite Tee Shirt


                              • #55
                                Are heel spurs and PF similar - my husband has been diagnosed with both?? !!
                                Proud member of People Who Hate to Kill Wildlife clique


                                • #56
                                  1. the surgery most used is to cut about 1/3 of the plantar fascia. Only 60% of patients improve. If you look at patients who rupture the plantar fascia, the results are similar. Thus, cutting the plantar fascia does not make physiologic sense to the vast majority of orthopaedic foot and ankle surgeons. (different training from any other foot doctor)

                                  2. heel spurs are a myth- people can have huge looking spurs on x-ray and absolutely no heel pain, and lots of people can have normal x-rays with no spur and lots of heel pain (me for example, I have had PF with no x-ray changes at all)

                                  3. high intensity shock wave is effective about 80% of the time, as is PRP

                                  4. I have no idea what they mean by the injection crystallizing, not something we find in ortho foot and ankle


                                  • #57
                                    Pf is no more common in fibromyalgia than in any patient, it is just common.


                                    • #58
                                      Thanks again, MD. Where to go for PRP, though.

                                      Thanks again,


                                      • #59
                                        Originally posted by sonomacounty View Post
                                        Thanks again, MD. Where to go for PRP, though.

                                        Thanks again,

                                        find an orthopaedic foot and anke specialist that does PRP at aofas.org


                                        • #60
                                          Thanks again, MD. Wondering how prp works for PF? I looked around aofas and did not see anything regarding prp. Or would I have to contact each ortho?

                                          I've heard PRP is extremely dependent on technique, so who knows who really does it well?

                                          Oh, the crystallized cortisone shot is from Post 41 in this thread, last paragraph.