[Q-Q]

I have had a severe case of PF (tears in the fascia which is a tough piece of tissue connecting toes to heel--and felt in the heel) for about 2 months--have been to physio several times; use ice frequently and do hamstring stretches regularly; also sleep (kind've) with a funny contraption called a night splint to keep the foot in a flexed position. This is no bloody joke, as walking is exceedingly painful. Dr. is now suggesting I go for a cortisone shot, but I've read adverse things about cortisone administered to this part of the body.

Anyone out there had pf and used treatments they found helpful?

By the way, my doctor says lots of people suffer from this condition and don't feel the pain anywhere near as I describe it. Yet, I haven't found anyone in my circle of friends and acquaintances that have had it. I'm beginning to believe he thinks I'm neurotic. Yeah, that takes care of the issue.

[Erinites]

Neurotiscism is irrelevant.

Do a "Google"search before you commit to any kind of treatments.

Cortisone works in most cases... but you have to do your own research.

But through research be cautious not to become entrapped in the webs of symptoms..

Chantale.

[Toro]

I had it and it was bloody painful. I had it for years before I figured out what it was. It would bother me a lot after I hadn't been on my feet for a while. After awhile, I had to stop running.

I did get rid of it though. Take a 2L coke bottle, fill it with water and freeze it. Then, every night, I'd roll the frozen bottle under my foot where I had the heel spurs for 20-30 minutes each night. I would also massage the area by taking my thumbs and pushing them up on the sole of my foot. My doctor recommended this since it apparently helps break up the deposits. Finally, go buy yourself the best arch supports you can find. Don't be afraid to spend money - mine were US$50 and they were worth it. They should last about six months before you need to get another pair.

It took me several months, but eventually it went away.

[twister]

Q-Q Q-Q:

I have had a severe case of PF (tears in the fascia which is a tough piece of tissue connecting toes to heel--and felt in the heel) for about 2 months--have been to physio several times; use ice frequently and do hamstring stretches regularly; also sleep (kind've) with a funny contraption called a night splint to keep the foot in a flexed position. This is no bloody joke, as walking is exceedingly painful. Dr. is now suggesting I go for a cortisone shot, but I've read adverse things about cortisone administered to this part of the body.

Anyone out there had pf and used treatments they found helpful?

By the way, my doctor says lots of people suffer from this condition and don't feel the pain anywhere near as I describe it. Yet, I haven't found anyone in my circle of friends and acquaintances that have had it. I'm beginning to believe he thinks I'm neurotic. Yeah, that takes care of the issue.

Okay as a kinesiologist.. this is what I would have you do... say no to the cortisone injection....get yourself into see a doctor who specializes in feet or go to a kinesiologist....
Plantar fascittis is also known as heel spur syndrome... hamstring stretches are great but you should be concentrating on stretching the Gastroc-Soleus unit also known as your calf muscles...
Question? Is it painful when you first get out of bed then the pain lessen during the day or does it stay about the same?
What type of shoes are you wearing? when did it first occur? also is there a discernable leg length difference between your right and left leg. (your hips could be out of allignment pulling one of your legs into a shorter position.)

You need to set forward a management plan
Phase 1 of the plan:
Step 1 RICE...Rest Ice Compression Elevation... 1 key REST gett off your foot you will not just "walk it off" 2. get an Ice bag on it right now for a max of 15 minutes ( this needs to be applied with a compression bandage. Elevation lift your leg higher than your heart. Sit on the couch etc but make certain your leg is higher than your heart. when you sleep at night.. put your leg up on pillows etc keep it higher.
So you Ice for 15 minute then take the ice off for 90 minutes. then reapply.
take NSaid's for pain Non steriodal anti inflammatory drugs Ibuprofen, Motrin Etc. You may need the shot of a steriod at the trigger point along with motrin but leave that as the last possible alternative.

Management of this condition is as follows: Stretching the fascia by passivly ( meaning someone else guides you through the motion ..to slight discomfort and no further) hyperextending the great toe and achilles tendon stretching especially if the ankle cannot dorsi-flect ( pulling your toes towards you) past 10-15 degrees from nuetral. Stretching should be done 3 times a day for 10-15 minutes. Stretch your legs and your hips.. if you punch "stretching into Google you should get a few that center on your problem. length of time 1 week approx.

Phase 2
Next thing you need to do is start a rehabilitation program It starts with toe crunch and toe spread, heel cord stretching and the rolling pin exercise (roll a rolling pin under your foot back and forth push out pull back).

Now step 2 repair of the facia.. Ultrasound to increase blood flow.. cross friction foot massage over injury site. Get a shock absorbing insole cut out the tender area. Wear a stiff supported shoe that has a firm support.. (not sandals or crap shoes.. take a pair of shoes if you can fold them both ways get rid of them you need support in that area. If you play athletics.. get your foot arch taped.. even if you don't this may help get it supported.
Exercise rehab: at this point you need to continue heel cord stretching, and the rolling pin . Begin a program of gradual pain free weight bearing...begin a program to help strengthen the foot flexors. length of time 1 to 3 weeks

Phase 3
Ultra sound where warranted.Cross friction massage. Use a heel cup to support weight along with ankle taping.
exercise rehab: heel cord and plantar fascia stretching continues. Shoes that have a reinforced heel counter for heel control must be worn See the folks at Kintec footlabs or any running store (penninsula runners)that specialises in a proper fit. don't go to foot locker or sports check.. they will just stand a stare at you... you need help from a specialist in regards to footwear otherwise this problem will come back.
Flexorfoot strengthening against tubular resistance is started. General lower leg exercise is performed.. PAIN FREE running program starts... you need to be PAIN FREE with ((-!00%) of your mobility back. Approx 2 weeks...

So if you start it tomorrow you should be pain free mid january.
take this stuff seriously.. get proper fitted shoes on your feet, wear proper shoes for proper function.. running wear a High Quality running shoe.. don't just go for the highest or lowest priced one on the shelf take the time to go to an accreditated shoe place that will check to see your walking gait.. if you have pronation problems.. toe striker/ heel stricker. etc.

[Q-Q]

Thanks, Toro, I'm doing pretty much what you did, except for the arch supports. I'd been told about orthotics but having to fork out over $300 for custom made ones was a bit much for my budget. I didn't know you could buy ready-made supports for just $50.00. Will definitely check that one out here. Since I pronate so much, it makes perfect sense. I'll try the massaging too. Inasmuch as you never mentioned drugs of any kind, I'm assuming you didn't use any. I'm wary of most drugs when I read some of their possible adverse effects.

That you actually were able to heal (no pun intended) using the methods you describe gives me much hope. It's a pain I wouldn't wish on anyone. I am so very glad you've got that behind you!!! Thanks for responding.

[Q-Q]

Twister? What an apt name

Thank you so much for the taking the trouble to give me your advice. I will print this out and read it over again carefully. There is nothing in it that sends up any red flags; in fact, it seems very sound. The only problem for one who is not inclined to be well disciplined is to get the regimen going and stay with it. But I do believe the pain has reached its zenith, so yes, I'm motivated.

By the way, I didn't mean to say ham stretches; I did mean to say calve stretches.

To answer your questions: The pain is bad first thing in the morning and becomes progressively worse, so that by day's end, I am using a cane to walk. (As an aside, I've also been told I have edema in both ankles and that the swelling is internal).

I wear two types of shoes Oasics TN593 and New Balance W766NC. I also very occasionally will don a pair of Berkenstocks but because there is no ankle support, I wear them sparingly.

I know you MAY be biased, but do you think a kinesiologist is superior to a podiatrist. I've been to the latter and haven't been impressed, but then again, perhaps I have not been going to the right one. How would I go about choosing a good kinesiologist. As for physiotherapists, they are all so different in their choices of treatments. Unfortunately, I have not found the ones I've been to very helpful. Could be that small towns don't attract the best in many of the professional fields (perhaps too broad a statement--dunno).

Again, thanks so much for your reply, Twister.

[Regina]

Something else you may want to consider why waiting for some custom foot orthotics and treatment is a heel pad in you runners. Something like a gel pad with a hole cut in the middle. You can buy them pre-made like that so you should look for those first. If you do use one, make sure you put them in both shoes anyway. You need to keep both legs the same length so as not to mess up your back at the same time.

[twister]

Q-Q Q-Q:

Twister? What an apt name

Thank you so much for the taking the trouble to give me your advice. I will print this out and read it over again carefully. There is nothing in it that sends up any red flags; in fact, it seems very sound. The only problem for one who is not inclined to be well disciplined is to get the regimen going and stay with it. But I do believe the pain has reached its zenith, so yes, I'm motivated.

By the way, I didn't mean to say ham stretches; I did mean to say calve stretches.

To answer your questions: The pain is bad first thing in the morning and becomes progressively worse, so that by day's end, I am using a cane to walk. (As an aside, I've also been told I have edema in both ankles and that the swelling is internal).

I wear two types of shoes Oasics TN593 and New Balance W766NC. I also very occasionally will don a pair of Berkenstocks but because there is no ankle support, I wear them sparingly.

I know you MAY be biased, but do you think a kinesiologist is superior to a podiatrist. I've been to the latter and haven't been impressed, but then again, perhaps I have not been going to the right one. How would I go about choosing a good kinesiologist. As for physiotherapists, they are all so different in their choices of treatments. Unfortunately, I have not found the ones I've been to very helpful. Could be that small towns don't attract the best in many of the professional fields (perhaps too broad a statement--dunno).

Again, thanks so much for your reply, Twister.

Q-Q where are you located? I can run a search for you of someone in your area.... uhm secondly podiatrist know thier stuff. Podiatrists work primarily with feet and ankle. as a kinesiologist I work with gait and walking issues and try to help both physios and podiatrists in getting thier ideas and recommendations through to the people I work with. Thats my role kinda the third pin in the triangle.... you say you have edema in your ankles... have you had a D Dimer test done to see if there is any clotting occuring in your viens.. building up the interstial tissue pressure cuasing the edema. You'll find that rest and getting your feet elevated with a little ice on them will help.. Also If I can query what age are you? do you have a chronic health condition besides this.. such as heart disease etc.. something that would preclude the use of ice...

[twister]

Regina Regina:

Something else you may want to consider why waiting for some custom foot orthotics and treatment is a heel pad in you runners. Something like a gel pad with a hole cut in the middle. You can buy them pre-made like that so you should look for those first. If you do use one, make sure you put them in both shoes anyway. You need to keep both legs the same length so as not to mess up your back at the same time.

Good point but make sure you see a physio so they can take a proper measurement of your leg length....

[Regina]

Yeah they can always pull on your leg to fix that.
Some runners use Tuli Heel cups and swear by them for that too.

[Q-Q]

Gee, guys, thank you all so much for your feedback. And yes, Regina, I'll also check out the heel gels with the cut-out.