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What to do first?

Posted by Lori R. on 4/02/00 at 00:00 (018158)

I think I have a heel spur or plantar fascitis. What should I do first? Should I see a podiatrist or an orthopedist. I ran the NYC marathon and each morning I noticed I had to stretch my foot before I had to run. Within the last 3 weeks my heel is hurting and I am now in trouble. I thought about the internet and searched for heel spur and there it was. Would you recommend a massage first or a podiatrist. What about the inserts, night splints (is that for stretching). I am an occupational therapist and I know about splints. Of course, I want to do the marathon again in NOvember, 2000. Will I be ready?? Help.

Re: What to do first?

alan k on 4/02/00 at 00:00 (018159)

First, temporarily stop running. This is hard to take but it may prevent you from having to give it up for months, or possibly forever. Not everyone is mentally capable of rising to the challenge of exchanging rest for continued ability to practice your sport, so many wind up having to give it up forever because they couldn't give it up for a few weeks.

Second, be careful with the stretching

Third, when you do have to use your feet to get around, make sure your footwear is the best it can be, and perhaps Birkenstock sandals or expensive footwear with the right over-the-counter orthotic inserts. Never go barefoot even in the shower. Never.

Fourth, warm up your feet in the morning with toe crunches, massage, and preferably also applied heat, all before a gentle stretch and your first steps on the ground.

Fifth, nightsplints have a good reputation for effectiveness. Primarily they prevent your feet from pointing and scrunching as you sleep (a natural sleep response) and so prevent micro-tears in the morning as you get up and stretch them out again (thus also the importance of warming up). Nightsplints also contribute a mild stretch for some people. I definitely recommend them.

Six, massage your feet and calves often (they get tight from years of running) and exercise the tops of your feet and shins as well as quads with gentle resistance, as these muscles are all underdeveloped in relation to the treading muscles in the calf, hammie, and gluts which are overdeveloped in runners, perhaps everyone.

Seven, look into anti-inflammatory meds and herbs.

Read Scott's book and find a good podiatrist (good luck!).

good luck,

alan k


Re: What to do first?

BJC on 4/02/00 at 00:00 (018163)

Welcome, fellow OT...but sorry it had to be here! See a dr immediately, either ortho or podiatrist (I see a pod), for the sooner you see someone the better. Don't run...you are pounding your feet and increasing the damage cycle. You will get a lot of advice on this board, everyone is different. Follow your good OT sense and principles. Good luck, hope you nip this in the bud!

Re: What to do first?

YokoS on 4/03/00 at 00:00 (018174)

Lori, take this problem seriously. Stop running for a while.
Are you a member of NYRRC? If so, pick up a podiatrist from member's handbook. I didn't and I deeply regretted it.
(If you are not, E-mail me at (email removed))
I also have heel spur/PF problems and struggling about a year, plus I am a casual runner in NYC. I cancelled my NYC marathon entry last year due to this problem. I don't want you to have same (sad) experience as mine.

Re: What to do first?

john h on 4/03/00 at 00:00 (018181)

as a former runner with chronic PF my first and most important suggestion ist to stop running completly for 2-3 months. take up the stationary bike,swim, but give the foot a rest. make sure you do not have a stress fracture. take some over the counter anti inflamatory such as ibuprofen. do some mild stretching after the pain subsides. see your doc but pass on the shot or orthotics until a couple of months pass.

Re: What to do first? for yoko

john h on 4/03/00 at 00:00 (018182)

there is no such thing as a 'casual' runner who runs the NYC Marathon! have not seen you post in a while so i thought you had experienced the big 'cure'! hope you are back to 'casual' marathons?

Re: What to do first?

LoriR. on 4/03/00 at 00:00 (018214)

Thanks everyone for their help. Everyone says to see a MD. or podiatrist. I have to stop the running it seems. This will really hurt. I gave it up for 2 weeks. I have an apointment with a cranial-sacral, massage and healing person (all in one). She feels she can help in several sessions. Did you find one also. The pain is only alittle bit and it seems to come and go. Is that the situation. Are you a runner. I guess I can't do the NYC marathon in 2000!!!!! Well I did it in 1999. What if I race walk? I went to the superunning store and got an arch brace which feels good. The people there all said they had it also.

Re: What to do first?

Lori R. on 4/03/00 at 00:00 (018217)

I am a member of NYCRRC. It seems I need to take this problem seriously and not ignore it. I will see a massage person this week who is also a healer, cranial-sacral person and she says she can help in a series of sessions. I need to rest. This will be hard. Have any ideas. I guess I need to ride a bike. Can i race walk??

Re: What to do first?

Lori R. on 4/03/00 at 00:00 (018218)

Do you ice your foot in the morning and in the afternoon?

At least my pain is mild. will it get worse if I race walk? Will it get better if I just let it rest?

I need a doctor. Is it better to go to a podiatrist or an orthopedist?


Re: What to do first?

Bob G. on 4/04/00 at 00:00 (018238)

If it hurts, it is injured; REST is the first step (of possibly many subsequent steps). Search this Board for solutions. Only use Doctors that have MANY solid references; to do otherwise is foolhartedly.

Re: What to do first? -- to Lori R.

Nancy S. on 4/04/00 at 00:00 (018240)

Hi Lori -- No, please, for your own sake, do not racewalk right now. Rest really does mean rest, not just cutting back a little. I think almost everyone on this board, runner and nonrunner like, would tell you to put weight-bearing exercise out of your mind for now. I think it's a hard reality for everyone to hit at first -- 'no, you can't really mean to call a halt to something so important to me' -- but if you don't, I fear you may be much sorrier down the line. The importance of initially resting injured feet appears throughout messages all over this board, and also in Scott's PF Book (click on it at top of page). After a good rest, there are all kinds of stretching and strengthening you can do to start preparing yourself for runnning again -- but this takes time and patience, building up slowly, no giant leaps. Believe me, you won't be sorry if you start taking care of your feet now, in the early stages of the problem. Otherwise the probem just gets worse, and hangs on, and on, and on . . .
After a bad experience with a podiatrist, if I had it to do over I would see an orthopedist. Other people on this board have had problems with podiatrists, but some have found a good one. If you know of a good one, from people who have been to him or her, I would go for that. If you're choosing out of the blue, my own opinion is that an orthopedist would probably be better, perhaps one who specializes in sports medicine. Good luck to you, and please take care of those feet --Nancy S.

Re: What to do first?

alan k on 4/04/00 at 00:00 (018246)

I am not a runner but I was a huge yoga enthusiast who did 'Astanga Yoga' which is very active full of leaping and vigorous movement. It hurt more than I can say to give it up, and I know exactly how you feel.

I will return to it one day, and I remind myself that if I really love it I will let it go-- for now.

Please don't think you have to give up running forever. You only give it up forever if you refuse to give it up now. If you give it up now, it is almost certain that you will run again in the future (only a very few uninformed, or informed but foolish, or simply unlucky few get chronic long-term pf)

Don't try to fudge it with racewalking, etc (which some posters have said was actually wrose for them than running, by the way). Hold out for running in the future.


alan k


Re: What to do first?

YokoS on 4/04/00 at 00:00 (018255)

Bike is OK, I think.
I ride stationary bike for 40min every other day, and so far so good.
My pain was also mild at beginning, therefore, I kept running until pains knocked me down. After 1st cortizone shot, pains were gone, so I went back to park right away. 2nd, 3rd shots didn't give me any relief, then I become serious which was too late!!
I don't want you to repeat my mistake. Forget about race walk.
By the way, I paid $500 for my custom made ortho which I was told
reasonable price in Manhattan by several running mates.

Re: What to do first?

alan k on 4/02/00 at 00:00 (018159)

First, temporarily stop running. This is hard to take but it may prevent you from having to give it up for months, or possibly forever. Not everyone is mentally capable of rising to the challenge of exchanging rest for continued ability to practice your sport, so many wind up having to give it up forever because they couldn't give it up for a few weeks.

Second, be careful with the stretching

Third, when you do have to use your feet to get around, make sure your footwear is the best it can be, and perhaps Birkenstock sandals or expensive footwear with the right over-the-counter orthotic inserts. Never go barefoot even in the shower. Never.

Fourth, warm up your feet in the morning with toe crunches, massage, and preferably also applied heat, all before a gentle stretch and your first steps on the ground.

Fifth, nightsplints have a good reputation for effectiveness. Primarily they prevent your feet from pointing and scrunching as you sleep (a natural sleep response) and so prevent micro-tears in the morning as you get up and stretch them out again (thus also the importance of warming up). Nightsplints also contribute a mild stretch for some people. I definitely recommend them.

Six, massage your feet and calves often (they get tight from years of running) and exercise the tops of your feet and shins as well as quads with gentle resistance, as these muscles are all underdeveloped in relation to the treading muscles in the calf, hammie, and gluts which are overdeveloped in runners, perhaps everyone.

Seven, look into anti-inflammatory meds and herbs.

Read Scott's book and find a good podiatrist (good luck!).

good luck,

alan k


Re: What to do first?

BJC on 4/02/00 at 00:00 (018163)

Welcome, fellow OT...but sorry it had to be here! See a dr immediately, either ortho or podiatrist (I see a pod), for the sooner you see someone the better. Don't run...you are pounding your feet and increasing the damage cycle. You will get a lot of advice on this board, everyone is different. Follow your good OT sense and principles. Good luck, hope you nip this in the bud!

Re: What to do first?

YokoS on 4/03/00 at 00:00 (018174)

Lori, take this problem seriously. Stop running for a while.
Are you a member of NYRRC? If so, pick up a podiatrist from member's handbook. I didn't and I deeply regretted it.
(If you are not, E-mail me at (email removed))
I also have heel spur/PF problems and struggling about a year, plus I am a casual runner in NYC. I cancelled my NYC marathon entry last year due to this problem. I don't want you to have same (sad) experience as mine.

Re: What to do first?

john h on 4/03/00 at 00:00 (018181)

as a former runner with chronic PF my first and most important suggestion ist to stop running completly for 2-3 months. take up the stationary bike,swim, but give the foot a rest. make sure you do not have a stress fracture. take some over the counter anti inflamatory such as ibuprofen. do some mild stretching after the pain subsides. see your doc but pass on the shot or orthotics until a couple of months pass.

Re: What to do first? for yoko

john h on 4/03/00 at 00:00 (018182)

there is no such thing as a 'casual' runner who runs the NYC Marathon! have not seen you post in a while so i thought you had experienced the big 'cure'! hope you are back to 'casual' marathons?

Re: What to do first?

LoriR. on 4/03/00 at 00:00 (018214)

Thanks everyone for their help. Everyone says to see a MD. or podiatrist. I have to stop the running it seems. This will really hurt. I gave it up for 2 weeks. I have an apointment with a cranial-sacral, massage and healing person (all in one). She feels she can help in several sessions. Did you find one also. The pain is only alittle bit and it seems to come and go. Is that the situation. Are you a runner. I guess I can't do the NYC marathon in 2000!!!!! Well I did it in 1999. What if I race walk? I went to the superunning store and got an arch brace which feels good. The people there all said they had it also.

Re: What to do first?

Lori R. on 4/03/00 at 00:00 (018217)

I am a member of NYCRRC. It seems I need to take this problem seriously and not ignore it. I will see a massage person this week who is also a healer, cranial-sacral person and she says she can help in a series of sessions. I need to rest. This will be hard. Have any ideas. I guess I need to ride a bike. Can i race walk??

Re: What to do first?

Lori R. on 4/03/00 at 00:00 (018218)

Do you ice your foot in the morning and in the afternoon?

At least my pain is mild. will it get worse if I race walk? Will it get better if I just let it rest?

I need a doctor. Is it better to go to a podiatrist or an orthopedist?


Re: What to do first?

Bob G. on 4/04/00 at 00:00 (018238)

If it hurts, it is injured; REST is the first step (of possibly many subsequent steps). Search this Board for solutions. Only use Doctors that have MANY solid references; to do otherwise is foolhartedly.

Re: What to do first? -- to Lori R.

Nancy S. on 4/04/00 at 00:00 (018240)

Hi Lori -- No, please, for your own sake, do not racewalk right now. Rest really does mean rest, not just cutting back a little. I think almost everyone on this board, runner and nonrunner like, would tell you to put weight-bearing exercise out of your mind for now. I think it's a hard reality for everyone to hit at first -- 'no, you can't really mean to call a halt to something so important to me' -- but if you don't, I fear you may be much sorrier down the line. The importance of initially resting injured feet appears throughout messages all over this board, and also in Scott's PF Book (click on it at top of page). After a good rest, there are all kinds of stretching and strengthening you can do to start preparing yourself for runnning again -- but this takes time and patience, building up slowly, no giant leaps. Believe me, you won't be sorry if you start taking care of your feet now, in the early stages of the problem. Otherwise the probem just gets worse, and hangs on, and on, and on . . .
After a bad experience with a podiatrist, if I had it to do over I would see an orthopedist. Other people on this board have had problems with podiatrists, but some have found a good one. If you know of a good one, from people who have been to him or her, I would go for that. If you're choosing out of the blue, my own opinion is that an orthopedist would probably be better, perhaps one who specializes in sports medicine. Good luck to you, and please take care of those feet --Nancy S.

Re: What to do first?

alan k on 4/04/00 at 00:00 (018246)

I am not a runner but I was a huge yoga enthusiast who did 'Astanga Yoga' which is very active full of leaping and vigorous movement. It hurt more than I can say to give it up, and I know exactly how you feel.

I will return to it one day, and I remind myself that if I really love it I will let it go-- for now.

Please don't think you have to give up running forever. You only give it up forever if you refuse to give it up now. If you give it up now, it is almost certain that you will run again in the future (only a very few uninformed, or informed but foolish, or simply unlucky few get chronic long-term pf)

Don't try to fudge it with racewalking, etc (which some posters have said was actually wrose for them than running, by the way). Hold out for running in the future.


alan k


Re: What to do first?

YokoS on 4/04/00 at 00:00 (018255)

Bike is OK, I think.
I ride stationary bike for 40min every other day, and so far so good.
My pain was also mild at beginning, therefore, I kept running until pains knocked me down. After 1st cortizone shot, pains were gone, so I went back to park right away. 2nd, 3rd shots didn't give me any relief, then I become serious which was too late!!
I don't want you to repeat my mistake. Forget about race walk.
By the way, I paid $500 for my custom made ortho which I was told
reasonable price in Manhattan by several running mates.