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saw doctor today

Posted by john h on 4/27/00 at 16:26 (019494)

i visited a poditrist today who is not the surgeon who performed surgery on my left foot. i have bilaterial pf and both of my feet are currently about the same. i have never had early morning 1st step pain and have had pf for 6 years. he easily found where the pain spot is which i can never do on myself. he said he could feel the swelling at the spot on both feet. believe it or not i suggested he give me a shot in the foot that was not operated on as i have never had a cortisone shot and thought if the shot provides some relief it may give me a clue as to where the problem is . the shot was not really that painful just uncomfortable. he told me to ice it for 3 days as it might be sore.
it has been 1 hour since the shot and i currently feel no pain at all. he said i should wear hard orthotics which i have and take naperson to work in conjuction with the cortisone shot. he noted that both bands of fascia from both great toes were tight and he said after surgery the band should not be as tight as they were. he thinks the surgery i had released to little fascia to relieve pressure on the fascia and thus cause inflamation which he could clearly feel when he poked the bottom of my foot. he felt there was no reason to perfom an MRI, ultrasound, or bonescan as he clearly thinks it is PF. he said this is not rocket science and that the bow string effect of an inflamed fascia is very likely the source of my pain thus the hard orthotic which does not give. he said he rarely does tarsal tunnel releases because they are rare. he does a two types of minimal invasive Pf surgery. one is a 2 stitch incision. he quit doing surgery through a scope several years ago. says he has you in a surgery shoe for about two weeks and says he is getting about a 90% success rate wtih his pf surgery. i know he has been perfoming surgery for around 10 years. well that is it folks. i am glad he could find a real sore spot by pressing because i think that makes me more comfortable that i do have pf and not some exotic disease. will keep you informed about the results if any i get from the shot.

Re: saw doctor today

Nancy S. on 4/27/00 at 18:04 (019505)

Hi John, nice to hear you don't have some exotic disease! Also, this is the first time I got your 'big picture.' So did you end up getting the shot in the side or bottom of the heel?
Interesting take on hard orthotics by your dr. -- the bowstring effect. (But what about the like-walking-on-concrete effect?) How long have you worn hard orthotics, and have you not had pain you would ascribe to them?
And my last question: I don't understand why relief from a cortisone shot would indicate that a person would be a good candidate for EWST. Do you know? --Nancy

Re: saw doctor today

john h on 4/27/00 at 18:28 (019509)

nancy: my understanding if you get relief from the cortisone shot and the dr can reproduce pain by pressing on a spot they have very much narrowed the field of your problem to a given spot and probably to PF. If pain is caused by the fascia being stretched each time you take a step then it would make some sense that a hard orthotic would not allow the fascia to stretch as much. my shot was from the side directly into the spot that he could easily cause me pain by pressing on. i brought my custom ($300) hard orthotics with me and he held them up to my feet and said they still conformed to feet well. he held up some store bought orthotics i have been wearing and told me they were not even hitting the arch in the correct position. i had not given that much thought. this dr is part of a group of 8 with 5 or 6 locations and they have a good reputation in our area.

Re: saw doctor todayRe John

Laurie R on 4/27/00 at 18:41 (019510)

Hi John,
It sounds like you also have a good doctor.I am glad your appointment went well.I hope your shot helps you.I had 2 cortisone shots and they did not help at all.Is your foot numb from the shot?That was the only thing that helped my pain for a few hours was the stuff they use to numb my foot.My very best to you John.....Laurie R

Re: saw doctor today

Nancy S. on 4/27/00 at 21:01 (019526)

Hi John, although I got no relief from the shot (except for a few hours due to anesthetic), my pod easily reproduced PF pain in The Spot (sent me through the ceiling). Seems like the latter would be enough to tell, so I can't imagine the shot results determining whether you're an EWST candidate.
What you say about the fascia stretching and hard orthotics makes some sense to me intellectually. But for me, the hard orthotics really hurt after a time and even cause PF-like pain in my non-PF foot, which nothing else has. I guess this is just another example of 'We're all different.'
I've tried a lot of orthotics now (mostly over-the-counter), and it's really amazing me how different each arch support fits (or doesn't). The tiniest bit off, and it's no good for you, whereas the same thing may be perfect for someone else. I guess our feet are like snowflakes, absolutely no two are the same. --Nancy

Re: saw doctor today

dfeet on 4/27/00 at 21:29 (019530)

hi,john. Thanks for sharing your story and your pod visit. I know I've said this before, but here I go again-Beware of the rigid orthotics. Listen to your body. As I was informed,(after I had already developed TTS), the rigids can cause trauma to the arches and subsequently more damage to not only the fascia but to the surrounding soft tissue exacerbating inflamation. The rigids work for some ,but please listen to your body. Sounds like your Pod is on the ball. Thanks again for sharing-dfeet

Re: saw doctor today

john h on 4/28/00 at 07:18 (019545)

nancy' i also have mixed feelings about the hard orthotics. i wore them for about 3-4 years when i was running and i agree intelectually speaking they make sense in that they allow less flexion of the fascia than soft ones. the dr. made his point very clearly to me on the ones i had on at the time of the visit (over the counter) the arch in the orthotic was not hitting the proper place on my foot. i shall try my old hard orthos today for at least a few hous to see what happens.

Re: saw doctor today

alan k on 4/28/00 at 17:40 (019576)

That sounds like good news john. I'ld like to be able to get a diagnosis of pf too if I could. Could he explain why you have never had morning pain? Or maybe ask him next time.
Where was the spot of pain and how did he find it?

alan k


Re: saw doctor today

john h on 4/28/00 at 17:56 (019577)

alan: the dr pressed hard with one finger on a spot where the ligiment (fascia) from the great toe connects to the heel. He also found the same very sore spot on the other foot. he noted the band of fascia from the great toe to the heel was like a banjo string when i flex my great toe up just a little bit. he said on the foot that had surgery that the band should not be taught at all. there was no question he found the spot where the pain originates from when i am standing. it has now been about 30 hours since i had the steriod shot and the foot that had the shot is about 80% better. do not know how long this will last but i am somewhat confident we are working in the right area. he told me to put my hard custom orthothics back on which i had quit wearing about 2 years ago. i wore them 1/2 day with no problem and will gradually work back into them unless i have some sort of set back. speaking of hard orthotics - what is really the difference between hard orthotics and birks. birks are hard and take some getting used to. same with hard orthotics? this group of poditrist gave up endoscopic surgery several years ago as they thought it was more invasive than the minimal invasvive surgery they do now. his words were 'its a gimmick'! the shot was much less painful than i had been anticipating on a scale of 1-10 with 10 being a kidney stone this was a 5. i failed to ask him about morning pain but will in 8 weeks when i go back. my personal thoughts on morning pain is that some peoples fascia contract more than others during the night and thus are more suspectable to 1st step pain. i wear a night splint on one foot and switch it around from night to night.

Re: Let us know how the shot effect goes.

Kim B. on 4/28/00 at 17:58 (019578)

Hi John,

I am considering giving a shot a try. Even though my foot pain seems to be getting better, (I have gone from an 8 to about a 3 pain level) I have had PF for about a year now and feeling desperate to try something to get it to go away completely. It's still tempermental and I have to baby them a lot to keep the severe pain away. My PF started in the left foot, but now I have it in both feet. So it's double trouble. So, I would like to be updated on the effects and end result of your shot therapy.

I have a friend who recently told me that she and her elderly mother got their heel pain to subside after getting the shots, just once! That is encouraging.

I still think I would only have this done at a time that I am not accutely faired up. Getting a shot when I am in dire pain is too much like adding insult to injury. My intuition is that it would make things worse for me.

Keep me posted!

Regards, Kim B.



Re: saw doctor today

Nancy S. on 4/28/00 at 23:06 (019590)

John, I think there is a big difference between Birks and hard orthotics. Although it's hard to tell at first, there is some give in the Birks footbed, and with wear they conform a bit to the individual's foot. Compared with other shoes, Birks may feel too hard at first; but compared with hard orthotics, they feel like paradise. As the medical supply store guy pointed out to me, there is absolutely no give in hard plastic, and he said I might as well be pounding my feet into brick. But I still say, if yours end up feeling good, then definitely go with them. My BioSoles seem to be conforming a bit, and yet I feel a lot of support from them, so I'm hoping this will be a happy combo for me -- Birks for around the house and short journeys, and BioSoles in my workshoeshikingboots for barn work on my feet. I know that a lot of cushioning and instability in there is not good for me, yet I can't take the hard orthotics -- so hopefully I'm finding a happy medium. I think I'm starting to repeat myself -- it's after midnight. How much time do you spend on your feet on an average day, John? --Nancy

Re: saw doctor today

john h on 4/29/00 at 08:44 (019600)

nancy: i used hard orthotics for about 4-5 years especially when i was running about 30 miles a week. as i developed PF i began to modify a lot of things. i changed my orthotics, probably unknowningly changes my gait and heel strike and of course got worse and worse. it took some getting used to the hard orthotics just like it took me a couple of months to adjust to birks. i am not saying hard orthotics are the answer i am just trying them once again. intelectually speaking i think we are trying to keep the fascia from various stretching forces as we walk or stand. we want the fascia t not pull back and forth so as to allow the inflamation to subside. we also are trying to biomechanically keep the foot in a proper position in relationship to the bones and prevent over pronating or the opposite. it seems that soft orthotics cannot do that as well as a hard orthotic. soft orthotics will bend and twist. i have written several medical specialist in the field of biomechanics to try and get some answers to some of our questions. i think hard or soft orthotics probably depends on your condition and cause of your pain. certainly a lot of research has been done in this field. finally if it hurts do not do it but like birks i am giving it a chance. i am a type A person and on my feet off and on all day. i would like to be on my feet all day.

Re: saw doctor today

dfeet on 4/29/00 at 11:08 (019604)

Hooray for type A. I too am a type A, but this past week I've been trying to be a type B-been trying to get Bob g's rest thing going on. Birks are 'harder' than the normal shoe, but like nancy pointed out they do give more than theo orthotics. I don't think anyone is trying to force you not to wear the rigids, but like you have been doing, just try to wear them with a little bit of caution. What is scary is that with these afflictions(TTS/Pf), I've been told by my orthopod that fat pad atrophy is a common occurence, so it would stand to reason that something as hard as rigid orthotics could contribute to inflamation. My orthopod, incidently, is not a big fan of orthotics unless there is a proven alignment problem. He believes that a lot of PF/TTS has underlying systemic causes or primarily do to overuse/trauma. If there is an alignment problem then the need for orthotics is in the treatment plan. Yes, the idea of maintaining a static stretch to the fascia is important-this decreases the build up of scar tissue from the micro tears, and allows the fascia to heal in a more favorable way. But you have to strike your own balance of inserts-too hard for some too soft for others. Happy feet-dfeet

Re: saw doctor today

john h on 4/29/00 at 19:01 (019613)

i had not worn my hard orthotics for two years until i started researching othotics and biomechanics of the feet. i had sort of drifted to it di not make much difference since 3 doctors had each recommended a rigid, soft, and off the shelf ortho. the more i read i am beging to think it makes a big difference. (read my post under orthotics). the only way to hold the arch up and keep the fascia from stretching or putting tension on it is with something rigid or semi rigid. if you keep bouncing around on an inflamed fascia it will never heal. soft orthotics (and i have a drawer full) will certainly allow you fascia to pull on your heel more so with soft orthotics than rigid or semi rigid orthotics. most post are indicating and i agree that rest is important (rest meaning not putting tension on the fascia). i think the reason we all think so highly of the birks is that the arch support they provide is better than any shoe on the market and it is at least semi-rigid if not rigid. i would like to hear from dr weil and zuckerman on this subject as i assume foot biomechanics was part of their training.

it is has now been 3 days since my cortisone shot and putting my old custom rigid (Langer Sportsthotics $300) orthotics back in my shoes. Probably been the most pain free 3 days i have had in at least a year. I am taking it one day at at time however as i have had a lot of setbacks.


Re: saw doctor today

Nancy S. on 4/29/00 at 22:58 (019620)

John, as suspicious as I am of my hard custom orthotics, I definitely would not want soft ones either. (What DO I want, anyway?) I know that my feet need to be in a stable position, I can feel it every second if they aren't.
Did I understand you correctly, that you were running for a long time in hard orthotics and THEN got PF? I may have misunderstood you on this, but am curious of course. Sometimes I think the ideal thing would be a flat insole over my hard orthotics, for work. I don't know if these exist except in drugstores, where they look as if they'd disintegrate in two hours. Or bunch up.
Yeah, I wonder sometimes about the type A issue. I'm pretty laid back in the rest of my life, but when it comes to work I tend to take on that driven, intense quality, and before this scourge hit I worked at least 6 days a week, often 10 or more hours a day. And I want to do it again! But it probably isn't in the cards. My husband was helping me in the barn today, getting antique stuff ready to take to a shop where I rent space, and he had to tell me about 20 times to Sit Down! Have to form new work habits, and it's a daily struggle. --Nancy

Re: saw doctor today

Nancy S. on 4/29/00 at 23:09 (019622)

Hi dfeet, I'm wondering: if your orthopod is not a fan of orthotics if misalignment isn't a problem, what does he recommend for aligned Pf people in the way of footwear? Just shoes with no other kind of support? I'm very curious, because I don't think I'm misaligned (at least I wasn't before i started limping a year ago). And come to think of it, except for my Birks, I haven't tried wearing any other shoes without orthotics/insoles/inserts/etc. in them since this whole thing started. Maybe I should get out of this chair right now and try it! I'm serious. But I would like to know what your orthopod recommends, if no orthotics in certain cases. Thanks --Nancy

Re: saw doctor today

john h on 4/30/00 at 09:26 (019634)

i ran for about 5 years in rigid custom orthotics about 30 miles a week up and down hills and mostly on pavement. i think it was the hills that did me in. during that time i had one severe bout with achilles tendonitits. i also would be on the stairmaster 5 days a week for 30min to 1 hour and run in all the local 5k and 10k races. i am not good at all resting, standing still,etc. the only thing that keeps me still is professional football and baseball and then i can become your typical couch potato with a miller light beer.

Re: saw doctor today

john h on 4/30/00 at 09:29 (019636)

it has now been 3 days since my shot and my foot continues to be much better and i continue with the rigid orthotics for about 7 hours a day and birks the rest of the day. i hope this continues!!!!

Re: misaligned or not? Depends on who you ask!

ChrisO on 4/30/00 at 10:04 (019639)

Hi Nancy - you know, I've been wondering just a little bit lately if the whole 'orthotics to correct alignment' is the wisest thing to do. Or even if orthotics is the wisest thing to do period! I feel as though, is spite of high arches, I'd been just fine, as an athlete and in my regular life, for well over twenty years. After all, we don't try to change the structure of a pulled hamstring or an elbow inflamed with tendonitis. And, because the orthotics cause SO MUCH discomfort, I really wonder if those are as necessary as, say, rest. I know the M-O is to wear the orthotics for an hour each day and build up but.........I wore yet another new pair yesterday recommended by my Chiro with the statement that it's my alignment that must change as opposed to just 'arch support orthos' that only support existing problems. Well - you know the drill - I'm willing to try anything! There's no question that his inserts provided more stability - that was nice - it made me feel more 'sure-footed'. I wore them for an hour (recommended) while I did yard work and boy did I suffer, in both feet, for the rest of the day! My arches are still BOTH screaming (up to now one foot was close to pain-free) at me! After wearing them, icing and resting, I used Dr. R's FABS for an hour or two thinking they'd provide some soft comfort. But I'm afraid the damage was already done. Now I'm afraid to wear ANY again. You know, with SO MANY insert devices out there with SO MANY theories on their use and effectiveness, how the heck are we supposed to ever get a feel for what works? And if one Doc says 'support the bad arch' and another says 'change your alignment', how are we supposed to know how much time to give either theory? I'm starting to think that only rest works.
OK, that's my frustration leak for this week!

Re: To Chris Re: misaligned or not? Depends on who you ask!

Helene M on 4/30/00 at 13:29 (019649)

Chris, I relate to everything you said. I, too, am afraid...no, terrified, to wear any arch support ever again. I've been virtually 'disabled ' for 4 months because of a new pair of semi-rigid orthotics I got back in December. When I told my pod of my fear, he just didn't understand.

Re: saw doctor today

Nancy S. on 4/27/00 at 18:04 (019505)

Hi John, nice to hear you don't have some exotic disease! Also, this is the first time I got your 'big picture.' So did you end up getting the shot in the side or bottom of the heel?
Interesting take on hard orthotics by your dr. -- the bowstring effect. (But what about the like-walking-on-concrete effect?) How long have you worn hard orthotics, and have you not had pain you would ascribe to them?
And my last question: I don't understand why relief from a cortisone shot would indicate that a person would be a good candidate for EWST. Do you know? --Nancy

Re: saw doctor today

john h on 4/27/00 at 18:28 (019509)

nancy: my understanding if you get relief from the cortisone shot and the dr can reproduce pain by pressing on a spot they have very much narrowed the field of your problem to a given spot and probably to PF. If pain is caused by the fascia being stretched each time you take a step then it would make some sense that a hard orthotic would not allow the fascia to stretch as much. my shot was from the side directly into the spot that he could easily cause me pain by pressing on. i brought my custom ($300) hard orthotics with me and he held them up to my feet and said they still conformed to feet well. he held up some store bought orthotics i have been wearing and told me they were not even hitting the arch in the correct position. i had not given that much thought. this dr is part of a group of 8 with 5 or 6 locations and they have a good reputation in our area.

Re: saw doctor todayRe John

Laurie R on 4/27/00 at 18:41 (019510)

Hi John,
It sounds like you also have a good doctor.I am glad your appointment went well.I hope your shot helps you.I had 2 cortisone shots and they did not help at all.Is your foot numb from the shot?That was the only thing that helped my pain for a few hours was the stuff they use to numb my foot.My very best to you John.....Laurie R

Re: saw doctor today

Nancy S. on 4/27/00 at 21:01 (019526)

Hi John, although I got no relief from the shot (except for a few hours due to anesthetic), my pod easily reproduced PF pain in The Spot (sent me through the ceiling). Seems like the latter would be enough to tell, so I can't imagine the shot results determining whether you're an EWST candidate.
What you say about the fascia stretching and hard orthotics makes some sense to me intellectually. But for me, the hard orthotics really hurt after a time and even cause PF-like pain in my non-PF foot, which nothing else has. I guess this is just another example of 'We're all different.'
I've tried a lot of orthotics now (mostly over-the-counter), and it's really amazing me how different each arch support fits (or doesn't). The tiniest bit off, and it's no good for you, whereas the same thing may be perfect for someone else. I guess our feet are like snowflakes, absolutely no two are the same. --Nancy

Re: saw doctor today

dfeet on 4/27/00 at 21:29 (019530)

hi,john. Thanks for sharing your story and your pod visit. I know I've said this before, but here I go again-Beware of the rigid orthotics. Listen to your body. As I was informed,(after I had already developed TTS), the rigids can cause trauma to the arches and subsequently more damage to not only the fascia but to the surrounding soft tissue exacerbating inflamation. The rigids work for some ,but please listen to your body. Sounds like your Pod is on the ball. Thanks again for sharing-dfeet

Re: saw doctor today

john h on 4/28/00 at 07:18 (019545)

nancy' i also have mixed feelings about the hard orthotics. i wore them for about 3-4 years when i was running and i agree intelectually speaking they make sense in that they allow less flexion of the fascia than soft ones. the dr. made his point very clearly to me on the ones i had on at the time of the visit (over the counter) the arch in the orthotic was not hitting the proper place on my foot. i shall try my old hard orthos today for at least a few hous to see what happens.

Re: saw doctor today

alan k on 4/28/00 at 17:40 (019576)

That sounds like good news john. I'ld like to be able to get a diagnosis of pf too if I could. Could he explain why you have never had morning pain? Or maybe ask him next time.
Where was the spot of pain and how did he find it?

alan k


Re: saw doctor today

john h on 4/28/00 at 17:56 (019577)

alan: the dr pressed hard with one finger on a spot where the ligiment (fascia) from the great toe connects to the heel. He also found the same very sore spot on the other foot. he noted the band of fascia from the great toe to the heel was like a banjo string when i flex my great toe up just a little bit. he said on the foot that had surgery that the band should not be taught at all. there was no question he found the spot where the pain originates from when i am standing. it has now been about 30 hours since i had the steriod shot and the foot that had the shot is about 80% better. do not know how long this will last but i am somewhat confident we are working in the right area. he told me to put my hard custom orthothics back on which i had quit wearing about 2 years ago. i wore them 1/2 day with no problem and will gradually work back into them unless i have some sort of set back. speaking of hard orthotics - what is really the difference between hard orthotics and birks. birks are hard and take some getting used to. same with hard orthotics? this group of poditrist gave up endoscopic surgery several years ago as they thought it was more invasive than the minimal invasvive surgery they do now. his words were 'its a gimmick'! the shot was much less painful than i had been anticipating on a scale of 1-10 with 10 being a kidney stone this was a 5. i failed to ask him about morning pain but will in 8 weeks when i go back. my personal thoughts on morning pain is that some peoples fascia contract more than others during the night and thus are more suspectable to 1st step pain. i wear a night splint on one foot and switch it around from night to night.

Re: Let us know how the shot effect goes.

Kim B. on 4/28/00 at 17:58 (019578)

Hi John,

I am considering giving a shot a try. Even though my foot pain seems to be getting better, (I have gone from an 8 to about a 3 pain level) I have had PF for about a year now and feeling desperate to try something to get it to go away completely. It's still tempermental and I have to baby them a lot to keep the severe pain away. My PF started in the left foot, but now I have it in both feet. So it's double trouble. So, I would like to be updated on the effects and end result of your shot therapy.

I have a friend who recently told me that she and her elderly mother got their heel pain to subside after getting the shots, just once! That is encouraging.

I still think I would only have this done at a time that I am not accutely faired up. Getting a shot when I am in dire pain is too much like adding insult to injury. My intuition is that it would make things worse for me.

Keep me posted!

Regards, Kim B.



Re: saw doctor today

Nancy S. on 4/28/00 at 23:06 (019590)

John, I think there is a big difference between Birks and hard orthotics. Although it's hard to tell at first, there is some give in the Birks footbed, and with wear they conform a bit to the individual's foot. Compared with other shoes, Birks may feel too hard at first; but compared with hard orthotics, they feel like paradise. As the medical supply store guy pointed out to me, there is absolutely no give in hard plastic, and he said I might as well be pounding my feet into brick. But I still say, if yours end up feeling good, then definitely go with them. My BioSoles seem to be conforming a bit, and yet I feel a lot of support from them, so I'm hoping this will be a happy combo for me -- Birks for around the house and short journeys, and BioSoles in my workshoeshikingboots for barn work on my feet. I know that a lot of cushioning and instability in there is not good for me, yet I can't take the hard orthotics -- so hopefully I'm finding a happy medium. I think I'm starting to repeat myself -- it's after midnight. How much time do you spend on your feet on an average day, John? --Nancy

Re: saw doctor today

john h on 4/29/00 at 08:44 (019600)

nancy: i used hard orthotics for about 4-5 years especially when i was running about 30 miles a week. as i developed PF i began to modify a lot of things. i changed my orthotics, probably unknowningly changes my gait and heel strike and of course got worse and worse. it took some getting used to the hard orthotics just like it took me a couple of months to adjust to birks. i am not saying hard orthotics are the answer i am just trying them once again. intelectually speaking i think we are trying to keep the fascia from various stretching forces as we walk or stand. we want the fascia t not pull back and forth so as to allow the inflamation to subside. we also are trying to biomechanically keep the foot in a proper position in relationship to the bones and prevent over pronating or the opposite. it seems that soft orthotics cannot do that as well as a hard orthotic. soft orthotics will bend and twist. i have written several medical specialist in the field of biomechanics to try and get some answers to some of our questions. i think hard or soft orthotics probably depends on your condition and cause of your pain. certainly a lot of research has been done in this field. finally if it hurts do not do it but like birks i am giving it a chance. i am a type A person and on my feet off and on all day. i would like to be on my feet all day.

Re: saw doctor today

dfeet on 4/29/00 at 11:08 (019604)

Hooray for type A. I too am a type A, but this past week I've been trying to be a type B-been trying to get Bob g's rest thing going on. Birks are 'harder' than the normal shoe, but like nancy pointed out they do give more than theo orthotics. I don't think anyone is trying to force you not to wear the rigids, but like you have been doing, just try to wear them with a little bit of caution. What is scary is that with these afflictions(TTS/Pf), I've been told by my orthopod that fat pad atrophy is a common occurence, so it would stand to reason that something as hard as rigid orthotics could contribute to inflamation. My orthopod, incidently, is not a big fan of orthotics unless there is a proven alignment problem. He believes that a lot of PF/TTS has underlying systemic causes or primarily do to overuse/trauma. If there is an alignment problem then the need for orthotics is in the treatment plan. Yes, the idea of maintaining a static stretch to the fascia is important-this decreases the build up of scar tissue from the micro tears, and allows the fascia to heal in a more favorable way. But you have to strike your own balance of inserts-too hard for some too soft for others. Happy feet-dfeet

Re: saw doctor today

john h on 4/29/00 at 19:01 (019613)

i had not worn my hard orthotics for two years until i started researching othotics and biomechanics of the feet. i had sort of drifted to it di not make much difference since 3 doctors had each recommended a rigid, soft, and off the shelf ortho. the more i read i am beging to think it makes a big difference. (read my post under orthotics). the only way to hold the arch up and keep the fascia from stretching or putting tension on it is with something rigid or semi rigid. if you keep bouncing around on an inflamed fascia it will never heal. soft orthotics (and i have a drawer full) will certainly allow you fascia to pull on your heel more so with soft orthotics than rigid or semi rigid orthotics. most post are indicating and i agree that rest is important (rest meaning not putting tension on the fascia). i think the reason we all think so highly of the birks is that the arch support they provide is better than any shoe on the market and it is at least semi-rigid if not rigid. i would like to hear from dr weil and zuckerman on this subject as i assume foot biomechanics was part of their training.

it is has now been 3 days since my cortisone shot and putting my old custom rigid (Langer Sportsthotics $300) orthotics back in my shoes. Probably been the most pain free 3 days i have had in at least a year. I am taking it one day at at time however as i have had a lot of setbacks.


Re: saw doctor today

Nancy S. on 4/29/00 at 22:58 (019620)

John, as suspicious as I am of my hard custom orthotics, I definitely would not want soft ones either. (What DO I want, anyway?) I know that my feet need to be in a stable position, I can feel it every second if they aren't.
Did I understand you correctly, that you were running for a long time in hard orthotics and THEN got PF? I may have misunderstood you on this, but am curious of course. Sometimes I think the ideal thing would be a flat insole over my hard orthotics, for work. I don't know if these exist except in drugstores, where they look as if they'd disintegrate in two hours. Or bunch up.
Yeah, I wonder sometimes about the type A issue. I'm pretty laid back in the rest of my life, but when it comes to work I tend to take on that driven, intense quality, and before this scourge hit I worked at least 6 days a week, often 10 or more hours a day. And I want to do it again! But it probably isn't in the cards. My husband was helping me in the barn today, getting antique stuff ready to take to a shop where I rent space, and he had to tell me about 20 times to Sit Down! Have to form new work habits, and it's a daily struggle. --Nancy

Re: saw doctor today

Nancy S. on 4/29/00 at 23:09 (019622)

Hi dfeet, I'm wondering: if your orthopod is not a fan of orthotics if misalignment isn't a problem, what does he recommend for aligned Pf people in the way of footwear? Just shoes with no other kind of support? I'm very curious, because I don't think I'm misaligned (at least I wasn't before i started limping a year ago). And come to think of it, except for my Birks, I haven't tried wearing any other shoes without orthotics/insoles/inserts/etc. in them since this whole thing started. Maybe I should get out of this chair right now and try it! I'm serious. But I would like to know what your orthopod recommends, if no orthotics in certain cases. Thanks --Nancy

Re: saw doctor today

john h on 4/30/00 at 09:26 (019634)

i ran for about 5 years in rigid custom orthotics about 30 miles a week up and down hills and mostly on pavement. i think it was the hills that did me in. during that time i had one severe bout with achilles tendonitits. i also would be on the stairmaster 5 days a week for 30min to 1 hour and run in all the local 5k and 10k races. i am not good at all resting, standing still,etc. the only thing that keeps me still is professional football and baseball and then i can become your typical couch potato with a miller light beer.

Re: saw doctor today

john h on 4/30/00 at 09:29 (019636)

it has now been 3 days since my shot and my foot continues to be much better and i continue with the rigid orthotics for about 7 hours a day and birks the rest of the day. i hope this continues!!!!

Re: misaligned or not? Depends on who you ask!

ChrisO on 4/30/00 at 10:04 (019639)

Hi Nancy - you know, I've been wondering just a little bit lately if the whole 'orthotics to correct alignment' is the wisest thing to do. Or even if orthotics is the wisest thing to do period! I feel as though, is spite of high arches, I'd been just fine, as an athlete and in my regular life, for well over twenty years. After all, we don't try to change the structure of a pulled hamstring or an elbow inflamed with tendonitis. And, because the orthotics cause SO MUCH discomfort, I really wonder if those are as necessary as, say, rest. I know the M-O is to wear the orthotics for an hour each day and build up but.........I wore yet another new pair yesterday recommended by my Chiro with the statement that it's my alignment that must change as opposed to just 'arch support orthos' that only support existing problems. Well - you know the drill - I'm willing to try anything! There's no question that his inserts provided more stability - that was nice - it made me feel more 'sure-footed'. I wore them for an hour (recommended) while I did yard work and boy did I suffer, in both feet, for the rest of the day! My arches are still BOTH screaming (up to now one foot was close to pain-free) at me! After wearing them, icing and resting, I used Dr. R's FABS for an hour or two thinking they'd provide some soft comfort. But I'm afraid the damage was already done. Now I'm afraid to wear ANY again. You know, with SO MANY insert devices out there with SO MANY theories on their use and effectiveness, how the heck are we supposed to ever get a feel for what works? And if one Doc says 'support the bad arch' and another says 'change your alignment', how are we supposed to know how much time to give either theory? I'm starting to think that only rest works.
OK, that's my frustration leak for this week!

Re: To Chris Re: misaligned or not? Depends on who you ask!

Helene M on 4/30/00 at 13:29 (019649)

Chris, I relate to everything you said. I, too, am afraid...no, terrified, to wear any arch support ever again. I've been virtually 'disabled ' for 4 months because of a new pair of semi-rigid orthotics I got back in December. When I told my pod of my fear, he just didn't understand.