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All About Heel Spurs

Posted by Dr R on 4/27/00 at 19:48 (019517)

To Heel Spur Suffers.
I have been practicing for 15 years and have a success rate of about 90% to resolve heel spur symptoms. I Have only operated on less than one tenth of 1 %. Anotherwards less than 1 in a 1000 patients. I personally believe that I have most of the answers to treating this problem. In general the better the Dr. and the more concerned the DR. the better the results. However the patient must be part of the program and follow instructions and be willing to do what is necessary to get better. Most Drs. undertreat the problem.
If there is enough interest out there I would consider doing something special with Scott to share my ' secrets of treatment'. Scott if you want to contact me please do.

Thanks,

Dr. Roth.


Re: All About Heel Spurs

Susan S on 4/27/00 at 23:08 (019538)

I, for one, would be interested your 'secrets of treatment'. As I would think most of the sufferes here would. The people here have tried all kinds of treatments and are dedicated to following anything that might help with this pain I would be interested in any help from you. Thnak you.

Re: All About Heel Spurs

john h on 4/28/00 at 09:40 (019550)

dr roth: i tend to believe your stats of an overall 90% cure rate for PF but that would include all who walk thur your door. Most who post on this board are not your average PF sufferer. Many have suffered this problem for 5-10 years. Pehaps we are the people who do to much and are not very good at resting with type 'A' personalities. i know over the years when i would show some improvement i would do something stupid like run or walk to far.

Re: All About Heel Spurs

Dr.R on 4/28/00 at 12:56 (019555)

You are probably right that your in a subset of difficult patients. However what I think I will do is put togther a page on my web site to discuss the secrets on. I can not do it now by will attempt in the next month or so. So hold on help is on the way http://www.fabs.com .
Thanks

Dr. Roth


Re: All about treating SYMPTOMS

Mike W on 4/28/00 at 15:21 (019571)

Hello DR. Roth,

You have written that 'Arch and heel pain is generally caused by a condition called plantar fasciitis occurs when the main ligament on the bottom of the foot between the heel bone and the ball of the foot becomes inflamed.' The plantar fascia (plantar aponeurosis) is really a broad band of the tendon of the flexor digitorum muscle, not a ligament. Like 99% of health care providers you define PF by it's symptoms and neglect the physiological cause and naturally your treatments focus on and quite often are effective at relieving the symptoms. Treating only the symptoms can lead to chronic PF, unnecessary procedures, long recovery times and the potential for serious side effects.

My definition of the underying cause of plantar fasciitis is a condition caused by repetitive strain on one or more short, tight or weak lower leg or foot muscles and their related tendons at the point where they attach to or pass through/around the heel or toe bones.
Therefore my focus is on improving the strength and flexibility of these neglected lower leg and foot muscles.

From your Concurrent treatment section you say that 'fabs work best when combined with a program of stretching and over the counter anti inflammatory medication. Stretching the Achilles tendon is the most effective way to stretch the plantar fascia.' It is incorrect terminology to attempt to stretch the Achilles tendon. What patients should do is stretch (and strengthen)the calf muscles (and all lower leg and foot muscles)that attach to the achilles tendon. Tendons are not very elastic, if you try to stretch them you will be doing more harm than good. There are 28 lower leg muscles that have related tendons that either attach to or pass through the heel or toe bones not just one!

There is no magic pill (or secrets) for eliminating PF, the magic is in providing the body's natural healing ability a chance to heal.

Regards,

Mike Wilmot
Physical Therapist, Principal Personal Foot Trainers, and former chronic sufferer of PF Email (email removed)


Re: All about treating SYMPTOMS

john h on 4/28/00 at 18:12 (019580)

mike: as i write this i am reading directly from a book entitled 'The Foot & Ankle Source Book' by David Tremaine, MD.
Following is a direct quote ' Ligaments are tissue fibers that connect bones together to stabilize joints. The longest ligiment in the foot, called plantar fascia, runs along the sole as shown---'. You note that the fascia is not a ligiment. Someone is wrong here.

Re: All about treating SYMPTOMS

Dr.R. on 5/02/00 at 15:18 (019780)

Thanks for your comments. I think we all agree that tight structures is the problem. Basically my instructions are understood and work a great majority of the time. Again thanks

Re: All about treating SYMPTOMS

KarenK on 5/03/00 at 10:07 (019809)

Your comments are so true. I have posted many, many times that the best thing to do for pf is see a physical therapist, not an Md. unfortunately I live in Missouri one of states that requires a physician referral to a physical therapist, so I have had to go to the Md. first. Waste of money!! The physical therapist had to work out the knots and tension before I could stretch on my own. Prior to the pt when I tried to stretch, it would put tension on my achilles and thus worsen my condition. After pt, I can now stretch and feel the stretch in the calves and lower leg, not the achilles! Hands on treatment is the way to go, not a list of stretches, pay the bill and you're on your own. I have such great respect for physical therapists.Thank you!

Re: All About Heel Spurs

Susan S on 4/27/00 at 23:08 (019538)

I, for one, would be interested your 'secrets of treatment'. As I would think most of the sufferes here would. The people here have tried all kinds of treatments and are dedicated to following anything that might help with this pain I would be interested in any help from you. Thnak you.

Re: All About Heel Spurs

john h on 4/28/00 at 09:40 (019550)

dr roth: i tend to believe your stats of an overall 90% cure rate for PF but that would include all who walk thur your door. Most who post on this board are not your average PF sufferer. Many have suffered this problem for 5-10 years. Pehaps we are the people who do to much and are not very good at resting with type 'A' personalities. i know over the years when i would show some improvement i would do something stupid like run or walk to far.

Re: All About Heel Spurs

Dr.R on 4/28/00 at 12:56 (019555)

You are probably right that your in a subset of difficult patients. However what I think I will do is put togther a page on my web site to discuss the secrets on. I can not do it now by will attempt in the next month or so. So hold on help is on the way http://www.fabs.com .
Thanks

Dr. Roth


Re: All about treating SYMPTOMS

Mike W on 4/28/00 at 15:21 (019571)

Hello DR. Roth,

You have written that 'Arch and heel pain is generally caused by a condition called plantar fasciitis occurs when the main ligament on the bottom of the foot between the heel bone and the ball of the foot becomes inflamed.' The plantar fascia (plantar aponeurosis) is really a broad band of the tendon of the flexor digitorum muscle, not a ligament. Like 99% of health care providers you define PF by it's symptoms and neglect the physiological cause and naturally your treatments focus on and quite often are effective at relieving the symptoms. Treating only the symptoms can lead to chronic PF, unnecessary procedures, long recovery times and the potential for serious side effects.

My definition of the underying cause of plantar fasciitis is a condition caused by repetitive strain on one or more short, tight or weak lower leg or foot muscles and their related tendons at the point where they attach to or pass through/around the heel or toe bones.
Therefore my focus is on improving the strength and flexibility of these neglected lower leg and foot muscles.

From your Concurrent treatment section you say that 'fabs work best when combined with a program of stretching and over the counter anti inflammatory medication. Stretching the Achilles tendon is the most effective way to stretch the plantar fascia.' It is incorrect terminology to attempt to stretch the Achilles tendon. What patients should do is stretch (and strengthen)the calf muscles (and all lower leg and foot muscles)that attach to the achilles tendon. Tendons are not very elastic, if you try to stretch them you will be doing more harm than good. There are 28 lower leg muscles that have related tendons that either attach to or pass through the heel or toe bones not just one!

There is no magic pill (or secrets) for eliminating PF, the magic is in providing the body's natural healing ability a chance to heal.

Regards,

Mike Wilmot
Physical Therapist, Principal Personal Foot Trainers, and former chronic sufferer of PF Email (email removed)


Re: All about treating SYMPTOMS

john h on 4/28/00 at 18:12 (019580)

mike: as i write this i am reading directly from a book entitled 'The Foot & Ankle Source Book' by David Tremaine, MD.
Following is a direct quote ' Ligaments are tissue fibers that connect bones together to stabilize joints. The longest ligiment in the foot, called plantar fascia, runs along the sole as shown---'. You note that the fascia is not a ligiment. Someone is wrong here.

Re: All about treating SYMPTOMS

Dr.R. on 5/02/00 at 15:18 (019780)

Thanks for your comments. I think we all agree that tight structures is the problem. Basically my instructions are understood and work a great majority of the time. Again thanks

Re: All about treating SYMPTOMS

KarenK on 5/03/00 at 10:07 (019809)

Your comments are so true. I have posted many, many times that the best thing to do for pf is see a physical therapist, not an Md. unfortunately I live in Missouri one of states that requires a physician referral to a physical therapist, so I have had to go to the Md. first. Waste of money!! The physical therapist had to work out the knots and tension before I could stretch on my own. Prior to the pt when I tried to stretch, it would put tension on my achilles and thus worsen my condition. After pt, I can now stretch and feel the stretch in the calves and lower leg, not the achilles! Hands on treatment is the way to go, not a list of stretches, pay the bill and you're on your own. I have such great respect for physical therapists.Thank you!