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Is it time to get more aggressive?

Posted by Beverly on 5/18/00 at 22:42 (020569)

Here I am at the two month point, and other than marginal improvements,
I don't feel like I'm much better. I am not limping anymore, and that is good. I attribute that to rest. Many days, my foot does not hurt if I am not on it, and that is good too.

But I still can't get through the grocery store without great pain, and so most visits, I'm still riding the cart. Even simple things like going to Barnes & Noble or church I have to plan out. If I do one. I can't do the other. I never had any idea how much standing I did doing normal stuff ... things I always considered passive activities.

I leave in 10 days for my long awaited trip to the mountains with my father. I'm flying. He is driving. I thought flying would be easier for me, but I am picturing navigating in the airport, and then waiting in the airport several hours to catch a bus that will take me to the mountains. The good thing is that I will get to the resort two days before Daddy; so I can spend those two days in total rest. I am even mailing a care package of pantry food to the resort, and taking a small ice chest on the plane so that I don't have to leave the cabin till Dad gets there.

My orthodics are so new (just two days) it is way too soon to say whether or not they will help. They seem pretty comfortable - soft not hard. Other than ice, massage, and rest, that is all my POD has suggested (besides the ultrasound I did in the beginning.)

Some of you know I began treatment with stretching, and my pod had me stop. He thought that was preventing my recovery. I've been a good girl and I've done what he's told me to do these long two months.

Now, I wonder if I should change doctors... take matters into my own hands and try stretching? That PFT looks interesting, or I could begin with simple nonweight bearing stretches the physical therapist showed me that my pod has said 'don't do.' My internist says that the younger pods follow the more aggressive treatment and people often get better faster, but the 'rest cure' the older pods tend to follow is safer even if it is slower.

I am very tired of having this. What should I do? Most of you know this, but I am not on my feet for work;so I can't blame it on that. I sit on my butt at a computer in my own house, and I only work as much as I want to work. I know I'm lucky for that. In fact, I thank God everyday for that blessing. But I have always been active in volunteer work and very active in my church. I have had to cut back drastically on these things, and I am not happy about that. And even at my computer, I find I have to be careful how I place my feet or that hurts too.

Also, although I'm only a little overweight (about 20 lbs), would loosing that weight make a difference? I'm 5 ft. 5 inches tall, and I wear a size 14. I'm trying. I've lost about 5 pounds. But if I thought it would help, I'd go on a drastic diet.

I have a good day, and I am so happy and optimistic. Although I've yet to have a pain free day, there are days it only bothers me a bit. Then I do a simple thing like go grocery shopping on my two feet or going to a party where there is a fair amount of standing (and yes, even there I sit as much as possible), and I am knocked back to square one.

When friends ask how my foot is, they seem surprised that I'm not better, and in my circle of friends, one of them had PF last year. She was down about 2 months, but she has made a complete recovery, and is playing tennis and wearing any old shoes.

Thanks for listening,
Bev

PS: My pod still says I am not a canidate for a night splint. He says my case is not extreme enough. Keep in mind, my PF is injured & strained but I caught this before it was torn. That observation was made by the pod through an exam. I have not had any x-rays.


Re: Is it time to get more aggressive?

Bob G. on 5/18/00 at 23:30 (020570)

Your Pod says you are not a candidate for a nightsplint??? OMG!!!

What harm can a nightsplint do, besides disrupting your sleep? I would not be jogging or dancing if it had not been for the nightsplint.

From what you've posted, I was thinking all along nightsplint. Hey, what do I know. It's your foot.

Best of luck, Beverly.

Pain-free thanks to the nightsplint


Re: Is it time to get more aggressive?

wendyn on 5/19/00 at 00:18 (020572)

For the airport Beverley - please consider using either a cane or a wheelchair. A cane can make a really big difference - try one around the house for a bit - you may be surprised. Most airports will provide a wheelchair free of charge - and yes - your ego _will_ survive.

I understand your frustration - a lot of us do. Two months seems like an eternity right now, and it's hard to accept giving up the things you used to take for granted. It's been a year now since I could bike, jog, do aerobics - or walk more than a few blocks. I _CAN_ relate.

I don't have any magic answers for you, other than you are going to have to be patient. This is brutally difficult for those of us that are 'Type A' personalities and who have no patience for anything (myself included).

With respect to the weight issue...there is no way to know for sure if it will help (losing it). I weigh about 114 right now which is pretty much my maximum weight (the most I've weight non-pregnant is 117). I am close to 5 foot 2. My foot problems started when I was around 60 pounds or less. It may help if you lose weight - but it may not. Follow a healthy balanced diet and get as much exercise as you can - but don't starve yourself or you'll just booger up your metabolism.

As for doctors - a second opinion is always a good idea. Try an orthepedic surgeon for a different view point.

Good luck on your holiday - let us know how you do!

Wendyn


Re: Is it time to get more aggressive?

VickiJ on 5/19/00 at 08:02 (020578)

Hi Beverly,
I empathize completely with your dilemma.
As I've posted, I was on crutches because of pf and I learned tried many things and finally came up with the right combo for my situation by TALKING TO MANY PROFESSIONALS and trying several things, including shots, etc.

I think you need to talk to people whose goal is to get people mobile again. Many doctors aim to reduce pain...which may be telling you to stay on your butt...no one individual has the answer for everyone's case of PF and while I totally agree with rest being a huge key, I personally believe that PF is a result of an imbalance of strength and weakness of muscles in the feet and legs. I was introduced to that theory by a physical therapist friend who works with my sister at a convalescent home taking care of elderly and victims of tragic accidents (I say that to make it clear that he had no financial interest in recommending one treatment over anther for my pf).

Rollering my pf, the bottom of my feet, over a hard ball, religiously---several times a day--coupled with stretching got me off crutches. But I was still in pain if I spent much time on my feet.

I know there are several people on the board who love their night splints and I'm not going to participate in a debate about them but I will share with you that I have two friends who are university professors and specialize in exercise science who were not enthusiastic about me using a night splint or casting...lengthening the pf is only part of the solution. Splints, casts, etc do nothing for the weak or tight muscles in the legs and feet which may be a large part of the problem as they were in my case. But, several people here do swear by them.... And by the way, rollering my feet over the hard ball for a minute or two before I got out of bed prevented the reinjuring horrendous 'first step of the morning' syndrome. I also rollered with the ball before I got up from sitting whenever possible...or used the crutches or a cane if I couldn't use the ball.

Talk with more professionals as well as study everything here...yes, it takes time, energy and money but in my experience that's the only way to put together a specific plan that will help your specific problems.

re the airport: DO NOT BE EMBARRASSED OR ASHAMED TO CALL AHEAD AND REQUEST WHEELCHAIR ASSISTANCE. Get a doctors' prescription for it if you need to. You deserve all the help and pampering you can get!!

Good Luck
Vicki


Re: Is it time to get more aggressive?

Lori K. on 5/19/00 at 09:57 (020587)

Hi Beverly! Wow, you sound a lot like me! I was at the 2 month mark when my pod said I wasn't an extreme enough case for the night splint-and he told me absolutely no stretching or I would keep re-injuring it. So what now? He wanted to do a series of 3 shots-I was scared but I had one, and for me it made it worse-the pain was even worse for about 5 days. Not that shots are bad for everyone, but it was at that point that I decided to try a new doctor. I felt I needed another opinion, because my mom had great success with the night splint, and after 2 months of not being able to walk at the grocery store and having to use crutches for church and trying to decide which store was a priority because I knew I could barely handle getting through one, I felt I was extreme enough. I found an orthopedic surgeon who specializes in feet, and I like her because she is much more aggressive than my conservative pod. She immediately gave me a night splint, and told me stretching is very important, even if just for a few seconds to start out. She actually put me in a hard cast first though for 6 weeks, but that was because I had a trauma to my foot where I actually felt it pop, or tear. I know we're all different and some things work for some and not others,(and doctors are all so different!)I just know that for me I needed a second opinion(actually 3rd, my first doctor gave me heel cushions and said I'd probably be playing tennis in 3 weeks!) and I feel like I'm on the right track now. I've been in my cast for 3 weeks, so I don't know what's going to work for me, but I am more positive because I am trying new things. Good luck Beverly and have a great trip! Lori

Re: Is it time to get more aggressive?

Steve P on 5/19/00 at 10:04 (020588)

Beverly -- I may have mentioned this in an earlier post, but I am now taking an anti-depressant & I notice that I'm feeling better overall, including my feet. The physical signs of tension (especially tightness in my back & neck) are gone now, my mood is better, and my feet feel a little better.
I have never in my 50 years been on any such drug before, but I'm glad I am now. I see it as another weapon in the arsenal against PF.

Re: Is it time to get more aggressive?

Dr. Zuckerman on 5/19/00 at 20:27 (020620)

You need to try different things , Listen to your body. Stretching is great if done correctly and in the right amounts. Are you posterior calf muscles tight ( Achilles Tendon.). If you lack the motion at the ankle Pf will never get better. So at least start doing calf muscles. The Nite Splint if you get get use to it, can't hurt you. The Mike's personal trainers are a great additional to this horrible pain. Rest is important but not complete rest. Atropy of muscles can become a problem secondary to pf. Get a trainer or phyical therapyist and or Chiropractor. I truley believe that you have to jump on plantar fasciitis and not play around and hope that it will get better with one type of treatment. So listen to the board.

Re: to Dr. Zuckerman

Beverly on 5/20/00 at 00:23 (020632)

Dr. Zuckerman,
Thank you so much for posting. Yes, in my right foot my achilles tendon does get sore (down low in the skinny part where it's mostly bone). What kind of stretches do you mean for the calf?
I know about things like flexing my foot back and holding it, and pulling my big toe back and holding it. Does that stretch the calf or do you mean the wall stretches?

Thank you,
Beverly


Re: to Dr. Zuckerman

Dr. Zuckerman on 5/20/00 at 14:13 (020649)

Add the wall stretches. Keep the foot flat, when doing the wall stretching . It has to be done three-four times daily for about fifteen repetitions. If you have more pain, then reduce the amount of stretching times per day, twice daily. If this still hurts the area and or foot. You will need to see a physical therapy person for help and examination of other area of the lower extremity that are tight. I find that you need to have a complete lower extremity evaluation to determine which muscles art tight and or if the hip , knee or back is adding to the problem. So start with the wall stretching first and see where it leads you. Just don't over do it. More may not be better. Listen to your body if increase pain back off rest and try the next day. The theory no pain no gain doesn't apply here.

Re: to Dr. Zuckerman-- further stretching info-- "locking" the arch

alan k on 5/21/00 at 07:30 (020662)

I want to add to that: if you are looking for a way to ease off stretching if it is too intense try multiple stretches which are not held for more than a second or so. But remember that this is not an agressive regimen that will dramatically increase flexibility fast, so one should resort to it only if having damage from longer stretches.

Warm up the muscles first with at least ankle rolls and foot scrunches in the air or with towel. Also, some sit-ups to warm the body in general.

Before going into the stretch, flex your foot and toes to tighten the muscles on the top of the foot and the shin/outside shin. Tightening these muscles will cause a relaxation response on the opposing muscles, thus they are ready to stretch.

Finally, the foot position in the wall stretch is important. You can 'lock' your arch by making sure the foot is perpendicular to the wall, keeping the weight distributed evenly across the outside blade of the foot while also sinking weight into the part of the ball of the foot that is under the toe. If you concentrate on these sort of contradictory instructions of weight on the ball under the big toe while also on the outside blade of foot, you arch will be in its safest position for the wall stretch.

best wishes,
alan k


Re: Alan: both feet or one at a time?

Beverly on 5/21/00 at 16:30 (020671)

Alan,

Thank you for your wall stretch tips. I wish there was a picture book of these various stretches for the feet and calves. (I've seen a few stick people diagrams in Scott's book and other sites but I'd love to see bigger/more detailed pictures or pictures of real people doing the stretch.) Do I lean into the wall with both feet at the same time or do I put one foot infront of the other so that I am leaning into the wall with my weight on the front foot (more like a hamstring stretch seen in warmup pictures at the gym)? Do I keep my knees straight or bent a bit?

Thanks,
Beverly


Re: Alan: both feet or one at a time?

alan k on 5/21/00 at 18:59 (020677)

One foot is up to the wall with knee bent of course. The foot position I described is good for feet anywhere anytime and doing it for both is good but for the wall stretch it is important to concentrate on the back foot. Back leg should be straight.

A variation is to step the back foot closer to wall, and bend leg instead, sort of squatting down. This gets a lower prtion of the calf and achilles.


alan k


Re: Is it time to get more aggressive?

Bob G. on 5/18/00 at 23:30 (020570)

Your Pod says you are not a candidate for a nightsplint??? OMG!!!

What harm can a nightsplint do, besides disrupting your sleep? I would not be jogging or dancing if it had not been for the nightsplint.

From what you've posted, I was thinking all along nightsplint. Hey, what do I know. It's your foot.

Best of luck, Beverly.

Pain-free thanks to the nightsplint


Re: Is it time to get more aggressive?

wendyn on 5/19/00 at 00:18 (020572)

For the airport Beverley - please consider using either a cane or a wheelchair. A cane can make a really big difference - try one around the house for a bit - you may be surprised. Most airports will provide a wheelchair free of charge - and yes - your ego _will_ survive.

I understand your frustration - a lot of us do. Two months seems like an eternity right now, and it's hard to accept giving up the things you used to take for granted. It's been a year now since I could bike, jog, do aerobics - or walk more than a few blocks. I _CAN_ relate.

I don't have any magic answers for you, other than you are going to have to be patient. This is brutally difficult for those of us that are 'Type A' personalities and who have no patience for anything (myself included).

With respect to the weight issue...there is no way to know for sure if it will help (losing it). I weigh about 114 right now which is pretty much my maximum weight (the most I've weight non-pregnant is 117). I am close to 5 foot 2. My foot problems started when I was around 60 pounds or less. It may help if you lose weight - but it may not. Follow a healthy balanced diet and get as much exercise as you can - but don't starve yourself or you'll just booger up your metabolism.

As for doctors - a second opinion is always a good idea. Try an orthepedic surgeon for a different view point.

Good luck on your holiday - let us know how you do!

Wendyn


Re: Is it time to get more aggressive?

VickiJ on 5/19/00 at 08:02 (020578)

Hi Beverly,
I empathize completely with your dilemma.
As I've posted, I was on crutches because of pf and I learned tried many things and finally came up with the right combo for my situation by TALKING TO MANY PROFESSIONALS and trying several things, including shots, etc.

I think you need to talk to people whose goal is to get people mobile again. Many doctors aim to reduce pain...which may be telling you to stay on your butt...no one individual has the answer for everyone's case of PF and while I totally agree with rest being a huge key, I personally believe that PF is a result of an imbalance of strength and weakness of muscles in the feet and legs. I was introduced to that theory by a physical therapist friend who works with my sister at a convalescent home taking care of elderly and victims of tragic accidents (I say that to make it clear that he had no financial interest in recommending one treatment over anther for my pf).

Rollering my pf, the bottom of my feet, over a hard ball, religiously---several times a day--coupled with stretching got me off crutches. But I was still in pain if I spent much time on my feet.

I know there are several people on the board who love their night splints and I'm not going to participate in a debate about them but I will share with you that I have two friends who are university professors and specialize in exercise science who were not enthusiastic about me using a night splint or casting...lengthening the pf is only part of the solution. Splints, casts, etc do nothing for the weak or tight muscles in the legs and feet which may be a large part of the problem as they were in my case. But, several people here do swear by them.... And by the way, rollering my feet over the hard ball for a minute or two before I got out of bed prevented the reinjuring horrendous 'first step of the morning' syndrome. I also rollered with the ball before I got up from sitting whenever possible...or used the crutches or a cane if I couldn't use the ball.

Talk with more professionals as well as study everything here...yes, it takes time, energy and money but in my experience that's the only way to put together a specific plan that will help your specific problems.

re the airport: DO NOT BE EMBARRASSED OR ASHAMED TO CALL AHEAD AND REQUEST WHEELCHAIR ASSISTANCE. Get a doctors' prescription for it if you need to. You deserve all the help and pampering you can get!!

Good Luck
Vicki


Re: Is it time to get more aggressive?

Lori K. on 5/19/00 at 09:57 (020587)

Hi Beverly! Wow, you sound a lot like me! I was at the 2 month mark when my pod said I wasn't an extreme enough case for the night splint-and he told me absolutely no stretching or I would keep re-injuring it. So what now? He wanted to do a series of 3 shots-I was scared but I had one, and for me it made it worse-the pain was even worse for about 5 days. Not that shots are bad for everyone, but it was at that point that I decided to try a new doctor. I felt I needed another opinion, because my mom had great success with the night splint, and after 2 months of not being able to walk at the grocery store and having to use crutches for church and trying to decide which store was a priority because I knew I could barely handle getting through one, I felt I was extreme enough. I found an orthopedic surgeon who specializes in feet, and I like her because she is much more aggressive than my conservative pod. She immediately gave me a night splint, and told me stretching is very important, even if just for a few seconds to start out. She actually put me in a hard cast first though for 6 weeks, but that was because I had a trauma to my foot where I actually felt it pop, or tear. I know we're all different and some things work for some and not others,(and doctors are all so different!)I just know that for me I needed a second opinion(actually 3rd, my first doctor gave me heel cushions and said I'd probably be playing tennis in 3 weeks!) and I feel like I'm on the right track now. I've been in my cast for 3 weeks, so I don't know what's going to work for me, but I am more positive because I am trying new things. Good luck Beverly and have a great trip! Lori

Re: Is it time to get more aggressive?

Steve P on 5/19/00 at 10:04 (020588)

Beverly -- I may have mentioned this in an earlier post, but I am now taking an anti-depressant & I notice that I'm feeling better overall, including my feet. The physical signs of tension (especially tightness in my back & neck) are gone now, my mood is better, and my feet feel a little better.
I have never in my 50 years been on any such drug before, but I'm glad I am now. I see it as another weapon in the arsenal against PF.

Re: Is it time to get more aggressive?

Dr. Zuckerman on 5/19/00 at 20:27 (020620)

You need to try different things , Listen to your body. Stretching is great if done correctly and in the right amounts. Are you posterior calf muscles tight ( Achilles Tendon.). If you lack the motion at the ankle Pf will never get better. So at least start doing calf muscles. The Nite Splint if you get get use to it, can't hurt you. The Mike's personal trainers are a great additional to this horrible pain. Rest is important but not complete rest. Atropy of muscles can become a problem secondary to pf. Get a trainer or phyical therapyist and or Chiropractor. I truley believe that you have to jump on plantar fasciitis and not play around and hope that it will get better with one type of treatment. So listen to the board.

Re: to Dr. Zuckerman

Beverly on 5/20/00 at 00:23 (020632)

Dr. Zuckerman,
Thank you so much for posting. Yes, in my right foot my achilles tendon does get sore (down low in the skinny part where it's mostly bone). What kind of stretches do you mean for the calf?
I know about things like flexing my foot back and holding it, and pulling my big toe back and holding it. Does that stretch the calf or do you mean the wall stretches?

Thank you,
Beverly


Re: to Dr. Zuckerman

Dr. Zuckerman on 5/20/00 at 14:13 (020649)

Add the wall stretches. Keep the foot flat, when doing the wall stretching . It has to be done three-four times daily for about fifteen repetitions. If you have more pain, then reduce the amount of stretching times per day, twice daily. If this still hurts the area and or foot. You will need to see a physical therapy person for help and examination of other area of the lower extremity that are tight. I find that you need to have a complete lower extremity evaluation to determine which muscles art tight and or if the hip , knee or back is adding to the problem. So start with the wall stretching first and see where it leads you. Just don't over do it. More may not be better. Listen to your body if increase pain back off rest and try the next day. The theory no pain no gain doesn't apply here.

Re: to Dr. Zuckerman-- further stretching info-- "locking" the arch

alan k on 5/21/00 at 07:30 (020662)

I want to add to that: if you are looking for a way to ease off stretching if it is too intense try multiple stretches which are not held for more than a second or so. But remember that this is not an agressive regimen that will dramatically increase flexibility fast, so one should resort to it only if having damage from longer stretches.

Warm up the muscles first with at least ankle rolls and foot scrunches in the air or with towel. Also, some sit-ups to warm the body in general.

Before going into the stretch, flex your foot and toes to tighten the muscles on the top of the foot and the shin/outside shin. Tightening these muscles will cause a relaxation response on the opposing muscles, thus they are ready to stretch.

Finally, the foot position in the wall stretch is important. You can 'lock' your arch by making sure the foot is perpendicular to the wall, keeping the weight distributed evenly across the outside blade of the foot while also sinking weight into the part of the ball of the foot that is under the toe. If you concentrate on these sort of contradictory instructions of weight on the ball under the big toe while also on the outside blade of foot, you arch will be in its safest position for the wall stretch.

best wishes,
alan k


Re: Alan: both feet or one at a time?

Beverly on 5/21/00 at 16:30 (020671)

Alan,

Thank you for your wall stretch tips. I wish there was a picture book of these various stretches for the feet and calves. (I've seen a few stick people diagrams in Scott's book and other sites but I'd love to see bigger/more detailed pictures or pictures of real people doing the stretch.) Do I lean into the wall with both feet at the same time or do I put one foot infront of the other so that I am leaning into the wall with my weight on the front foot (more like a hamstring stretch seen in warmup pictures at the gym)? Do I keep my knees straight or bent a bit?

Thanks,
Beverly


Re: Alan: both feet or one at a time?

alan k on 5/21/00 at 18:59 (020677)

One foot is up to the wall with knee bent of course. The foot position I described is good for feet anywhere anytime and doing it for both is good but for the wall stretch it is important to concentrate on the back foot. Back leg should be straight.

A variation is to step the back foot closer to wall, and bend leg instead, sort of squatting down. This gets a lower prtion of the calf and achilles.


alan k