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Are orthodics the answer for serious athletes?

Posted by Tracy H. on 7/16/00 at 20:42 (023407)

I'm on my second pair of custom orthodics. The first pair did little - the arch was not high enough. My current pair fits perfectly and completely relieves pain as long as I do not do anything strenous. However, even low-impact activity such as a Precor elliptal machine causes my fascia to feel like it is tearing (as I'm sure it is). Can orthodics prevent the fascia from flexing to the extent which is needed for such physical activity? From my personal experience, arch supports have limited (although necessary) application. I am starting to think that only surgery will give my fascia enough flexiblility to exercise. I know the risks of surgery and have pursued all available treatments. Just seeking some physiological information on why the inserts aren't working!

Re: Are orthodics the answer for serious athletes?

Bob G. on 7/16/00 at 23:14 (023409)

Hi, Tracy!

Perhaps rest may be the cure. I am 4 months pain-free...took me 10 months of rest. Would have been sooner if I had not been so eager and started back too soon.

Everybody's different. Do a search under my name if you want my story; Don't mind the blonde jokes.

Good luck! :)


Re: Are orthodics the answer for serious athletes?

john h on 7/17/00 at 08:34 (023418)

bob: when you say 10 months of rest what exactly do you mean? stay in bed when not working? minimal time on your feet? no cardiac activity at all?

Re: Are orthodics the answer for serious athletes?

Rock on 7/17/00 at 09:55 (023421)

Tracy,

As an ironman triathlete and ultra-runner, I am probably the most active of all the regular posters on this board [last week's actvity: swam 5 miles, biked 180 miles, ran 24 miles.].

It is my estimate that 10% or more of ironman triathletes and ultra-runners wear orthotics. I have worn orthotics for 8 years - whenever I wear shoes. Yes, properly made orthotics will prevent excessive stretching of your fascia during activies. The difficult part is that very few medical people will make an orthotic radical enough to eliminate the excessive motion of people with imperfect feet.

Once again, I have posted that rest for PF is often misunderstood to mean total rest. I suggest that rest for PF should be avoiding the activities that caused your injury and/or those that cause re-injury.

Rock.
TN. USA.


Re: Are orthodics the answer for serious athletes?

T. Hurst on 7/17/00 at 19:36 (023452)

Rock - I'm on my second pair of custom orthodics! Who would I turn to to make a more rigid pair (assuming I can spare another $300)? Seems like my current pair perfectly fits the contour of my arch. How would the design be altered to make things any better?

Re: Are orthodics the answer for serious athletes?

T. Hurst on 7/17/00 at 19:43 (023453)

Yes, I agree - rest is key. Or else the fascia cannot heal. My problem is I can experience near complete healing - no pain in my heel - then even slight exercise will reinjure the fascia and I'm back where I started. No matter how much I stretch, take NSAIDs, etc., I cannot lenghten the fascia to the point where it will not tear with exercise. I know I am the exception on this! It's frustrating. I think if I had rested/stretched/iced/NSAIDs one year ago when I first felt pain, my pf would be manageable. At this point, I feel it is beyond management without surgery. 20/20 hindsight!

Re: Are orthodics the answer for serious athletes?

JudyS on 7/17/00 at 19:54 (023456)

Rock - I am agreeing more and more that at least SOME activity is necessary. Even Nancy's new PT said so. It makes sense really because some activity helps to prevent stiffening and lack of circulation. I'm not running again yet, but I can work in the yard for a couple of hours or play ball for awhile. When I do, I find that I am actually less sore - as long as ice follows activity.

Re: Are orthodics the answer for serious athletes?

ChuckC on 7/17/00 at 22:44 (023488)

Tracy, I wear hard plastic, 3/4 length orthotics that are covered with a layer of thin leather. Although I can run 40 miles a week, there are certain things I cannot do while wearing orthotics. I can't run up steep hills, do wall push-ups, drive a car with a manual transmission (because pushing in on the clutch aggrevates my PF), etc.

Experiment to find the things you can do and do those. Walking is a good start if it is not too painful. It took me four or five months to get used to my orthotics although I must admit that I was running races (with great pain) in two months.

I agree with most of the posters to your message--you have to do some activity as soon as you can. Staying totally off your feet does not permit the fascia to heal properly or quickly. I think an occasional twinge of pain or a little soreness that eases up after a few minutes is o.k. Normally, these go away and everything is fine the next morning. When they are not, then you know you have overdone it and need to back off what you were doing that caused it.

Although I wore Birkenstocks for a while and they helped alleviate the PF pain, I now wear my orthotics exclusively. I think the Birkenstocks were so hard that they caused my back pain to reappear.

Hope this helps.


Re: Are orthodics the answer for serious athletes?

Hank C. on 7/18/00 at 06:33 (023499)

T.,
Like you I have a good pair of custom orthotics. What helped me in addition, however, is a pair of shoes
with fairly rigid soles. I bought a pair of hiking shoes for a 2 week trip to Alaska in June. Although I did
quite of bit of hiking there plus other activities, my pf did not bother me at all. It had been doing better even
before the trip however I hardly noticed it at all during my stay. I did a sprint distance (ironman is way out
of my league) triathlon this weekend and wore the hiking shoes because my feet seem to be 'happier'
in them. Of course I still wear the custom orthotics. For the time being I've put my Brooks running shoes in the
closet. I only run every other day and try to do almost all my running on a soft surface. I'm avoiding the
asphalt for now. I've had pf for almost 2 years.
best of luck, Hank

Re: Are orthodics the answer for serious athletes?

Rock on 7/18/00 at 14:19 (023530)

I do not know the details, but I am told by my P.T. O.C.S ('orthotic designer' to me) guy in Knoxville TN that 'posting' is the key to minimizing excess motions of my feet after the shape of the arch has been made as good as possible. I am going to see him Thursday about doing this.

He said that my other really big problem is that my calves cannot stretch to full length because of adhesions and knots that have to be worked out by deep massage/PT. Interesting that he thinks that the of adhesions and knots in my calves are partially a result of excess motions in my feet in the first 38 years of life (before orthotics and before running) as well as being an active 45 year old.

Rock.


Re: Are orthodics the answer for serious athletes?

Rock on 7/18/00 at 14:27 (023531)

Tracy,

The plantar fascia is really a thin wide ligament (bone to bone connector) that is not intended to stretch. What is supposed to stretch are the muscles in your calves. Two major problems with stretching calf muscles:

1. Knots / adhesions will prevent stretching calves to normal length.

2. Most calf streches overload the plantar fascia (often it's attchment to the heel bone) and cause re-injury. So one must prevent one's arch from going flat while streching calves !

Rock.



Re: Are orthodics the answer for serious athletes?

T. Hurst on 7/18/00 at 19:24 (023538)

It never occurred to me before how flexible the running shoes I wear every day are! After I read your post, I realized my feet hurt very little when I wear my hiking boots, which by their nature are very rigid. If I could only run and play soccer in my hiking boots. Soccer, especially, requires extreme foot flexibility, my enemy right now. Thanks for making some sense of this.

Re: Are orthodics the answer for serious athletes?

Bob G. on 7/16/00 at 23:14 (023409)

Hi, Tracy!

Perhaps rest may be the cure. I am 4 months pain-free...took me 10 months of rest. Would have been sooner if I had not been so eager and started back too soon.

Everybody's different. Do a search under my name if you want my story; Don't mind the blonde jokes.

Good luck! :)


Re: Are orthodics the answer for serious athletes?

john h on 7/17/00 at 08:34 (023418)

bob: when you say 10 months of rest what exactly do you mean? stay in bed when not working? minimal time on your feet? no cardiac activity at all?

Re: Are orthodics the answer for serious athletes?

Rock on 7/17/00 at 09:55 (023421)

Tracy,

As an ironman triathlete and ultra-runner, I am probably the most active of all the regular posters on this board [last week's actvity: swam 5 miles, biked 180 miles, ran 24 miles.].

It is my estimate that 10% or more of ironman triathletes and ultra-runners wear orthotics. I have worn orthotics for 8 years - whenever I wear shoes. Yes, properly made orthotics will prevent excessive stretching of your fascia during activies. The difficult part is that very few medical people will make an orthotic radical enough to eliminate the excessive motion of people with imperfect feet.

Once again, I have posted that rest for PF is often misunderstood to mean total rest. I suggest that rest for PF should be avoiding the activities that caused your injury and/or those that cause re-injury.

Rock.
TN. USA.


Re: Are orthodics the answer for serious athletes?

T. Hurst on 7/17/00 at 19:36 (023452)

Rock - I'm on my second pair of custom orthodics! Who would I turn to to make a more rigid pair (assuming I can spare another $300)? Seems like my current pair perfectly fits the contour of my arch. How would the design be altered to make things any better?

Re: Are orthodics the answer for serious athletes?

T. Hurst on 7/17/00 at 19:43 (023453)

Yes, I agree - rest is key. Or else the fascia cannot heal. My problem is I can experience near complete healing - no pain in my heel - then even slight exercise will reinjure the fascia and I'm back where I started. No matter how much I stretch, take NSAIDs, etc., I cannot lenghten the fascia to the point where it will not tear with exercise. I know I am the exception on this! It's frustrating. I think if I had rested/stretched/iced/NSAIDs one year ago when I first felt pain, my pf would be manageable. At this point, I feel it is beyond management without surgery. 20/20 hindsight!

Re: Are orthodics the answer for serious athletes?

JudyS on 7/17/00 at 19:54 (023456)

Rock - I am agreeing more and more that at least SOME activity is necessary. Even Nancy's new PT said so. It makes sense really because some activity helps to prevent stiffening and lack of circulation. I'm not running again yet, but I can work in the yard for a couple of hours or play ball for awhile. When I do, I find that I am actually less sore - as long as ice follows activity.

Re: Are orthodics the answer for serious athletes?

ChuckC on 7/17/00 at 22:44 (023488)

Tracy, I wear hard plastic, 3/4 length orthotics that are covered with a layer of thin leather. Although I can run 40 miles a week, there are certain things I cannot do while wearing orthotics. I can't run up steep hills, do wall push-ups, drive a car with a manual transmission (because pushing in on the clutch aggrevates my PF), etc.

Experiment to find the things you can do and do those. Walking is a good start if it is not too painful. It took me four or five months to get used to my orthotics although I must admit that I was running races (with great pain) in two months.

I agree with most of the posters to your message--you have to do some activity as soon as you can. Staying totally off your feet does not permit the fascia to heal properly or quickly. I think an occasional twinge of pain or a little soreness that eases up after a few minutes is o.k. Normally, these go away and everything is fine the next morning. When they are not, then you know you have overdone it and need to back off what you were doing that caused it.

Although I wore Birkenstocks for a while and they helped alleviate the PF pain, I now wear my orthotics exclusively. I think the Birkenstocks were so hard that they caused my back pain to reappear.

Hope this helps.


Re: Are orthodics the answer for serious athletes?

Hank C. on 7/18/00 at 06:33 (023499)

T.,
Like you I have a good pair of custom orthotics. What helped me in addition, however, is a pair of shoes
with fairly rigid soles. I bought a pair of hiking shoes for a 2 week trip to Alaska in June. Although I did
quite of bit of hiking there plus other activities, my pf did not bother me at all. It had been doing better even
before the trip however I hardly noticed it at all during my stay. I did a sprint distance (ironman is way out
of my league) triathlon this weekend and wore the hiking shoes because my feet seem to be 'happier'
in them. Of course I still wear the custom orthotics. For the time being I've put my Brooks running shoes in the
closet. I only run every other day and try to do almost all my running on a soft surface. I'm avoiding the
asphalt for now. I've had pf for almost 2 years.
best of luck, Hank

Re: Are orthodics the answer for serious athletes?

Rock on 7/18/00 at 14:19 (023530)

I do not know the details, but I am told by my P.T. O.C.S ('orthotic designer' to me) guy in Knoxville TN that 'posting' is the key to minimizing excess motions of my feet after the shape of the arch has been made as good as possible. I am going to see him Thursday about doing this.

He said that my other really big problem is that my calves cannot stretch to full length because of adhesions and knots that have to be worked out by deep massage/PT. Interesting that he thinks that the of adhesions and knots in my calves are partially a result of excess motions in my feet in the first 38 years of life (before orthotics and before running) as well as being an active 45 year old.

Rock.


Re: Are orthodics the answer for serious athletes?

Rock on 7/18/00 at 14:27 (023531)

Tracy,

The plantar fascia is really a thin wide ligament (bone to bone connector) that is not intended to stretch. What is supposed to stretch are the muscles in your calves. Two major problems with stretching calf muscles:

1. Knots / adhesions will prevent stretching calves to normal length.

2. Most calf streches overload the plantar fascia (often it's attchment to the heel bone) and cause re-injury. So one must prevent one's arch from going flat while streching calves !

Rock.



Re: Are orthodics the answer for serious athletes?

T. Hurst on 7/18/00 at 19:24 (023538)

It never occurred to me before how flexible the running shoes I wear every day are! After I read your post, I realized my feet hurt very little when I wear my hiking boots, which by their nature are very rigid. If I could only run and play soccer in my hiking boots. Soccer, especially, requires extreme foot flexibility, my enemy right now. Thanks for making some sense of this.