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PF Remission / Flare-Ups

Posted by Rock on 7/25/00 at 08:37 (023877)

I. PF Remission / Flare-Ups.

After 4 months of PF, my PF seems to be mostly in a state of remission with a flare-up every few weeks. As an extremely active PF person (swim 5 mi /week, bike 200 mi / week, run 26 mi / week) , I thought it might be useful for me to share a few observations about how high activity interacts with these ocasional flare-ups.

First, some definitions:
flare-up = 'some pain in heel when walking short distances'
remission = 'no pain at all'.

1. Flare-ups seem to happen if I get a bit lazy on my calf stretches, or if I stretch a bit too much !

2. On flare-up days, biking 40-120 miles will make the pain go away for days.

3. On flare-up days, swimming 1.5 - 2.0 miles will make the pain go away for days.

4. On flare-up days, running 5-16 miles will NOT make the pain go away afterwards, but it will NOT make it any worse. Also, the PF does not hurt when running. Actually, I would run longer distances, but my AT (not on same leg as PF) is my limiting factor. Only once, when racing a hilly 50 mile trail ultra-marathon [4/15/00] did PF get worse as a result of running (I wish I had skipped that race!).

Conclusion: Activity helps, but stretching of calves must be perfect !


QUESTION: Does activity make your PF better or worse ?

II. Current Professional Therapy:

1. Massage once a week
2. PT once a week (extra hard massage)
3. Orthotics Rebuild

My orthotrics guy (P.T. O.C.S.) is changing forefoot posting from 0 degrees to 15 degrees. This approach (not often strongly used by PODs) will have the effect of slanting my forefoot outward and greatly reducing the stress on the calf/achilles complex while the foot is planted on the ground. I should get the rebuilt Orthotics back in about one week. I will post the results, if any, to this board in a few weeks.

Rock.


Re: PF Remission / Flare-Ups

Rick R on 7/25/00 at 14:35 (023910)

Rock,

I am convinced that at some point in the recovery process a return to activity is essential to recovery. Somewhere in my second decade of this I decided that if my condition needed to be worse to get help then so be it. No doctor that I trusted with any sharp object would do anything, and the guy I trusted seemed to think I should get better on my own. Somehow it didn't dawn on him the absurdity of letting time heal after over 10 years of waiting around for it to subside. I returned to running with the intention of making things worse, or at least to go down fighting. Just my rotten luck, things got better. I did eventually grow my left heel spur in a few years to proportions to great to ignore; I either had to get it a social security number of have it removed. After I was running again, I never had the kind of pain that I was experiencing prior to returning to running.

I'm now doing about 15 miles a week durring the summer and 30 - 35 in the winter (summer gets too busy).

But let's be careful here. There is clearly a need for rest too, most importantly at the onset stages. Just where those lines should be drawn is likely a very patient specific point. I'm concerned some might take our opinions on the value of exercise too far and cause more dammage.

Just as running seems counterintuitive so does the hard massage on such a sore area. My daughter, bless her heart, started massaging for me and I protested greatly! She insisted it was the right thing to do. After only a few times I was a believer. They all were tired of puting up with me, I could get them do just about anything to shut me up.

Good Luck,

Rick


Re: PF Remission / Flare-Ups

Rick R on 7/25/00 at 14:35 (023910)

Rock,

I am convinced that at some point in the recovery process a return to activity is essential to recovery. Somewhere in my second decade of this I decided that if my condition needed to be worse to get help then so be it. No doctor that I trusted with any sharp object would do anything, and the guy I trusted seemed to think I should get better on my own. Somehow it didn't dawn on him the absurdity of letting time heal after over 10 years of waiting around for it to subside. I returned to running with the intention of making things worse, or at least to go down fighting. Just my rotten luck, things got better. I did eventually grow my left heel spur in a few years to proportions to great to ignore; I either had to get it a social security number of have it removed. After I was running again, I never had the kind of pain that I was experiencing prior to returning to running.

I'm now doing about 15 miles a week durring the summer and 30 - 35 in the winter (summer gets too busy).

But let's be careful here. There is clearly a need for rest too, most importantly at the onset stages. Just where those lines should be drawn is likely a very patient specific point. I'm concerned some might take our opinions on the value of exercise too far and cause more dammage.

Just as running seems counterintuitive so does the hard massage on such a sore area. My daughter, bless her heart, started massaging for me and I protested greatly! She insisted it was the right thing to do. After only a few times I was a believer. They all were tired of puting up with me, I could get them do just about anything to shut me up.

Good Luck,

Rick