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Help has come, I hope.

Posted by D on 7/27/00 at 18:04 (024116)

I went to my new POD today. I hope I am on the road to healing. I am in a walking cast, have inserts for my shoes and medication (meloxicam) and the stretches. The cast does help the foot with the pain. I am wondering has anyone else has done what I am about to start and did it work. And a big thanks to Dr. Z and the others that wrote to help. I will keep you posted. Thank you.

Re: Help has come, I hope.

jan on 7/27/00 at 18:38 (024118)

I'm in a 'walking cast' ...a velcro boot. Aren't they lovely. I'm on week four. I also got my insurance to cover my wheelchair for home use. (And the occassional week-end outing). The two work well together to enforce rest. I am doing better but had a minor set back Mon when my pod tried again to repeat ultra-sound. (it made me worse). But it's Thursday now and pain from ultra-sound is going away. Of course, I'm doing almost no walking so can't say yet if there's any real heeling happening.

Re: Help has come, I hope.

Fred on 7/27/00 at 20:51 (024125)

I have had a walking cast for about 3 weeks now and have been taking celebrex, the only NSAID I have tried which I am able to tolerate. I also have custom orthotics which help considerably. Haven't had any pain in my heel/foot in about two weeks despite being increasingly active, i.e.,walking slowly for up to about 45 minutes and swimming several times a week (I have a fiberglass cast with a wonderful Goretex waterproof cast liner which permits swimming and bathing without a cast cover).

I really think this is going to take care of my PF, provided I am careful and patient with rehab when the cast comes off week after next. Best of luck to you.


Re: Help has come, I hope.

Suzi D on 7/27/00 at 21:24 (024127)

I also have a boot. A Velcro blue frankenstein boot which my second POD gave me. It worked great and after a couple of weeks he wanted me to wean myself off of it. Now I've moved out of state, and the ortho guy says 'they don't work'. I told him it helped a lot, and he just shrugged it off. He gave me a heel cup. yippee. I don't understand all the different opinions and treatments. I've worn the boot since moving and it's started to hurt more than help. I just don't get it. Now, I'm using a cane and doing cautious stretches. I'm thinking of going for massage therapy.

pf'ly yours,
Suzi


Re: Help has come, I hope.

Beverly on 7/27/00 at 21:24 (024128)

I had to stop wearing my boot after a few days. I wonder now if I had the right size, but it made my foot tingle and go numb, and it made my back hurt (but I have upperbody troubles). The boot was optional for me, and so I elected to focus on extreme rest for awhile instead.

Beverly


Re: Help has come, I hope.

mss on 7/27/00 at 22:18 (024133)

I was in a removeable walking cast for seven weeks and it helped almost completely eliminating the pain from PF and tendonitis. I have been wearing custom othotics for two months since getting out of the cast and have been doing well, except for overdoing it a couple of times or not wearing the orthotics like I should have. I spent the last couple of weeks of the seven weeks wearing the boot less and less each day, as intstructed, and feel like this was very important for the recovery. Remember to take it slow after the cast.

Re: Help has come, I hope.

Dr.Biehler on 7/28/00 at 07:21 (024138)

Casts and removable casts can be a big help in giving the foot time to heal. You must keep in mind that they can cause a functional limb lenght difference that can effect other parts of the body. If the cast is not removable, the achillies will tend to shorten and the muscle will tend to atrophy from the lack of movement. This is alright as long as you are aware of this and don't over do it, in any way, when the cast first comes off. Dr. Biehler

Re: Help has come, I hope.

Jan on 7/28/00 at 12:12 (024165)

So what amount of walking is acceptable in the boot? I find I do better only if I can really stay of of it. I succeed in that in the evenings so by morning, I'm feeling ok. By the time I get to my desk I'm sore again. I'm trying to fight needing a wheelchair at work hoping if I give the boot enough time I'm this pattern will fade. I'm finishing up week 4 and am still in this cycle. Will it subside and do I just need to give it more time? Or, am I trying to use the boot for too much walking and I should take time off work? If so, how long?

Re: Help has come, I hope. -- for Dr. Biehler

Nancy S. on 7/28/00 at 14:34 (024178)

Dr. Biehler, do you have sort of an average standard by which you would guide someone as to what would be 'overdoing' it after a cast comes off?
I haven't been casted, but my PF was severe for 8+ months and then I mostly rested for 3 months in the winter, tried to ease back into activity, but apparently overdid it and ended up with achilles tendonitis in both feet. (Forgive me if I'm boring you, I probably told you all this when I first asked you a question a few weeks ago!)
I'm seeing a specialist next week, but in the meantime I still keep wondering what might have caused the AT. I never had it before. I suspect my high rigid orthotics last fall didn't help, and maybe I didn't do enough offsetting activity during my PF rest, and maybe I tried to get back to work too fast -- etc. etc. blah blah -- I wonder and wonder.
I'm just wondering, if I were your patient and coming out of a serious form of rest for bad PF, what you might have told me about how much activity would be overdoing it, and how to avoid AT.
Thank you --Nancy

Re: Help has come, I hope. -- for Dr. Biehler

Dr. Biehler on 7/28/00 at 17:57 (024191)

Nancy s; When I trained at Keller Hospital at West Point, the surgen I worked with always tried casting as a last resort before surgery for plantar fasciitis. I think his results were about 50/50 with the casting. The problem can be that on coming out if the cast , the leg has been considerably weakend and sometimes the tendons have contracted. In this state, if there is not the normal range of motion available in the ankle, sometimes even normal walking can cause a tear in the achillies. This can be prevented by being forwarned and using a heel lift untill the range of motion comes back and the leg gets stronger. Dr. Biehler

Re: Help has come, I hope. -- for Dr. Biehler

Pauline on 7/29/00 at 22:43 (024271)

What exactly is a removable cast? Do you sleep with it or remove it
at night. Sorry to be so dumb, but I don't think I could stand a real
cast. The last time I tried one they cut it off 24 hrs later because
of panic. I'm not a good patient for a full cast. Knowing I could
take it off in a panic emergency would really help me.

Re: Help has come, I hope. -- for Dr. Biehler

john a on 8/01/00 at 14:55 (024338)

That reminds me of the time a decade ago that, in desperation, I had a doctor cast my elbow to try to get rid of chronic bursitis. I clearly remember being so happy at taking this, presumably final, step, and bounding joyfully up the steps two at a time (WAY before my PF days!), only to stumble and fall, you guessed it, right on my newly cast elbow, which was now just a mere cast's width beyond any hope of soothing by ice pack. Isn't life just wonderful sometimes?

Re: Help has come, I hope.

jan on 7/27/00 at 18:38 (024118)

I'm in a 'walking cast' ...a velcro boot. Aren't they lovely. I'm on week four. I also got my insurance to cover my wheelchair for home use. (And the occassional week-end outing). The two work well together to enforce rest. I am doing better but had a minor set back Mon when my pod tried again to repeat ultra-sound. (it made me worse). But it's Thursday now and pain from ultra-sound is going away. Of course, I'm doing almost no walking so can't say yet if there's any real heeling happening.

Re: Help has come, I hope.

Fred on 7/27/00 at 20:51 (024125)

I have had a walking cast for about 3 weeks now and have been taking celebrex, the only NSAID I have tried which I am able to tolerate. I also have custom orthotics which help considerably. Haven't had any pain in my heel/foot in about two weeks despite being increasingly active, i.e.,walking slowly for up to about 45 minutes and swimming several times a week (I have a fiberglass cast with a wonderful Goretex waterproof cast liner which permits swimming and bathing without a cast cover).

I really think this is going to take care of my PF, provided I am careful and patient with rehab when the cast comes off week after next. Best of luck to you.


Re: Help has come, I hope.

Suzi D on 7/27/00 at 21:24 (024127)

I also have a boot. A Velcro blue frankenstein boot which my second POD gave me. It worked great and after a couple of weeks he wanted me to wean myself off of it. Now I've moved out of state, and the ortho guy says 'they don't work'. I told him it helped a lot, and he just shrugged it off. He gave me a heel cup. yippee. I don't understand all the different opinions and treatments. I've worn the boot since moving and it's started to hurt more than help. I just don't get it. Now, I'm using a cane and doing cautious stretches. I'm thinking of going for massage therapy.

pf'ly yours,
Suzi


Re: Help has come, I hope.

Beverly on 7/27/00 at 21:24 (024128)

I had to stop wearing my boot after a few days. I wonder now if I had the right size, but it made my foot tingle and go numb, and it made my back hurt (but I have upperbody troubles). The boot was optional for me, and so I elected to focus on extreme rest for awhile instead.

Beverly


Re: Help has come, I hope.

mss on 7/27/00 at 22:18 (024133)

I was in a removeable walking cast for seven weeks and it helped almost completely eliminating the pain from PF and tendonitis. I have been wearing custom othotics for two months since getting out of the cast and have been doing well, except for overdoing it a couple of times or not wearing the orthotics like I should have. I spent the last couple of weeks of the seven weeks wearing the boot less and less each day, as intstructed, and feel like this was very important for the recovery. Remember to take it slow after the cast.

Re: Help has come, I hope.

Dr.Biehler on 7/28/00 at 07:21 (024138)

Casts and removable casts can be a big help in giving the foot time to heal. You must keep in mind that they can cause a functional limb lenght difference that can effect other parts of the body. If the cast is not removable, the achillies will tend to shorten and the muscle will tend to atrophy from the lack of movement. This is alright as long as you are aware of this and don't over do it, in any way, when the cast first comes off. Dr. Biehler

Re: Help has come, I hope.

Jan on 7/28/00 at 12:12 (024165)

So what amount of walking is acceptable in the boot? I find I do better only if I can really stay of of it. I succeed in that in the evenings so by morning, I'm feeling ok. By the time I get to my desk I'm sore again. I'm trying to fight needing a wheelchair at work hoping if I give the boot enough time I'm this pattern will fade. I'm finishing up week 4 and am still in this cycle. Will it subside and do I just need to give it more time? Or, am I trying to use the boot for too much walking and I should take time off work? If so, how long?

Re: Help has come, I hope. -- for Dr. Biehler

Nancy S. on 7/28/00 at 14:34 (024178)

Dr. Biehler, do you have sort of an average standard by which you would guide someone as to what would be 'overdoing' it after a cast comes off?
I haven't been casted, but my PF was severe for 8+ months and then I mostly rested for 3 months in the winter, tried to ease back into activity, but apparently overdid it and ended up with achilles tendonitis in both feet. (Forgive me if I'm boring you, I probably told you all this when I first asked you a question a few weeks ago!)
I'm seeing a specialist next week, but in the meantime I still keep wondering what might have caused the AT. I never had it before. I suspect my high rigid orthotics last fall didn't help, and maybe I didn't do enough offsetting activity during my PF rest, and maybe I tried to get back to work too fast -- etc. etc. blah blah -- I wonder and wonder.
I'm just wondering, if I were your patient and coming out of a serious form of rest for bad PF, what you might have told me about how much activity would be overdoing it, and how to avoid AT.
Thank you --Nancy

Re: Help has come, I hope. -- for Dr. Biehler

Dr. Biehler on 7/28/00 at 17:57 (024191)

Nancy s; When I trained at Keller Hospital at West Point, the surgen I worked with always tried casting as a last resort before surgery for plantar fasciitis. I think his results were about 50/50 with the casting. The problem can be that on coming out if the cast , the leg has been considerably weakend and sometimes the tendons have contracted. In this state, if there is not the normal range of motion available in the ankle, sometimes even normal walking can cause a tear in the achillies. This can be prevented by being forwarned and using a heel lift untill the range of motion comes back and the leg gets stronger. Dr. Biehler

Re: Help has come, I hope. -- for Dr. Biehler

Pauline on 7/29/00 at 22:43 (024271)

What exactly is a removable cast? Do you sleep with it or remove it
at night. Sorry to be so dumb, but I don't think I could stand a real
cast. The last time I tried one they cut it off 24 hrs later because
of panic. I'm not a good patient for a full cast. Knowing I could
take it off in a panic emergency would really help me.

Re: Help has come, I hope. -- for Dr. Biehler

john a on 8/01/00 at 14:55 (024338)

That reminds me of the time a decade ago that, in desperation, I had a doctor cast my elbow to try to get rid of chronic bursitis. I clearly remember being so happy at taking this, presumably final, step, and bounding joyfully up the steps two at a time (WAY before my PF days!), only to stumble and fall, you guessed it, right on my newly cast elbow, which was now just a mere cast's width beyond any hope of soothing by ice pack. Isn't life just wonderful sometimes?