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Another question for Dr. Z or anybody....

Posted by Sue R on 8/21/00 at 21:14 (025969)

Dr. Z or anybody,

I've been talking about how my fascia (or tendon) sticks out big time when I flex my foot. And since this is where I hurt now, it concerns me. However, I'm wondering if since my arches are super high, if they didn't always stick out and I'm just freaked about it now that I have pf. So my questions are:

1) Is it normal to have that fascia stick out and be so tight when I flex? (esp for high arch feet)

2) Is this why my arches are so irritated when I wear hard orthotics? (and I think I need the support!)

3) Does anyone else have this problem?

Dr. Z...for your info..I have been to several docs and they are stumped or maybe just thinking I need to give it some time. My POD says I need to be in orthotics (but they hurt). I've tested neg on nerve tests and PT testing showed that my alignment and muscle strength is good.

Thanks for your help!

Sue R


Re: Another question for Dr. Z or anybody....

john h on 8/21/00 at 21:19 (025971)

if i flex my great toe up just a little my band of fascia sticks out and is tight. i think this is probably normal.

Re: To Sue, Another question for Dr. Z or anybody....

Pauline on 8/22/00 at 08:36 (025985)

Sue,
I think you and I have similar though not exact problems. My arches
are very tender and yes I have puffyness over the tendon. When I
flex my foot it is sometimes more 'swellen' than at other times.
I have found when I am completely off my feet for 2 days the puffyness goes down, never away but down. When I walk again up it comes. I cannot put an orthotic near it. I have four pairs of custom orthotics and they are extremely painful to try to wear. The
latest Dr I'm seeing thinks there may be involvement of the tendon sheath. This doesn't surprise me because I think when you have inflammation in the fascia it affects everything. If there is something other than strictly inflammation going on I would really be more concerned and perhaps the ultra sound that is scheduled today will tell him something more.

Personally after 3 Orthos and lots of tests I think in the end it will only be confirmed as atypical Plantar Fasciitis. Second time round so more difficult to get rid of.

I have one pair of custom orthotics made of a softer material not plastic in any sense. Before you spend more money on orthotics think about trying the jell type that are sold over the counter. They might provide the soft support you need. Another thought is that
New Balance running shoes offers many varieties with higher arches.
Go to the type store where you can take 1/2 a day if necessary and
try on various shoes. Ask for those with higher arches. They may provide you with natural support without an orthotic.

Continue soft massage many times a day, icing until you used 5,000 lbs and keep feet up.


Re: To Sue, Another question for Dr. Z or anybody....

Sue R on 8/22/00 at 09:54 (026003)

Thanks, Pauline. Let us know how your appt goes today. I'm anxious to hear. Good luck to you!

Sue R


Re: Another question for Dr. Z or anybody....

Helene M on 8/22/00 at 11:02 (026013)

Yes, I have the same problem as you, Sue. My fascia sticks out when I flex my foot. I don't even have to pull back my big toe to see it. However I remember that it always stuck out of my high arched feet, even before I got PF. Maybe that's normal. I guess Dr. Z will answer that. I also have a very hard time tolerating any pressure on my arches. My feet are very thin-skinned. How about yours? Maybe that's why it's so hard to wear orthotics.

Re: Another question for Dr. Z or anybody....

Sue R on 8/22/00 at 11:10 (026014)

Helen,

I was able to wear orthotics from 1995 - May of this year, when I got this second horrible flare up. Now I can't wear them, but I'm still trying. I know I need the support so it's difficult either way.

Sue R


Re: Another question for Dr. Z or anybody....

Dr. Biehler on 8/22/00 at 14:14 (026029)

It is normal for the fascia to stick out when the foot is flexed if it is a very high arch foot. As we get older the fat pad over the fascia starts to atrophy and the tendon appears more prevelent and it is a lot easier for the fasia to become brusied. If you were wearing orthotics they might need to be completly redone to accomadate for this. Dr. Biehler

Re: Another question for Dr. Z or anybody....

suzi on 8/22/00 at 18:12 (026056)

Dr. biehler, what should someone like me do who has extremely flat feet and desperately needs some sort of support to help the flattened out fascia from continually being reinjured, but cannot tolerate being in an enclosed shoe or wearing orthodics?? It's a no win situation! where are you located?

Re: Another question for Dr. Z or anybody....

Dr. Biehler on 8/22/00 at 22:01 (026072)

If you can't wear shoes, that narrows the choices. First you have to determine why your feet are flat. Is your tibia bowed? Is the calcanious plantarflexed, lax ligaments or a collapsed arch? Some people think they have flay feet when really it's the front of their foot that is in varus and they are used to cranking their subtaylor joint around to get their foot on the ground. You post the front of their foot and they have an arch again. I am located in New York. I have a map on my web site: mydoctor,com/kbiehler

Re: Another question for Dr. Z or anybody....

john h on 8/21/00 at 21:19 (025971)

if i flex my great toe up just a little my band of fascia sticks out and is tight. i think this is probably normal.

Re: To Sue, Another question for Dr. Z or anybody....

Pauline on 8/22/00 at 08:36 (025985)

Sue,
I think you and I have similar though not exact problems. My arches
are very tender and yes I have puffyness over the tendon. When I
flex my foot it is sometimes more 'swellen' than at other times.
I have found when I am completely off my feet for 2 days the puffyness goes down, never away but down. When I walk again up it comes. I cannot put an orthotic near it. I have four pairs of custom orthotics and they are extremely painful to try to wear. The
latest Dr I'm seeing thinks there may be involvement of the tendon sheath. This doesn't surprise me because I think when you have inflammation in the fascia it affects everything. If there is something other than strictly inflammation going on I would really be more concerned and perhaps the ultra sound that is scheduled today will tell him something more.

Personally after 3 Orthos and lots of tests I think in the end it will only be confirmed as atypical Plantar Fasciitis. Second time round so more difficult to get rid of.

I have one pair of custom orthotics made of a softer material not plastic in any sense. Before you spend more money on orthotics think about trying the jell type that are sold over the counter. They might provide the soft support you need. Another thought is that
New Balance running shoes offers many varieties with higher arches.
Go to the type store where you can take 1/2 a day if necessary and
try on various shoes. Ask for those with higher arches. They may provide you with natural support without an orthotic.

Continue soft massage many times a day, icing until you used 5,000 lbs and keep feet up.


Re: To Sue, Another question for Dr. Z or anybody....

Sue R on 8/22/00 at 09:54 (026003)

Thanks, Pauline. Let us know how your appt goes today. I'm anxious to hear. Good luck to you!

Sue R


Re: Another question for Dr. Z or anybody....

Helene M on 8/22/00 at 11:02 (026013)

Yes, I have the same problem as you, Sue. My fascia sticks out when I flex my foot. I don't even have to pull back my big toe to see it. However I remember that it always stuck out of my high arched feet, even before I got PF. Maybe that's normal. I guess Dr. Z will answer that. I also have a very hard time tolerating any pressure on my arches. My feet are very thin-skinned. How about yours? Maybe that's why it's so hard to wear orthotics.

Re: Another question for Dr. Z or anybody....

Sue R on 8/22/00 at 11:10 (026014)

Helen,

I was able to wear orthotics from 1995 - May of this year, when I got this second horrible flare up. Now I can't wear them, but I'm still trying. I know I need the support so it's difficult either way.

Sue R


Re: Another question for Dr. Z or anybody....

Dr. Biehler on 8/22/00 at 14:14 (026029)

It is normal for the fascia to stick out when the foot is flexed if it is a very high arch foot. As we get older the fat pad over the fascia starts to atrophy and the tendon appears more prevelent and it is a lot easier for the fasia to become brusied. If you were wearing orthotics they might need to be completly redone to accomadate for this. Dr. Biehler

Re: Another question for Dr. Z or anybody....

suzi on 8/22/00 at 18:12 (026056)

Dr. biehler, what should someone like me do who has extremely flat feet and desperately needs some sort of support to help the flattened out fascia from continually being reinjured, but cannot tolerate being in an enclosed shoe or wearing orthodics?? It's a no win situation! where are you located?

Re: Another question for Dr. Z or anybody....

Dr. Biehler on 8/22/00 at 22:01 (026072)

If you can't wear shoes, that narrows the choices. First you have to determine why your feet are flat. Is your tibia bowed? Is the calcanious plantarflexed, lax ligaments or a collapsed arch? Some people think they have flay feet when really it's the front of their foot that is in varus and they are used to cranking their subtaylor joint around to get their foot on the ground. You post the front of their foot and they have an arch again. I am located in New York. I have a map on my web site: mydoctor,com/kbiehler