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Newbie PFer

Posted by angie on 9/05/00 at 19:12 (027326)

Today I got the 'good' news I have PF of the right foot and a bone spur on the left. Does anyone have a few words of wisdom regarding what treatments to try first? I can't believe my luck. In November I had breast cancer surgery, follwed by chemo and radiation. The chemo triggered bilateral arthritis in my hands and I thought the pains in my foot were that too. I look forward to any input. Thanks.

Re: Newbie PFer

Dena on 9/05/00 at 20:04 (027333)

Angie:

I can't add much to the 'technical' discussion since I'm new to this board. I can tell you, however, that the other members here are wonderful and supportive and excessively generous with encouragement and knowledge.

Hang in there!!!

Dena

Re: Newbie PFer

alan k on 9/05/00 at 20:31 (027336)

Depending on the situation there are different priorities. Here's what I think most people benefit from:

rest, especially refraining from any repetitive activity that may have led to the problem.

exercise and stretching which does not put too much stress on the plantar fascia

massage self massage, partner massage, or by someone experienced

new footwear, heel lifts, inserts, birkenstock sandals. DON'T SKIMP on buying new pf-friendly shoes or birkenstocks! I thought $50 heel lifts, the first thing my doctor recommended after a few weeks of pain, was a lot to shell out. 1-2 thousand dollars later this seems funny (but not very funny, obvioulsy)

don't walk barefoot. Get sandals for the shower.

drink at least 8 glasses of water a day (very important for healing)

take supplements especially vitamin C, E, D, Magnesium, Calcium, Zinc. Consult a doctor or do research about safe dosages, or use as recommended on the bottle.

Accept that you are going to get a little sad about this but try to get your spirits up for faster healing, as soon as possible. From what you say you probably already have some experience in doing this.

Good luck to you!


alan k

http://www.acutai.com


.

Re: Newbie PFer

Nancy S. on 9/06/00 at 05:43 (027358)

Welcome, Angie,
Did you get your news from your primary doctor? Are you being referred to a foot specialist? If you click on Scott's 'PF Book' at the top of the page, you will find tons of information there, and it will help you know enough to ask good questions of the doctor and be active in your treatment. In the meantime, alan k's post to you has good suggestions.
I'm sorry you've had so much to deal with in such a short time -- that's a lot. Don't hesitate to post with any more questions, large or small. We all know how tough this is.
Nancy

Re: Newbie PFer

Denise on 9/06/00 at 06:27 (027365)

Angie, I too am a newbie PFer. Mine started on July 11. I seemed to just wake up with it. Here are some tips that I have discovered so far:
1. STOP all impact activity including walking for exercise. I plan to restart walking when I NO LONGER have pain when arising in the a.m.
(I do practice yoga which is gentle stretching and is good for you - also aerobic if you hold your poses).
2. Never go barefoot (not even in the shower - I wear a thongs).
3.Do not wear flat shoes!! Wear a tennis shoe but not Keds.
4.Stetch in the morning (I do yoga). Not hard stretches because you can reinjure your foot.
5. If you sit at a desk as I do all day, KEEP YOUR HEELS ON THE FLOOR. I had a bad habit of propping by heels up on a box because I am short and petite and my heels don't comfortably reach the floor (this was putting stress on the fascia - I learned this from Michael Young at MRTHERAPY.com). Somebody here recommended browsing that site and I learned a lot.

I've ordered a hard rubber heel lift (1/4') from a shoe repair shop which will be ready to pickup on Saturday. Meanwhile I am wearing a Dr. Scholl's heel cushion. I read that a soft cushion can cause heel instability and that is why I am ordering the hard cushions.

On Aug 24 I saw a POD and he told me to keep exercising (I guess he wants future business). He measured me for an orthotic but at this point I'm feeling so much better I may not need to wear it.

Today I have an appointment with a PT. I had good luck with a PT when I had tennis elbow (it has never recurred).

Finally, thank God for this website and Scott who maintains it!! I learned what to do and what not to do from everyone's postings.

Good luck! Let me know if you want me to elaborate on anything.



Re: Heels on the floor

wendyn on 9/06/00 at 08:38 (027370)

Denise! Tell me more about this heels on the floor idea. I also prop my feet on a big box under my desk - I don't like to have them hanging...it used to aggravate TTS and cause a lot of throbbing. Even with my tiny special ordered chair lowered all the way, I can barely keep my feet on the floor and still have my back against the back support. Today I will try though...but please pass on more info if you can.

Re: Newbie PFer

angie on 9/06/00 at 17:44 (027408)

My Primary Care Doctor diagnosed PF. I have had the classic symptoms of pain on first walking after waking up and after periods of inactivity. She told me to stretch my foot by rolling it back and forth over a bottle of frozen drinking water and gave me a prescription for Voltaren. If I'm not better in three weeks she will send me to a POD. I mentioned the PF to my Phyisical Therapist today. He recommends heel stretches, rolling my foot over a tennis ball, icing down and wearing Birks. I do (did) have a habit of walking barefoot around the house. We moved in a year ago and much of the floor is tiled. Does anyone else get chronic leg pains after walking/standing for more than an hour, or is it just me? Thanks for all your kind responses.

Re: Heels on the floor

Beverly on 9/06/00 at 19:20 (027413)

I prop my feet up on an ergodynamic foot rest. It's the kind that can glide back and forth. I thought that was better for me. I'm curious what Dr. Z/B or other med people think.

My best pearl of wisdom is: get a referral to an orthopedic surgeon who specializes in the lowerbody and when you start feeling better, keep going easy. I overdid it when I first felt better and I am still paying for that months and months later.

Good Luck,
Beverly

Re: Newbie PFer

wendyn on 9/06/00 at 22:15 (027433)

Angie - you're story sounds very 'typical'. It also sounds like you're getting some decent medical advice. Chances are very good that if you follow along with the voltaren, the birks, the stretching and the icing - you will make a full recovery.

Hoping for the best for you!

Re: Heels on the floor

Denise on 9/07/00 at 05:47 (027445)

Wendyn, You must be short like me (I'm barely 5'). I was chuckling when I read your posting. I, too, HAD a big box under my desk. I always propped my feet up and crossed my right foot over my left foot. My left foot is where is have a heel spur at the bottom and in the back. I think propping my feet up was putting a lot of pressure on my left heel.

I discovered this idea when I browsed the MRTHERAPY.com site. Salina found this site and shared with everyone. I read the article on PF and it talked about how PF is caused by an inflexible fascia that is repeatedly placed under tension. The article goes on to say, 'This can occur in various situations, such as running or WHEN PEOPLE WHO SIT AT A DESK HOLD THEIR HEELS OFF THE FLOOR FOR LONG PERIODS OF TIME.' That's WAS me.

I sent a note to the author of this article and questioned him about it. Bottom line he wrote back to me and said that I will NEVER permanently get rid of this problem until I stop holding my heels up off of the floor.

Makes sense to me. Of course, there are other factors that cause PF since this is a condition caused by over-use. I'm an avid tennis player. I used to play single 4Xs per week (not anymore unfortunately). But certainly propping my feet up on my left heel can't be helping. It's just not something I would have thought of if I had not browsed the website (Thanks Salina for sharing).

Maybe Dr. Z or B have some additonal input on foot propping.

Re: Heels on the floor

wendyn on 9/07/00 at 08:38 (027453)

Thanks Denise! Yep - I'm a short too, just under 5 foot 2. I'm sitting here with my feet on my box at work. I will try this feet on the floor thing again - but it's just not terribly comfortable for me. Hard on my back because I can't put my feet firmly on the floor. I've tried one of those little ergo foot rests that beverly uses - but I seem to need my feet up higher.

I have a special ergo desk that's lowered as much as possible - and a newer ergo chair that's supposed to be for little people. Don't know what else I can do!

Re: Dr.Z/B.: What do you think about this "heels off the floor theory when sitting?"

Beverly on 9/07/00 at 12:47 (027482)

Dr Z or Dr B,

What do you think about this theory that heels should not be off the floor when sitting? I had never heard that. I DON'T have my feet propped up on a box when I sit at my computer. I use a foot rest that has the option to glide. I like to periodically glide it back and forth. I figured it was giving me a little stretching too. I know it's better for my back and circulation, but is this true that having feet off the floor while sitting at computer is bad? My foot rest typically sits at an angle.

Thanks,
Beverly

Re: Dr.Z/B.: What do you think about this "heels off the floor theory when sitting?"

Dr. Biehler on 9/07/00 at 19:59 (027509)

I have read the article that was reffered to.I do believe that the muscles in the foot can become cramped and cause sever pain untill they are massaged out. I do not feel that holding your heels off the ground while sitting effects the fascia. It is not a low powered constant tension that injures the fascia. The fascia is like a ligament. It is injured by an amount of strain that can cause a ligament or tendon to tear. Steroids or anti-inflamatory drugs can be used to reduce the edema and give the fascia time to heal. It is the same with tapings and orthotics. You need to reduce the stress just like you would do with any grade 2 sprain while it mends.

Re: Dr.Z/B.: What do you think about this "heels off the floor theory when sitting?"

Denise on 9/08/00 at 05:04 (027540)

Thanks Dr. B! I think the way Wendyn and I are propping our feet is different from Beverly's. I was just using a cardboard box and since I haven't been propping this week, I feel much better. It's just one more thing I was doing to aggravate an already sore fascia.

Of course, I'm no longer jogging (did a lot of hill jogging) and I'm not playing tennis (SOB!) - just resting and doing yoga stretches. However, I was discontinuing this activity before and still not seeing results until I stopped propping my feet.

Bottom line I think there is a difference between propping the foot and resting in on some ergonomic device such as Beverly seems to have in her office. Do you concur?

Re: Dr.Z/B.: What do you think about this "heels off the floor theory when sitting?"

Dr. Biehler on 9/08/00 at 06:28 (027543)

Let pain be your guide. Avoid the pain. It's one of your bodies ways of talking to you.

Re: Dr.Z/B.: What do you think about this "heels off the floor theory when sitting?"

Karen Stl on 9/13/00 at 10:35 (028089)

I also prop my feet up. I think the key is how you are using the prop. I have a box under my desk and treat it as a raised floor which brings my knees up and takes pressure off my back. My feet are flat on the box, as if it's the floor. I do not use the box as one would use an ottoman, that points your foot and does not keep the achilles and calf muscle stretched out which I have come to find is extremely important.

Re: Newbie PFer

Dena on 9/05/00 at 20:04 (027333)

Angie:

I can't add much to the 'technical' discussion since I'm new to this board. I can tell you, however, that the other members here are wonderful and supportive and excessively generous with encouragement and knowledge.

Hang in there!!!

Dena

Re: Newbie PFer

alan k on 9/05/00 at 20:31 (027336)

Depending on the situation there are different priorities. Here's what I think most people benefit from:

rest, especially refraining from any repetitive activity that may have led to the problem.

exercise and stretching which does not put too much stress on the plantar fascia

massage self massage, partner massage, or by someone experienced

new footwear, heel lifts, inserts, birkenstock sandals. DON'T SKIMP on buying new pf-friendly shoes or birkenstocks! I thought $50 heel lifts, the first thing my doctor recommended after a few weeks of pain, was a lot to shell out. 1-2 thousand dollars later this seems funny (but not very funny, obvioulsy)

don't walk barefoot. Get sandals for the shower.

drink at least 8 glasses of water a day (very important for healing)

take supplements especially vitamin C, E, D, Magnesium, Calcium, Zinc. Consult a doctor or do research about safe dosages, or use as recommended on the bottle.

Accept that you are going to get a little sad about this but try to get your spirits up for faster healing, as soon as possible. From what you say you probably already have some experience in doing this.

Good luck to you!


alan k

http://www.acutai.com


.

Re: Newbie PFer

Nancy S. on 9/06/00 at 05:43 (027358)

Welcome, Angie,
Did you get your news from your primary doctor? Are you being referred to a foot specialist? If you click on Scott's 'PF Book' at the top of the page, you will find tons of information there, and it will help you know enough to ask good questions of the doctor and be active in your treatment. In the meantime, alan k's post to you has good suggestions.
I'm sorry you've had so much to deal with in such a short time -- that's a lot. Don't hesitate to post with any more questions, large or small. We all know how tough this is.
Nancy

Re: Newbie PFer

Denise on 9/06/00 at 06:27 (027365)

Angie, I too am a newbie PFer. Mine started on July 11. I seemed to just wake up with it. Here are some tips that I have discovered so far:
1. STOP all impact activity including walking for exercise. I plan to restart walking when I NO LONGER have pain when arising in the a.m.
(I do practice yoga which is gentle stretching and is good for you - also aerobic if you hold your poses).
2. Never go barefoot (not even in the shower - I wear a thongs).
3.Do not wear flat shoes!! Wear a tennis shoe but not Keds.
4.Stetch in the morning (I do yoga). Not hard stretches because you can reinjure your foot.
5. If you sit at a desk as I do all day, KEEP YOUR HEELS ON THE FLOOR. I had a bad habit of propping by heels up on a box because I am short and petite and my heels don't comfortably reach the floor (this was putting stress on the fascia - I learned this from Michael Young at MRTHERAPY.com). Somebody here recommended browsing that site and I learned a lot.

I've ordered a hard rubber heel lift (1/4') from a shoe repair shop which will be ready to pickup on Saturday. Meanwhile I am wearing a Dr. Scholl's heel cushion. I read that a soft cushion can cause heel instability and that is why I am ordering the hard cushions.

On Aug 24 I saw a POD and he told me to keep exercising (I guess he wants future business). He measured me for an orthotic but at this point I'm feeling so much better I may not need to wear it.

Today I have an appointment with a PT. I had good luck with a PT when I had tennis elbow (it has never recurred).

Finally, thank God for this website and Scott who maintains it!! I learned what to do and what not to do from everyone's postings.

Good luck! Let me know if you want me to elaborate on anything.



Re: Heels on the floor

wendyn on 9/06/00 at 08:38 (027370)

Denise! Tell me more about this heels on the floor idea. I also prop my feet on a big box under my desk - I don't like to have them hanging...it used to aggravate TTS and cause a lot of throbbing. Even with my tiny special ordered chair lowered all the way, I can barely keep my feet on the floor and still have my back against the back support. Today I will try though...but please pass on more info if you can.

Re: Newbie PFer

angie on 9/06/00 at 17:44 (027408)

My Primary Care Doctor diagnosed PF. I have had the classic symptoms of pain on first walking after waking up and after periods of inactivity. She told me to stretch my foot by rolling it back and forth over a bottle of frozen drinking water and gave me a prescription for Voltaren. If I'm not better in three weeks she will send me to a POD. I mentioned the PF to my Phyisical Therapist today. He recommends heel stretches, rolling my foot over a tennis ball, icing down and wearing Birks. I do (did) have a habit of walking barefoot around the house. We moved in a year ago and much of the floor is tiled. Does anyone else get chronic leg pains after walking/standing for more than an hour, or is it just me? Thanks for all your kind responses.

Re: Heels on the floor

Beverly on 9/06/00 at 19:20 (027413)

I prop my feet up on an ergodynamic foot rest. It's the kind that can glide back and forth. I thought that was better for me. I'm curious what Dr. Z/B or other med people think.

My best pearl of wisdom is: get a referral to an orthopedic surgeon who specializes in the lowerbody and when you start feeling better, keep going easy. I overdid it when I first felt better and I am still paying for that months and months later.

Good Luck,
Beverly

Re: Newbie PFer

wendyn on 9/06/00 at 22:15 (027433)

Angie - you're story sounds very 'typical'. It also sounds like you're getting some decent medical advice. Chances are very good that if you follow along with the voltaren, the birks, the stretching and the icing - you will make a full recovery.

Hoping for the best for you!

Re: Heels on the floor

Denise on 9/07/00 at 05:47 (027445)

Wendyn, You must be short like me (I'm barely 5'). I was chuckling when I read your posting. I, too, HAD a big box under my desk. I always propped my feet up and crossed my right foot over my left foot. My left foot is where is have a heel spur at the bottom and in the back. I think propping my feet up was putting a lot of pressure on my left heel.

I discovered this idea when I browsed the MRTHERAPY.com site. Salina found this site and shared with everyone. I read the article on PF and it talked about how PF is caused by an inflexible fascia that is repeatedly placed under tension. The article goes on to say, 'This can occur in various situations, such as running or WHEN PEOPLE WHO SIT AT A DESK HOLD THEIR HEELS OFF THE FLOOR FOR LONG PERIODS OF TIME.' That's WAS me.

I sent a note to the author of this article and questioned him about it. Bottom line he wrote back to me and said that I will NEVER permanently get rid of this problem until I stop holding my heels up off of the floor.

Makes sense to me. Of course, there are other factors that cause PF since this is a condition caused by over-use. I'm an avid tennis player. I used to play single 4Xs per week (not anymore unfortunately). But certainly propping my feet up on my left heel can't be helping. It's just not something I would have thought of if I had not browsed the website (Thanks Salina for sharing).

Maybe Dr. Z or B have some additonal input on foot propping.

Re: Heels on the floor

wendyn on 9/07/00 at 08:38 (027453)

Thanks Denise! Yep - I'm a short too, just under 5 foot 2. I'm sitting here with my feet on my box at work. I will try this feet on the floor thing again - but it's just not terribly comfortable for me. Hard on my back because I can't put my feet firmly on the floor. I've tried one of those little ergo foot rests that beverly uses - but I seem to need my feet up higher.

I have a special ergo desk that's lowered as much as possible - and a newer ergo chair that's supposed to be for little people. Don't know what else I can do!

Re: Dr.Z/B.: What do you think about this "heels off the floor theory when sitting?"

Beverly on 9/07/00 at 12:47 (027482)

Dr Z or Dr B,

What do you think about this theory that heels should not be off the floor when sitting? I had never heard that. I DON'T have my feet propped up on a box when I sit at my computer. I use a foot rest that has the option to glide. I like to periodically glide it back and forth. I figured it was giving me a little stretching too. I know it's better for my back and circulation, but is this true that having feet off the floor while sitting at computer is bad? My foot rest typically sits at an angle.

Thanks,
Beverly

Re: Dr.Z/B.: What do you think about this "heels off the floor theory when sitting?"

Dr. Biehler on 9/07/00 at 19:59 (027509)

I have read the article that was reffered to.I do believe that the muscles in the foot can become cramped and cause sever pain untill they are massaged out. I do not feel that holding your heels off the ground while sitting effects the fascia. It is not a low powered constant tension that injures the fascia. The fascia is like a ligament. It is injured by an amount of strain that can cause a ligament or tendon to tear. Steroids or anti-inflamatory drugs can be used to reduce the edema and give the fascia time to heal. It is the same with tapings and orthotics. You need to reduce the stress just like you would do with any grade 2 sprain while it mends.

Re: Dr.Z/B.: What do you think about this "heels off the floor theory when sitting?"

Denise on 9/08/00 at 05:04 (027540)

Thanks Dr. B! I think the way Wendyn and I are propping our feet is different from Beverly's. I was just using a cardboard box and since I haven't been propping this week, I feel much better. It's just one more thing I was doing to aggravate an already sore fascia.

Of course, I'm no longer jogging (did a lot of hill jogging) and I'm not playing tennis (SOB!) - just resting and doing yoga stretches. However, I was discontinuing this activity before and still not seeing results until I stopped propping my feet.

Bottom line I think there is a difference between propping the foot and resting in on some ergonomic device such as Beverly seems to have in her office. Do you concur?

Re: Dr.Z/B.: What do you think about this "heels off the floor theory when sitting?"

Dr. Biehler on 9/08/00 at 06:28 (027543)

Let pain be your guide. Avoid the pain. It's one of your bodies ways of talking to you.

Re: Dr.Z/B.: What do you think about this "heels off the floor theory when sitting?"

Karen Stl on 9/13/00 at 10:35 (028089)

I also prop my feet up. I think the key is how you are using the prop. I have a box under my desk and treat it as a raised floor which brings my knees up and takes pressure off my back. My feet are flat on the box, as if it's the floor. I do not use the box as one would use an ottoman, that points your foot and does not keep the achilles and calf muscle stretched out which I have come to find is extremely important.