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ESWT, PF, and a couple questions

Posted by Ken A on 9/15/00 at 15:26 (028306)

I just found heelspurs.com about 10 days ago, and just came across this board last night. I had no idea such a great place for information existed! I feel like I have been living in a cave. I've had PF and heel spur in my left foot for at least 6 years. My right foot sometimes has some pain too. I've had 2 shots of cortisone and wear orthotics. The orthotics definitely helped a lot, and there was some relief from cortisone. Even with orthotics, I still have some pain at point of insertion when walking more than short distances. This latest episode has both feet hurting like never before. In fact my entire bottom of my foot/feet hurt. I'm wondering if I caused this episode 3 weeks ago by repeatedly using an inversion table (for my back) to invert completely, hanging only by my feet/ankles. I didn't think it would aggravate my PF since it tends to somewhat bend the foot in a curled under position I think I was wrong. Very wrong. :-) In the last several days the pain has lessened, but I still can't walk without a lot of pain, and I can only walk less than 20 yards or so. My preferred mode of transportation currently is crawling. :-) Am I right to assume that inverting could have caused problems? Are orthotics still necessary after successful ESWT? Is the treatment covered by any insurance companies? I still find it hard to believe that there is finally something that can actually be done about most PF cases! Thanks to all the participants on this board and to Scott for this great site!

Re: ESWT, PF, and a couple questions

Dr. Zuckerman on 9/15/00 at 15:34 (028308)

If you have a mal-alignment that caused the pf in the first place stay with the orthosis.

I am not an expert in the use of an inversion table but if you are using your feet and ankles you are stressing the following tendons and muscles in the human foot.

Achilles tendon
Flexor Hallucis brevis and longus
All of the extensor and the rest of the gang that makes the foot go up and down.

Ok. stop with the table it can and probaby is causing you pain in the foot There are alot of other tendons in the bottom of the foot that can hurt just like the plantar fascia. So stop with the table.

If you need any additional information on ESWT either e-mail or call my office at 1-856-848-3338 or there is vast amount of information on this web site. If you need any specific information let us know.
There are alot people on this board that are pf experts from experience.

Re: ESWT, PF, and a couple questions

Ken A on 9/15/00 at 16:43 (028312)

Hello Dr. Zuckerman,

Thank you for the quick response! I'm not sure what caused PF but I suspect it was caused by injury. That's only a guess though. Not too terribly long (maybe a couple months?) after I basically used my feet for hammers (6 years ago), my left heel began hurting, especially in the morning. I used my tennis shoe clad feet to pound against a wrecking bar, which is basically a flat, 2.5' wide crow bar. I do remember that it made my feet sore and tinglely! I guess with people like me running around loose, your waiting room will never be empty. :-) I have an appointment with my podiatrist in a few days.....I assume he should know if I have a mal-alignment. I never told him about the wrecking bar thing because I only connected the two recently.

With this episode I do notice some tenderness in my Achilles tendon/heel area. I haven't used the table since the pain began, but for the last year, I was using the table without noticing any problems, however I was only inverting maybe 60 degrees or so. At that angle there is considerably less pressure on the feet, but there is still a lot of pressure. But, as you suggest I will not use it.

I just called to request your information packet. Thanks again for the help, and I will continue to work my way through this website.

Re: ESWT, PF, and a couple questions

Dr. Zuckerman on 9/15/00 at 18:38 (028322)

Scott's book will be a great help.

Re: ESWT, PF, and a couple questions

Kim B. on 9/16/00 at 09:40 (028366)

Hi Ken, Thanks for posting re: the inversion table. I've always wondered if one could be of some help for my back and neck problems, but I guess they are pretty tough on the ankles. Very intersting.

Read Scott's PF book at the beginning of this site as Dr. Z instructed, and review the info Dr. Z's office sends you. It's very interesting too.

I think your using your feet as a hammer part have a lot to do with your injury. It may have never even had a chance to heal properly because you were constantly reinjuring them, (work, inversion table, etc. I hope you get all this figured out. Good luck and welcome aboard. Kim B.

Re: ESWT, PF, and a couple questions

Ken A on 9/16/00 at 16:47 (028395)

Hi Kim, the inversion table seemed to help my back somewhat, and I'm going to miss using it.

One of the first things I did was to read Scott's book and it was a real eye-opener. After reading thru the book and much of this site, I tried icing, taping, DMSO, ibuphrophen gel, and stretching. All of those seem to help a bit, although I have stopped stretching since I'm not convinced that it is continuing to help. I think my pf is just to inflamed at the moment. I just started taping today and I think it will help a lot. Before now, I haven't had to tape for at least a couple of years. Ultimately I think ESWT will be the best course of action for me.

I'm staying off my feet except when absolutely necessary. Crawling wouldn't be so bad if it weren't for the fact that my 65lb dog thinks it's an open invitation to try to knock me over. :-)

Re: ESWT, PF, and a couple questions

john h on 9/16/00 at 19:07 (028409)

kim: if the inversion table is the one that will invert you upside down and you are hanging like a bat with the special shoes that come with the table then i have been there and done that. i had mine in the garage and my neighbors would come by and see me hanging upside down and have a great time laughing. i had it for about a year (supposed to help the back) but alas it joined my pile of things that failed to cure anything except lighten my wallet.

Re: ESWT, PF, and a couple questions

David L on 9/18/00 at 13:10 (028527)

Yes...orthotics are definitely necessary after ESWT. For our post-therapy instructions, see: http://www.sonorex.com/world/files/patients/sptpi.html
Sincerely,
David Lowy
VP, Canada
Sonorex Therapy Centers http://www.sonorex.com

Re: ESWT, PF, and a couple questions

Ken A on 9/19/00 at 16:53 (028694)

Thanks David, guess I can't have everything. I'll be happy if ESWT helps me even if I need to continue wearing 'em. I'm assuming that I will try ESWTat some point, hopefully in the not to distant future.

Re: ESWT, PF, and a couple questions

Dr. Zuckerman on 9/15/00 at 15:34 (028308)

If you have a mal-alignment that caused the pf in the first place stay with the orthosis.

I am not an expert in the use of an inversion table but if you are using your feet and ankles you are stressing the following tendons and muscles in the human foot.

Achilles tendon
Flexor Hallucis brevis and longus
All of the extensor and the rest of the gang that makes the foot go up and down.

Ok. stop with the table it can and probaby is causing you pain in the foot There are alot of other tendons in the bottom of the foot that can hurt just like the plantar fascia. So stop with the table.

If you need any additional information on ESWT either e-mail or call my office at 1-856-848-3338 or there is vast amount of information on this web site. If you need any specific information let us know.
There are alot people on this board that are pf experts from experience.

Re: ESWT, PF, and a couple questions

Ken A on 9/15/00 at 16:43 (028312)

Hello Dr. Zuckerman,

Thank you for the quick response! I'm not sure what caused PF but I suspect it was caused by injury. That's only a guess though. Not too terribly long (maybe a couple months?) after I basically used my feet for hammers (6 years ago), my left heel began hurting, especially in the morning. I used my tennis shoe clad feet to pound against a wrecking bar, which is basically a flat, 2.5' wide crow bar. I do remember that it made my feet sore and tinglely! I guess with people like me running around loose, your waiting room will never be empty. :-) I have an appointment with my podiatrist in a few days.....I assume he should know if I have a mal-alignment. I never told him about the wrecking bar thing because I only connected the two recently.

With this episode I do notice some tenderness in my Achilles tendon/heel area. I haven't used the table since the pain began, but for the last year, I was using the table without noticing any problems, however I was only inverting maybe 60 degrees or so. At that angle there is considerably less pressure on the feet, but there is still a lot of pressure. But, as you suggest I will not use it.

I just called to request your information packet. Thanks again for the help, and I will continue to work my way through this website.

Re: ESWT, PF, and a couple questions

Dr. Zuckerman on 9/15/00 at 18:38 (028322)

Scott's book will be a great help.

Re: ESWT, PF, and a couple questions

Kim B. on 9/16/00 at 09:40 (028366)

Hi Ken, Thanks for posting re: the inversion table. I've always wondered if one could be of some help for my back and neck problems, but I guess they are pretty tough on the ankles. Very intersting.

Read Scott's PF book at the beginning of this site as Dr. Z instructed, and review the info Dr. Z's office sends you. It's very interesting too.

I think your using your feet as a hammer part have a lot to do with your injury. It may have never even had a chance to heal properly because you were constantly reinjuring them, (work, inversion table, etc. I hope you get all this figured out. Good luck and welcome aboard. Kim B.

Re: ESWT, PF, and a couple questions

Ken A on 9/16/00 at 16:47 (028395)

Hi Kim, the inversion table seemed to help my back somewhat, and I'm going to miss using it.

One of the first things I did was to read Scott's book and it was a real eye-opener. After reading thru the book and much of this site, I tried icing, taping, DMSO, ibuphrophen gel, and stretching. All of those seem to help a bit, although I have stopped stretching since I'm not convinced that it is continuing to help. I think my pf is just to inflamed at the moment. I just started taping today and I think it will help a lot. Before now, I haven't had to tape for at least a couple of years. Ultimately I think ESWT will be the best course of action for me.

I'm staying off my feet except when absolutely necessary. Crawling wouldn't be so bad if it weren't for the fact that my 65lb dog thinks it's an open invitation to try to knock me over. :-)

Re: ESWT, PF, and a couple questions

john h on 9/16/00 at 19:07 (028409)

kim: if the inversion table is the one that will invert you upside down and you are hanging like a bat with the special shoes that come with the table then i have been there and done that. i had mine in the garage and my neighbors would come by and see me hanging upside down and have a great time laughing. i had it for about a year (supposed to help the back) but alas it joined my pile of things that failed to cure anything except lighten my wallet.

Re: ESWT, PF, and a couple questions

David L on 9/18/00 at 13:10 (028527)

Yes...orthotics are definitely necessary after ESWT. For our post-therapy instructions, see: http://www.sonorex.com/world/files/patients/sptpi.html
Sincerely,
David Lowy
VP, Canada
Sonorex Therapy Centers http://www.sonorex.com

Re: ESWT, PF, and a couple questions

Ken A on 9/19/00 at 16:53 (028694)

Thanks David, guess I can't have everything. I'll be happy if ESWT helps me even if I need to continue wearing 'em. I'm assuming that I will try ESWTat some point, hopefully in the not to distant future.