Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

plantar fasciitis

Posted by Kevin B on 11/29/00 at 00:33 (033780)

hey everyone, i rested completely over thanksgiving, and i can now describe my pain as 'achy,' especially when i get out of bed, but i hardly even notice it throughout the day. i purchased over the counter arch supports while i wait for custom made orthotics, which i was casted for yesterday. i also received a massage and ultrasound yesterday, and ran for two slow miles and i felt no pain. today i did a pool workout, and still no pain. i plan on running light again tomorrow, and continuing this pattern for a while. is this 'achyness' that has come from minor pain several weeks ago a good sign that i might possibly have this thing kicked, or is it just waiting for me to do a little more before it rears its ugly head? also, if god forbid any pain does come back, what should i do? i also wanted to extend a warm thanks to the designers of this page and the doctors who offer advice and the fellow sufferers who offer support. it is a huge help, although depressing, it is educational. please respond to this letter, especially on comments about the use of massage and ultrasound. also, i am using a hot whirlpool before and an icewhirlpool after workouts. sincerely, kevin

Re: plantar fasciitis

Julie F on 11/29/00 at 03:12 (033783)

Kevin, what did everyone tell you a couple of weeks ago? STOP RUNNING FOR GOODNESS SAKE. PF is an injury and needs time to heal. You are doing all the right things, taking an active part in your rehabilitation, which is great, but you must be patient. This sounds very voice-of-doom, I know, but if you keep running now, you could be letting yourself in for trouble and delaying your recovery, as people who have run through the pain and lived to regret it can testify.

Have you read the PF Book? It says that you should stop weight-bearing activities, switch to non-weight-bearing ones, and wait until there is NO pain, before increasing activity very gradually.

Sorry to repeat myself, but - BE PATIENT. That's the great lesson I've learned from this (and it was certainly one I needed to learn). I've had PF for four months: it's 80% better now and liveable with, and I am looking forward optimistically to full recovery. But I'm taking no chances. At your age, it might not even take that long - length of recovery time is a very individual matter - but please don't take risks at this stage.

I'm a fan of ultrasound: I've had several treatments and believe they have helped, along with daily use of my personal intra-sonic massage device which works on similar principles but at a lower frequency.

All the best, Julie

Re: Ditto that.......

Nancy N on 11/29/00 at 10:56 (033797)

Add me to the growing chorus of us who are urging you not to run with PF! Everything Julie and Judy have already said sums it up beautifully. But I will try again, just in case :)

At your age, you should heal pretty quickly IF--and only IF--you allow the injury time to heal. If you tore something in your shoulder and someone kept punching that area, you would stop them, wouldn't you? And you would do that because, otherwise, the injury would keep being aggravated and therefore not heal very well. Well, PF is the same thing, only it's in your foot. And when you run on it, you might as well be punching that sore shoulder. It can't heal if it's under that kind of stress.

Even when you feel OK on it, you should give it some extra time just to be sure that everything is OK. At least, if I wanted to be free of it, I certainly would.

All of this may sound depressing or nay-saying to you, but this is the collective voice of experience on this board, and you have chosen to come to us for advice. So you should view that advice with the same attitude you had when you asked for it--that you were asking someone who's been there how best to deal with your injury. Hopefully, that's worth listening to. We know that running is very important to you, and despite the pleas for you to stop running for a while, we really truly are on your side. We want you to stop running for now so that one day you can start again. On the other hand, if you keep running now, you may turn a minor injury into a major one, and as a result never be able to run again. That's a choice you have to make, and hopefully we are enabling you to make an informed decision. Please, give your body the chance to do what it's trying to do--to heal your foot so that you can run again.

Re: Amen to that, Nancy.......eom

Julie F on 11/29/00 at 12:02 (033802)

You put it perfectly! I love the shoulder analogy.

Re: plantar fasciitis

Kevin B. on 11/29/00 at 15:02 (033811)

thank you all for your advice. as much as i wanted to, i didn't run because it felt a little more than achy. i got massage and ultrasound today and i'm getting an icebath tonight and i'm doing a poolworkout tomorrow. i will definitely not run for a little while longer as much as that sucks.....how long do all of you recommend not running after i feel no pain? thank you again for your advice and support. sincerely, kevin

Re: Stop running or you might end up like us!

Beverly on 11/29/00 at 15:19 (033814)

Kevin,

You are at an age when it is easy to seem invinsible. I know when I was 20something, I thought the same thing. And you have youth on your side for healing; so please take advantage of it, and REST! Stop running.

PF is one of those nasty critters that can fool you for awhile. You think you are better, and infact, your body probably is in a healing process. But if you do too much too soon... BOOM! You could be back to square one or worse.

It really is not the end of the world to put running on the shelf for awhile. You're way too young to let PF take an ugly hold on your feet.

Now, you probably feel like we've lectured you as a group of collective 'Mothers,' but I just hate to see someone on the road to recovery possibly sabataging it.

Please take it easy.
Beverly

Re: When do we consider ourselves cured?? (doctors input welcome!)

Nancy N on 11/29/00 at 15:47 (033819)

Kevin--

I'm glad to hear that you've backed off on the running for now. I know it's disappointing (I've been wanting to take dance lessons for about two years now myself), but it will be worth it in the long run (no pun intended!).

I think you're asking a good question here, and I'm not sure how to answer you. To the doctors, and to anyone who does consider themseves cured--how long did you go pain-free before you decided you were cured? How long was it before you were able to add regular, foot-intensive activities into your daily lives? I'd be very curious to hear your criteria.

Kevin, you may want to add some extra time to whatever the consensus turns out to be just to be on the safe side--I know it's another delay, but it could make all the difference in the world, especially since running can be so hard on the feet even when they are healthy.

Re: When do we consider ourselves cured?? (doctors input welcome!)

Julie F on 11/29/00 at 16:57 (033824)

I should think the answer is variable and that it depends on what caused the PF in the first place (and whether that cause, and not just the pain, has been addressed), on how long the condition has lasted - and probably several other variables. In other words, it depends on the individual - as we know, every case is unique.

I'm guessing here, but I don't think the first few days or weeks of absence of pain necessarily means 'cure', and I'd imagine that plunging into full weight-bearing stuff too soon after the disappearance of pain would not be very wise. Scott's advice seems sensible to me: to wait until there is NO pain before increasing activities, and then go gently and gradually, backing off for awhile if pain recurs even slightly.

Kevin, you're being sensible now. Keep it up! and don't mind all us old mothers clucking at you. We really do want you to run again.

Re: Nancy N.: What's up with TexBabs

Julie F on 11/30/00 at 02:39 (033844)

Hi Barbara

Being depressed can help to cause weight gain - it slows the metabolism, and also we can slide into doing more comfort-eating without realizing that we're doing it. So it isn't just the lack of exercise. But there are exercises that you can do without insulting your feet - simple ones that work through the joints (not the ones that hurt, of course) in a sitting or lying-down position - that will affect the metabolism and help you feel better about yourself. Please e-mail me if you want and I'll tell you about them.

And perhaps you should consider reframing your ideas about Weight Watchers. I gained 30 pounds (30 seems to be our magic number!) in my first couple of years of taking tamoxifen. It's a well-known side effect, and I blamed it all on tamoxifen, but eventually I realized that post-breast-cancer I also 'treated' myself whenever I felt like it. I must have thought I deserved all that Haagen-Dazs etc. Whatever the cause(s) the weight piled on. When I decided it really had to come off, I went to Weight Watchers, something I'd always sworn I'd never do. I didn't stay for the meetings (in my case it would have meant listening to southeast London ladies nattering away) but it helped me a lot in three ways: the points system which makes it easy to keep track of exactly how much you're eating; writing it all down on the tally sheets, which makes you think before you eat because you know you're going to have to write it down; and the weekly weigh-in. The growing sense of pleasure and achievement every time the scales registered a pound or two less made it easy to keep going. It took nearly a year, but the 30 pounds did come off.

You've started swimming again, which is good news. That will help too, not just with the weight, but to lift your spirits.

I wish you all the best, and do get in touch if you want to talk exercise.

Julie

Re: Nancy N.: What's up with TexBabs

Julie F on 11/30/00 at 03:16 (033847)

An afterthought. I think _making the decision_ to shed the pounds is probably the critical factor - at least it was for me - and the weight loss follows on from that. The decision puts you back in control, so instead of sitting around thinking 'It will never come off' or 'I want it all off by next Sunday', you make a project of it, and accept that you're going to be devoting a few months and a lot of your attention to it. For me that sense of being in control at last was extrtemely helpful in itself. And it's such a worthwhile project, because you'll feel better while you're engaged in it, not just when you reach the goal.

Re: To Nancy N.

Beverly on 11/30/00 at 12:44 (033881)

Nancy,

This is not the diet to just go out and do without consulting your doctor, because it is very high in fat, but have you tried the Dr. Atkins/low carb diet? You are never hungry on it. You get to eat lots of food. But it is a high fat diet and may not be right for every person.

I crave carbs and so it was not right for me. I do Weight Watchers off and one. I am a little overweight (could greatly benefit from loosing 20 pounds and it wouldn't hurt me to loose 30).

I personally like Weight Watchers best.
Good Luck,
Beverly

Re: Nancy N.: What's up with TexBabs

Barbara TX on 11/30/00 at 16:11 (033888)

Nancy - I WISH that the weight that I put on because of the medication would be easier to take off... I'm afraid that it is like any other weight! What a drag. I know that Julie mentioned that depression helps you put on the pounds, but all of the dramatic weight gain was immediately after I began taking the effexor and I was un-depressed then. The doctor doesn't want me to just quit the effexor (Dr. Z mentioned to me as well that that wouldn't be a good idea) and so she cut the dosage in half and we'll see if I can lose some weight while still on it.

I have always been a big person, but just big-footed and tall, with very broad shoulders. I have always felt strong and athletic, although as a little girl this was not appreciated as much as it was when I was in college! I was always the tallest girl, but it gave me a little hutzpah instead of depressing me - I think that's because my parents handled it in just the right way. I actually came around the corner in college and a group of guys were discussing me, and how one of them wanted to date me, but he never could because I was too tall - and I'm only six feet tall (which is certainly not the tallest woman I've met!). Because of the way I was raised, I didn't care a bit about what he said - little dweebie nerd!

Anyway, I have been on every NSAID known to man and it still doesn't help my feet. Such a shame to eat lovely, home prepared organic food and careful supplements for most of my adult life and then NUKE myself with every pill I can get my hands on. Speaking of food preparation - I was the most slender when I lived alone and didn't have to cook for anyone. If I were single I would live out of tins and take-out. Your portions are always controlled and you can spend less time stirring, mixing, patting and chopping FOOD. Count yourself lucky. There are some great frozen pre-prepared meals out there that are economical for a single person and not for a whole family.

But, ultimately you are right about PF striking the thin as well as the fat. It struck me when I was thinner and THEN made me fat. I had just slimmed down to my prepregnancy weight (I gain 45-50 pounds when pregnant, so that's a feat) and I was just about to undertake another pregnancy when I just felt in my heart that something wasn't right. A month later I could not walk. Fate? Destiny? Providence? Well, anyway, I don't know if I did the right thing. I would have gained that weight anyway, so why not do it having a baby? At least you get something for your troubles... Anyway - REGRETS are useless. Really useless.

I am off to drink a pot of black coffee (NO SUGAR! I PROMISE!) So gald you are feeling better Nancy! B.

Re: plantar fasciitis

Julie F on 11/29/00 at 03:12 (033783)

Kevin, what did everyone tell you a couple of weeks ago? STOP RUNNING FOR GOODNESS SAKE. PF is an injury and needs time to heal. You are doing all the right things, taking an active part in your rehabilitation, which is great, but you must be patient. This sounds very voice-of-doom, I know, but if you keep running now, you could be letting yourself in for trouble and delaying your recovery, as people who have run through the pain and lived to regret it can testify.

Have you read the PF Book? It says that you should stop weight-bearing activities, switch to non-weight-bearing ones, and wait until there is NO pain, before increasing activity very gradually.

Sorry to repeat myself, but - BE PATIENT. That's the great lesson I've learned from this (and it was certainly one I needed to learn). I've had PF for four months: it's 80% better now and liveable with, and I am looking forward optimistically to full recovery. But I'm taking no chances. At your age, it might not even take that long - length of recovery time is a very individual matter - but please don't take risks at this stage.

I'm a fan of ultrasound: I've had several treatments and believe they have helped, along with daily use of my personal intra-sonic massage device which works on similar principles but at a lower frequency.

All the best, Julie

Re: Ditto that.......

Nancy N on 11/29/00 at 10:56 (033797)

Add me to the growing chorus of us who are urging you not to run with PF! Everything Julie and Judy have already said sums it up beautifully. But I will try again, just in case :)

At your age, you should heal pretty quickly IF--and only IF--you allow the injury time to heal. If you tore something in your shoulder and someone kept punching that area, you would stop them, wouldn't you? And you would do that because, otherwise, the injury would keep being aggravated and therefore not heal very well. Well, PF is the same thing, only it's in your foot. And when you run on it, you might as well be punching that sore shoulder. It can't heal if it's under that kind of stress.

Even when you feel OK on it, you should give it some extra time just to be sure that everything is OK. At least, if I wanted to be free of it, I certainly would.

All of this may sound depressing or nay-saying to you, but this is the collective voice of experience on this board, and you have chosen to come to us for advice. So you should view that advice with the same attitude you had when you asked for it--that you were asking someone who's been there how best to deal with your injury. Hopefully, that's worth listening to. We know that running is very important to you, and despite the pleas for you to stop running for a while, we really truly are on your side. We want you to stop running for now so that one day you can start again. On the other hand, if you keep running now, you may turn a minor injury into a major one, and as a result never be able to run again. That's a choice you have to make, and hopefully we are enabling you to make an informed decision. Please, give your body the chance to do what it's trying to do--to heal your foot so that you can run again.

Re: Amen to that, Nancy.......eom

Julie F on 11/29/00 at 12:02 (033802)

You put it perfectly! I love the shoulder analogy.

Re: plantar fasciitis

Kevin B. on 11/29/00 at 15:02 (033811)

thank you all for your advice. as much as i wanted to, i didn't run because it felt a little more than achy. i got massage and ultrasound today and i'm getting an icebath tonight and i'm doing a poolworkout tomorrow. i will definitely not run for a little while longer as much as that sucks.....how long do all of you recommend not running after i feel no pain? thank you again for your advice and support. sincerely, kevin

Re: Stop running or you might end up like us!

Beverly on 11/29/00 at 15:19 (033814)

Kevin,

You are at an age when it is easy to seem invinsible. I know when I was 20something, I thought the same thing. And you have youth on your side for healing; so please take advantage of it, and REST! Stop running.

PF is one of those nasty critters that can fool you for awhile. You think you are better, and infact, your body probably is in a healing process. But if you do too much too soon... BOOM! You could be back to square one or worse.

It really is not the end of the world to put running on the shelf for awhile. You're way too young to let PF take an ugly hold on your feet.

Now, you probably feel like we've lectured you as a group of collective 'Mothers,' but I just hate to see someone on the road to recovery possibly sabataging it.

Please take it easy.
Beverly

Re: When do we consider ourselves cured?? (doctors input welcome!)

Nancy N on 11/29/00 at 15:47 (033819)

Kevin--

I'm glad to hear that you've backed off on the running for now. I know it's disappointing (I've been wanting to take dance lessons for about two years now myself), but it will be worth it in the long run (no pun intended!).

I think you're asking a good question here, and I'm not sure how to answer you. To the doctors, and to anyone who does consider themseves cured--how long did you go pain-free before you decided you were cured? How long was it before you were able to add regular, foot-intensive activities into your daily lives? I'd be very curious to hear your criteria.

Kevin, you may want to add some extra time to whatever the consensus turns out to be just to be on the safe side--I know it's another delay, but it could make all the difference in the world, especially since running can be so hard on the feet even when they are healthy.

Re: When do we consider ourselves cured?? (doctors input welcome!)

Julie F on 11/29/00 at 16:57 (033824)

I should think the answer is variable and that it depends on what caused the PF in the first place (and whether that cause, and not just the pain, has been addressed), on how long the condition has lasted - and probably several other variables. In other words, it depends on the individual - as we know, every case is unique.

I'm guessing here, but I don't think the first few days or weeks of absence of pain necessarily means 'cure', and I'd imagine that plunging into full weight-bearing stuff too soon after the disappearance of pain would not be very wise. Scott's advice seems sensible to me: to wait until there is NO pain before increasing activities, and then go gently and gradually, backing off for awhile if pain recurs even slightly.

Kevin, you're being sensible now. Keep it up! and don't mind all us old mothers clucking at you. We really do want you to run again.

Re: Nancy N.: What's up with TexBabs

Julie F on 11/30/00 at 02:39 (033844)

Hi Barbara

Being depressed can help to cause weight gain - it slows the metabolism, and also we can slide into doing more comfort-eating without realizing that we're doing it. So it isn't just the lack of exercise. But there are exercises that you can do without insulting your feet - simple ones that work through the joints (not the ones that hurt, of course) in a sitting or lying-down position - that will affect the metabolism and help you feel better about yourself. Please e-mail me if you want and I'll tell you about them.

And perhaps you should consider reframing your ideas about Weight Watchers. I gained 30 pounds (30 seems to be our magic number!) in my first couple of years of taking tamoxifen. It's a well-known side effect, and I blamed it all on tamoxifen, but eventually I realized that post-breast-cancer I also 'treated' myself whenever I felt like it. I must have thought I deserved all that Haagen-Dazs etc. Whatever the cause(s) the weight piled on. When I decided it really had to come off, I went to Weight Watchers, something I'd always sworn I'd never do. I didn't stay for the meetings (in my case it would have meant listening to southeast London ladies nattering away) but it helped me a lot in three ways: the points system which makes it easy to keep track of exactly how much you're eating; writing it all down on the tally sheets, which makes you think before you eat because you know you're going to have to write it down; and the weekly weigh-in. The growing sense of pleasure and achievement every time the scales registered a pound or two less made it easy to keep going. It took nearly a year, but the 30 pounds did come off.

You've started swimming again, which is good news. That will help too, not just with the weight, but to lift your spirits.

I wish you all the best, and do get in touch if you want to talk exercise.

Julie

Re: Nancy N.: What's up with TexBabs

Julie F on 11/30/00 at 03:16 (033847)

An afterthought. I think _making the decision_ to shed the pounds is probably the critical factor - at least it was for me - and the weight loss follows on from that. The decision puts you back in control, so instead of sitting around thinking 'It will never come off' or 'I want it all off by next Sunday', you make a project of it, and accept that you're going to be devoting a few months and a lot of your attention to it. For me that sense of being in control at last was extrtemely helpful in itself. And it's such a worthwhile project, because you'll feel better while you're engaged in it, not just when you reach the goal.

Re: To Nancy N.

Beverly on 11/30/00 at 12:44 (033881)

Nancy,

This is not the diet to just go out and do without consulting your doctor, because it is very high in fat, but have you tried the Dr. Atkins/low carb diet? You are never hungry on it. You get to eat lots of food. But it is a high fat diet and may not be right for every person.

I crave carbs and so it was not right for me. I do Weight Watchers off and one. I am a little overweight (could greatly benefit from loosing 20 pounds and it wouldn't hurt me to loose 30).

I personally like Weight Watchers best.
Good Luck,
Beverly

Re: Nancy N.: What's up with TexBabs

Barbara TX on 11/30/00 at 16:11 (033888)

Nancy - I WISH that the weight that I put on because of the medication would be easier to take off... I'm afraid that it is like any other weight! What a drag. I know that Julie mentioned that depression helps you put on the pounds, but all of the dramatic weight gain was immediately after I began taking the effexor and I was un-depressed then. The doctor doesn't want me to just quit the effexor (Dr. Z mentioned to me as well that that wouldn't be a good idea) and so she cut the dosage in half and we'll see if I can lose some weight while still on it.

I have always been a big person, but just big-footed and tall, with very broad shoulders. I have always felt strong and athletic, although as a little girl this was not appreciated as much as it was when I was in college! I was always the tallest girl, but it gave me a little hutzpah instead of depressing me - I think that's because my parents handled it in just the right way. I actually came around the corner in college and a group of guys were discussing me, and how one of them wanted to date me, but he never could because I was too tall - and I'm only six feet tall (which is certainly not the tallest woman I've met!). Because of the way I was raised, I didn't care a bit about what he said - little dweebie nerd!

Anyway, I have been on every NSAID known to man and it still doesn't help my feet. Such a shame to eat lovely, home prepared organic food and careful supplements for most of my adult life and then NUKE myself with every pill I can get my hands on. Speaking of food preparation - I was the most slender when I lived alone and didn't have to cook for anyone. If I were single I would live out of tins and take-out. Your portions are always controlled and you can spend less time stirring, mixing, patting and chopping FOOD. Count yourself lucky. There are some great frozen pre-prepared meals out there that are economical for a single person and not for a whole family.

But, ultimately you are right about PF striking the thin as well as the fat. It struck me when I was thinner and THEN made me fat. I had just slimmed down to my prepregnancy weight (I gain 45-50 pounds when pregnant, so that's a feat) and I was just about to undertake another pregnancy when I just felt in my heart that something wasn't right. A month later I could not walk. Fate? Destiny? Providence? Well, anyway, I don't know if I did the right thing. I would have gained that weight anyway, so why not do it having a baby? At least you get something for your troubles... Anyway - REGRETS are useless. Really useless.

I am off to drink a pot of black coffee (NO SUGAR! I PROMISE!) So gald you are feeling better Nancy! B.