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Bleeding and healing - to Dr Z

Posted by Julie F on 12/14/00 at 03:23 (034931)

Dr Zuckerman, I've been re-reading Tuesday's thread - 'Heel spurs poking into tissue'. It is fascinating as well as informative. I also remember an explanation you gave of ESWT a few weeks ago, when you said that it causes a bleed which kickstarts the healing process.

Do you think you could go a little more deeply into the role of the blood supply in healing? Exactly how and why does it work the way it does? I'd be really grateful for more insight into this process.

Many thanks and best wishes, Julie

Re: Bleeding and healing - to Dr Z

Dr. Zuckerman on 12/14/00 at 19:54 (034969)

I will try to clarify this. The theory and this is what I believe is that the fibers of the pf at the attachment at the medial tubercle of the heel bone have stopped re-attachment to the insertion which is at the heel bone. This is due to lack of blood supply on a cellular level. So surgery and or the ESWT injures the area and thus with injury we have bleeding which is good. This is how we have healing. injury, then bleeding which brings on the inflamatory phase of healing.
which begins the healing phase of healing. Bleeding is how I describe the injury phase which is necessary to begin the inflamatory phase of healing So the pf gets a second chance at healing which means it's attachment to the bone can occur. In summary or trying to make this simple. You have bleeding which brings the necessary cells to the injured site to start the healing process which has stopped. It would be like a bone that hasn't healed . You cut out the dead bone until there is bleeding bone which means there is healthly bone and then the bone has a chance to heal again.

If this is confusing let me know and I will think of another way to explain this.

Re: Bleeding and healing - to Dr Z

Julie F on 12/15/00 at 03:17 (034991)

Hi Dr Z

Many thanks for this explanation. It's very clear and not the least bit confusing, and I'm grateful for it.

So this would explain why massage and ultrasound can help? And even partly why (the right kind of) exercise, which stimulates circulation, can help, apart from its stretching and strengthening benefits?

Your explanation also fills in my understanding of why cartilage, which has no blood supply, can't regenerate itself.

Something has suddenly occurred to me while writing this. Do you think that poor circulation in the extremities could be a predisposing factor to PF? It might be an interesting research question: ask the people on this site whether they are cold-footed or warm-footed and see if the response indicates anything.

I'm definitely a cold-footed person (ask my husband!).

Thanks, Dr Z.

All the best, Julie

Re: Bleeding and healing - to Dr Z

Dr. Zuckerman on 12/14/00 at 19:54 (034969)

I will try to clarify this. The theory and this is what I believe is that the fibers of the pf at the attachment at the medial tubercle of the heel bone have stopped re-attachment to the insertion which is at the heel bone. This is due to lack of blood supply on a cellular level. So surgery and or the ESWT injures the area and thus with injury we have bleeding which is good. This is how we have healing. injury, then bleeding which brings on the inflamatory phase of healing.
which begins the healing phase of healing. Bleeding is how I describe the injury phase which is necessary to begin the inflamatory phase of healing So the pf gets a second chance at healing which means it's attachment to the bone can occur. In summary or trying to make this simple. You have bleeding which brings the necessary cells to the injured site to start the healing process which has stopped. It would be like a bone that hasn't healed . You cut out the dead bone until there is bleeding bone which means there is healthly bone and then the bone has a chance to heal again.

If this is confusing let me know and I will think of another way to explain this.

Re: Bleeding and healing - to Dr Z

Julie F on 12/15/00 at 03:17 (034991)

Hi Dr Z

Many thanks for this explanation. It's very clear and not the least bit confusing, and I'm grateful for it.

So this would explain why massage and ultrasound can help? And even partly why (the right kind of) exercise, which stimulates circulation, can help, apart from its stretching and strengthening benefits?

Your explanation also fills in my understanding of why cartilage, which has no blood supply, can't regenerate itself.

Something has suddenly occurred to me while writing this. Do you think that poor circulation in the extremities could be a predisposing factor to PF? It might be an interesting research question: ask the people on this site whether they are cold-footed or warm-footed and see if the response indicates anything.

I'm definitely a cold-footed person (ask my husband!).

Thanks, Dr Z.

All the best, Julie