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plantars fasciitis and ankle pain

Posted by Dana on 1/09/01 at 20:59 (036269)

It's been a while since I have visited or posted a message. The pain in my left foot has gone away but it started in my right. As long as I was wearing my Birks I could tolerate the pain. My pod was only concerned with my left because that is what my pcp sent me to have check. Now, I have complicated everything because I fractured my right ankle over Thanksgiving. I had the cast removed last week and now I support an air cast. The problem is that not only do I have pain in the ankle but unbelieveable pain in the heel. Any suggestions. I'm a teacher and I am on my feet a lot. This is really becoming discouraging. By the way the fracture was bilateral.

Re: plantars fasciitis and ankle pain

Kay S on 1/10/01 at 09:27 (036299)

Dana--Good grief! I have to say I really squirmed when I read your post. On top of heel pain, you didn't need a fx ankle. When I was in a camwalker, the doc padded it so I had an arch and it really helped the heel pain. (my surgery was for tt) Unfortunately, that was only while I was in that camwalker, but then that's another whole story. I hope you will start making some progress soon in a positive direction. Hang in there.
Kay

Re: plantars fasciitis and ankle pain

Nancy N on 1/10/01 at 10:13 (036312)

Ellen--

The information in this message is so valuable--why did you exclude it from the archive? Thanks for sharing it.

Re: plantars fasciitis and ankle pain

john h on 1/10/01 at 16:43 (036340)

dana: i would be concerned about having enough calcium in by body. have you ever had it checked with a scan.

Re: plantars fasciitis and ankle pain

Dr. Zuckerman on 1/10/01 at 16:56 (036344)

Kay,

The fact that a well padded boot cast helped tells Dr. Z that a orthosis with a filled in arch ( not rigid) could be very helpful to you. It the orthosis that Richard is adjusting for you doesn't help let me. He is fillng in the arch and first ray completely. This is the same as a well padded arch.

Re: plantars fasciitis and ankle pain

Kay S on 1/10/01 at 19:52 (036359)

Ellen--ditto Nancy's comments.

Re: plantars fasciitis and ankle pain

Ellen Watson on 1/11/01 at 09:17 (036400)

Dear Nancy and Kay,

Thanks for your kind words. I guess I thought that since my comments weren't directed towards pf, they wouldn't hold long-term interest. Anyway, here's some more dealing with crutches tips for Dana:

I was non weight-bearing for 3 months, than partial weight-bearing for 3. And I lived on the top floor of a 4-floor walk up, with no bell-buzzer system, so to get anything or anybody into my apartment I had to navigate the stairs.

Until a physical therapist helped me gain enough stability with crutches to hop up steps I crawled up and down on my knees -- ungainly but safe. I put stools or chairs at the top of each landing, so that instead of having to crawl to the next level, I could sit down, push my self up on the crutches and then walk to the next set of stairs.

I insisted on having one session with the therapist where we dealt with how to fall -- this on the advice of a friend who is a doctor, who said that a major problem with crutches is secondary injuries and fractures due to falls. If you find yourself falling, you have to try not to tense up and not to cushion your fall with your arms, because if you break your arm you'll be in much bigger trouble. I fell twice, got the wind knocked out of me and a bump on my head, but no serious injuries. To get up, wiggle your way, with crutches in hand, to a stair and raise yourself up. If there are no stairs in your apartment, arrange a series of stools of increasing height next to each other (this is best done in advance, in preparation for the chance that you might fall), and move yourself from one height to the next till you can get upright on your crutches.

Move your bed as close to the bathroom door as you can. If you still have a distance to travel,keep a bedpan or commode at bedside for middle of the night emergencies. If you have to move quickly and are a little unsteady on crutches when first getting up in the morning or in the middle of the night, you can also keep a chair handy and use that instead of crutches--put your knee on the chair, and move it a step at a time.

For the bathtub, I got a chair that could be adjusted so that it fit half in the bath-tub and half out--you could sit yourself on one end and slide into the bath tub area. Also, no one told me until several months later that there are plastic slide covers made to protect casts from water while bathing, so that would have been much easier than covering up with a plastic bag. A seat that fits on top of the toilet seat to raise its height will make it easier to get on and off of the toilet.

I never did find a good way to keep my leg raised at night -- tried a wedge, but my foot always slide off -- maybe someone out there has good suggestions.

Things will take much longer to do, so you have to plan additional time for everything. I missed many many subway trains (I live in New York City) because I couldn't move fast enough. Just getting a cup of tea from the kitchen over to my computer was a long-drawn out chore. Little things that you took for granted you now have to think about and try to figure out ways to do them more efficiently. Backpacks help a lot, but be careful not to overload them, or you'll develop back problems.

This is a little Machiavellian, but when you return to work you may want to continue to use your crutches, even if you don't actually have to. A crutch is a symbol that you have a problem, and people will respond to you with more sympathy than if you just have a cane or a cast. So if you need to be excused from lunch room duties to rest and put your leg up, or ask for other accomodations -- better parking space, no after-school activities, whatever, you'll do better with crutches! (When I traveled with crutches on the subway, someone would always give me a seat. With a cane, I always wound up having to stand.)

For your classroom, you might ask if you can bring in a bar-stool height chair. That would make it easier for you to get up and sit down. Two would be even better, because you could sit down and put your leg up on the other.

What I didn't do, but wish I had, was weight training for my arms. I think that would have helped with the crutches. Also, let me repeat the tip I gave yesterday -- padded bicycle gloves really help a lot.

Hope this helps,

Ellen

Re: plantars fasciitis and ankle pain

Kay S on 1/11/01 at 18:49 (036453)

Ellen--I am amazed at your posts. You have covered so many areas that most of us had to learn the hard way. I think your hints should be somewhere a new person could get to if they needed that kind of advice. We could call it 'crutch hints from Ellen'!
Seriously, you could write a manual for patients. Maybe you should consider doing just that and selling it to an ortho doc.
Thank you for sharing your information.
Kay

Re: plantars fasciitis and ankle pain

Dana on 1/12/01 at 05:41 (036474)

Thanks Ellen for all the good hints and information. I am in physcial therapy. I am getting some flexibility back but the pain and ache (different) is unbearable at times. My ankle expecially will start to ache and then I will get a pain down the outside ankle bone. Unfortunatle my ortho only prescribed pt for 2 weeks. I have a week to go. I guess we will wait and see. The heel pain also comes and goes.

Re: plantars fasciitis and ankle pain

Ellen Watson on 1/12/01 at 09:14 (036481)

Dear Dana,

2 weeks of physical therapy doesn't sound like nearly enough. See if your doc will extend it. What kind of insurance do you have? I now have Empire Blue Cross/Blue Shield, and they have been really good about approving pt. I see a sports medicine doctor who is much more supportive than the original orthopedic surgeon who did the surgery, and he writes whatever prescription is needed and backs it up with medical justification if they question it. His favorite line about me is, 'Ellen, you're falling apart, but at least it's one part at a time!'. Even though your pain is concentrated in the same area -- your ankle and your foot -- it may be being caused by different reasons that need to be addressed by separate types of therapy regimens.

I didn't have this sort of support when I first broke my ankle. Back then I was a self-employed, noninsured stay-at-home writer when I was hit by the car, and I made do with the short stint of therapy that the insurance company of the woman who hit me would pay for. I paid for the massage therapy myself, and it was worth every expensive penny, although I couldn't afford to do it for long. It took close to two years before I got back enough flexibility in my foot to walk down steps normally. I think that if I had been able to continue the massage therapy, and if I had done the elastic band flexibility exercises that I now do, that I may have regained more normal movement sooner.

You might also ask for some serious pain killers -- I was given tylenol with codeine when I left the hospital. Fortunately, I only needed it for a few nights, but it really helped. Even though there is now a lot of talk in the medical literature about pain, most docs still don't deal with it adequately. You wouldn't want to take narcotic pain killers long-term, but if the acute pain you are feeling is a short-term postfracture event, they may help get you through.

Ellen

Re: plantars fasciitis and ankle pain

Kay S on 1/10/01 at 09:27 (036299)

Dana--Good grief! I have to say I really squirmed when I read your post. On top of heel pain, you didn't need a fx ankle. When I was in a camwalker, the doc padded it so I had an arch and it really helped the heel pain. (my surgery was for tt) Unfortunately, that was only while I was in that camwalker, but then that's another whole story. I hope you will start making some progress soon in a positive direction. Hang in there.
Kay

Re: plantars fasciitis and ankle pain

Nancy N on 1/10/01 at 10:13 (036312)

Ellen--

The information in this message is so valuable--why did you exclude it from the archive? Thanks for sharing it.

Re: plantars fasciitis and ankle pain

john h on 1/10/01 at 16:43 (036340)

dana: i would be concerned about having enough calcium in by body. have you ever had it checked with a scan.

Re: plantars fasciitis and ankle pain

Dr. Zuckerman on 1/10/01 at 16:56 (036344)

Kay,

The fact that a well padded boot cast helped tells Dr. Z that a orthosis with a filled in arch ( not rigid) could be very helpful to you. It the orthosis that Richard is adjusting for you doesn't help let me. He is fillng in the arch and first ray completely. This is the same as a well padded arch.

Re: plantars fasciitis and ankle pain

Kay S on 1/10/01 at 19:52 (036359)

Ellen--ditto Nancy's comments.

Re: plantars fasciitis and ankle pain

Ellen Watson on 1/11/01 at 09:17 (036400)

Dear Nancy and Kay,

Thanks for your kind words. I guess I thought that since my comments weren't directed towards pf, they wouldn't hold long-term interest. Anyway, here's some more dealing with crutches tips for Dana:

I was non weight-bearing for 3 months, than partial weight-bearing for 3. And I lived on the top floor of a 4-floor walk up, with no bell-buzzer system, so to get anything or anybody into my apartment I had to navigate the stairs.

Until a physical therapist helped me gain enough stability with crutches to hop up steps I crawled up and down on my knees -- ungainly but safe. I put stools or chairs at the top of each landing, so that instead of having to crawl to the next level, I could sit down, push my self up on the crutches and then walk to the next set of stairs.

I insisted on having one session with the therapist where we dealt with how to fall -- this on the advice of a friend who is a doctor, who said that a major problem with crutches is secondary injuries and fractures due to falls. If you find yourself falling, you have to try not to tense up and not to cushion your fall with your arms, because if you break your arm you'll be in much bigger trouble. I fell twice, got the wind knocked out of me and a bump on my head, but no serious injuries. To get up, wiggle your way, with crutches in hand, to a stair and raise yourself up. If there are no stairs in your apartment, arrange a series of stools of increasing height next to each other (this is best done in advance, in preparation for the chance that you might fall), and move yourself from one height to the next till you can get upright on your crutches.

Move your bed as close to the bathroom door as you can. If you still have a distance to travel,keep a bedpan or commode at bedside for middle of the night emergencies. If you have to move quickly and are a little unsteady on crutches when first getting up in the morning or in the middle of the night, you can also keep a chair handy and use that instead of crutches--put your knee on the chair, and move it a step at a time.

For the bathtub, I got a chair that could be adjusted so that it fit half in the bath-tub and half out--you could sit yourself on one end and slide into the bath tub area. Also, no one told me until several months later that there are plastic slide covers made to protect casts from water while bathing, so that would have been much easier than covering up with a plastic bag. A seat that fits on top of the toilet seat to raise its height will make it easier to get on and off of the toilet.

I never did find a good way to keep my leg raised at night -- tried a wedge, but my foot always slide off -- maybe someone out there has good suggestions.

Things will take much longer to do, so you have to plan additional time for everything. I missed many many subway trains (I live in New York City) because I couldn't move fast enough. Just getting a cup of tea from the kitchen over to my computer was a long-drawn out chore. Little things that you took for granted you now have to think about and try to figure out ways to do them more efficiently. Backpacks help a lot, but be careful not to overload them, or you'll develop back problems.

This is a little Machiavellian, but when you return to work you may want to continue to use your crutches, even if you don't actually have to. A crutch is a symbol that you have a problem, and people will respond to you with more sympathy than if you just have a cane or a cast. So if you need to be excused from lunch room duties to rest and put your leg up, or ask for other accomodations -- better parking space, no after-school activities, whatever, you'll do better with crutches! (When I traveled with crutches on the subway, someone would always give me a seat. With a cane, I always wound up having to stand.)

For your classroom, you might ask if you can bring in a bar-stool height chair. That would make it easier for you to get up and sit down. Two would be even better, because you could sit down and put your leg up on the other.

What I didn't do, but wish I had, was weight training for my arms. I think that would have helped with the crutches. Also, let me repeat the tip I gave yesterday -- padded bicycle gloves really help a lot.

Hope this helps,

Ellen

Re: plantars fasciitis and ankle pain

Kay S on 1/11/01 at 18:49 (036453)

Ellen--I am amazed at your posts. You have covered so many areas that most of us had to learn the hard way. I think your hints should be somewhere a new person could get to if they needed that kind of advice. We could call it 'crutch hints from Ellen'!
Seriously, you could write a manual for patients. Maybe you should consider doing just that and selling it to an ortho doc.
Thank you for sharing your information.
Kay

Re: plantars fasciitis and ankle pain

Dana on 1/12/01 at 05:41 (036474)

Thanks Ellen for all the good hints and information. I am in physcial therapy. I am getting some flexibility back but the pain and ache (different) is unbearable at times. My ankle expecially will start to ache and then I will get a pain down the outside ankle bone. Unfortunatle my ortho only prescribed pt for 2 weeks. I have a week to go. I guess we will wait and see. The heel pain also comes and goes.

Re: plantars fasciitis and ankle pain

Ellen Watson on 1/12/01 at 09:14 (036481)

Dear Dana,

2 weeks of physical therapy doesn't sound like nearly enough. See if your doc will extend it. What kind of insurance do you have? I now have Empire Blue Cross/Blue Shield, and they have been really good about approving pt. I see a sports medicine doctor who is much more supportive than the original orthopedic surgeon who did the surgery, and he writes whatever prescription is needed and backs it up with medical justification if they question it. His favorite line about me is, 'Ellen, you're falling apart, but at least it's one part at a time!'. Even though your pain is concentrated in the same area -- your ankle and your foot -- it may be being caused by different reasons that need to be addressed by separate types of therapy regimens.

I didn't have this sort of support when I first broke my ankle. Back then I was a self-employed, noninsured stay-at-home writer when I was hit by the car, and I made do with the short stint of therapy that the insurance company of the woman who hit me would pay for. I paid for the massage therapy myself, and it was worth every expensive penny, although I couldn't afford to do it for long. It took close to two years before I got back enough flexibility in my foot to walk down steps normally. I think that if I had been able to continue the massage therapy, and if I had done the elastic band flexibility exercises that I now do, that I may have regained more normal movement sooner.

You might also ask for some serious pain killers -- I was given tylenol with codeine when I left the hospital. Fortunately, I only needed it for a few nights, but it really helped. Even though there is now a lot of talk in the medical literature about pain, most docs still don't deal with it adequately. You wouldn't want to take narcotic pain killers long-term, but if the acute pain you are feeling is a short-term postfracture event, they may help get you through.

Ellen