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Taping or orthotics

Posted by Bill E. on 1/30/01 at 10:36 (037737)

This is partially in response to a thread by Susan on stretching below.

I haven't tried taping for a couple of reasons. First, my PF pain isn't very severe and it seems that the time and effort to tape, un tape, clean and moisturize the foot is more work than it is worth to me. On the other hand, my personal goal is to get to complete recovery so I can run and continue other outdoor activities, so I am willing to try just about anything that will speed the healing.

I did find that using over the counter orthotics helped a lot. I have narrow feet, high arches, and supinate a little. When I first tried some of the orthotics, they bothered me but now I find that even the ones with high arch support are quite comfortable and add to my comfort the next day. Not to particularly recommend anything, I like the Spenco and Superfeet. (not really cheap) I think that a combination of arch support and cushioning are needed for me. I have a Spenco 'orthotic' that is mainly cushioning and it isn't nearly as effective.

Anyway, does anyone have any particular comments about the value of taping, more to encourage healing than to reduce pain.

And, yes, I have read Scott's book several times. I am looking for more specific comments, either personal or professional/medical.

Bill

Re: Taping or orthotics

Dr. Zuckerman on 1/30/01 at 19:53 (037791)

It you find that the taping it too much trouble then try the futuro elastic ankle supports. The purpose of the taping as well as any type of orthosis whether over the counter or custom made is to control the elongation of the plantar fascia. This occurs with execessive pronation.

Taping in my opinion is one of the best way to prevent the plantar fascia from elongating excessively during walking.

It does take time and is a pain in the butt but can and does restrict excessive elongation of the plantar fasica. Don't let pain determine your need for treatment. Treat this before the problem becomes painful and chronic and you have to wear tape just to function. I am putting the fear of chronic pain into your heel.

Another way to go is the pronation spring control made by fabriform. Can find this on http://www.biomechanics.com

Re: Taping or orthotics

Julie on 1/31/01 at 02:00 (037811)

Bill, I agree with Dr Zuckerman. Taping does not just relieve pain, it actively helps to avoid re-injuring the fascia. One of the first things I learned here, from the PF Book and the board (and my pod, to give him credit) was that 'if it hurts, it's being re-injured'. So taping, while it does indeed reduce pain, doesn't just reduce pain, it helps prevent re-injury whilst carrying on with whatever level of activity you can tolerate.

When my pf was at its worst (and it was never as bad as that of others on the board) taping enabled me to walk for reasonable distances/time without pain; ie. without re-injury. Now that I am 98% better, I am still using tape for support. Most of the time I'm all right without it, but at the first whisper of a twinge, back to the tape.

It is not a big deal. Applying the tape in the morning takes me about one minute; taking it off and cleaning my foot at night takes about two minutes. As I told Susan, I use the simplest method Scott describes: two strips connecting the ball of the foot and the heel. See my post to her for more details about tension, etc.

The Futuro ankle brace is excellent. I use it a lot in combination with the tape, and sometimes by itself (more now than before). It doesn't feel to me like enough support in itself, but in combination with the tape it gives me a feeling of full security.

So now you have both professional and personal comments. Try it and see. I have found it very effective and, when I really needed it (when I couldn't avoid being on my feet for a long time) a lifesaver. I hope you'll find it as helpful as I have.

All the best, Julie

Re: Taping or orthotics

Julie on 1/31/01 at 02:05 (037812)

Dr Z I tried the biomechanics link you gave and got an information page but there seemed no way of getting into or searching the site for information about fabrifoam. Can you tell me what I'm doing wrong?

Thanks, Julie

Re: Taping or orthotics

Sue R on 1/31/01 at 07:51 (037827)

Julie,

Do you find that taping that way (Scott's method) pulls on your ankle or other joints? Also, doesn't the tape irritate the ball of your foot?

I've been taping around the heel and the arch for support and it does help some. I'm looking for other options though as I can't wear my orthotics and really need support for these high arched feet!

Thanks for any advice you can give me!

Sue R

Re: Taping or orthotics

Julie on 1/31/01 at 08:36 (037832)

Hi Sue

No, I don't find that the tape pulls on my ankle or other joints. Which doesn't mean it mightn't pull on some people's. It could be due to your high arch (Scott may be able to comment as he has a high arch). It may also have to do with the tension at which the tape is applied. Scott's instructions tell us that you have to experiment. You want it tense enough to supply support to the arch; not tight enough to 'pull'. I once experimented with keeping my foot in neutral while I applied the tape, and it was so tight I had to take it off immediately.

The tape has to connect the ball of the foot and the heel to effectively provide the necessary support. I wouldn't have thought taping just around the arch and heel would do much, but I could be wrong.

Julie

Re: Taping or orthotics

Sue R on 1/31/01 at 10:49 (037842)

But doesn't the tape irritate the ball of the foot? I've tried it and by the end of the day, the skin felt like it could come right off! Help!

The way I tape is I run a long pice from the top of my foot around the heel (but not under it) to the top of my foot again. Then I wrap some around the arch so that it meets with the first piece of tape on top of my foot. Anyone else try this? It just seems to hold the arch up a bit when I walk.

Do you tape every day? Have you tried pre-wrap or something besides tape?

Thanks,
Sue R

Re: Taping or orthotics

JudyS on 1/31/01 at 11:42 (037851)

Hi Sue - my apologies for intruding on your conversation with Julie....but I thought I'd let you know that, as a high-arched person also, I found the most effective taping was the one that looks like an omega symbol or an open-ended figure 8(one of Scott's posted methods). I eventually learned the best way to position my foot, where to position the spot where the tape crosses itself, and how much pressure to apply. The method uses such little tape that I could reapply it immediately if it felt wrong when I stood up.
Also, after 2 years of trial and error, I've found that shoes by Josef Siebel seem to be the most comfortable for these arches!

Re: Taping or orthotics

Sue R on 1/31/01 at 12:04 (037853)

Judy,

But doesn't your skin get irritated? Do you do it pretty tight? And how does it feel when you walk?

Do you still have heel pain or is it primarily arches? Have you considered ESWT?

I have lots of questions I know. But I'm curious to see how high arched folks treat their pain. I think our problems are often separate.

Oh yea, where do you get shoes by Josef Siebel? Do you have luck with NB shoes?

Thanks,
Sue R

Re: Taping or orthotics

JudyS on 1/31/01 at 12:34 (037855)

Sue, I didn't have the skin irritation problem. I think because it's a small amount of tape, I tried to find the kind that looks the least irritating, and I tried not to wrap it around the heel too tightly. Having said that, one time a nurse taped my feet the traditional way - which included wrapping tape completely around the top of my foot. But he failed to put any protectant under that tape so, at the end of the day when my feet were more swollen, that tape literally tore the skin's surface! I had what related to burns for a week and scars for months.
I have only about 15-20% of the heel pain I had a year ago (I was crawling at that point) but I knock on wood because I know it's just lurking waiting to explode again. Also, I have yet to be able to be on them for more than about a half-day. Last summer I developed a demanding problem in the upper arch and that's what I'm trying to nail down now. It seemed to develop with the use of a cast then exacerbated by orthotics. It appears to be in a joint at the top of the arch or maybe even in a tendon.
I got my shoes at a tiny 'better' shoe store in San Luis Obispo. I live in San Diego but my son goes to college in SLO and our BobG had recommended that shoe store. But I'm pretty sure you can find them at better-quality shoe stores.
I very much want to explore the possibility of ESWT for my lingering heel pain. But, because it's so diminished, I'd rather focus on the arch pain right now. Also, I'm writing a bit of a 'treatis' regarding ESWT to present to my doc and my insurance company in order to see if they'll support me should I decide to try it. My doc has really been pushing surgery but I continue to be reluctant given my progress and the fact that the non-invasiveness of ESWT is a smarter way to go first.
I am very grateful to Donna for having provided that article regarding the special problems related to high arches. I'm going to explore the suggestions from that article also - and try to (humbly!) give the article to my doc. I have always felt that the treatments we find for PF and many foot problems assume an overpronation problem - which we have the opposit of. Having said that, many of the treatments can and should be the same but where we differ is with orthotics, shoes, PT, and perhaps even surgery. While my current Pod is pushing surgery, the one I had last summer says no surgery because my arches are so high and rigid!
I am using no orthotics right now. Essentially it's a test to see how much, if any, they've contributed to the arch pain. I was so amazed to see the high-arch article say that very thing about orthotics! I have to say that, so far, the arch pain is not diminished and the heel pain is not increased with no use of orthotics.

Re: Taping or orthotics

Sue R on 1/31/01 at 13:53 (037863)

Thanks, Judy, for all of the info. I AM pursuing ESWT even though my pain is in both the heel and arch, the arch being worse. The doc says I'm a candidate. I'm still not sure I believe him but I know that I do have heel pain, esp when I push on the spot. The pain is in the lower arch (closest to my heel) and he said that the ESWT can affect that area even though the treatment is on the insertion. I'm still asking questions and will hopefully figure this plan out eventually. I've definitely not nearly ready to consider surgery. That scares me more than anything.

So for now, I'll just keep doing what I'm doing and pray that something works eventually.

Sue R

Re: Taping or orthotics

Julie on 1/31/01 at 15:33 (037880)

Judy, you don't have to apologize; there's no such thing as 'intruding'.

Sue, no, I don't have a problem with irritation, and I think you might have to try out different kinds of tape. if the one you're using feels as though it's pulling the skin off, try some others until you find one that works without causing this problem. Try Judy's omega method - as you also have a high arch, you may find it works better for you than the two-strip technique. It's also very economical on tape, and easy to apply. It didn't work so well for me - but I don't have a high arch.

To answer your other question, yes, I was taping every day until quite recently. I'm now going without it about half the time, using it when I feel I need it, but feel ready to wean myself off it as my foot has improved so much.

I think the doctors have said in the past that if you have insertional pain, you are probably a candidate for ESWT even if the pain has radiated to other areas. Good luck if you do 'pass' and have it.

All the best, Julie

Re: Taping or orthotics

Dr. Zuckerman on 1/30/01 at 19:53 (037791)

It you find that the taping it too much trouble then try the futuro elastic ankle supports. The purpose of the taping as well as any type of orthosis whether over the counter or custom made is to control the elongation of the plantar fascia. This occurs with execessive pronation.

Taping in my opinion is one of the best way to prevent the plantar fascia from elongating excessively during walking.

It does take time and is a pain in the butt but can and does restrict excessive elongation of the plantar fasica. Don't let pain determine your need for treatment. Treat this before the problem becomes painful and chronic and you have to wear tape just to function. I am putting the fear of chronic pain into your heel.

Another way to go is the pronation spring control made by fabriform. Can find this on http://www.biomechanics.com

Re: Taping or orthotics

Julie on 1/31/01 at 02:00 (037811)

Bill, I agree with Dr Zuckerman. Taping does not just relieve pain, it actively helps to avoid re-injuring the fascia. One of the first things I learned here, from the PF Book and the board (and my pod, to give him credit) was that 'if it hurts, it's being re-injured'. So taping, while it does indeed reduce pain, doesn't just reduce pain, it helps prevent re-injury whilst carrying on with whatever level of activity you can tolerate.

When my pf was at its worst (and it was never as bad as that of others on the board) taping enabled me to walk for reasonable distances/time without pain; ie. without re-injury. Now that I am 98% better, I am still using tape for support. Most of the time I'm all right without it, but at the first whisper of a twinge, back to the tape.

It is not a big deal. Applying the tape in the morning takes me about one minute; taking it off and cleaning my foot at night takes about two minutes. As I told Susan, I use the simplest method Scott describes: two strips connecting the ball of the foot and the heel. See my post to her for more details about tension, etc.

The Futuro ankle brace is excellent. I use it a lot in combination with the tape, and sometimes by itself (more now than before). It doesn't feel to me like enough support in itself, but in combination with the tape it gives me a feeling of full security.

So now you have both professional and personal comments. Try it and see. I have found it very effective and, when I really needed it (when I couldn't avoid being on my feet for a long time) a lifesaver. I hope you'll find it as helpful as I have.

All the best, Julie

Re: Taping or orthotics

Julie on 1/31/01 at 02:05 (037812)

Dr Z I tried the biomechanics link you gave and got an information page but there seemed no way of getting into or searching the site for information about fabrifoam. Can you tell me what I'm doing wrong?

Thanks, Julie

Re: Taping or orthotics

Sue R on 1/31/01 at 07:51 (037827)

Julie,

Do you find that taping that way (Scott's method) pulls on your ankle or other joints? Also, doesn't the tape irritate the ball of your foot?

I've been taping around the heel and the arch for support and it does help some. I'm looking for other options though as I can't wear my orthotics and really need support for these high arched feet!

Thanks for any advice you can give me!

Sue R

Re: Taping or orthotics

Julie on 1/31/01 at 08:36 (037832)

Hi Sue

No, I don't find that the tape pulls on my ankle or other joints. Which doesn't mean it mightn't pull on some people's. It could be due to your high arch (Scott may be able to comment as he has a high arch). It may also have to do with the tension at which the tape is applied. Scott's instructions tell us that you have to experiment. You want it tense enough to supply support to the arch; not tight enough to 'pull'. I once experimented with keeping my foot in neutral while I applied the tape, and it was so tight I had to take it off immediately.

The tape has to connect the ball of the foot and the heel to effectively provide the necessary support. I wouldn't have thought taping just around the arch and heel would do much, but I could be wrong.

Julie

Re: Taping or orthotics

Sue R on 1/31/01 at 10:49 (037842)

But doesn't the tape irritate the ball of the foot? I've tried it and by the end of the day, the skin felt like it could come right off! Help!

The way I tape is I run a long pice from the top of my foot around the heel (but not under it) to the top of my foot again. Then I wrap some around the arch so that it meets with the first piece of tape on top of my foot. Anyone else try this? It just seems to hold the arch up a bit when I walk.

Do you tape every day? Have you tried pre-wrap or something besides tape?

Thanks,
Sue R

Re: Taping or orthotics

JudyS on 1/31/01 at 11:42 (037851)

Hi Sue - my apologies for intruding on your conversation with Julie....but I thought I'd let you know that, as a high-arched person also, I found the most effective taping was the one that looks like an omega symbol or an open-ended figure 8(one of Scott's posted methods). I eventually learned the best way to position my foot, where to position the spot where the tape crosses itself, and how much pressure to apply. The method uses such little tape that I could reapply it immediately if it felt wrong when I stood up.
Also, after 2 years of trial and error, I've found that shoes by Josef Siebel seem to be the most comfortable for these arches!

Re: Taping or orthotics

Sue R on 1/31/01 at 12:04 (037853)

Judy,

But doesn't your skin get irritated? Do you do it pretty tight? And how does it feel when you walk?

Do you still have heel pain or is it primarily arches? Have you considered ESWT?

I have lots of questions I know. But I'm curious to see how high arched folks treat their pain. I think our problems are often separate.

Oh yea, where do you get shoes by Josef Siebel? Do you have luck with NB shoes?

Thanks,
Sue R

Re: Taping or orthotics

JudyS on 1/31/01 at 12:34 (037855)

Sue, I didn't have the skin irritation problem. I think because it's a small amount of tape, I tried to find the kind that looks the least irritating, and I tried not to wrap it around the heel too tightly. Having said that, one time a nurse taped my feet the traditional way - which included wrapping tape completely around the top of my foot. But he failed to put any protectant under that tape so, at the end of the day when my feet were more swollen, that tape literally tore the skin's surface! I had what related to burns for a week and scars for months.
I have only about 15-20% of the heel pain I had a year ago (I was crawling at that point) but I knock on wood because I know it's just lurking waiting to explode again. Also, I have yet to be able to be on them for more than about a half-day. Last summer I developed a demanding problem in the upper arch and that's what I'm trying to nail down now. It seemed to develop with the use of a cast then exacerbated by orthotics. It appears to be in a joint at the top of the arch or maybe even in a tendon.
I got my shoes at a tiny 'better' shoe store in San Luis Obispo. I live in San Diego but my son goes to college in SLO and our BobG had recommended that shoe store. But I'm pretty sure you can find them at better-quality shoe stores.
I very much want to explore the possibility of ESWT for my lingering heel pain. But, because it's so diminished, I'd rather focus on the arch pain right now. Also, I'm writing a bit of a 'treatis' regarding ESWT to present to my doc and my insurance company in order to see if they'll support me should I decide to try it. My doc has really been pushing surgery but I continue to be reluctant given my progress and the fact that the non-invasiveness of ESWT is a smarter way to go first.
I am very grateful to Donna for having provided that article regarding the special problems related to high arches. I'm going to explore the suggestions from that article also - and try to (humbly!) give the article to my doc. I have always felt that the treatments we find for PF and many foot problems assume an overpronation problem - which we have the opposit of. Having said that, many of the treatments can and should be the same but where we differ is with orthotics, shoes, PT, and perhaps even surgery. While my current Pod is pushing surgery, the one I had last summer says no surgery because my arches are so high and rigid!
I am using no orthotics right now. Essentially it's a test to see how much, if any, they've contributed to the arch pain. I was so amazed to see the high-arch article say that very thing about orthotics! I have to say that, so far, the arch pain is not diminished and the heel pain is not increased with no use of orthotics.

Re: Taping or orthotics

Sue R on 1/31/01 at 13:53 (037863)

Thanks, Judy, for all of the info. I AM pursuing ESWT even though my pain is in both the heel and arch, the arch being worse. The doc says I'm a candidate. I'm still not sure I believe him but I know that I do have heel pain, esp when I push on the spot. The pain is in the lower arch (closest to my heel) and he said that the ESWT can affect that area even though the treatment is on the insertion. I'm still asking questions and will hopefully figure this plan out eventually. I've definitely not nearly ready to consider surgery. That scares me more than anything.

So for now, I'll just keep doing what I'm doing and pray that something works eventually.

Sue R

Re: Taping or orthotics

Julie on 1/31/01 at 15:33 (037880)

Judy, you don't have to apologize; there's no such thing as 'intruding'.

Sue, no, I don't have a problem with irritation, and I think you might have to try out different kinds of tape. if the one you're using feels as though it's pulling the skin off, try some others until you find one that works without causing this problem. Try Judy's omega method - as you also have a high arch, you may find it works better for you than the two-strip technique. It's also very economical on tape, and easy to apply. It didn't work so well for me - but I don't have a high arch.

To answer your other question, yes, I was taping every day until quite recently. I'm now going without it about half the time, using it when I feel I need it, but feel ready to wean myself off it as my foot has improved so much.

I think the doctors have said in the past that if you have insertional pain, you are probably a candidate for ESWT even if the pain has radiated to other areas. Good luck if you do 'pass' and have it.

All the best, Julie