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Plantar fasciitis/shin splints

Posted by Janice W. on 2/21/01 at 11:49 (039557)

Hi,
I have recently developed pf since the birth of my second child. I was running 3 miles a day before i got pregnant, and didn't get back into working out until about 6 months after he was born. I've been working out off and on, trying to get back into it slowly and developed extreme pain on the bottom of both feet when running. That generally signaled the need for new shoes, i've been through three pairs of shoes, two sets of inserts and seen the podiatrist who diagnosed pf. This was back in november. Prior to my pregnancy i had never had any problems running at all. Now i've got shin splints, which i tried running through the pain for a while, eventually stopped becuase it started hurting when i was just walking around. I went to the dr and was told it was just spasms in the muscle and i was given indocin for inflammation, i have been taking it for a week and it seems to work, but the pain has been ongoing for three weeks, and i have stopped exercising completely, trying to take it easy. My question is how much longer should i wait before exercising and is there any physical therapy (specific) you can recommend, maybe a website with specific exercises. The podiatrist said this is becoming more common with women who have had one or more pregnancies, something to do with hormones. He said my calves were really tight and i needed to stretch, which i have also been doing for several months but it doesn't seem to be helping? What about orthotics. The dr. gave me some but they weren't custom. I know this is a long email, and i apologize in advance, but i am trying to gather as much information as I can. I would like to get back into shape, postpregnancy, and with these recurring foot problems it's very difficult. Running has been the most effective aerobic activity for me but i would also like to try the stairmaster, i don't have easy access to a pool. Thanking you in advance for any and all information.

Re: Plantar fasciitis/shin splints

Julie on 2/21/01 at 16:16 (039572)

Hello Janice, and welcome to the board. You will get a lot of useful information and support here.

The doctors will answer your post, but while you're waiting, click on the link for The PF Book at the top of the home page. Print it out, and study it: it's the best source of information and ideas you'll find anywhere. You can also search the book and all the message boards for information on any topic you key in.

The first line of treatment for PF is rest. It's an injury, and it needs time and rest in order to heal. Stay off your feet as much as possible, and don't even think of running until the pain is completely gone (this may take weeks or months depending on how far advanced your condition is) and then resume activity gently.

Many people including myself have found taping a great help, not just in relieving the pain but in providing support for the arch and taking the strain off the fascia. There are instructions and illustrations in the PF Book, Part 2. Icing is useful for reducing inflammation, but remember that it also masks the pain, so take care not to do too much.

I'm sure you know that shin splints also need rest in order to heal - so you have two good reasons for cutting back on weight-bearing exercise!

As for stretching, I think you should find a good physical therapist who can prescribe exercises that are right for you. Different stretches suit different people, and many have found the generally-recommended wall stretches make matters worse - this can be because they are too strong, or because they are not often done correctly. Best to consult a practitioner who can give you the help you need.

Last but not least, never go barefoot. The arches need support at all times. I and many others swear by Birkenstocks, but they don't suit everybody. Make sure all the shoes you wear have good support. It would be worth your while to do a search on shoes - there have been a great many informative posts in recent months.

Richard, our resident pedorthist, can answer questions on orthotics on the orthotics/shoes board.

I hope this is a helpful start.

All the best

Julie

Re: Plantar fasciitis/shin splints

Julie on 2/21/01 at 16:18 (039573)

Sorry: a line got omitted from my post above. After the reference to icing, it should have said that anti-inflammatory drugs such as Ibuprofen are also useful (for reducing inflammation) but mask the pain.

Re: Plantar fasciitis/shin splints

Dr. Zuckerman on 2/21/01 at 18:24 (039581)

Julie took the words right out of my mouth. She has alot of experience and knowledge to go with her advice.

Shin Splints are usually from the Anterior Tibial tendon being over used . This run in front of the leg and then inserts into the top of the foot in the area of the arch. The pain is from severe abnormal pulling of this tendon away from the bone. This is another of the overuse injuries.

So what to do . Icing, Stretching of both the posterior calf muscle groups and the anterior leg muscles is very helpful.

At this point i would go see a physical therapist so that he can evaluate your strenght and recommend a specific pt program for you.

Biking is pretty good for this. The type of surfact that you run on and the distance needs to be evaluated. So tell us what surfaces do you run on .

Do you stretch before and after and what kind of stretching do you do.

Re: Plantar fasciitis/shin splints

Richard, C.Ped on 2/22/01 at 08:06 (039623)

Hi Janice,
As Julie put it, I am the resident C.Ped. I have treated quite a few people with shin splints here with great success. My suggestion would be to try a custom orthosis. This comes with a warning: The MUST be made correctly. Watch out for window scrapers. I can't stress that enough. It must fit your foot properly.

Basically, there are things going on anteriorly that need pressure and stress reduced. A properly made custom orthosis should do the trick. It should allow you to have a more neutral gait, thus reducing stress while walking.

For now, I would not push it, which means resting.
If you have any questions about the orthosis, please let me know. I am more than happy to help you in any way I can.
Richard, C.Ped

Re: shin splints Article

Donna SL on 2/22/01 at 11:22 (039641)

Janice,

I found a very good article on shin splints.

http://www.clark.net/pub/pribut/spshin.html

It basically explains how oppossing muscles cause shin splints.
Get into a good physical therapy program, and get them to work on you lower legs, esp. the calves with deep tissue massage, ultra sound,etc. Sometimes your muscles get so tight, and you may of acquired tendonitis in you lower extremities, that only PT can get rid of it. I had all kinds of problems with PF, etc., and improved dramatically with PT, after tryiny many orthotics. Try to get into a PT clinic associated with a sports medicine center.

I had a really bad bout of anterior shin splints the last couple of weeks, and I requested the PT to do electrical stimulation with ice on the shins in additiion to the above, and that seemed to knock them out almost immediately. Also, your hamstrings, IT-band, and other upper leg muscles may be tight too. You need more than orthotics to help cure these problems.

Also, make sure your shoes are not to stiff in the forefoot, and you are wearing the proper shoe for your foot type.

Donna

Re: Plantar fasciitis/shin splints

Julie on 2/21/01 at 16:16 (039572)

Hello Janice, and welcome to the board. You will get a lot of useful information and support here.

The doctors will answer your post, but while you're waiting, click on the link for The PF Book at the top of the home page. Print it out, and study it: it's the best source of information and ideas you'll find anywhere. You can also search the book and all the message boards for information on any topic you key in.

The first line of treatment for PF is rest. It's an injury, and it needs time and rest in order to heal. Stay off your feet as much as possible, and don't even think of running until the pain is completely gone (this may take weeks or months depending on how far advanced your condition is) and then resume activity gently.

Many people including myself have found taping a great help, not just in relieving the pain but in providing support for the arch and taking the strain off the fascia. There are instructions and illustrations in the PF Book, Part 2. Icing is useful for reducing inflammation, but remember that it also masks the pain, so take care not to do too much.

I'm sure you know that shin splints also need rest in order to heal - so you have two good reasons for cutting back on weight-bearing exercise!

As for stretching, I think you should find a good physical therapist who can prescribe exercises that are right for you. Different stretches suit different people, and many have found the generally-recommended wall stretches make matters worse - this can be because they are too strong, or because they are not often done correctly. Best to consult a practitioner who can give you the help you need.

Last but not least, never go barefoot. The arches need support at all times. I and many others swear by Birkenstocks, but they don't suit everybody. Make sure all the shoes you wear have good support. It would be worth your while to do a search on shoes - there have been a great many informative posts in recent months.

Richard, our resident pedorthist, can answer questions on orthotics on the orthotics/shoes board.

I hope this is a helpful start.

All the best

Julie

Re: Plantar fasciitis/shin splints

Julie on 2/21/01 at 16:18 (039573)

Sorry: a line got omitted from my post above. After the reference to icing, it should have said that anti-inflammatory drugs such as Ibuprofen are also useful (for reducing inflammation) but mask the pain.

Re: Plantar fasciitis/shin splints

Dr. Zuckerman on 2/21/01 at 18:24 (039581)

Julie took the words right out of my mouth. She has alot of experience and knowledge to go with her advice.

Shin Splints are usually from the Anterior Tibial tendon being over used . This run in front of the leg and then inserts into the top of the foot in the area of the arch. The pain is from severe abnormal pulling of this tendon away from the bone. This is another of the overuse injuries.

So what to do . Icing, Stretching of both the posterior calf muscle groups and the anterior leg muscles is very helpful.

At this point i would go see a physical therapist so that he can evaluate your strenght and recommend a specific pt program for you.

Biking is pretty good for this. The type of surfact that you run on and the distance needs to be evaluated. So tell us what surfaces do you run on .

Do you stretch before and after and what kind of stretching do you do.

Re: Plantar fasciitis/shin splints

Richard, C.Ped on 2/22/01 at 08:06 (039623)

Hi Janice,
As Julie put it, I am the resident C.Ped. I have treated quite a few people with shin splints here with great success. My suggestion would be to try a custom orthosis. This comes with a warning: The MUST be made correctly. Watch out for window scrapers. I can't stress that enough. It must fit your foot properly.

Basically, there are things going on anteriorly that need pressure and stress reduced. A properly made custom orthosis should do the trick. It should allow you to have a more neutral gait, thus reducing stress while walking.

For now, I would not push it, which means resting.
If you have any questions about the orthosis, please let me know. I am more than happy to help you in any way I can.
Richard, C.Ped

Re: shin splints Article

Donna SL on 2/22/01 at 11:22 (039641)

Janice,

I found a very good article on shin splints.

http://www.clark.net/pub/pribut/spshin.html

It basically explains how oppossing muscles cause shin splints.
Get into a good physical therapy program, and get them to work on you lower legs, esp. the calves with deep tissue massage, ultra sound,etc. Sometimes your muscles get so tight, and you may of acquired tendonitis in you lower extremities, that only PT can get rid of it. I had all kinds of problems with PF, etc., and improved dramatically with PT, after tryiny many orthotics. Try to get into a PT clinic associated with a sports medicine center.

I had a really bad bout of anterior shin splints the last couple of weeks, and I requested the PT to do electrical stimulation with ice on the shins in additiion to the above, and that seemed to knock them out almost immediately. Also, your hamstrings, IT-band, and other upper leg muscles may be tight too. You need more than orthotics to help cure these problems.

Also, make sure your shoes are not to stiff in the forefoot, and you are wearing the proper shoe for your foot type.

Donna