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Occupational Disease

Posted by John S. on 3/26/01 at hrmin (042507)

Both my sister and I have developed heel spurs. We both work at the same mall, which has a concrete floor. My sister has carpet at her place of work and mine is tiled. She went to a Podiatrist that told her the cause of her heel spurs was the floor she worked on everyday. Yet, when I went to the same doctor he told me my heel spurs weren't caused by work. We both have worked the same jobs for the last five years and had no problems with our feet before. I'm confused, can you help me?

Re: Occupational Disease

Dr. Zuckerman on 3/26/01 at 11:22 (042508)

Heel pain, plantar fascia pain, heel spur pain . These conditions are a repetitive motion injury and can be aggravated by standing on cement. There is no question in my mind that there is a relationship between heel spur pain and standing on hard cement. Foot types and foot structure can be genetic and thus the type of foot can cause pain, heel spur pain.

I hope this clarifies this relationship. Now it is very important to educate yourself and prevent your foot pain from becoming chronic and very serious. I suggest that you read the online book plantar fasciitis . Feel free to ask any questions that you may have.

Re: Occupational Disease

JudyS on 3/26/01 at 12:37 (042525)

Dr. Z - can PF be caused, bilaterally, by something so simple as overstretching the calf, back of leg and/or Planter in one's normal stretching routine?

Re: Occupational Disease

Dr. Zuckerman on 3/26/01 at 14:11 (042539)

It is possible

Re: Occupational Disease

Julie on 3/26/01 at 20:55 (042583)

Judy, my understanding is that if the calf muscles are tight/shortened (and therefore contributing to PF) stretching them correctly can alleviate PF. But if they aren't tight, stretching them can worsen PF (that started happening to me, but fortunately I twigged quickly). I would guess, therefore, that overstretching could contribute to PF, especially if there are other predisposing/contributing factors.

Re: Occupational Disease

JudyS on 3/27/01 at 11:21 (042642)

Good point, Julie and that's why I'd asked the question - I was musing the other day about the onset of my PF (almost 3 years ago!). And, given that it has always been bilateral I considered 3 possible causes. One, new running shoes - Nike had 'updated' my favorite style...., two, new hardwood floors and, three, I realized that I'd been doing more intensive calf-muscle stretching. You know the one where you lie on your back, extend a leg straight up and pull your toes down with your hand? I remember too that I continued to do that stretch in the first year of PF - thinking that I HAD to keep the back of the leg stretched as much as possible! I'm sure now that it only made things worse.
I should say too that the reason I began to wonder about stretching is that I've completely abandoned my morning, in-the-bed, stretching these last 2 weeks as a result of stressful travel to Michigan. And you know what? My pain level, which was already getting more manageable, is reduced even more now! So I'll re-design my stretching, probably for evenings, and see what happens.

Re: Occupational Disease

Julie on 3/28/01 at 02:23 (042751)

Judy, that's interesting. Whilst all the possible causes you list could have contributed and probably did, I think you've certainly nailed the stretching one. I'd guess that as an intelligent runner you've always been aware of the need for stretching before and after running, and that therefore your calf muscles are and always have been well stretched. So that strong stretch (yes, I know it) was unnecessary, and probably - as the calf muscles didn't need it - pulled on Achilles and the fascia and made your PF worse.

I know it's advised to stretch before getting out of bed in the morning, but that particular stretch really is too strong for the morning, when all your muscles are tight. If you want to continue doing it, you're wise to switch to the evenings, but be careful even then. It may just be too strong period. Particularly if you noticed improvement when you laid off it. You could try just extending the leg up and from that position flexing and extending the ankle - no pulling on the toes. And do it on the floor, rather than in bed - unless your bed is floor-hard, it can't support your spine properly.

Re: Occupational Disease

JudyS on 3/28/01 at 10:23 (042785)

Oops Julie - I left the wrong impression. My morning stretches have always been very gentle ones. I abandoned that 'stronger' one (one of my 'evening stretches) a year ago when I figured out that it was quite likely contributing instead of helping!

Re: Oops!

Julie on 3/28/01 at 10:33 (042787)

Good! Sorry if I misunderstood you.

Re: Occupational Disease

Dr. Zuckerman on 3/26/01 at 11:22 (042508)

Heel pain, plantar fascia pain, heel spur pain . These conditions are a repetitive motion injury and can be aggravated by standing on cement. There is no question in my mind that there is a relationship between heel spur pain and standing on hard cement. Foot types and foot structure can be genetic and thus the type of foot can cause pain, heel spur pain.

I hope this clarifies this relationship. Now it is very important to educate yourself and prevent your foot pain from becoming chronic and very serious. I suggest that you read the online book plantar fasciitis . Feel free to ask any questions that you may have.

Re: Occupational Disease

JudyS on 3/26/01 at 12:37 (042525)

Dr. Z - can PF be caused, bilaterally, by something so simple as overstretching the calf, back of leg and/or Planter in one's normal stretching routine?

Re: Occupational Disease

Dr. Zuckerman on 3/26/01 at 14:11 (042539)

It is possible

Re: Occupational Disease

Julie on 3/26/01 at 20:55 (042583)

Judy, my understanding is that if the calf muscles are tight/shortened (and therefore contributing to PF) stretching them correctly can alleviate PF. But if they aren't tight, stretching them can worsen PF (that started happening to me, but fortunately I twigged quickly). I would guess, therefore, that overstretching could contribute to PF, especially if there are other predisposing/contributing factors.

Re: Occupational Disease

JudyS on 3/27/01 at 11:21 (042642)

Good point, Julie and that's why I'd asked the question - I was musing the other day about the onset of my PF (almost 3 years ago!). And, given that it has always been bilateral I considered 3 possible causes. One, new running shoes - Nike had 'updated' my favorite style...., two, new hardwood floors and, three, I realized that I'd been doing more intensive calf-muscle stretching. You know the one where you lie on your back, extend a leg straight up and pull your toes down with your hand? I remember too that I continued to do that stretch in the first year of PF - thinking that I HAD to keep the back of the leg stretched as much as possible! I'm sure now that it only made things worse.
I should say too that the reason I began to wonder about stretching is that I've completely abandoned my morning, in-the-bed, stretching these last 2 weeks as a result of stressful travel to Michigan. And you know what? My pain level, which was already getting more manageable, is reduced even more now! So I'll re-design my stretching, probably for evenings, and see what happens.

Re: Occupational Disease

Julie on 3/28/01 at 02:23 (042751)

Judy, that's interesting. Whilst all the possible causes you list could have contributed and probably did, I think you've certainly nailed the stretching one. I'd guess that as an intelligent runner you've always been aware of the need for stretching before and after running, and that therefore your calf muscles are and always have been well stretched. So that strong stretch (yes, I know it) was unnecessary, and probably - as the calf muscles didn't need it - pulled on Achilles and the fascia and made your PF worse.

I know it's advised to stretch before getting out of bed in the morning, but that particular stretch really is too strong for the morning, when all your muscles are tight. If you want to continue doing it, you're wise to switch to the evenings, but be careful even then. It may just be too strong period. Particularly if you noticed improvement when you laid off it. You could try just extending the leg up and from that position flexing and extending the ankle - no pulling on the toes. And do it on the floor, rather than in bed - unless your bed is floor-hard, it can't support your spine properly.

Re: Occupational Disease

JudyS on 3/28/01 at 10:23 (042785)

Oops Julie - I left the wrong impression. My morning stretches have always been very gentle ones. I abandoned that 'stronger' one (one of my 'evening stretches) a year ago when I figured out that it was quite likely contributing instead of helping!

Re: Oops!

Julie on 3/28/01 at 10:33 (042787)

Good! Sorry if I misunderstood you.