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I don't know.

Posted by wendyn on 6/01/01 at 00:08 (049532)

I haven't had a lot of time to read the posts - there are a few I really want to respond to but my time is limited for the next couple days...

For anyone who is still interested, I did see my orthepedic surgeon today.

He is, hands down, I'm sure the most arrogant doctor I have dealt with in a long time. He is also very good at what he does.

He asked if I'd gotten new orthotics like he prescribed. I said I did - I told him they helped a lot. I told him I also got custom Birks - his response?

'Cool!' (?) (He's pretty young.)

I asked him about what was happeing with my feet in general...

'I don't know'.

He said all he knows for sure is that I have a ganglion in one foot that appears to be incidental and nothing to do with my problem. I also have feet that are getting flatter - problems with my post tib tendon - and a lot of seemingly nerve related pain.

I asked him about why in most cases of post tib tendon collapse he would do surgery - but in my case he won't - he said

'I don't know what is happening with your feet so I don't want to go in and make things worse.'

I asked about the burning and color changes....and sure nuff - the old 'RSD phrase' surfaced.

He said basically RSD is a collection of symptoms, when the body reacts in a way that they don't understand. He did provide an interesting analogy....

If you injure a salamander's leg - his nervous system will shut down the circulation to the leg - it will fall off and he will grow a new one. They believe that humans have some rudimentary form of this old reflex - and that it can kick in inappropriately following some injuries.

Because my case is no longer 'acute' and I am getting better on my own 'with no help from him'....he thinks I should just carry on. If the case were acute, he would prescribe aggresive physio treatments, neurotonin or elavil etc.

I asked if I was going to get any better....

'I don't know'.

What does this mean for the future....

'I don't know'.

He also reminded me for the hundredth time not to ever gain weight. Thank you - I need the added pressure. He recommended heel cord stretches and toe raises every day. Good orthotics and supportive shoes forever.

So - how do I feel about all of this?

I don't know.

Re: One more

wendyn on 6/01/01 at 00:12 (049533)

I asked about the knots on my shins...

you guessed it......

'I don't know.'

Re: One more

Laurie R on 6/01/01 at 00:30 (049537)

Dear Wendy , This I don't know stuff had to be making you crazy.. I know I would be feeling a little crazy. So he was not to concerned about your shins??? I think he is a good doctor by not wanting to cut your feet ... That is jsut what the specialist said to me last week. He told me I may never walk agian if he did the surgery now . So I guess you and I are in the same place ,I got no answers and you got I don't knows..... Hummmmmm ,What do we do Wendy??? How is your pain in your feet? I know you said you are getting better ....My very best to you..Laurie R

Re: I don't know.

Mike W on 6/01/01 at 08:28 (049555)

Hello Wendy,

I believe that many traditional exercises like the heel cord stretch and toe raises are not only incorrect but exactly the opposite of what you should be doing.

If you go to my new website http://www.foottrainer.com and click Plantar Fasciitis and then Incorrect Exercises you will find the reasons why I think they are incorrect.

We also have excellent foot and leg muscle/tendon anatomy pictures and practical rehabilitation information.

Regards,

Mike W

Re: I don't know.

john h on 6/01/01 at 09:42 (049563)

wendy: i really don't know what the doctor said.

Re: Thanks, Mike

Julie on 6/01/01 at 09:46 (049564)

Hi Mike

I like your new website. The foot and leg anatomy pictures are excellent.

I've been trying to caution enthusiastic stretchers about the wall and stair exercises for ages. It's uphill work, partly because podiatrists recommend these counterproductive techniques, and because people need to feel they are 'doing something': never mind that they're probably hurting themselves.

From now on I will save myself lots of on-line time by simply referring people to http://www.foottrainer.com/plantar fasciitis/incorrect exercise.

Listen, folks: here is one sentence from http://www:foottrainer/com that should be engraved on all our hearts:

'ALL WEIGHT BEARING PLANTAR FASCIITIS EXERCISES ARE INCORRECT'.

Re: I don't know.

john h on 6/01/01 at 09:58 (049565)

mike: i had not looked at your web site lately. it is excellent! on your foot anatomy pictures you show the medial plantar fascia running along the inside edge of the foot and outside of the plantar fascia (i assume). when i bend my toes back i can see clearly the outline of the fasica but this band of medial fasica does not seem to be effected by pulling the toes back. on occasion this band on the inside of the foot will cramp or spasm on my foot and cause considerable pain. i can ususally stop it with massage very quickly. i always thought this was a muscle but if i am looking at the picture correctly it is labeled medial plantar fascia. i have read that spasm in this area is a result of fasciaitis. have you ever read this and am i interpreting the picture correctly.

it is amazing how so many doctors can put out so many exercises and stretches for the foot and others can show why these same exercises can be counter productive. good info here. should be read by all.

Re: I don't know.

john a on 6/01/01 at 10:46 (049580)

Nice site, Mike. My only complaint is that the picture of the PFTs is so small! You really should have a larger picture, perhaps pointing out the various components, etc. I also see that the design of the head is different from the one I bought about a year ago, and seem to recall you saying that the updated head would be sent out to all past buyers. Did I misunderstand, or is it not really possible to put the new head on an old device?

Re: I don't know.

Julie on 6/01/01 at 12:02 (049595)

Wendy, this doctor doesn't sound arrogant. Any doctor who can say 'I don't know' even once, let alone four times (or was it five?) is at least honest. And I like the sound of a doctor who'll say 'I don't want to go in and make things worse'.

This is just my opinion based on a reading of your report, but for what it's worth, I'd say he clearly thinks you're doing a good job of self-healing. So do I. And you ARE getting better, so carry on doing what you're doing and keep on just putting one foot in front of the other (ha) and see where it gets you. I reckon you'll get better still (but of course I don't know).

Re: I don't know.

JudyS on 6/01/01 at 12:20 (049597)

Mike - I like your 'stretches' page also. Around here we've almost all found out that traditionally-prescribed 'stretching' seems to only make matters worse. Maybe it's time for some professional (you? :) ) to write a thorough paper for fellow-pros describing why those exercises make matters worse and introduce a whole new approach to stretching and strengthening for PF.
I had a little bit of trouble understand the paragraph dealing with why the usual medical description of PF is misleading. Would you be able to clarify that somewhat for me? Thank you.

Re: One more

JudyS on 6/01/01 at 12:25 (049598)

Wendy - I have those 'knots' also and have had for about 20 years. I figured they were from running, etc. and I've ignored them. They don't hurt. I asked a Doc once about them and he said 'ignore them'!

Re: One more

Rock on 6/01/01 at hrmin (049602)

I have to agree 100% about comments on weight bearing on the BALL OF THE FOOT activites being the BAD THING.

Think about it, if your weight is on the heel, or if the shoe is VERY stiff, either by an orthotic or road cycling shoe, you will not be able to overstrectch the soft tissues along the bottom of your injured foot. Right ? It is the GOLDEN rule for us PF people.

This is how I keep my activity level very high (weekly volume: swim 4 miles, bike 100 miles, run 40 miles) even during a flare-up and return to (100% pain free) remission.

Here is one trick that I just learned:

If you are riding a mtn bikeor stationary bike without wearing super stiff cycling shoes, position your heels on the pedals (never the balls of your feet). This will avoid PF reinjury and still allow you to bike ride for hours. Yes, I know it looks dumb, but who cares about that.

I hope this helps...
Rock.
CO.USA.

Re: One more

Nancy N on 6/01/01 at 13:25 (049604)

How does keeping the heels on the pedals help? I try to keep my feet flat, with the pedal centered below the ball of my foot. I can't imagine trying to ride with my heels on the pedals--I think they'd slip off, and even if they didn't, it seems like it would be mighty uncomfortable--but maybe I am wrong??

Re: Foot Muscle Info

Mike W on 6/01/01 at 13:31 (049605)

Hello John,

I am a bit confused by your questions but will try to answer with some information on foot anatomy.

You are interpretting the picture correctly but you should be aware that that my anatomy pictures show 3 different layers. So, the medial and lateral fascia are shown in the subcutaneous picture and the muscles that are enveloped by them are shown in the other 2 pictures.

Fascia does not cramp, muscles do so you are right.

Muscle cramps are a sign from your body that they are not working well.
If you read my section on Muscle Innervation you will learn how to relax these muscles and help stop these spasms.

I hope this answers your question.

Thanks for the positive feedback. My new site has only been up for a few days.

Regards,

Mike W

Re: Thanks for the feedback

Mike W on 6/01/01 at 14:05 (049612)

Hello John,

Thanks for the feedback. I will try to get larger pictures.

Last December I completed the 'Foot Trainer' which has a different head than the 'Personal Foot Trainer'. Instead of steel and gum rubber it is a plastic mold with neopreme pads.

I spent a lot of time and effort with the new design and am pleased with the result.

Along with improving the design I have developed new Foot Trainer Rehabilitation Exercises and have been seeing excellent results. Over the past year I have received lots of feed back from my customers and I really learned and fine tuned what works and what does not.

I would be happy to email or mail the New Exercises to you and any other
customers.

You can perform all of the new exercises with the PFT.

John it is not practical to put the new head on the PFT but if you email me maybe we can work something out.

Regards,

Mike W

Re: Thanks Julie

Mike W on 6/01/01 at 14:22 (049615)

Hello Julie,

A few months ago I had a referral from Physiotherapist who had plantar fasciits herself for over 1 year. She bought a pair of Foot Trainers and about 3 weeks later she was 100%. She ordered a couple of Foot Trainers for her customers and they all got relief as well and now every patient uses them.

She told me that she has been treating plantar fasciitis for over 15 years and that she now realizes why the traditional exercises are so ineffective, because many of them are incorrect. They are taught them at school and they are the law until they learn differently.

She and a partner with a Masters in Physiotherapy have expressed interest in doing a scientific study on Foot Trainer Exercises.

I hope you get 100% soon.

Regards,

Mike W

Re: Medical Definition

Mike W on 6/01/01 at 14:34 (049618)

Hello Judy,
See my above post re: Foot Trainer Study.

It is misleading because:
Inflammation and pain are symptoms not the cause.
Technically they are refferring to the plantar aponeurosis not the plantar fascia.
There are 4 other muscles/tendons that also attach to the heel bone not just the plantar fascia. If you go to my anatomy pictures you can see them.

Thanks for you interest.

Regards,

Mike W

Re: Thanks Julie

Julie on 6/01/01 at 15:22 (049622)

Hello Mike

That is a very interesting tale! The trouble is, it seems that many professionals who treat PF never do learn differently. Perhaps their patients, failing to get better, simply lose heart and go away.

When I realized for myself that the wall stretches advised by my pod weren't helping, I told him, and he agreed that I should drop them, saying that if the calf muscles are tight, these stretches can help; if they aren't, the stretches can make things worse. 'I accepted that at the time, but have since wondered (and am now pretty sure) that even if tight calf muscles are a contributory factor, the wall stretch isn't the way round that problem. I returned to and increased the simple foot exercises that I've long practised and taught in yoga, and they (amongst other things) have got me to my present reasonable state.

I have to declare myself: my own interest in the PFT (which as you know I have just ordered, inspired by your new site) is primarily professional. I want to see and understand how it works, so that I can better help any students of mine who turn up with PF . PF-wise myself, I've been 95-97% since the beginning of the year.

Maybe the PFT will nudge me that extra 3-5%!

I second Judy's motion. There is surely a need for somebody to challenge the received notion of stretches for PF. Why not submit an article to Podiatry Today?

All the best, Julie

Re: I don't know.

Beverly on 6/01/01 at 16:49 (049623)

Wendy,

Hearing, 'I don't know' has got to be one of the most frustrating things any of us as a patient can hear. It's also scarey. But at least the guy was being honest. I'd rather have a doctor say, 'I don't know' than to guess or just pat me on the head and say, 'I'm sure you'll get better.'
It does sound like your doing better. Glad to hear it.
Best wishes,
Beverly

Re: I don't know.

josh s on 6/01/01 at hrmin (049640)

Hi Wendyn,

I hesitate to write this as I've missed any of your previous posts so I don't know what other advice or care you've recieved. Regarding your young orthopod, my general mistrust of health professionals interprets all these 'I don't know''s as impressive humility or ignorant apathy, maybe both. Unfortunately, I've encountered much more of the latter from our MD friends of late.
As you mentioned progressive flatfoot and posterior tibialis I want to pass on some web pages I've found on tibialis posterior dysfunction (tpd). I'm no expert, but apparently it's one of those conditions that is underestimated and underdiagnosed. I've interpreted the part of your post where the orthopod says he does'nt know what's going on with you to possibly refer to tpd. If this is the case, these sites may be useful to him as well.
http://www.mvpdoc.com [a site by Mueller, DPM who developed a special orthotic for TPD. Pretty technical, but lots of good info.]
http://www.podiatrytoday.com/archive/pod_200012/pod_200012d6.html [article from Pod. Today by several DPM's experienced with such.]
http://www.podiatrymgt.com/cme/Kir-o1.htm [one famous DPM's approach]
http://www.curtin.edu.au/curtin/dept/physio/podiatry/encyclopedia/pt [did'nt read this but appears to be part of a course for podiatrists]
http://www.afo-lab.com/Styles/PosteriorTibial.htm [site for a different style of orthotic for severe arch collapsing conditions w/ several causative factors not mentioned elsewhere]

Hope this helpful
Best Wishes

Re: I don't know.

wendyn on 6/02/01 at 01:22 (049658)

Thanks guys for all your comments!

It's very late here so I won't write much and I'm way behind on posts.

The I don't know came across as honest and I do appreciate that.

It is his mannerisms and overall attitude that is very arrogant (I think you'd have to meet him to understand). I probably should have explained that better.

He is extremely well respected - no matter who I talk to about my feet (podiatrists, physio therapists, sports med etc). When I mention his name they just say ohhhh - with a genuine tone of awe. If it comes to foot surgery - he is supposed to be one of the best. He completely rebuilt my friends foot (she has rheumatoid arthritis) so I've seen what he can handle. A little un-nerving that he'd tackle her feet and not mine.

I do appreciate his honesty - and that he does not presume to know more than he does. But, it's still frustrating!

Re: I don't know.

Cynthia D on 6/02/01 at 21:11 (049707)

Wendy, when they asked you how you would be paying for your visit, did you say 'I don't know!'?

Cool.

Re: I don't know.

wendyn on 6/02/01 at 21:47 (049711)

That's funny Cynthia! Too bad it's covered under insurance so they never had to ask.

Re: One more

JudyS on 6/03/01 at 13:30 (049763)

My experience with 'heel only' peddling is the same as Nancy N's - it's awkward, the feet slip off the pedals and it makes for unusual stress on other ligaments. However, using the 'ball only' typical method really puts pressure on the Plantar - unless you use a very low-pressure setting on the bike. I sort of developed a 'flat-foot' method that helps a bit - it's the same method I use for doing a leg press. The problem with it is in concentrating, which you really have to do to keep the foot in a strictly neutral position.

Re: One more

Julie on 6/03/01 at 14:30 (049770)

Judy, by 'flat-foot' do you mean you were pedalling with your arch? Sounds as though that would be the most likely way of keeping your foot in a neutral position. When I was thinking about Val's cycling problem, it seemed to me that you wouldn't want the feet to be either too dorsiflexed or plantarflexed.

Re: Pedaling & How !

Valerie S on 6/04/01 at hrmin (049882)

Hi.

Over the last several days, I have been trying different ways of pedaling... I was unable to pedal with my heels. I feel like I am going to fall right off the bike. I tried with the balls of my feet for a minute, and boy could I feel it in the arch of my foot. So I have also adapted a 'neutral' or flat-footed position, pedaling with the arch. I wear my Birks and Futuro ankle brace, so don't feel any stress in the fascia.

Just my experience... I am now biking several miles a day.
Val.

Re: Pedaling & How !

Nancy N on 6/04/01 at 20:11 (049913)

When I mentioned my stationary bike to Dr. Z, he advised the flat-foot approach, so that is what I try to do. It's nowhere near as awkward as I would think the heels-on-pedals would be.

Re: One more

wendyn on 6/01/01 at 00:12 (049533)

I asked about the knots on my shins...

you guessed it......

'I don't know.'

Re: One more

Laurie R on 6/01/01 at 00:30 (049537)

Dear Wendy , This I don't know stuff had to be making you crazy.. I know I would be feeling a little crazy. So he was not to concerned about your shins??? I think he is a good doctor by not wanting to cut your feet ... That is jsut what the specialist said to me last week. He told me I may never walk agian if he did the surgery now . So I guess you and I are in the same place ,I got no answers and you got I don't knows..... Hummmmmm ,What do we do Wendy??? How is your pain in your feet? I know you said you are getting better ....My very best to you..Laurie R

Re: I don't know.

Mike W on 6/01/01 at 08:28 (049555)

Hello Wendy,

I believe that many traditional exercises like the heel cord stretch and toe raises are not only incorrect but exactly the opposite of what you should be doing.

If you go to my new website http://www.foottrainer.com and click Plantar Fasciitis and then Incorrect Exercises you will find the reasons why I think they are incorrect.

We also have excellent foot and leg muscle/tendon anatomy pictures and practical rehabilitation information.

Regards,

Mike W

Re: I don't know.

john h on 6/01/01 at 09:42 (049563)

wendy: i really don't know what the doctor said.

Re: Thanks, Mike

Julie on 6/01/01 at 09:46 (049564)

Hi Mike

I like your new website. The foot and leg anatomy pictures are excellent.

I've been trying to caution enthusiastic stretchers about the wall and stair exercises for ages. It's uphill work, partly because podiatrists recommend these counterproductive techniques, and because people need to feel they are 'doing something': never mind that they're probably hurting themselves.

From now on I will save myself lots of on-line time by simply referring people to http://www.foottrainer.com/plantar fasciitis/incorrect exercise.

Listen, folks: here is one sentence from http://www:foottrainer/com that should be engraved on all our hearts:

'ALL WEIGHT BEARING PLANTAR FASCIITIS EXERCISES ARE INCORRECT'.

Re: I don't know.

john h on 6/01/01 at 09:58 (049565)

mike: i had not looked at your web site lately. it is excellent! on your foot anatomy pictures you show the medial plantar fascia running along the inside edge of the foot and outside of the plantar fascia (i assume). when i bend my toes back i can see clearly the outline of the fasica but this band of medial fasica does not seem to be effected by pulling the toes back. on occasion this band on the inside of the foot will cramp or spasm on my foot and cause considerable pain. i can ususally stop it with massage very quickly. i always thought this was a muscle but if i am looking at the picture correctly it is labeled medial plantar fascia. i have read that spasm in this area is a result of fasciaitis. have you ever read this and am i interpreting the picture correctly.

it is amazing how so many doctors can put out so many exercises and stretches for the foot and others can show why these same exercises can be counter productive. good info here. should be read by all.

Re: I don't know.

john a on 6/01/01 at 10:46 (049580)

Nice site, Mike. My only complaint is that the picture of the PFTs is so small! You really should have a larger picture, perhaps pointing out the various components, etc. I also see that the design of the head is different from the one I bought about a year ago, and seem to recall you saying that the updated head would be sent out to all past buyers. Did I misunderstand, or is it not really possible to put the new head on an old device?

Re: I don't know.

Julie on 6/01/01 at 12:02 (049595)

Wendy, this doctor doesn't sound arrogant. Any doctor who can say 'I don't know' even once, let alone four times (or was it five?) is at least honest. And I like the sound of a doctor who'll say 'I don't want to go in and make things worse'.

This is just my opinion based on a reading of your report, but for what it's worth, I'd say he clearly thinks you're doing a good job of self-healing. So do I. And you ARE getting better, so carry on doing what you're doing and keep on just putting one foot in front of the other (ha) and see where it gets you. I reckon you'll get better still (but of course I don't know).

Re: I don't know.

JudyS on 6/01/01 at 12:20 (049597)

Mike - I like your 'stretches' page also. Around here we've almost all found out that traditionally-prescribed 'stretching' seems to only make matters worse. Maybe it's time for some professional (you? :) ) to write a thorough paper for fellow-pros describing why those exercises make matters worse and introduce a whole new approach to stretching and strengthening for PF.
I had a little bit of trouble understand the paragraph dealing with why the usual medical description of PF is misleading. Would you be able to clarify that somewhat for me? Thank you.

Re: One more

JudyS on 6/01/01 at 12:25 (049598)

Wendy - I have those 'knots' also and have had for about 20 years. I figured they were from running, etc. and I've ignored them. They don't hurt. I asked a Doc once about them and he said 'ignore them'!

Re: One more

Rock on 6/01/01 at hrmin (049602)

I have to agree 100% about comments on weight bearing on the BALL OF THE FOOT activites being the BAD THING.

Think about it, if your weight is on the heel, or if the shoe is VERY stiff, either by an orthotic or road cycling shoe, you will not be able to overstrectch the soft tissues along the bottom of your injured foot. Right ? It is the GOLDEN rule for us PF people.

This is how I keep my activity level very high (weekly volume: swim 4 miles, bike 100 miles, run 40 miles) even during a flare-up and return to (100% pain free) remission.

Here is one trick that I just learned:

If you are riding a mtn bikeor stationary bike without wearing super stiff cycling shoes, position your heels on the pedals (never the balls of your feet). This will avoid PF reinjury and still allow you to bike ride for hours. Yes, I know it looks dumb, but who cares about that.

I hope this helps...
Rock.
CO.USA.

Re: One more

Nancy N on 6/01/01 at 13:25 (049604)

How does keeping the heels on the pedals help? I try to keep my feet flat, with the pedal centered below the ball of my foot. I can't imagine trying to ride with my heels on the pedals--I think they'd slip off, and even if they didn't, it seems like it would be mighty uncomfortable--but maybe I am wrong??

Re: Foot Muscle Info

Mike W on 6/01/01 at 13:31 (049605)

Hello John,

I am a bit confused by your questions but will try to answer with some information on foot anatomy.

You are interpretting the picture correctly but you should be aware that that my anatomy pictures show 3 different layers. So, the medial and lateral fascia are shown in the subcutaneous picture and the muscles that are enveloped by them are shown in the other 2 pictures.

Fascia does not cramp, muscles do so you are right.

Muscle cramps are a sign from your body that they are not working well.
If you read my section on Muscle Innervation you will learn how to relax these muscles and help stop these spasms.

I hope this answers your question.

Thanks for the positive feedback. My new site has only been up for a few days.

Regards,

Mike W

Re: Thanks for the feedback

Mike W on 6/01/01 at 14:05 (049612)

Hello John,

Thanks for the feedback. I will try to get larger pictures.

Last December I completed the 'Foot Trainer' which has a different head than the 'Personal Foot Trainer'. Instead of steel and gum rubber it is a plastic mold with neopreme pads.

I spent a lot of time and effort with the new design and am pleased with the result.

Along with improving the design I have developed new Foot Trainer Rehabilitation Exercises and have been seeing excellent results. Over the past year I have received lots of feed back from my customers and I really learned and fine tuned what works and what does not.

I would be happy to email or mail the New Exercises to you and any other
customers.

You can perform all of the new exercises with the PFT.

John it is not practical to put the new head on the PFT but if you email me maybe we can work something out.

Regards,

Mike W

Re: Thanks Julie

Mike W on 6/01/01 at 14:22 (049615)

Hello Julie,

A few months ago I had a referral from Physiotherapist who had plantar fasciits herself for over 1 year. She bought a pair of Foot Trainers and about 3 weeks later she was 100%. She ordered a couple of Foot Trainers for her customers and they all got relief as well and now every patient uses them.

She told me that she has been treating plantar fasciitis for over 15 years and that she now realizes why the traditional exercises are so ineffective, because many of them are incorrect. They are taught them at school and they are the law until they learn differently.

She and a partner with a Masters in Physiotherapy have expressed interest in doing a scientific study on Foot Trainer Exercises.

I hope you get 100% soon.

Regards,

Mike W

Re: Medical Definition

Mike W on 6/01/01 at 14:34 (049618)

Hello Judy,
See my above post re: Foot Trainer Study.

It is misleading because:
Inflammation and pain are symptoms not the cause.
Technically they are refferring to the plantar aponeurosis not the plantar fascia.
There are 4 other muscles/tendons that also attach to the heel bone not just the plantar fascia. If you go to my anatomy pictures you can see them.

Thanks for you interest.

Regards,

Mike W

Re: Thanks Julie

Julie on 6/01/01 at 15:22 (049622)

Hello Mike

That is a very interesting tale! The trouble is, it seems that many professionals who treat PF never do learn differently. Perhaps their patients, failing to get better, simply lose heart and go away.

When I realized for myself that the wall stretches advised by my pod weren't helping, I told him, and he agreed that I should drop them, saying that if the calf muscles are tight, these stretches can help; if they aren't, the stretches can make things worse. 'I accepted that at the time, but have since wondered (and am now pretty sure) that even if tight calf muscles are a contributory factor, the wall stretch isn't the way round that problem. I returned to and increased the simple foot exercises that I've long practised and taught in yoga, and they (amongst other things) have got me to my present reasonable state.

I have to declare myself: my own interest in the PFT (which as you know I have just ordered, inspired by your new site) is primarily professional. I want to see and understand how it works, so that I can better help any students of mine who turn up with PF . PF-wise myself, I've been 95-97% since the beginning of the year.

Maybe the PFT will nudge me that extra 3-5%!

I second Judy's motion. There is surely a need for somebody to challenge the received notion of stretches for PF. Why not submit an article to Podiatry Today?

All the best, Julie

Re: I don't know.

Beverly on 6/01/01 at 16:49 (049623)

Wendy,

Hearing, 'I don't know' has got to be one of the most frustrating things any of us as a patient can hear. It's also scarey. But at least the guy was being honest. I'd rather have a doctor say, 'I don't know' than to guess or just pat me on the head and say, 'I'm sure you'll get better.'
It does sound like your doing better. Glad to hear it.
Best wishes,
Beverly

Re: I don't know.

josh s on 6/01/01 at hrmin (049640)

Hi Wendyn,

I hesitate to write this as I've missed any of your previous posts so I don't know what other advice or care you've recieved. Regarding your young orthopod, my general mistrust of health professionals interprets all these 'I don't know''s as impressive humility or ignorant apathy, maybe both. Unfortunately, I've encountered much more of the latter from our MD friends of late.
As you mentioned progressive flatfoot and posterior tibialis I want to pass on some web pages I've found on tibialis posterior dysfunction (tpd). I'm no expert, but apparently it's one of those conditions that is underestimated and underdiagnosed. I've interpreted the part of your post where the orthopod says he does'nt know what's going on with you to possibly refer to tpd. If this is the case, these sites may be useful to him as well.
http://www.mvpdoc.com [a site by Mueller, DPM who developed a special orthotic for TPD. Pretty technical, but lots of good info.]
http://www.podiatrytoday.com/archive/pod_200012/pod_200012d6.html [article from Pod. Today by several DPM's experienced with such.]
http://www.podiatrymgt.com/cme/Kir-o1.htm [one famous DPM's approach]
http://www.curtin.edu.au/curtin/dept/physio/podiatry/encyclopedia/pt [did'nt read this but appears to be part of a course for podiatrists]
http://www.afo-lab.com/Styles/PosteriorTibial.htm [site for a different style of orthotic for severe arch collapsing conditions w/ several causative factors not mentioned elsewhere]

Hope this helpful
Best Wishes

Re: I don't know.

wendyn on 6/02/01 at 01:22 (049658)

Thanks guys for all your comments!

It's very late here so I won't write much and I'm way behind on posts.

The I don't know came across as honest and I do appreciate that.

It is his mannerisms and overall attitude that is very arrogant (I think you'd have to meet him to understand). I probably should have explained that better.

He is extremely well respected - no matter who I talk to about my feet (podiatrists, physio therapists, sports med etc). When I mention his name they just say ohhhh - with a genuine tone of awe. If it comes to foot surgery - he is supposed to be one of the best. He completely rebuilt my friends foot (she has rheumatoid arthritis) so I've seen what he can handle. A little un-nerving that he'd tackle her feet and not mine.

I do appreciate his honesty - and that he does not presume to know more than he does. But, it's still frustrating!

Re: I don't know.

Cynthia D on 6/02/01 at 21:11 (049707)

Wendy, when they asked you how you would be paying for your visit, did you say 'I don't know!'?

Cool.

Re: I don't know.

wendyn on 6/02/01 at 21:47 (049711)

That's funny Cynthia! Too bad it's covered under insurance so they never had to ask.

Re: One more

JudyS on 6/03/01 at 13:30 (049763)

My experience with 'heel only' peddling is the same as Nancy N's - it's awkward, the feet slip off the pedals and it makes for unusual stress on other ligaments. However, using the 'ball only' typical method really puts pressure on the Plantar - unless you use a very low-pressure setting on the bike. I sort of developed a 'flat-foot' method that helps a bit - it's the same method I use for doing a leg press. The problem with it is in concentrating, which you really have to do to keep the foot in a strictly neutral position.

Re: One more

Julie on 6/03/01 at 14:30 (049770)

Judy, by 'flat-foot' do you mean you were pedalling with your arch? Sounds as though that would be the most likely way of keeping your foot in a neutral position. When I was thinking about Val's cycling problem, it seemed to me that you wouldn't want the feet to be either too dorsiflexed or plantarflexed.

Re: Pedaling & How !

Valerie S on 6/04/01 at hrmin (049882)

Hi.

Over the last several days, I have been trying different ways of pedaling... I was unable to pedal with my heels. I feel like I am going to fall right off the bike. I tried with the balls of my feet for a minute, and boy could I feel it in the arch of my foot. So I have also adapted a 'neutral' or flat-footed position, pedaling with the arch. I wear my Birks and Futuro ankle brace, so don't feel any stress in the fascia.

Just my experience... I am now biking several miles a day.
Val.

Re: Pedaling & How !

Nancy N on 6/04/01 at 20:11 (049913)

When I mentioned my stationary bike to Dr. Z, he advised the flat-foot approach, so that is what I try to do. It's nowhere near as awkward as I would think the heels-on-pedals would be.