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runners and plantar

Posted by Michele S on 6/15/01 at 23:42 (050808)

I have had plantar f. for 9 years. I was finally able to get some relief with cutom made soft orthotics about 2-3 years ago. They worked for a bout 2 years, then stopped working for some reason. I tried having them built up again and that worked for a little while, but I can no longer wear them as they cause a lot of pain.The 'over the counter' spenco arch supports seemed to help for the last 8 months or so. All of a sudden , I am in chronic pain again after being on my feet for more than 5 minutes.I was a long distance runner and gradually had to stop running last year. My feet hurt more now than when I used to run. I'm not even sure that I have plantar because I don't have heel pain first thing in the morning. It just gets worse as the day goes on and I basically feel the pain all the time. Does anyone have advice for a long term sufferer like me? Has anyone found relief with accupuncture? I also have neck, shoulder, and wrist pain which makes me think that the pain in my feet is an early onset of arthritis caused by excessive sports.
thank you

Re: runners and plantar

Donna SL on 6/16/01 at 03:31 (050816)

Michele,

You haven't described the type of pain you are having, or where in your feet, but usually pain that gets worse the longer you are on them may be due to nerve entrapment of the calcaneal nerves. This can cause all kinds of pain like deep aching, burning, stabbing pain, etc. Do you have any pain in the rims of your heel? Nerve entrapment can mimic PF, but the key is the onset of symptoms. You can have pain throughout the entire foot also.

Try to get a nerve conduction test of the lateral and medial plantar nerves, and the associated branches. It may not always show, if it's in the early stages. I suffered with the same symptoms as you, and this went undiagnosed for almost two years. This will not get better on it's own. The only treatments offered for this are usually cortisone shots, or surgery. I declined both for now, and decided to try more conservative therapy. What helped the most was Active release technigue (ART), which seems to have reduced my symptoms by around 90%. If is a form of tissue manipulation usually done by a chiropractor. It breaks up adhesions, and scar tissue from long standing PF, that could possibly be pressing on the nerves.

Do not let anyone do deep tissue massage on your feet, or ankle area. This could possibly make things worse. ART is not deep tissue massage. Also, Vioxx helped. I tried acupuncture for the first time last week in addition, to see if this would accelerate the tiny bit of remaining inflamation I have, and it seemed to help also, but its too early to tell for sure. The ART has done more than anything I have tried so far. I would try that first, because it is a totally non-invasive procedure.

Also, it's very important to get your back checked, and to make sure there isn't something in the lower lumbar spine causing pinching of the nerves that lead to the feet.(Radiculopathy) Also you should be checked for polyneuropathy if you are having pain in your wrist. The neck, shoulder, and wrist pain may or may not be due to back problems also. I would think with arthritis though that you would be very stiff, or have pain in the morning, and it would improve the more you moved about. Preferably a physiatrist (physical medicine and rehab md), or a neurologist should be able to diagnose what's going on.

More than likely you probably just have some nerve entrapment in the feet that is totally unrelated to anything else, other than from having PF for so long. A good podiatrist may be able to determine if you have nerve entrapment from an exam.

In the interim, you should start icing the medial side of your ankle (behind the bump), and medial, and underside of the foot, and heel as well as the rest of the feet. If you are not already on a prescription dose of anti-inflammatories, you should start them as soon as possible. Vioxx worked very well for me.

Donna

Re: runners and plantar

Dr. Zuckerman on 6/16/01 at 09:43 (050829)

Hi,

Donna said it all. Maybe some cross training such as swimming and bike rider to give the legs in shape

Re: runners and plantar

Errol H on 6/16/01 at hrmin (050879)

Michele: You might also check out my recent postings for Silcone Dynamic Orthotics. I've had PF for 4 years (and without the acute pain in the morning), and the SDO's are the first thing to really make a difference. They're definitely shock-absorbing! Best of Luck, Errol H.

Re: Donna-ART

josh s on 6/17/01 at hrmin (050927)

Donna, I've read about ART several times on this site and searched around a bit for info and have'nt found anything really solid. Do you know of any links or numbers to call where I can get good info about lower extremity ART? Thanks.

Re: runners and plantar

Michele S on 6/18/01 at 00:12 (050929)

Donna,Errol and Dr. Z
Thank you very much for the information. My pain covers the entire bottom of my feet and it worsens the longer I walk or stand. It ranges from dull ache to burning pain, mostly in the arches and not so much in the heel . Vioxx has helped me too.Donna, I'm curious to know more about ART. Are you going for ongoing treatment?
I am beginning to fell like the Amelda Marcos of orthotics.
I just tried someTrigger Point self Therapy and was surprised that it immediately relieved some pain. You press hard on the back of your calves ( below the back of your knees) until you find a tender spot. The triigger point for Plantar is inbetween the back and inside of the meaty part of your calf -closer to the inside. You'll know when you've found it because it hurts like hell when you push on it. Hold the point for as long as you can stand and it will relieve pain in your feet. It worked for me. Try it and tell me what you think. It helped me walk back to my car last night when I didn't think I could make it.
Michele

Re: Donna-ART

Donna SL on 6/18/01 at 22:56 (051012)

Hi Josh,

Did you do a search on 'active release therapy' on this board? I wrote a ton of information in April. If you use any of the Internet search engines put in 'active release, or active release technique' I used the improper name at the time, and called it therapy instead of technique.

The official web site is http://www.activerelease.com They provide a little info. Some other chiros have put some additional info on various sites you'll find on the web. I've given several links with more information in my previous postings that I found by searching the internet.

The number is 1-888-396-2727

This number is listed on the site. Give them a call, and they will give you an ART practitioner in your area certified in lower body, and should be able to give you more information. Not all the chiropracters are listed on the site, so it's better to call.

Donna

Re: Thanks

josh s on 6/19/01 at hrmin (051014)

Thanks much Donna!

Re: Michele Re: runners and plantar

Donna SL on 6/19/01 at 09:54 (051022)

Hi Michele,

It seems like you definitely have some nerve problems. It may be tarsal tunnel syndrome, or some other form of neuropathy. Also, have you had an MRI to rule out other problems?

Please look at the reply I just wrote to Josh. It mentions how you can find the info I wrote about ART on the web, and how to find a practitioner.

I'm still having treatments, but I've cut down to once a week, or less. I still have some biomechanical issues that need to be worked out, and also recently found out I have some back problems that need to be resolved. I'm just continuing the ART treatment as preventative maintenance until I get the other problems worked out.

I didn't even know I had injured an area in my lower lumbar spine that recently showed up on some testing, that may be contributing to some of my foot problems. That's why I suggest you investigate any possible causes of pain. You can still start ART anytime though.

I'm very familiar with trigger point massage, and had it performed professionaly, but it did't do much for this problem, or have any lasting effects. If you couldn't find an ART practitioner myfascial release may help somewhat, but is not as effective.

Donna

Re: donna

josh s on 6/19/01 at hrmin (051071)

Hi Donna, I was wondering if you'd like to describe the ART work you're receiving? I'm interested specifically in work on the gastroc, soleus and peroneals. I've had some good success on increasing dorsiflexion ROM in my ankles from Rolfing work, but always had the feeling that I need alot more work. I've got pretty bad equinus ankles and would do just about anything to increase ROM appreciably. Could you describe what it feels like, where your therapist works on you and with what part of his body? Also, any descriptions he's given you verbally of what he's doing to specific muscles and what his intent is while doing so would be great. Does he work on ligaments?

I'm trying to find an ART practitioner now, but it's looking like I'll have to travel for at least 200 miles, and my insurance may not cover. I realize you could probably write descriptively for ages about your ART experiences, but any info you'd like to pass on would help me make a decision. Thanks!

Re: donna

Donna SL on 6/20/01 at 00:43 (051074)

All my information on ART is provided in my previous post.

Re: runners and plantar

Rock on 6/25/01 at hrmin (051530)

Michele S,

Based on the population that post to these msg boards, It looks to me that a lack of activity causes PF to get worse and not get better.

I suggest that one increase activities (swim,bike,...) as long as they do not cause the PF to get worse.

And yes, I have had PF and my activty levels are so high that nobody on this board belives how much swimming, biking and running I do.

Rock.

{Male, age 46, 5'11', 156 lbs}

Re: runners and plantar

wendyn on 6/26/01 at 07:11 (051538)

I tend to agree with Rock - activity (as long as it's not making the PF WORSE) is important. The increased blood flow seems to actually help, and anyone with foot problems needs to keep their weight under control. It's important to listen to your bod.

Re: runners and plantar

Julie on 6/26/01 at 09:39 (051545)

So do I, Wendy, and would add that muscles, including foot muscles, that are not being used will weaken, and it's vital to strengthen. The problem for most people seems to be finding and developing a routine of activity that helps but doesn't harm. The non-weight-bearing ones, e.g. swimming and biking, are probably best, and yoga minus most standing poses.

Rock, I don't believe you ran through your PF, did you? And you aren't counselling others to run through theirs, are you? Just asking.

Re: runners and plantar

Rock on 6/26/01 at hrmin (051581)

Julie,

Last summer when I had a moderate case of PF in my right foot, I cut back my running from 50 miles per week to 25 miles per week. I did increase my bike and swim miles by maybe 10%.

My opinion about running through PF is that it should not be done unless one is sure that running is not preventing healing. To do so might involve not running up any hills and having really great orthotics.

So what happened was that by the end of the summer I was able to complete an ironman distance triathlon (Pineman in OH) in September and a 50 mile trail run in October (Mile High in CO). Since then I have been running just under 40 miles per week. While I now compete in really long races, I am afraid to really race them because I might get a major flare up of of PF and/or achilles. I am just happy to be 'out there' !

Also, I have not run up hills in more than a year, I hike them because I think running up hills is way too stressfull on PF and achilles.

Rock.

Re: runners and plantar

Julie on 6/27/01 at 03:03 (051610)

Thanks, Rock. And - wow! You've obviously got your PF well trained, and I'm delighted for you.

Re: runners and plantar

Donna SL on 6/16/01 at 03:31 (050816)

Michele,

You haven't described the type of pain you are having, or where in your feet, but usually pain that gets worse the longer you are on them may be due to nerve entrapment of the calcaneal nerves. This can cause all kinds of pain like deep aching, burning, stabbing pain, etc. Do you have any pain in the rims of your heel? Nerve entrapment can mimic PF, but the key is the onset of symptoms. You can have pain throughout the entire foot also.

Try to get a nerve conduction test of the lateral and medial plantar nerves, and the associated branches. It may not always show, if it's in the early stages. I suffered with the same symptoms as you, and this went undiagnosed for almost two years. This will not get better on it's own. The only treatments offered for this are usually cortisone shots, or surgery. I declined both for now, and decided to try more conservative therapy. What helped the most was Active release technigue (ART), which seems to have reduced my symptoms by around 90%. If is a form of tissue manipulation usually done by a chiropractor. It breaks up adhesions, and scar tissue from long standing PF, that could possibly be pressing on the nerves.

Do not let anyone do deep tissue massage on your feet, or ankle area. This could possibly make things worse. ART is not deep tissue massage. Also, Vioxx helped. I tried acupuncture for the first time last week in addition, to see if this would accelerate the tiny bit of remaining inflamation I have, and it seemed to help also, but its too early to tell for sure. The ART has done more than anything I have tried so far. I would try that first, because it is a totally non-invasive procedure.

Also, it's very important to get your back checked, and to make sure there isn't something in the lower lumbar spine causing pinching of the nerves that lead to the feet.(Radiculopathy) Also you should be checked for polyneuropathy if you are having pain in your wrist. The neck, shoulder, and wrist pain may or may not be due to back problems also. I would think with arthritis though that you would be very stiff, or have pain in the morning, and it would improve the more you moved about. Preferably a physiatrist (physical medicine and rehab md), or a neurologist should be able to diagnose what's going on.

More than likely you probably just have some nerve entrapment in the feet that is totally unrelated to anything else, other than from having PF for so long. A good podiatrist may be able to determine if you have nerve entrapment from an exam.

In the interim, you should start icing the medial side of your ankle (behind the bump), and medial, and underside of the foot, and heel as well as the rest of the feet. If you are not already on a prescription dose of anti-inflammatories, you should start them as soon as possible. Vioxx worked very well for me.

Donna

Re: runners and plantar

Dr. Zuckerman on 6/16/01 at 09:43 (050829)

Hi,

Donna said it all. Maybe some cross training such as swimming and bike rider to give the legs in shape

Re: runners and plantar

Errol H on 6/16/01 at hrmin (050879)

Michele: You might also check out my recent postings for Silcone Dynamic Orthotics. I've had PF for 4 years (and without the acute pain in the morning), and the SDO's are the first thing to really make a difference. They're definitely shock-absorbing! Best of Luck, Errol H.

Re: Donna-ART

josh s on 6/17/01 at hrmin (050927)

Donna, I've read about ART several times on this site and searched around a bit for info and have'nt found anything really solid. Do you know of any links or numbers to call where I can get good info about lower extremity ART? Thanks.

Re: runners and plantar

Michele S on 6/18/01 at 00:12 (050929)

Donna,Errol and Dr. Z
Thank you very much for the information. My pain covers the entire bottom of my feet and it worsens the longer I walk or stand. It ranges from dull ache to burning pain, mostly in the arches and not so much in the heel . Vioxx has helped me too.Donna, I'm curious to know more about ART. Are you going for ongoing treatment?
I am beginning to fell like the Amelda Marcos of orthotics.
I just tried someTrigger Point self Therapy and was surprised that it immediately relieved some pain. You press hard on the back of your calves ( below the back of your knees) until you find a tender spot. The triigger point for Plantar is inbetween the back and inside of the meaty part of your calf -closer to the inside. You'll know when you've found it because it hurts like hell when you push on it. Hold the point for as long as you can stand and it will relieve pain in your feet. It worked for me. Try it and tell me what you think. It helped me walk back to my car last night when I didn't think I could make it.
Michele

Re: Donna-ART

Donna SL on 6/18/01 at 22:56 (051012)

Hi Josh,

Did you do a search on 'active release therapy' on this board? I wrote a ton of information in April. If you use any of the Internet search engines put in 'active release, or active release technique' I used the improper name at the time, and called it therapy instead of technique.

The official web site is http://www.activerelease.com They provide a little info. Some other chiros have put some additional info on various sites you'll find on the web. I've given several links with more information in my previous postings that I found by searching the internet.

The number is 1-888-396-2727

This number is listed on the site. Give them a call, and they will give you an ART practitioner in your area certified in lower body, and should be able to give you more information. Not all the chiropracters are listed on the site, so it's better to call.

Donna

Re: Thanks

josh s on 6/19/01 at hrmin (051014)

Thanks much Donna!

Re: Michele Re: runners and plantar

Donna SL on 6/19/01 at 09:54 (051022)

Hi Michele,

It seems like you definitely have some nerve problems. It may be tarsal tunnel syndrome, or some other form of neuropathy. Also, have you had an MRI to rule out other problems?

Please look at the reply I just wrote to Josh. It mentions how you can find the info I wrote about ART on the web, and how to find a practitioner.

I'm still having treatments, but I've cut down to once a week, or less. I still have some biomechanical issues that need to be worked out, and also recently found out I have some back problems that need to be resolved. I'm just continuing the ART treatment as preventative maintenance until I get the other problems worked out.

I didn't even know I had injured an area in my lower lumbar spine that recently showed up on some testing, that may be contributing to some of my foot problems. That's why I suggest you investigate any possible causes of pain. You can still start ART anytime though.

I'm very familiar with trigger point massage, and had it performed professionaly, but it did't do much for this problem, or have any lasting effects. If you couldn't find an ART practitioner myfascial release may help somewhat, but is not as effective.

Donna

Re: donna

josh s on 6/19/01 at hrmin (051071)

Hi Donna, I was wondering if you'd like to describe the ART work you're receiving? I'm interested specifically in work on the gastroc, soleus and peroneals. I've had some good success on increasing dorsiflexion ROM in my ankles from Rolfing work, but always had the feeling that I need alot more work. I've got pretty bad equinus ankles and would do just about anything to increase ROM appreciably. Could you describe what it feels like, where your therapist works on you and with what part of his body? Also, any descriptions he's given you verbally of what he's doing to specific muscles and what his intent is while doing so would be great. Does he work on ligaments?

I'm trying to find an ART practitioner now, but it's looking like I'll have to travel for at least 200 miles, and my insurance may not cover. I realize you could probably write descriptively for ages about your ART experiences, but any info you'd like to pass on would help me make a decision. Thanks!

Re: donna

Donna SL on 6/20/01 at 00:43 (051074)

All my information on ART is provided in my previous post.

Re: runners and plantar

Rock on 6/25/01 at hrmin (051530)

Michele S,

Based on the population that post to these msg boards, It looks to me that a lack of activity causes PF to get worse and not get better.

I suggest that one increase activities (swim,bike,...) as long as they do not cause the PF to get worse.

And yes, I have had PF and my activty levels are so high that nobody on this board belives how much swimming, biking and running I do.

Rock.

{Male, age 46, 5'11', 156 lbs}

Re: runners and plantar

wendyn on 6/26/01 at 07:11 (051538)

I tend to agree with Rock - activity (as long as it's not making the PF WORSE) is important. The increased blood flow seems to actually help, and anyone with foot problems needs to keep their weight under control. It's important to listen to your bod.

Re: runners and plantar

Julie on 6/26/01 at 09:39 (051545)

So do I, Wendy, and would add that muscles, including foot muscles, that are not being used will weaken, and it's vital to strengthen. The problem for most people seems to be finding and developing a routine of activity that helps but doesn't harm. The non-weight-bearing ones, e.g. swimming and biking, are probably best, and yoga minus most standing poses.

Rock, I don't believe you ran through your PF, did you? And you aren't counselling others to run through theirs, are you? Just asking.

Re: runners and plantar

Rock on 6/26/01 at hrmin (051581)

Julie,

Last summer when I had a moderate case of PF in my right foot, I cut back my running from 50 miles per week to 25 miles per week. I did increase my bike and swim miles by maybe 10%.

My opinion about running through PF is that it should not be done unless one is sure that running is not preventing healing. To do so might involve not running up any hills and having really great orthotics.

So what happened was that by the end of the summer I was able to complete an ironman distance triathlon (Pineman in OH) in September and a 50 mile trail run in October (Mile High in CO). Since then I have been running just under 40 miles per week. While I now compete in really long races, I am afraid to really race them because I might get a major flare up of of PF and/or achilles. I am just happy to be 'out there' !

Also, I have not run up hills in more than a year, I hike them because I think running up hills is way too stressfull on PF and achilles.

Rock.

Re: runners and plantar

Julie on 6/27/01 at 03:03 (051610)

Thanks, Rock. And - wow! You've obviously got your PF well trained, and I'm delighted for you.