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run fast, run hard

Posted by Donna on 6/30/01 at 23:31 (051961)

Hi I read in this foot book about someone who ran hard and ran fast on purpose to tear his P.F. and after the inital pain he was all better. Is that really crazy or a possible cure without having to cut open ones foot. I am tempted to try it because I have failed all conservetive treatments , ossatron twice, and one endoscopic plantar fasciotomy. Should I try it?

Re: run fast, run hard

Dr. Zuckerman on 7/01/01 at 00:11 (051964)

If you are having pain at the insertion of the pf then mis surgical approach will do the job. The EPF failed due to the lack of cutting at the insertion so if this is where the pain is let me know and I would be happy to do the mis heel spur procedure . I am going away for the next week. You can talk to Denise my patient coordinator . She can be reached at heelhelp @bee,net. Any question I will answer until noon tommorrow and then I am off for the next week.

Re: run fast, run hard

wendyn on 7/01/01 at 08:44 (051974)

No. If you want it 'ripped' then have a surgicial procedure done to open it up.

Re: run fast, run hard

Donna B on 7/01/01 at 19:07 (052002)

Dr. Z. Where is the insertion of the pf and what is mis surgical approach? I have no heel spurs but the worse case of pf my doctor has ever seen. I could possibly be the biggest challenge you ever had except you are where N.J. and I am in Calif. Now I am the example for my doctor of how Ossatron doesnt work for everyone. ( I had one patient that it didn't work for, twice...in fact nothing worked for her) well thats me. None respondent. At 11 months of treatment on work comp. and having to say goodbye to my current job as grocery checker because nothing has worked. So, my question was should I go for that run? Is it possible? What have I got to loose? Sore feet?

Re: run fast, run hard

wendyn on 7/01/01 at 19:12 (052003)

Donna (I'm not a doctor) but seriously...what I'd be worried about is the things other than your PF. If you're not used to running - and you suddenly go for an all out sprint...I'd be concerned about what that could do to other muscles, tendons and joints - like your quads, your hamstrings, your calve muscles, your hips, your back, the tendons in your feet - your ankle joints....

It really is hard enough dealing with PF - I'd hate to see someone do anything that could cause any extra problems for their bodies.

Re: run fast, run hard

Donna B. on 7/01/01 at 19:14 (052004)

wendyn, I want to avoid a evasive surgery. Say....making it happen naturally. If this is possible, although I don't know if a doctor would want to say that it would be o.k. for certain reasons. But thanks for replying.

Re: run fast, run hard

Donna B on 7/01/01 at 20:00 (052007)

I'm not that old yet. 40 yrs ,127 lbs. love to ride my bike , stationary and outside regular bike. Not affraid of any other injuries,but still haven't gotten my answer if this is possible. Surely some runners might know.

Re: run fast, run hard

wendyn on 7/01/01 at 22:41 (052020)

Donna - some folks here are pretty reluctant to post on the doctor board - you may want to try reposting on the treatment board to get some more feedback from fellow runners.

Even if you're in good shape - please still be careful with this idea. If you read any running program - the suggestions for those starting out is to always start slow...walking - jogging, working up to sprints, gradually increasing time and intensity. There's so many of us here who were (are?) in excellent physical condition - and we still end up developing monsters like PF and TTS. Add a stress fracture or a blown hamstring in there - and things would really suck (sorry, the phrase seemed most appropriate!). I was assuming that it's been quite some time since you ran, perhaps it would be less risky if it's only been a short while.

Still, I can't blame you for wanting to avoid surgery and wanting to explore all possible treatments - even if they do sound a little unusual. Surgery for many of is just doesn't even present as a real option that we're willing to consider.

Can you share a little more about the story in the book?

Re: run fast, run hard

Julie on 7/02/01 at 03:10 (052033)

Hi Donna

Dr Z has now gone on holiday, so let me try to answer your question. MIS is minimal incision surgery, which speaks for itself. I think his view is that because it is less invasive than EPF (endoscopic plantar fasciotomy) it is less likely to result in failure or complications, and is therefore more appropriate for most cases - obviously it depends on the individual case.

The fascia inserts at the forward medial (inside) aspect of the calcaneus (heelbone). You can see a diagram of it on the home page of this website.

What conservative treatments did you follow before the Ossatron?

Regarding running to tear the fascia, Wendy has said it all. I too think it really would be dangerous for you to do this.

Re: run fast, run hard

Nancy N on 7/02/01 at 11:51 (052066)

Donna--I'm not a doctor, either, but something else to keep in mind is that surgery gives the doctor control over how much of the fascia is cut. Trying to tear it yourself by running offers no such control mechanism--and you could very seriously hurt yourself, possibly irreparably. Were I in your shoes, I'd opt for the safety and control of the surgery, even though I totally understand how you feel about it--I did everything I could to avoid it, for the same reasons as you. But if you have a good doctor who knows how and why you should have the surgery done, and if you trust him/her, then surgery is probably the way you should go. Six months' healing time sure beats crippling yourself.

Re: run fast, run hard

Donna B. on 7/02/01 at 13:38 (052073)

Julie, thanks for replying. I have been in physical therapy for 10 months,had 3 cortisone shots in right foot,2 in left, have custom orthos. have used ice,vioxx, naproxin and some streching. I think thats it. Just really disapointed. Would you work in the grocery store standing 5 to 8 hrs. with p.f. pain? Or should I get on with life and do something else? Doctors don't know how long p.f. can last.

Re: run fast, run hard

Donna B on 7/02/01 at 13:47 (052075)

Nancy, If it weren't for my job I wouldn't even need a surgery. I do fine otherwise. I am just trying to hold on to my job of 12 yrs. My doctor said my chances were 50-50. But also could get worse. Possible...and my sucess so far has been preety bad so I can't take any more failures and am giving up. Should I take that job and shove it. I make 16.90 hr. with excel. benefits.But its hard standing there...

Re: run fast, run hard - your job

Julie on 7/02/01 at 15:00 (052077)

Donna, if your job involves standing all day, I guess it isn't all that surprising that your pf hasn't healed: you're re-injuring yourself every hour of every day. This really puts a different light on it: obviously you haven't been able to get the REST your poor foot needs. And it's entirely possible that the nature of your job has contributed to your problems.

No - I wouldn't work standing all day with pf pain. I couldn't. I couldn't stand all day even now, when my pf is just about gone (and if I did, I'm sure it would come back).

So - maybe, is it time for you to start letting go, and opening yourself to a change in your life? I don't know what your skills are, or what the job possibilities are where you live, but I hope it will be possible for you to change to something that will give you a chance of healing.

Re: run fast, run hard

Andrea R. on 7/02/01 at 15:02 (052078)

Donna,

Get your doctor to write you a script for a standing chair or stool. My employer had to purchase a ergonomically correct chair for my back. If you mainly do a lot of standing the 'standing chair' lets you comfortably rest your rearend and take some weight off your feet without actually sitting which can both your back.

Have you tried a night splint? You should be stretching every day. Start by massaging your feet first. Then use a towel while sitting it bed with your leg straight out and pull you upper foot towards you. You can also use a tennis ball and roll it back and forth on the floor. This would cure you but can help ease some of the pain. I found it worked better than the cortisone shots.

Do you have short term disability insurance? A few weeks off staying off your feet can't hurt. Some people have been able to get workman's comp but I'm not sure under what conditions. The time off my feet after surgery for my left foot really helped the PF in my right foot.

Best of luck,

Andrea

Re: run fast, run hard

Nancy N on 7/02/01 at 20:07 (052090)

Donna--

I understand where you're coming from. I just don't think that giving yourself an uncontrolled injury is a good idea. I also agree with Julie that all your standing is probably part of the reason you haven't healed. Is there anything else you're interested in that might be better on your feet.

I hope we're not all coming across like we're attacking you. We all know what this pain is like, and we've all had financial constraints. We just want to make sure you take the best care of yourself that you possibly can.

Re: run fast, run hard

JudyS on 7/02/01 at 21:12 (052096)

Actually, Julie, I think the difference in those two procedures is something else.......the EPF (endoscopic) is less invasive than the MIS because it uses a scope in a very tiny incision....but some feel it's less desirable than MIS because the surgeon can't actually see as much of the Plantar as might be effective with the Minimal Incision Surgery. The MIS, however, IS less invasive than the 3rd type of surgery - who's title I've forgotten but I know that it's incision is larger and the release itself may even be more aggressive. That's the one that seems to be becoming more and more out of favor.
Docs - help! Knock me in the nose if I have this wrong...

Re: EPF/MIS/???

Julie on 7/03/01 at 03:01 (052115)

Oops, and thanks, Judy, for the correction. I was confusing EPF with the third kind of surgery (whose name I also cannot remember).

Re: run fast, run hard

Dr. Zuckerman on 7/01/01 at 00:11 (051964)

If you are having pain at the insertion of the pf then mis surgical approach will do the job. The EPF failed due to the lack of cutting at the insertion so if this is where the pain is let me know and I would be happy to do the mis heel spur procedure . I am going away for the next week. You can talk to Denise my patient coordinator . She can be reached at heelhelp @bee,net. Any question I will answer until noon tommorrow and then I am off for the next week.

Re: run fast, run hard

wendyn on 7/01/01 at 08:44 (051974)

No. If you want it 'ripped' then have a surgicial procedure done to open it up.

Re: run fast, run hard

Donna B on 7/01/01 at 19:07 (052002)

Dr. Z. Where is the insertion of the pf and what is mis surgical approach? I have no heel spurs but the worse case of pf my doctor has ever seen. I could possibly be the biggest challenge you ever had except you are where N.J. and I am in Calif. Now I am the example for my doctor of how Ossatron doesnt work for everyone. ( I had one patient that it didn't work for, twice...in fact nothing worked for her) well thats me. None respondent. At 11 months of treatment on work comp. and having to say goodbye to my current job as grocery checker because nothing has worked. So, my question was should I go for that run? Is it possible? What have I got to loose? Sore feet?

Re: run fast, run hard

wendyn on 7/01/01 at 19:12 (052003)

Donna (I'm not a doctor) but seriously...what I'd be worried about is the things other than your PF. If you're not used to running - and you suddenly go for an all out sprint...I'd be concerned about what that could do to other muscles, tendons and joints - like your quads, your hamstrings, your calve muscles, your hips, your back, the tendons in your feet - your ankle joints....

It really is hard enough dealing with PF - I'd hate to see someone do anything that could cause any extra problems for their bodies.

Re: run fast, run hard

Donna B. on 7/01/01 at 19:14 (052004)

wendyn, I want to avoid a evasive surgery. Say....making it happen naturally. If this is possible, although I don't know if a doctor would want to say that it would be o.k. for certain reasons. But thanks for replying.

Re: run fast, run hard

Donna B on 7/01/01 at 20:00 (052007)

I'm not that old yet. 40 yrs ,127 lbs. love to ride my bike , stationary and outside regular bike. Not affraid of any other injuries,but still haven't gotten my answer if this is possible. Surely some runners might know.

Re: run fast, run hard

wendyn on 7/01/01 at 22:41 (052020)

Donna - some folks here are pretty reluctant to post on the doctor board - you may want to try reposting on the treatment board to get some more feedback from fellow runners.

Even if you're in good shape - please still be careful with this idea. If you read any running program - the suggestions for those starting out is to always start slow...walking - jogging, working up to sprints, gradually increasing time and intensity. There's so many of us here who were (are?) in excellent physical condition - and we still end up developing monsters like PF and TTS. Add a stress fracture or a blown hamstring in there - and things would really suck (sorry, the phrase seemed most appropriate!). I was assuming that it's been quite some time since you ran, perhaps it would be less risky if it's only been a short while.

Still, I can't blame you for wanting to avoid surgery and wanting to explore all possible treatments - even if they do sound a little unusual. Surgery for many of is just doesn't even present as a real option that we're willing to consider.

Can you share a little more about the story in the book?

Re: run fast, run hard

Julie on 7/02/01 at 03:10 (052033)

Hi Donna

Dr Z has now gone on holiday, so let me try to answer your question. MIS is minimal incision surgery, which speaks for itself. I think his view is that because it is less invasive than EPF (endoscopic plantar fasciotomy) it is less likely to result in failure or complications, and is therefore more appropriate for most cases - obviously it depends on the individual case.

The fascia inserts at the forward medial (inside) aspect of the calcaneus (heelbone). You can see a diagram of it on the home page of this website.

What conservative treatments did you follow before the Ossatron?

Regarding running to tear the fascia, Wendy has said it all. I too think it really would be dangerous for you to do this.

Re: run fast, run hard

Nancy N on 7/02/01 at 11:51 (052066)

Donna--I'm not a doctor, either, but something else to keep in mind is that surgery gives the doctor control over how much of the fascia is cut. Trying to tear it yourself by running offers no such control mechanism--and you could very seriously hurt yourself, possibly irreparably. Were I in your shoes, I'd opt for the safety and control of the surgery, even though I totally understand how you feel about it--I did everything I could to avoid it, for the same reasons as you. But if you have a good doctor who knows how and why you should have the surgery done, and if you trust him/her, then surgery is probably the way you should go. Six months' healing time sure beats crippling yourself.

Re: run fast, run hard

Donna B. on 7/02/01 at 13:38 (052073)

Julie, thanks for replying. I have been in physical therapy for 10 months,had 3 cortisone shots in right foot,2 in left, have custom orthos. have used ice,vioxx, naproxin and some streching. I think thats it. Just really disapointed. Would you work in the grocery store standing 5 to 8 hrs. with p.f. pain? Or should I get on with life and do something else? Doctors don't know how long p.f. can last.

Re: run fast, run hard

Donna B on 7/02/01 at 13:47 (052075)

Nancy, If it weren't for my job I wouldn't even need a surgery. I do fine otherwise. I am just trying to hold on to my job of 12 yrs. My doctor said my chances were 50-50. But also could get worse. Possible...and my sucess so far has been preety bad so I can't take any more failures and am giving up. Should I take that job and shove it. I make 16.90 hr. with excel. benefits.But its hard standing there...

Re: run fast, run hard - your job

Julie on 7/02/01 at 15:00 (052077)

Donna, if your job involves standing all day, I guess it isn't all that surprising that your pf hasn't healed: you're re-injuring yourself every hour of every day. This really puts a different light on it: obviously you haven't been able to get the REST your poor foot needs. And it's entirely possible that the nature of your job has contributed to your problems.

No - I wouldn't work standing all day with pf pain. I couldn't. I couldn't stand all day even now, when my pf is just about gone (and if I did, I'm sure it would come back).

So - maybe, is it time for you to start letting go, and opening yourself to a change in your life? I don't know what your skills are, or what the job possibilities are where you live, but I hope it will be possible for you to change to something that will give you a chance of healing.

Re: run fast, run hard

Andrea R. on 7/02/01 at 15:02 (052078)

Donna,

Get your doctor to write you a script for a standing chair or stool. My employer had to purchase a ergonomically correct chair for my back. If you mainly do a lot of standing the 'standing chair' lets you comfortably rest your rearend and take some weight off your feet without actually sitting which can both your back.

Have you tried a night splint? You should be stretching every day. Start by massaging your feet first. Then use a towel while sitting it bed with your leg straight out and pull you upper foot towards you. You can also use a tennis ball and roll it back and forth on the floor. This would cure you but can help ease some of the pain. I found it worked better than the cortisone shots.

Do you have short term disability insurance? A few weeks off staying off your feet can't hurt. Some people have been able to get workman's comp but I'm not sure under what conditions. The time off my feet after surgery for my left foot really helped the PF in my right foot.

Best of luck,

Andrea

Re: run fast, run hard

Nancy N on 7/02/01 at 20:07 (052090)

Donna--

I understand where you're coming from. I just don't think that giving yourself an uncontrolled injury is a good idea. I also agree with Julie that all your standing is probably part of the reason you haven't healed. Is there anything else you're interested in that might be better on your feet.

I hope we're not all coming across like we're attacking you. We all know what this pain is like, and we've all had financial constraints. We just want to make sure you take the best care of yourself that you possibly can.

Re: run fast, run hard

JudyS on 7/02/01 at 21:12 (052096)

Actually, Julie, I think the difference in those two procedures is something else.......the EPF (endoscopic) is less invasive than the MIS because it uses a scope in a very tiny incision....but some feel it's less desirable than MIS because the surgeon can't actually see as much of the Plantar as might be effective with the Minimal Incision Surgery. The MIS, however, IS less invasive than the 3rd type of surgery - who's title I've forgotten but I know that it's incision is larger and the release itself may even be more aggressive. That's the one that seems to be becoming more and more out of favor.
Docs - help! Knock me in the nose if I have this wrong...

Re: EPF/MIS/???

Julie on 7/03/01 at 03:01 (052115)

Oops, and thanks, Judy, for the correction. I was confusing EPF with the third kind of surgery (whose name I also cannot remember).