Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

torn PF thru stretching?

Posted by Chris C on 7/07/01 at hrmin (052408)

I have had significant pain in the PF for nearly a year. Went to the podiatrist in Feb., got a cortisone shot, which helped for about two weeks. Then pain returned. Got another shot in May, which helped for a while then pain returned and seemed to be in a different location. Lately, stretching the area has been tough, because the tenderness is very localized and pronounced. Today while I stretched I actually heard a tearing sound and felt the tendon giving way, which was initially quite painful, but now no worse then before. Any idea what I should do next?
I have never seen an orthopod about this, should I prefer a podiatrist to an orthopod, or what?

Thanks for any advice on this.

Re: torn PF thru stretching?

Dr. Biehler on 7/07/01 at 14:34 (052410)

If the shots have been helping but the pain is returning, you probably have not corrected the biomechanical problem that is causing the injurry. If the fascia has been torn, it will probably heal uneventfuly. Durring the healing time, you should ask your doctor if you should be wearing some kind of arch support to keep the fascia streched out as it heals. Be carefull with the exercises the first two weeks of the healing. Your podiatrist sounds like he is doing a good job. Dr. B.

Re: torn PF thru stretching?

Julie on 7/07/01 at 15:21 (052415)

Chris, can you tell us what stretches you've been doing, and what you were doing when the fascia tore?

Re: torn PF thru stretching?

Chris C. on 7/08/01 at 09:58 (052459)

Julie,

Generally I stretch using a variety of exercises. Two of those are on this site and include placing my foot on a step and letting my foot sink down to get a stretch in the calf. This is done gently, alternating feet.
The other, which I was doing when the tear was felt, was to lean into a wall, keeping the forward leg bent and stretching the calf in the rear leg. I have to admit, though, that I have been doing a good deal of biking (about 125 miles per week) which has not helped my condition. I am hard headed!!! I am also icing like a complete madman, say 5 times per day for about 10-15 minutes. That is helping. Have tried all sorts of anti-inflammatories, including VIOXX, Celbrex, Naprosyn, Alleve. Alleve works as well as any I think. Go figure.
Good luck.
Chris

Re: torn PF thru stretching?

Julie on 7/08/01 at 11:17 (052465)

Chris, though the wall stretch and the stair stretch are the classic ones recommended by pods for pf, both can be harmful. Hanging off the stair is dangerous: you have no control over it, and the fascia and Achilles Tendon are taking all your body weight. If you've been doing it, and the wall stretches regularly, they may have overstretched both to the point where something tore.

I strongly recommend that you back off these stretches. Weight-bearing stretching, although so often advised, isn't appropriate for pf, as many people on this site can testify: it can do more harm than good. You really ought to be looking at more non weight-bearing exercise - swimming, for instance. Biking is supposed to be good - though 125 miles a week sounds like an awful lot.

Have you read the heel pain book? Do: it contains a lot of information and advice about treatment. You don't say what else you've done, besides have cortisone shots and icing, but there are many conservative treatments that will help.

Re: torn PF thru stretching?

ChrisC on 7/08/01 at 18:41 (052485)

I do swim as well and recognize that I should back off the biking. Unfortunately I have agreed to a trip in August which involves a good deal of riding and I can't cancel the trip or I lose a lot of money!

Thanks for the advice on the stretching. I will have to back off now, since the pain is too intense to stretch.

Re: torn PF thru stretching?

Julie on 7/09/01 at 03:01 (052517)

Chris - the bottom line is that if anything hurts, stop. Except in very exceptional circumstances, if it hurts,it's making matters worse.' No pain no gain' is wrong, period. Be careful.

Re: torn PF thru stretching?

Dr. Biehler on 7/07/01 at 14:34 (052410)

If the shots have been helping but the pain is returning, you probably have not corrected the biomechanical problem that is causing the injurry. If the fascia has been torn, it will probably heal uneventfuly. Durring the healing time, you should ask your doctor if you should be wearing some kind of arch support to keep the fascia streched out as it heals. Be carefull with the exercises the first two weeks of the healing. Your podiatrist sounds like he is doing a good job. Dr. B.

Re: torn PF thru stretching?

Julie on 7/07/01 at 15:21 (052415)

Chris, can you tell us what stretches you've been doing, and what you were doing when the fascia tore?

Re: torn PF thru stretching?

Chris C. on 7/08/01 at 09:58 (052459)

Julie,

Generally I stretch using a variety of exercises. Two of those are on this site and include placing my foot on a step and letting my foot sink down to get a stretch in the calf. This is done gently, alternating feet.
The other, which I was doing when the tear was felt, was to lean into a wall, keeping the forward leg bent and stretching the calf in the rear leg. I have to admit, though, that I have been doing a good deal of biking (about 125 miles per week) which has not helped my condition. I am hard headed!!! I am also icing like a complete madman, say 5 times per day for about 10-15 minutes. That is helping. Have tried all sorts of anti-inflammatories, including VIOXX, Celbrex, Naprosyn, Alleve. Alleve works as well as any I think. Go figure.
Good luck.
Chris

Re: torn PF thru stretching?

Julie on 7/08/01 at 11:17 (052465)

Chris, though the wall stretch and the stair stretch are the classic ones recommended by pods for pf, both can be harmful. Hanging off the stair is dangerous: you have no control over it, and the fascia and Achilles Tendon are taking all your body weight. If you've been doing it, and the wall stretches regularly, they may have overstretched both to the point where something tore.

I strongly recommend that you back off these stretches. Weight-bearing stretching, although so often advised, isn't appropriate for pf, as many people on this site can testify: it can do more harm than good. You really ought to be looking at more non weight-bearing exercise - swimming, for instance. Biking is supposed to be good - though 125 miles a week sounds like an awful lot.

Have you read the heel pain book? Do: it contains a lot of information and advice about treatment. You don't say what else you've done, besides have cortisone shots and icing, but there are many conservative treatments that will help.

Re: torn PF thru stretching?

ChrisC on 7/08/01 at 18:41 (052485)

I do swim as well and recognize that I should back off the biking. Unfortunately I have agreed to a trip in August which involves a good deal of riding and I can't cancel the trip or I lose a lot of money!

Thanks for the advice on the stretching. I will have to back off now, since the pain is too intense to stretch.

Re: torn PF thru stretching?

Julie on 7/09/01 at 03:01 (052517)

Chris - the bottom line is that if anything hurts, stop. Except in very exceptional circumstances, if it hurts,it's making matters worse.' No pain no gain' is wrong, period. Be careful.