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Thoughts on an 'ideal' visit to the doctor . . .

Posted by Glenn X on 7/15/01 at hrmin (053264)

Doctors aren't much different than ‘the rest of us.' Most are capable, a few are exceptional, a handful are risky. I've experienced this range of performance in my own PF history, and agree with all the souls on this site that counsel active, informed, self-managed care. Nevertheless, I think all doctors should strive to elevate the caliber of their care, -- just as we should ALL elevate our vocations.

In that spirit, I've been musing over what an ideal visit to a doctor might be like. These are my personal thoughts, from my own very limited experience -- sprinkled liberally with the knowledge of countless others. They are incomplete thoughts, but if I had a doctor experience like the following, it would exceed my expectations.

Instructions before the visit Bring shoes (and inserts if applicable) -- 3 pair: Pair you like most, pair you wear most, pair that hurt most. Bring notes about your condition; write down what you might be doing daily to treat this, also any questions and concerns you may have.

The Exam
We're going to cover a lot of territory. Take notes when I say!
- What caused the injury, when, circumstances, and so forth.
- Describe the pain where time of day doing what duration of pain, etc.
- Is there pain with finger pressure on the foot? Poke, prod.
- (Maybe use some sort of pertinent pain scale).
- What work do you do? How much on feet? Surface? Does the discomfort limit your work? How?
- Describe recreation you do. How much on feet? Surface? Does the discomfort limit your recreation? How?
- How else is this limiting your life?
- What activities make the hurt worse, better?
- How have you been treating this on your own?
- How would you describe your feelings about this? Very Depressed / Somewhat Depressed / OK / Somewhat Upbeat / Very Upbeat? (Or some such)
(My PT uses a one page 0-10 scoring tool for pain, life activities, emotional feeling, etc., that does a nice job of characterizing where I am at any given point in time. If it were more customized to PF patients, it would be a good tool to use once a week at home).
- Calculate BMI (Write this down!) Any recent changes here?
- Calculate ankle dorsiflexion in degrees, flexibility measurement. (Write this down!)
- Observe gait, pronation?
- Who else have you seen about this? What treatments have they prescribed?
- How have you been treating this on your own?
--- And what ever else gets at the most accurate diagnosis
I'm missing a lot, but this would get at most of my own specifics.

Assuming Plantar Fasciitis
The Bad News
- PF is different. It is not a cut that heals in a few days, not a bone break that heals in a few weeks, not even your typical soft-tissue injury that gets better by limiting usage.
- This is a soft-tissue injury that, by its nature and location, you will almost certainly continue to aggravate.
- Your challenge is to minimize that aggravation, baby it, use it to your advantage.
- You need to take this seriously, and rein in your normal activities.
- You need to adopt some new habits, begin practicing some simple exercises. And you need to be disciplined about this. The regimen I'm going to suggest needs to happen every day, without exception.
- You need to manage (temper) your expectations. You're going to be disappointed if you 'expect' to recover quickly.
Keep taking notes

The Treatment --- (Well into PF this part can be complex, but early on, this is what I wish I'd heard.
- I will help you all I can, but YOU need to accept full responsibility for your recovery.
- I'm going to prescribe some treatment. Take notes.
- Limit your regular routine as much as is reasonable. If you are seeing me you've probably done this some already. If you can forego some of the recreations you enjoy for awhile, that will help. If your work requires standing or walking, ask for whatever accommodation seems 'reasonable.' Let me know if you need authorization for your employer. Be consistent about limiting your routine.
- Increase (maintain) your ankle flexibility with stretching. Here are written instructions and a diagram showing how to do this, how often to do this, how many reps, how long to hold, etc. The focus is on creating tension, not on pushing into pain. Let me demonstrate for you (maybe an aide can do this part) Now you demonstrate for me. Good!
- Massage your feet first thing in the morning. Here are written instructions. Let me show you how. Now demonstrate back for me. Repeat this ?? times a day.
- Do the yoga foot things (Julie suggests). Here are written instructions. Let me demonstrate.
- Continue with moderate physical activity. Continue to exercise the rest of your body as you are able and comfortable.
- Perhaps for some – do not gain weight. (Depending on BMI, maybe lose weight. If you have the will to want this behind you, you can do it).
- Log onto heelspurs.com. Read Scott's book about this. Roam around and learn as much as you can about this condition. If you need to, do this from the local library. Here are instructions on how to do this.
- Shoes: Don't wear shoes that hurt your feet. Whatever other advice seems fitting. (Be nice to show-and-tell some shoes that are particularly well suited to this condition).
- Here is a list of stores that can do a good job of fitting shoes to you. Mention my name and you'll get a 10% discount.
- OTC shoe inserts ? ? ? Depends
- Do NOT go barefoot anywhere at any time. (Write that down!
- Expect the cure to take weeks to get better / months to get fully healed. Write that down!
- Call me (my aide) before increasing activity.
- Keep a daily log of what you are doing to care for yourself.
- I want to see you again in two weeks, at which time we will go over these instructions again, see what's working, agree on any adjustments that are needed, and review your log.
- (Not sure when/if taping, night splints, icing, and other interventions enter the treatment regimen, but in all cases, I'd want to see demonstrations and/or detailed written instructions).
- Did you write all that down? Let me see your notes. Good job!
- (What am, I missing?)

The Good News
- 98 percent (or whatever the figure is) of people who suffer this injury are healed with a conservative, non-surgical course of treatment . . . But you need to do your homework!

FOUR MORE THOUGHTS RE TREATMENT:
1) We humans have an amazing capacity for selective hearing and memory. We're at the doctor's office to hear good news, not bad news. Once we hear good news, we are less attuned to bad news. That's why the good news above is so brief.
2) 'I hear and I forget, I see and I remember, I do and I understand' is an old learning adage that applies aptly to the office visit. There's all too much information flying about to possibly recall the important stuff afterwards. One day, three days later we're lucky to remember five important things from the visit. (And one of those will be the 98 percent figure). That's why it's important to write things down, why it's important to demonstrate and practice treatments in the office, why it's important for doctors to have handouts patients can take home and reference afterwards.
3) I've rarely had a doctor say, 'come back and see me in two (or whatever) weeks.' Usually after the visit I'm turned loose on my own. Some of that's American HMO stuff (I've since moved to a PPO), some of it's perhaps a feeling the doctor's done all he or she can at the moment. I don't know, but I think staying engaged with a doctor or other treatment professional you trust is important. Even if it's once a month, maybe a call from a nurse, maybe a note you drop the doctor reporting on progress, and they respond back to. Something. The fact that people stay engaged with others on this message board speaks to the importance and value of sustained connection during treatment of the condition.
4) 'Ideal' is beyond reasonable. What I've suggested is over the top in some ways, and certainly insufficient in others. But perhaps there are possibilities in bits and pieces of it that make sense. Thanks all who've read through this, and apologies to all doctors who are doing really good things outside the box of ideas portrayed here.

Re: Thoughts on an 'ideal' visit to the doctor . . .

john h on 7/15/01 at 16:04 (053265)

you have taken a lot of time and thought in writing this glen. thank you. also, thanks again to scott who has devoted years to this very serious problem for so many of us. thank you scott.

Re: Thoughts on an 'ideal' visit to the doctor . . .

Julie on 7/15/01 at 16:25 (053273)

Thank you, Glenn. This is excellent. I hope doctors will read it and learn something from it. As a guide to expectations it should be helpful to people here, and I think it should also be useful as a guide to the questions that an informed patient could ask.

I'd add that, because of 'selective memory', it 's always useful to be accompanied. Someone who is less involved is more likely to remember what was actually said (and more of it) - and can also remind the patient of questions s/he meant to ask but has forgotten. I also think it's useful for that companion to take the notes.

Re: Thoughts on an 'ideal' visit to the doctor . . .

Dr. Zuckerman on 7/15/01 at 16:26 (053274)

Good posting !!!!!

Re: Thoughts on an 'ideal' visit to the doctor . . .

Dr. Zuckerman on 7/15/01 at 16:31 (053276)

Another point. The doctor should have pictures , handouts and see the pateint back in one week just to go over the plan again. The doctor should have a plan. I am still amazed at how difficult it is to make the patient understand that this is more then just a broken bone this is a repetitive motion injury. Try to give the patient alot of example of what they have.

I tell them it is like a torn rotator cuff injury. A blown out knee. For some reason the foot doesn't get the respect it should have

Do you a patient wouldn't rest a torn rotator cuff, or a herniated dis I do just no one believe or understand that a pf injury is a tear and that we are walking on this injury.

Re: Thoughts on an 'ideal' visit to the doctor . . .

Tammie on 7/15/01 at 16:38 (053280)

Thank you, for this it is so VERY true I could see allot of the same and had some thoughts similar!!!! If you find this wonderful person Dr. he would be worth more money then he could handle lol! As people would hear there name and KNOW that was a real Person and a Dr. to! I do think today is hard for the medical profession as so many other professions, unfortuntatly they to have rules regualations and unfortunatly time limits to the wonderful insurance co. make sure of! It is like assembly rooms now at most dr. visits, and tho soem use a PA not all do and they to have there limits and time! I wish they made more hand out sheets also, I would like to refer to one so I can reassure myself I heard corectly as in such a short time allot of information transpires! Most lost as you are still trying to digest first mouthful! Thank you for writing this! It is good!

Re: Thoughts on an 'ideal' visit to the doctor . . .

Dan L on 7/15/01 at hrmin (053285)

Well said!!!! Fantastic observations, thoughts and ideas!!!!

Re: Thoughts on an 'ideal' visit to the doctor . . .

Kim K. on 7/15/01 at 19:01 (053286)

Where can I find a Dr. like this? I know for sure that I did not get that kind of care from the podiatrists I've been to and Iam on a PPO and I am the wife of a physician.

Re: Thoughts on an 'ideal' visit to the doctor . . .

Kim K. on 7/15/01 at 19:02 (053288)

Where can I find a Dr. like this? I know for sure that I did not get that kind of care from the podiatrists I've been to and Iam on a PPO and I am the wife of a physician.

Re: Thoughts on an 'ideal' visit to the doctor . . .

Laurie R on 7/15/01 at 20:33 (053292)

Hi Glenn, Thank you so much for your wonderful post... It will help many .. This board is the best on the net for foot pain ect.PF .... Thank you again for taking the time to share this with us..... Laurie R

Re: Thoughts on an 'ideal' visit to the doctor . . .

Doona M on 7/15/01 at 23:13 (053304)

If anybody finds a doctor, anywhere, that fits the one Glenn has described, give us his name so we can all go to him! lol......Donna M

Re: oops!! supposed to be Donna M

Donna M on 7/15/01 at 23:19 (053305)

Can't type my own name!

Re: PF Seriousness

Glenn X on 7/16/01 at hrmin (053370)

Good thoughts. What you suggest re rotator cuff or herniated disc is probably the single most important message one can come away from a PF doctor visit with -- and your comparisons are right on. PF NEEDS TO BE TAKEN SERIOUSLY EARLY ON. I didn't hear that when my problem first started. On the contrary, much of my advice has been to 'walk through it,' and 'stretch more aggressively (without ever having taken a measurement),' and 'the fascia is tough, push it a little.'
Good idea on the pictures too. And your remark about a 'plan.' Probably the best question the patient can ask, 'what's the plan?'
Appreciate your input to all the dialogues on heelspurs . . . a great deal! Thanks.

Re: PF Seriousness

john h on 7/16/01 at 17:23 (053391)

if you ask 99% of doctor's what their plan is you would get a blank stare. with the continued cutback in medical funding the doctors are pushed to get the patients in and out as fast as possible. foot problems to them are probably not high on their list of bad diseases.

Re: PF Seriousness

Julie on 7/17/01 at 02:57 (053444)

Glenn, I'm astounded. What kind of doctor gave you these diabolical bits of 'advice'?

Yes: PF needs to be taken seriously early. I've said this before: I shall be eternally thankful that I discovered this site within two weeks of the onset of mine. It took six months (not a long time in the scheme of things) to heal to the point where I could stop thinking about every step, and it's fully under control now. I don't like to think about what might have happened without the help I had here.

Re: PF Seriousness

john h on 7/17/01 at 09:26 (053467)

over time you tend to forget the progress or lack of in your fight with PF. reviewing my medical records i found i first went to the doctor (pod) in 1992 and he gave me no diagnosis. thought i might have a small fracture. He immediately gave me hard orthotics at $400 on first visit. i continued to run and apparently had no problems until i developed a case of severe tendonitis because of up hill running . this put me down for about 3 months. In 1994 my records have me back at an orthopedic foot and ankle specialist. she diagnoised me with PF and gave me anti-inflamatories, soft orthotics, and recomended stretching. I improved to the point where in 1996 i ran in a 5K and placed 2nd so i must have been doing well at that point. at some point after that i remember starting my run and feeling a very painful feeling in my right foot like i had twisted my ankle or a tendon pop. the pain subsided and i continued my run. within a few months my foot or feet (cannot remember when both feet started hurting) and i developed a burning sensation on the bottoms of both feet. i have a letter from my doctor that the burning would not be from PF and that if it did not go away i should have some nerve conduction testing. i clearly remember coming on at night and placing both feet on ice packs as the bottom of my feet were burning. i remember when running the burning on the bottom of both feet as i thought it was the hot asphalt i was running on. it would subside when i finished my run. no one ever really explained PF to me and until i found Scott's site i think i did everything wrong you could do wrong. no doctor ever told me this could become chronic or the importance of backing off my activities.
looking over my medical history it is very easy to see that with some proper intervention i may be running a 10k instead of looking at my computer. i of course accept some responsibility here but many doctors missed the boat along the way. i think it was glenn who suggested that doctors should have a handout for PF patients that has a suggested protocol for care and treatment and most certainly a warning that this disease can progress to a chronic condition if it is not treated with care.

Re: PF Seriousness

BrianJ on 7/17/01 at 09:59 (053472)

Right on, John. Early on in my PF, my doctors were much more interested in orthotics and cortisone shots than in explaining PF to me. Several doctors told me to 'get back to running' even though my feet hurt too much to take their advice. Then, I got a video of a podiatrist explaining why the 'stair stretch' would solve all my problems. I did that stretch three times a day for nine months and only got worse. I say all of this not to be overly negative, but to highlight why good advice from doctors is so important.

Re: PF Seriousness

Glenn X on 7/17/01 at hrmin (053540)

John and Judy and Brian -- and Others: I really appreciate your remarks about personal responsibility. I've fought the temptation to find fault and fix blame aplenty. I've had dreadful care, and still lack confidence in any professional treatment I'm getting outside the confines of this web site. Oregon (so far) seems far removed from doctors who really know their PF stuff. But not slipping into victimhood, and continuing to accept full responsibility for my outcomes, remains my number one most successful treatment path.

Re: PF Seriousness

Glenn X on 7/18/01 at hrmin (053613)

Julie: Just caught up with this. I'm in Oregon. Great state for everything but PF. Primary care physician, podiatrists, orthopaedic surgeon, physical therapists . . . collectively they've all fumbled the ball and I haven't been able to recover it. If you can interpret their advice you can learn something. But it's often contradictory. Ortho Surgeon suggested aggressive stretching facilitated by a PT. Put me on crutches in four weeks. Next podiatrist argued that I should never have stretched, and warned me against ANY stretching. Nugget of truth there, but he totally ignored the issue of flexibility. He's also the one that suggested the fascia's tough and I should walk through my pain.

I was actually three years in before I was measured for 'heel cord' flexibility. Minus 10 degrees. That DPM sent me to a PT. As I was continuing to aggravate my fascia, even on crutches, gaining flexibility made (makes) sense. I'm positive now on flexibility, (but tore my fascia in the process). Too aggressive, too much wobble board. (Whoever invented that instrument of PF torture)? Anyway, I've got too much going on right now. Just trying to maintain some measure of flexibility while I rest the F. Though still on crutches, tape helps. Have to say too, crutches are too much a crutch. I get around, but I don't get quite the true rest I need. Thinking about wheeling it.

Re: PF Seriousness

Julie on 7/19/01 at 06:47 (053687)

Glenn, you did get some awfully bad advice and are paying for it in spades, aren't you? But you're handling it fantastically well. It really is all about taking responsibility for yourself and dealing with the pain and all the problems day by day.

Maybe wheels would be a good idea, as a rest from crutches? The good thing about crutches, as far as I 'm aware (having no experience myself, but have seen the effect on long-term crutchers) is that using them builds upper body strength. But you don't really get the rest you need. Could you afford a really good wheelchair?

Meanwhile, I think you'll be able to maintain heel cord/calf flexibility - and circulation and energy flow - with those simple toe and ankle exercises I described the other day. Please let me know if I can be of any help.

Re: PF Seriousness

Glenn X on 7/19/01 at hrmin (053706)

Julie: Thank you for your most kind feelings. It is incredibly reassuring to read thoughtful words of encouragement on this website, particularly when your name preceeds them.

Re: Thoughts on an 'ideal' visit to the doctor . . .

john h on 7/15/01 at 16:04 (053265)

you have taken a lot of time and thought in writing this glen. thank you. also, thanks again to scott who has devoted years to this very serious problem for so many of us. thank you scott.

Re: Thoughts on an 'ideal' visit to the doctor . . .

Julie on 7/15/01 at 16:25 (053273)

Thank you, Glenn. This is excellent. I hope doctors will read it and learn something from it. As a guide to expectations it should be helpful to people here, and I think it should also be useful as a guide to the questions that an informed patient could ask.

I'd add that, because of 'selective memory', it 's always useful to be accompanied. Someone who is less involved is more likely to remember what was actually said (and more of it) - and can also remind the patient of questions s/he meant to ask but has forgotten. I also think it's useful for that companion to take the notes.

Re: Thoughts on an 'ideal' visit to the doctor . . .

Dr. Zuckerman on 7/15/01 at 16:26 (053274)

Good posting !!!!!

Re: Thoughts on an 'ideal' visit to the doctor . . .

Dr. Zuckerman on 7/15/01 at 16:31 (053276)

Another point. The doctor should have pictures , handouts and see the pateint back in one week just to go over the plan again. The doctor should have a plan. I am still amazed at how difficult it is to make the patient understand that this is more then just a broken bone this is a repetitive motion injury. Try to give the patient alot of example of what they have.

I tell them it is like a torn rotator cuff injury. A blown out knee. For some reason the foot doesn't get the respect it should have

Do you a patient wouldn't rest a torn rotator cuff, or a herniated dis I do just no one believe or understand that a pf injury is a tear and that we are walking on this injury.

Re: Thoughts on an 'ideal' visit to the doctor . . .

Tammie on 7/15/01 at 16:38 (053280)

Thank you, for this it is so VERY true I could see allot of the same and had some thoughts similar!!!! If you find this wonderful person Dr. he would be worth more money then he could handle lol! As people would hear there name and KNOW that was a real Person and a Dr. to! I do think today is hard for the medical profession as so many other professions, unfortuntatly they to have rules regualations and unfortunatly time limits to the wonderful insurance co. make sure of! It is like assembly rooms now at most dr. visits, and tho soem use a PA not all do and they to have there limits and time! I wish they made more hand out sheets also, I would like to refer to one so I can reassure myself I heard corectly as in such a short time allot of information transpires! Most lost as you are still trying to digest first mouthful! Thank you for writing this! It is good!

Re: Thoughts on an 'ideal' visit to the doctor . . .

Dan L on 7/15/01 at hrmin (053285)

Well said!!!! Fantastic observations, thoughts and ideas!!!!

Re: Thoughts on an 'ideal' visit to the doctor . . .

Kim K. on 7/15/01 at 19:01 (053286)

Where can I find a Dr. like this? I know for sure that I did not get that kind of care from the podiatrists I've been to and Iam on a PPO and I am the wife of a physician.

Re: Thoughts on an 'ideal' visit to the doctor . . .

Kim K. on 7/15/01 at 19:02 (053288)

Where can I find a Dr. like this? I know for sure that I did not get that kind of care from the podiatrists I've been to and Iam on a PPO and I am the wife of a physician.

Re: Thoughts on an 'ideal' visit to the doctor . . .

Laurie R on 7/15/01 at 20:33 (053292)

Hi Glenn, Thank you so much for your wonderful post... It will help many .. This board is the best on the net for foot pain ect.PF .... Thank you again for taking the time to share this with us..... Laurie R

Re: Thoughts on an 'ideal' visit to the doctor . . .

Doona M on 7/15/01 at 23:13 (053304)

If anybody finds a doctor, anywhere, that fits the one Glenn has described, give us his name so we can all go to him! lol......Donna M

Re: oops!! supposed to be Donna M

Donna M on 7/15/01 at 23:19 (053305)

Can't type my own name!

Re: PF Seriousness

Glenn X on 7/16/01 at hrmin (053370)

Good thoughts. What you suggest re rotator cuff or herniated disc is probably the single most important message one can come away from a PF doctor visit with -- and your comparisons are right on. PF NEEDS TO BE TAKEN SERIOUSLY EARLY ON. I didn't hear that when my problem first started. On the contrary, much of my advice has been to 'walk through it,' and 'stretch more aggressively (without ever having taken a measurement),' and 'the fascia is tough, push it a little.'
Good idea on the pictures too. And your remark about a 'plan.' Probably the best question the patient can ask, 'what's the plan?'
Appreciate your input to all the dialogues on heelspurs . . . a great deal! Thanks.

Re: PF Seriousness

john h on 7/16/01 at 17:23 (053391)

if you ask 99% of doctor's what their plan is you would get a blank stare. with the continued cutback in medical funding the doctors are pushed to get the patients in and out as fast as possible. foot problems to them are probably not high on their list of bad diseases.

Re: PF Seriousness

Julie on 7/17/01 at 02:57 (053444)

Glenn, I'm astounded. What kind of doctor gave you these diabolical bits of 'advice'?

Yes: PF needs to be taken seriously early. I've said this before: I shall be eternally thankful that I discovered this site within two weeks of the onset of mine. It took six months (not a long time in the scheme of things) to heal to the point where I could stop thinking about every step, and it's fully under control now. I don't like to think about what might have happened without the help I had here.

Re: PF Seriousness

john h on 7/17/01 at 09:26 (053467)

over time you tend to forget the progress or lack of in your fight with PF. reviewing my medical records i found i first went to the doctor (pod) in 1992 and he gave me no diagnosis. thought i might have a small fracture. He immediately gave me hard orthotics at $400 on first visit. i continued to run and apparently had no problems until i developed a case of severe tendonitis because of up hill running . this put me down for about 3 months. In 1994 my records have me back at an orthopedic foot and ankle specialist. she diagnoised me with PF and gave me anti-inflamatories, soft orthotics, and recomended stretching. I improved to the point where in 1996 i ran in a 5K and placed 2nd so i must have been doing well at that point. at some point after that i remember starting my run and feeling a very painful feeling in my right foot like i had twisted my ankle or a tendon pop. the pain subsided and i continued my run. within a few months my foot or feet (cannot remember when both feet started hurting) and i developed a burning sensation on the bottoms of both feet. i have a letter from my doctor that the burning would not be from PF and that if it did not go away i should have some nerve conduction testing. i clearly remember coming on at night and placing both feet on ice packs as the bottom of my feet were burning. i remember when running the burning on the bottom of both feet as i thought it was the hot asphalt i was running on. it would subside when i finished my run. no one ever really explained PF to me and until i found Scott's site i think i did everything wrong you could do wrong. no doctor ever told me this could become chronic or the importance of backing off my activities.
looking over my medical history it is very easy to see that with some proper intervention i may be running a 10k instead of looking at my computer. i of course accept some responsibility here but many doctors missed the boat along the way. i think it was glenn who suggested that doctors should have a handout for PF patients that has a suggested protocol for care and treatment and most certainly a warning that this disease can progress to a chronic condition if it is not treated with care.

Re: PF Seriousness

BrianJ on 7/17/01 at 09:59 (053472)

Right on, John. Early on in my PF, my doctors were much more interested in orthotics and cortisone shots than in explaining PF to me. Several doctors told me to 'get back to running' even though my feet hurt too much to take their advice. Then, I got a video of a podiatrist explaining why the 'stair stretch' would solve all my problems. I did that stretch three times a day for nine months and only got worse. I say all of this not to be overly negative, but to highlight why good advice from doctors is so important.

Re: PF Seriousness

Glenn X on 7/17/01 at hrmin (053540)

John and Judy and Brian -- and Others: I really appreciate your remarks about personal responsibility. I've fought the temptation to find fault and fix blame aplenty. I've had dreadful care, and still lack confidence in any professional treatment I'm getting outside the confines of this web site. Oregon (so far) seems far removed from doctors who really know their PF stuff. But not slipping into victimhood, and continuing to accept full responsibility for my outcomes, remains my number one most successful treatment path.

Re: PF Seriousness

Glenn X on 7/18/01 at hrmin (053613)

Julie: Just caught up with this. I'm in Oregon. Great state for everything but PF. Primary care physician, podiatrists, orthopaedic surgeon, physical therapists . . . collectively they've all fumbled the ball and I haven't been able to recover it. If you can interpret their advice you can learn something. But it's often contradictory. Ortho Surgeon suggested aggressive stretching facilitated by a PT. Put me on crutches in four weeks. Next podiatrist argued that I should never have stretched, and warned me against ANY stretching. Nugget of truth there, but he totally ignored the issue of flexibility. He's also the one that suggested the fascia's tough and I should walk through my pain.

I was actually three years in before I was measured for 'heel cord' flexibility. Minus 10 degrees. That DPM sent me to a PT. As I was continuing to aggravate my fascia, even on crutches, gaining flexibility made (makes) sense. I'm positive now on flexibility, (but tore my fascia in the process). Too aggressive, too much wobble board. (Whoever invented that instrument of PF torture)? Anyway, I've got too much going on right now. Just trying to maintain some measure of flexibility while I rest the F. Though still on crutches, tape helps. Have to say too, crutches are too much a crutch. I get around, but I don't get quite the true rest I need. Thinking about wheeling it.

Re: PF Seriousness

Julie on 7/19/01 at 06:47 (053687)

Glenn, you did get some awfully bad advice and are paying for it in spades, aren't you? But you're handling it fantastically well. It really is all about taking responsibility for yourself and dealing with the pain and all the problems day by day.

Maybe wheels would be a good idea, as a rest from crutches? The good thing about crutches, as far as I 'm aware (having no experience myself, but have seen the effect on long-term crutchers) is that using them builds upper body strength. But you don't really get the rest you need. Could you afford a really good wheelchair?

Meanwhile, I think you'll be able to maintain heel cord/calf flexibility - and circulation and energy flow - with those simple toe and ankle exercises I described the other day. Please let me know if I can be of any help.

Re: PF Seriousness

Glenn X on 7/19/01 at hrmin (053706)

Julie: Thank you for your most kind feelings. It is incredibly reassuring to read thoughtful words of encouragement on this website, particularly when your name preceeds them.