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PF advice (warning - long)

Posted by D.Thomas on 7/19/01 at 15:57 (053745)

I was diagnosed with PF about nine years ago. It all started going to the bars at night watching bands. I would stand on the hard cement floors at the bars for hours. Afterwards the bottom of my feet would hurt. I didn't do anything for them until it got bad enough that I had pain most of the time. I went to see a Pod and he sent me to PT and made a pair of full length semi-rigid orthotics. He also gave me Cort shots, but they never did anything for me. The orthotics tended to help with pain as long as I didn't push it being on my feet. For example, ever since this started I haven't been able to stand that long in one place without them starting to throb with pain. Once I sit down, the pain usually will go away. I basically changed my life by staying off my feet as much as possible. My favorite thing to do before this was to walk while playing golf. Well, after this started up, my feet wouldn't tolerate that anymore. In fact, even taking a cart, my feet usually would hurt after 18 holes just from walking from the cart to the ball. I would go home and ice them, and the pain would usually go away. Three years later they started to hurt again all the time and I went to see an Ortho this time and he sent me to have my orthotics redone. I got full length semi-rigid again, but the molding process was supposed to be better than my last ones. They seem to work better, but I would still get pain if I pushed them too much. I still couldn't stand in one place too long without them hurting.

Well, about six months ago, I started walking with my wife at night. We walked for three weeks and then stopped because of work and other stuff. Three weeks after we stopped I started getting major pain. It was slow and then it came on full time in both feet. This is the worst pain I have been in since all this started. I could barely walk and stand. I went to four different doctors and heard about twenty different stories of about what I need to do. At least hey all agreed that I have PF. I ended up going to a PT again, but the deep massage just made things unbearable. The stretching also made things worse. So I stopped. I had an EMG and that came out OK. I ended up going with this other Pod because he basically told me what I have been going through since this began without me saying a word. He told me that my orthotics were not corrective enough and that I needed this new design that came out a year ago. He said that my orthotics were only about 70% effective, and these news ones were 90%. He put me on lodine for two weeks while we waited for the new orthotics. Well, they didn't come for about four weeks. They are ¾ in length and rigid. He told me they would take awhile for them to work and to work into them slowly (2 to 4 weeks). Well it's been almost six weeks and I still have pain. I can't even wear a sock sometimes because they feel so uncomfortable. When my feet sweat it just makes things slippery with these rigid orthotics. I really don't know what to do next?

My PF is also somewhat different than most. I do not have pain in my heels. My feet ache in the morning, but they don't hurt on the first step which is common with people who have pain in their heels. I supposedly have good flexibility in my feet (Pod and PT confirmed). I am not over weight at all. I'm about 6'2' and weigh about 175. I do have extremely high arches. The pain is located only in the arch of both feet. The PT actually found the pain in the 'main cord' of the fascia, the one that attaches the big toe to the ankle in both feet. I actually felt a pea sized bump on the left foot in the fascia after the deep massage from the PT, but it does seem to have reduced in size once I stopped going to the PT.

I also have weird shaped feet, my ankles are narrow but the front of my feet tend to be wide. I have found that only wide shoes are comfortable. My feet tend to be very sensitive with any other size. My feet do move some in the wide shoes. I don't know if this is not helping the recovery process or not. It is real a pain to find shoes that fit my duck feet. I usually don't find good fitting shoes, I find shoes that don't hurt my feet. The SL-2 Last (narrow heel and wide toe box) from New Balance doesn't even feel comfortable.

Any advice on next steps? After three solid months of pain, the rest thing gets really old, really fast. Especially since I don't see much improvement.

Re: PF advice (warning - long)

wendyn on 7/19/01 at 21:36 (053769)

D Thomas - I am not a doctor - but until the doctors check in I thought I'd say hi.

I notice you say the pain really started about 3 weeks AFTER you stopped walking. That's interesting isn't it? I wonder why - were you doing anything else differently?

A lot of us are unable to use the very rigid orthotics - they seem to be most often useful for people who are very heavy. I still believe that my rigid orthotics probably did a lot more damage than good.

When you say it is so uncomfortable you can't even wear a sock - do you mean that it makes your shoe too tight - or you just can't stand the feeling of the sock?

Did your doctors do any other tests for you (blood work?)

Re: PF advice (warning - long)

D.Thomas on 7/20/01 at 07:59 (053799)

All the doctors thought it was the walking that caused it. I don't think I was doing anything else that was different. I can't remember if it was two weeks when the pain started or three. Like I said, the pain started slowly and then went full time.

I don't know what to do about the orthotics. I don't know if I'm suppose to give them more time or go get another pair? I hate how much they cost. It's also a major drag because he made me believe that these will really help.

Yea, both on the socks. Sometimes my feet are so sensitive from the pain that they don't like socks. And they make my shoe feel tight. But when I am off them for a while and not hurting, I can wear socks. I think it is when they are really inflammmed is when I have problem with socks, but I don't really know.

No on the blood work.

Re: PF advice (warning - long)

wendyn on 7/20/01 at 09:18 (053808)

The reason I ask is because that extreme sensitivity in your feet sounds like it could be more nerve related.

I would definately try to get blood work done - for diabetes, thyroid and B12. Chances are they're fine - but it's important to check.

Re: PF advice (warning - long)

Julie on 7/20/01 at 09:49 (053810)

Hi D Thomas

A comment on your orthotics. Whoever made them should be willing to make adjustments until they are right for you, so do get in touch with him or her and see if this can't be arranged.

You could also post a question on the Orthotics/Shoes message board - Richard, our resident certified pedorthist might have some advice for you. He has said in the past that an orthotic is only as good as the shoe it is put into - so are you sure that your footgear is all right? Supportive, cushioning, and the right size?

You've had PF for so long that you've probably tried everything, so I hesitate to say any more, but you might try reading the heel pain book - just in case there's something you haven't tried or thought of.

And take Wendy's advice about the tests she suggests - it may be something more than PF recurring.

Re: Shoes and socks

Julie on 7/20/01 at 10:02 (053813)

Another thought - if socks make your shoes feel too tight, then the shoes are too small. New shoes should be tried on with the socks you are going to wear them with, so maybe it's time for new ones?

And another. I've recently discovered Thorlos, a brand of sock made in several thicknesses. They are soft, warm and comforting, and give wonderful cushioning. The ones I have are the Light Hiking crews. I love them. Maybe they would give you a bit of relief - but you would need a bigger shoe size!

Re: PF advice (warning - long)

D.Thomas on 7/20/01 at 10:52 (053815)

I actually ordered some custom made shoes and hope that will help. The problem is that it takes 12 weeks to get them.

Re: PF advice (warning - long)

john a on 7/20/01 at 11:29 (053824)

By any chance are the custom shoes you ordered from Hersey ( http://www.herseycustomshoe.com ) ? I considered them over two years ago when I first got PF, but thought the price was too high. $2000 of useless footwear and inserts later, I'm reconsidering :-) They seem like a class outfit. Their web site gives me a really good feeling about them.

Re: PF advice (warning - long)

D.Thomas on 7/20/01 at 13:27 (053832)

Ha. Yep, that's them. They have are very nice people, but they do take awhile to get them. Anywhere up to 12 weeks. I am hoping that they fit like a glove. I have wasted enough money on shoes for my lifetime.

Re: PF advice (warning - long)

john a on 7/20/01 at 15:30 (053836)

Be sure to drop us a note when you've worn them for a while and tell us how you like them. My only concern about them is whether they can really be made accurately without going to be fitted in person. Did you go in person or do the foot measurements yourself?

Re: PF advice (warning - long)

D.Thomas on 7/20/01 at 18:33 (053849)

I sent my measurements to him. They were not really that hard to do. Plus, they say if they don't fit right, send them back nad they will fix them for free. With the problem I have finding a good fit, I decided to go for it.

Re: PF advice (warning - long)

wendyn on 7/19/01 at 21:36 (053769)

D Thomas - I am not a doctor - but until the doctors check in I thought I'd say hi.

I notice you say the pain really started about 3 weeks AFTER you stopped walking. That's interesting isn't it? I wonder why - were you doing anything else differently?

A lot of us are unable to use the very rigid orthotics - they seem to be most often useful for people who are very heavy. I still believe that my rigid orthotics probably did a lot more damage than good.

When you say it is so uncomfortable you can't even wear a sock - do you mean that it makes your shoe too tight - or you just can't stand the feeling of the sock?

Did your doctors do any other tests for you (blood work?)

Re: PF advice (warning - long)

D.Thomas on 7/20/01 at 07:59 (053799)

All the doctors thought it was the walking that caused it. I don't think I was doing anything else that was different. I can't remember if it was two weeks when the pain started or three. Like I said, the pain started slowly and then went full time.

I don't know what to do about the orthotics. I don't know if I'm suppose to give them more time or go get another pair? I hate how much they cost. It's also a major drag because he made me believe that these will really help.

Yea, both on the socks. Sometimes my feet are so sensitive from the pain that they don't like socks. And they make my shoe feel tight. But when I am off them for a while and not hurting, I can wear socks. I think it is when they are really inflammmed is when I have problem with socks, but I don't really know.

No on the blood work.

Re: PF advice (warning - long)

wendyn on 7/20/01 at 09:18 (053808)

The reason I ask is because that extreme sensitivity in your feet sounds like it could be more nerve related.

I would definately try to get blood work done - for diabetes, thyroid and B12. Chances are they're fine - but it's important to check.

Re: PF advice (warning - long)

Julie on 7/20/01 at 09:49 (053810)

Hi D Thomas

A comment on your orthotics. Whoever made them should be willing to make adjustments until they are right for you, so do get in touch with him or her and see if this can't be arranged.

You could also post a question on the Orthotics/Shoes message board - Richard, our resident certified pedorthist might have some advice for you. He has said in the past that an orthotic is only as good as the shoe it is put into - so are you sure that your footgear is all right? Supportive, cushioning, and the right size?

You've had PF for so long that you've probably tried everything, so I hesitate to say any more, but you might try reading the heel pain book - just in case there's something you haven't tried or thought of.

And take Wendy's advice about the tests she suggests - it may be something more than PF recurring.

Re: Shoes and socks

Julie on 7/20/01 at 10:02 (053813)

Another thought - if socks make your shoes feel too tight, then the shoes are too small. New shoes should be tried on with the socks you are going to wear them with, so maybe it's time for new ones?

And another. I've recently discovered Thorlos, a brand of sock made in several thicknesses. They are soft, warm and comforting, and give wonderful cushioning. The ones I have are the Light Hiking crews. I love them. Maybe they would give you a bit of relief - but you would need a bigger shoe size!

Re: PF advice (warning - long)

D.Thomas on 7/20/01 at 10:52 (053815)

I actually ordered some custom made shoes and hope that will help. The problem is that it takes 12 weeks to get them.

Re: PF advice (warning - long)

john a on 7/20/01 at 11:29 (053824)

By any chance are the custom shoes you ordered from Hersey ( http://www.herseycustomshoe.com ) ? I considered them over two years ago when I first got PF, but thought the price was too high. $2000 of useless footwear and inserts later, I'm reconsidering :-) They seem like a class outfit. Their web site gives me a really good feeling about them.

Re: PF advice (warning - long)

D.Thomas on 7/20/01 at 13:27 (053832)

Ha. Yep, that's them. They have are very nice people, but they do take awhile to get them. Anywhere up to 12 weeks. I am hoping that they fit like a glove. I have wasted enough money on shoes for my lifetime.

Re: PF advice (warning - long)

john a on 7/20/01 at 15:30 (053836)

Be sure to drop us a note when you've worn them for a while and tell us how you like them. My only concern about them is whether they can really be made accurately without going to be fitted in person. Did you go in person or do the foot measurements yourself?

Re: PF advice (warning - long)

D.Thomas on 7/20/01 at 18:33 (053849)

I sent my measurements to him. They were not really that hard to do. Plus, they say if they don't fit right, send them back nad they will fix them for free. With the problem I have finding a good fit, I decided to go for it.