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"safe" workouts?

Posted by Deb H. on 7/25/01 at 23:25 (054318)

Not sure where this topic fits, didn't know where else to put it. I haven't been to a podiatrist, but from what I've read on the internet, I'm sure I have PF. I'd never had heel pain until I increased my workouts (pain started in May). Now it's gotten to where it hurts just walking, and it's worse in the morning or after sitting. Anyway, other than swimming, what workouts are safe? I'm going to try shoe inserts and stretching more, but I've alreading been alternating aerobics (w/weights) and biking daily. This hasn't seemed to help much. Is biking o.k.? Or is it just as bad as an impact workout. Is there any way to continue working out and heal? I've worked too hard to get in shape and lose weight (before pain started). I'm afraid to quit the workouts and reverse all my hard work. Any suggestions are appreciated, thanks!
(I'm 30 years old, by the way)

Re: "safe" workouts?

LynneA on 7/26/01 at hrmin (054333)

Debbie, I have a heelspur on both heels and find that the bicycle is fine for me. I do 20 minutes most days, and have even progressed to 5 minutes on the step and 5 minutes on the treadmill. This is a new addition for me and I find slight pain afterwards but nothing like it was. My new theory is fit with pain, as opposed to unfit with pain! I always use my orthotics no matter what, and try to stretch before and after all exercise. At the risk of being thumped as an advertiser, which I'm not, I also use the Jade Balm and it is the product that has enabled the addition of more exercise into my life. It has worked like a dream for me. Exercise is a definite anti-depressant, and pain has to be the most depressing thing. So, I believe we should, where possible, keep exercising to keep the head together if nothing else!

Re: "safe" workouts?

Necee on 7/26/01 at 01:52 (054338)

Hi Debbie,
Your pain comes from inflammation, so by reducing the inflammation you reduce the pain. How? Well there are several ways, rest is very important from the onset, if you start treating it early it shouldn't become chronic. You can continue your exercises but be careful, proper stretching is a must, if possible change to a more 'feet friendly' exercise routine, I would cut back on my exercise time, if you experience pain then stop, after exercising I would suggest you use ice. You could soak your feet in cold water or use a frozen water bottle to massage the bottom of your feet.
In my opinion, whether its a heelspur, chronic PF, TTS,or whatever, the 'at home treatments' are going to be pretty much the same.
Reading the heel pain book is very informative, as well as keeping in touch with the message boards, much information is given here.
Taking anti-inflammatory medicines always helps me, as well as wearing an ankle brace.
Hope this has helped
Necee

Re: "safe" workouts?

Julie on 7/26/01 at 02:39 (054339)

Deb, the topic fits right here. Welcome to heelspurs.com.

I know you're concerned about exercise, but I think you're really putting the cart before the horse. You should see a foot specialist to get a full evaluation and an accurate diagnosis. Your symptoms do sound like plantar fasciitis, but self-diagnosis on the internet isn't the best way to start treating it. Plantar fasciitis is a serious condition, not to be tinkered with.

You don't know what is causing your heel pain, and that is what you need to establish so that it can be treated in the most appropriate and effective way. For example, if you have any biomechanical faults, such as over-pronation (very possible, as you say your pain started when you increased your impact workouts) you may need custom orthotics to correct the fault. That can be determined only by evaluation. A good podiatrist will be able to do that, will be able to advise you, and will be able to prescribe and help you carry out a comprehensive treatment plan. With luck, and your full involvement and co-operation, you'll get at the source, deal with it, and heal in a reasonable time.

Rest, as Necee has explained, is important. Not complete rest (you wouldn't like that anyway!) but avoidance of activities which can re-injure the fascia. That is, most weight-bearing exercise. NO impact workouts, and - in my view - no weight-bear ing stretching. As Dr Ed Davis has said on another thread, the weight-bearing wall stretches are suitable for some, but they must be done correctly: if they aren't, the knees, hips and lower back can be easily strained. Most people don't do them correctly and even then they can re-injure the fascia and, possibly, irritate the Achilles Tendon. On the whole, it's better to stick to non-weight-bearing stretching.

Read the heel pain book and inform yourself about PF, its causes and its treatment.

The footgear you choose is extremely important. Your arches need constant support in order not to increase the tension on the fascia, so make sure that you always wear good quality shoes that bend only at the metatarsal, not at the arch, and that give support and plenty of cushioning. Never go barefoot, not even to get to the toilet at night.

In the heel pain book part 2 you'll find instructions for taping, which rests the fascia and therefore contributes to healing as well as to pain relief. But if you try it and it helps, don't use it as an excuse to go impacting!

I can't stress it hard enough: see a podiatrist and be properly evaluated and diagnosed. Then take responsibility for your healing. Exercise will be a part of it, but only a part.

Re: "safe" workouts?

Julie on 7/26/01 at 05:31 (054343)

Lynne, I do understand your 'fit with pain' point of view. And I know I sound like the voice of doom, but I really think you should be very careful with increasing exercise, especially of the impact variety. PF isn't just inflammation, it's injury, where the fascia has torn away from its insertion in the heel bone. Any weight-bearing exercise, such as running, step, treadmill, etc, can cause further injury. And if you feel pain, it means you are re-injuring.

Do be careful. You don't want to end up with a chronic, possibly disabling condition. I know Jade Balm has relieved your pain, and I'm glad. But it is, as Dr Chris says, a topical analgesic, and if there are underlying biomechanical causes for your PF, it may be over-hopeful to regard Jade as a cure.

Re: I understand Deb

Carmen H on 7/26/01 at 08:12 (054352)

I am with you on the worked hard to get fit and don't want to let it go....
I am desperately tying to keep in mind that there's a reason for everything. I tried to do minimal exercise without weights and no walking or stair stepping (WARNING: I have heard stairmaster is VERY bad for people with PF) but it made my feet worse. I hope you listen to your pain and act accordingly. I caught it all early too but continued to try to live my normal life and got POOR advice from my Pod and now I am seriously miserable in pain every day. It's discouraging but Deb if you take a break your body will remember where it was before and you'll get back in shape relatively quickly. I actually took a break for two months when I hit a plateau and when I went back I got in better shape quicker then I had before. It was pretty encouraging and motivating. I hope you don't continue to exercise through pain.....This site and Julie in particular has been very helpful to every question I have posted. This has been the source of my sanity for many weeks now....
I definitely agree you NEED TO GO TO THE DOCTOR.

Re: I understand Deb

Rock on 7/27/01 at hrmin (054422)

All,

If you are smart about it you can work out all you want with even moderate cases of PF. The hard part seems to be that 'Smart' is different for most everybody!

The other danger appears to be that total rest can result in tissue atrophy which may make active PF really long term. After all, ever wonder why serious runners with PF return to running ?

Be careful out there...
Rock.

Re: Rock

Julie on 7/27/01 at 01:47 (054427)

Rock, I know your experience has been rather different from that of most people here. But you are an Iron Man athlete and you know what 'smart' is for you. My experience is different too. I practise and teach yoga, and have used what I know to help myself through PF - but I wouldn't go advising everyone with PF to find a yoga class - I know most yoga classes wouldn't be suitable for most people here.

I'm careful about what advice I give to whom. And I think it may not be the best thing to advise folk with PF to 'work out'. Most people who write here with exercise at the top of their priorities list are only too like to re-injure themselves if they go on working out. Lynne or Deb, for instance, reading your post, might think, Oh Great, I can go back to aerobics/step/treadmill - any or all of which could and probably would be bad news for their feet.

No-one has ever advised total/complete rest, which of course results in weakened, possibly atrophied, muscles and more problems down the line. The challenge is to find and adopt an exercise plan that is appropriate when one has PF. For most people, that will be non-weight-bearing exercise: swimming, biking, simple yoga without standing and especially without standing balances, therabands, Acu-Flex, PFT - the choice is large.

There are exceptions, like yourself. More power to you!

Re: Amen Julie

Carmen H on 7/27/01 at 15:02 (054528)

I agree Julie.....I am an avid exerciser as I have told you and I have been VERY careful about what I do. I think it's what has allowed me to keep walking this far.

Re: "safe" workouts?

LynneA on 7/26/01 at hrmin (054333)

Debbie, I have a heelspur on both heels and find that the bicycle is fine for me. I do 20 minutes most days, and have even progressed to 5 minutes on the step and 5 minutes on the treadmill. This is a new addition for me and I find slight pain afterwards but nothing like it was. My new theory is fit with pain, as opposed to unfit with pain! I always use my orthotics no matter what, and try to stretch before and after all exercise. At the risk of being thumped as an advertiser, which I'm not, I also use the Jade Balm and it is the product that has enabled the addition of more exercise into my life. It has worked like a dream for me. Exercise is a definite anti-depressant, and pain has to be the most depressing thing. So, I believe we should, where possible, keep exercising to keep the head together if nothing else!

Re: "safe" workouts?

Necee on 7/26/01 at 01:52 (054338)

Hi Debbie,
Your pain comes from inflammation, so by reducing the inflammation you reduce the pain. How? Well there are several ways, rest is very important from the onset, if you start treating it early it shouldn't become chronic. You can continue your exercises but be careful, proper stretching is a must, if possible change to a more 'feet friendly' exercise routine, I would cut back on my exercise time, if you experience pain then stop, after exercising I would suggest you use ice. You could soak your feet in cold water or use a frozen water bottle to massage the bottom of your feet.
In my opinion, whether its a heelspur, chronic PF, TTS,or whatever, the 'at home treatments' are going to be pretty much the same.
Reading the heel pain book is very informative, as well as keeping in touch with the message boards, much information is given here.
Taking anti-inflammatory medicines always helps me, as well as wearing an ankle brace.
Hope this has helped
Necee

Re: "safe" workouts?

Julie on 7/26/01 at 02:39 (054339)

Deb, the topic fits right here. Welcome to heelspurs.com.

I know you're concerned about exercise, but I think you're really putting the cart before the horse. You should see a foot specialist to get a full evaluation and an accurate diagnosis. Your symptoms do sound like plantar fasciitis, but self-diagnosis on the internet isn't the best way to start treating it. Plantar fasciitis is a serious condition, not to be tinkered with.

You don't know what is causing your heel pain, and that is what you need to establish so that it can be treated in the most appropriate and effective way. For example, if you have any biomechanical faults, such as over-pronation (very possible, as you say your pain started when you increased your impact workouts) you may need custom orthotics to correct the fault. That can be determined only by evaluation. A good podiatrist will be able to do that, will be able to advise you, and will be able to prescribe and help you carry out a comprehensive treatment plan. With luck, and your full involvement and co-operation, you'll get at the source, deal with it, and heal in a reasonable time.

Rest, as Necee has explained, is important. Not complete rest (you wouldn't like that anyway!) but avoidance of activities which can re-injure the fascia. That is, most weight-bearing exercise. NO impact workouts, and - in my view - no weight-bear ing stretching. As Dr Ed Davis has said on another thread, the weight-bearing wall stretches are suitable for some, but they must be done correctly: if they aren't, the knees, hips and lower back can be easily strained. Most people don't do them correctly and even then they can re-injure the fascia and, possibly, irritate the Achilles Tendon. On the whole, it's better to stick to non-weight-bearing stretching.

Read the heel pain book and inform yourself about PF, its causes and its treatment.

The footgear you choose is extremely important. Your arches need constant support in order not to increase the tension on the fascia, so make sure that you always wear good quality shoes that bend only at the metatarsal, not at the arch, and that give support and plenty of cushioning. Never go barefoot, not even to get to the toilet at night.

In the heel pain book part 2 you'll find instructions for taping, which rests the fascia and therefore contributes to healing as well as to pain relief. But if you try it and it helps, don't use it as an excuse to go impacting!

I can't stress it hard enough: see a podiatrist and be properly evaluated and diagnosed. Then take responsibility for your healing. Exercise will be a part of it, but only a part.

Re: "safe" workouts?

Julie on 7/26/01 at 05:31 (054343)

Lynne, I do understand your 'fit with pain' point of view. And I know I sound like the voice of doom, but I really think you should be very careful with increasing exercise, especially of the impact variety. PF isn't just inflammation, it's injury, where the fascia has torn away from its insertion in the heel bone. Any weight-bearing exercise, such as running, step, treadmill, etc, can cause further injury. And if you feel pain, it means you are re-injuring.

Do be careful. You don't want to end up with a chronic, possibly disabling condition. I know Jade Balm has relieved your pain, and I'm glad. But it is, as Dr Chris says, a topical analgesic, and if there are underlying biomechanical causes for your PF, it may be over-hopeful to regard Jade as a cure.

Re: I understand Deb

Carmen H on 7/26/01 at 08:12 (054352)

I am with you on the worked hard to get fit and don't want to let it go....
I am desperately tying to keep in mind that there's a reason for everything. I tried to do minimal exercise without weights and no walking or stair stepping (WARNING: I have heard stairmaster is VERY bad for people with PF) but it made my feet worse. I hope you listen to your pain and act accordingly. I caught it all early too but continued to try to live my normal life and got POOR advice from my Pod and now I am seriously miserable in pain every day. It's discouraging but Deb if you take a break your body will remember where it was before and you'll get back in shape relatively quickly. I actually took a break for two months when I hit a plateau and when I went back I got in better shape quicker then I had before. It was pretty encouraging and motivating. I hope you don't continue to exercise through pain.....This site and Julie in particular has been very helpful to every question I have posted. This has been the source of my sanity for many weeks now....
I definitely agree you NEED TO GO TO THE DOCTOR.

Re: I understand Deb

Rock on 7/27/01 at hrmin (054422)

All,

If you are smart about it you can work out all you want with even moderate cases of PF. The hard part seems to be that 'Smart' is different for most everybody!

The other danger appears to be that total rest can result in tissue atrophy which may make active PF really long term. After all, ever wonder why serious runners with PF return to running ?

Be careful out there...
Rock.

Re: Rock

Julie on 7/27/01 at 01:47 (054427)

Rock, I know your experience has been rather different from that of most people here. But you are an Iron Man athlete and you know what 'smart' is for you. My experience is different too. I practise and teach yoga, and have used what I know to help myself through PF - but I wouldn't go advising everyone with PF to find a yoga class - I know most yoga classes wouldn't be suitable for most people here.

I'm careful about what advice I give to whom. And I think it may not be the best thing to advise folk with PF to 'work out'. Most people who write here with exercise at the top of their priorities list are only too like to re-injure themselves if they go on working out. Lynne or Deb, for instance, reading your post, might think, Oh Great, I can go back to aerobics/step/treadmill - any or all of which could and probably would be bad news for their feet.

No-one has ever advised total/complete rest, which of course results in weakened, possibly atrophied, muscles and more problems down the line. The challenge is to find and adopt an exercise plan that is appropriate when one has PF. For most people, that will be non-weight-bearing exercise: swimming, biking, simple yoga without standing and especially without standing balances, therabands, Acu-Flex, PFT - the choice is large.

There are exceptions, like yourself. More power to you!

Re: Amen Julie

Carmen H on 7/27/01 at 15:02 (054528)

I agree Julie.....I am an avid exerciser as I have told you and I have been VERY careful about what I do. I think it's what has allowed me to keep walking this far.