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

First ever pod visit, need wisdom

Posted by Wendy in NJ on 9/02/01 at 06:24 (058757)

Last week was my first visit to the podiatrist. He was very friendly but did very little examining of my feet. He wanted to jump in with a cortisone shot and I asked him if we could wait and try something else I hadn't. I hadn't been icing it daily (often but not daily) and he instructed me to wear heels to get the weight off my heels. He said he is not in favor of allowing our feet to be flat in tennis shoes. Soooo, that's where I am at. (I do have to admit, my heel hurts much less in heels but I am already 6' tall!) I have a visit scheduled for Sept. 25. I need to know how much the shot hurts, please!! I am a big baby and just need to know should I review my Lamaze breathing???? He did mention they go through the side of the heel, not straight ahead. Thanks to anyone willing to jump in there with wisdom.

Re: First ever pod visit, need A NEW DOC

BrianG on 9/02/01 at 08:19 (058759)

Hi Wendy,

I'd be a little concerned about a Pod who is talking surgery on your 1st visit. There is so much to try before you get to that point. Right now you may want to try taping your feet, and looking into a good pair of orthotics. How long have you had sore heels? I'm going to stay aweay from the high heels advice, as I've never heard about that one. Are you sure this is the doc for you? Unless there is a real good reason why you are going to him, I think I'd keep looking. This man is too eager to start cutting, and filling his wallet !! Good luck

BCG

PS Are you working? Your going to want to give your feet a break, no matter what the treatment is.

Re: First ever pod visit, need wisdom

Julie on 9/02/01 at 08:41 (058762)

Wendy, in my view, the first thing any podiatrist should do, before recommending anything, let alone a cortisone shot, is a thorough examination and evaluation of your problem. That should include a gait analysis, where you are watched and possibly videod walking on a treadmill, to determine if there are any biomechanical faults that could be corrected with custom orthotics. It should also include flexibility texting to determine if shortened achilles tendons and calf muscles are contributing to your problem.

All this would be followed by a (hopefully) accurate diagnosis. Is it PF? Is it only PF or are other structures involved? When the condition is diagnosed and its cause identified, the doctor is then in a position to propose a comprehensive package of treatments to address it.

Unless you haven't told us everything, it sounds from your post as though this hasn't happened. But I would rather wait for one of the doctors here to advise you on whether or not to seek out another practitioner.

I think he is right about absolutely flat shoes not being a good idea. But good athletic shoes - at least the ones made for walking/hiking - have an elevated heel, and will offer your feet better support than a dress shoe. (Bear in mind that if it is established that you need orthotics, your shoes have to be able to accommodate them.)

If you're going to stick with this doctor (and even if you aren't) you should educate yourself as much as possible. Have you read the heel pain book yet? Do: it's a storehouse of information, armed with which you may be able to educate him into doing the right thing by you.

Re: First ever pod visit, need wisdom

wendyn on 9/02/01 at 08:47 (058764)

I'd be a little concerned about the recommendation to wear heels. I know that heels made my PF feel a bit better - but high heels can also cause all kinds of other foot problems. Flat shoes are lousy too - but there are lots of good athletic shoes and/or orthotics that should be what you need. I am still looking for decent dress shoes my self - so I can't help you there!

Re: First ever pod visit, need wisdom

john h on 9/02/01 at 09:00 (058766)

doctors: wendy said her doctor advised her to wear heels? is that right? that seems counter to what i have read. maybe a small heel lift? what i thought was the higher the heel the more weight on your toes and the more pull on the fascia? straighten me out here.

Re: First ever pod visit, need wisdom

Pauline on 9/02/01 at 09:30 (058772)

Wendy,
I think Wendyn's post says it all. Reading Scott's book will arm you with information that you need to know before your next visit and also give you conservative treatments that you can try way before you consider surgery.
My opinion on the cortisone is take it slow. No need to rush into injections. If you decide that you want to try it go ahead. You maybe be surprised about the pain. Like child birth everyone reports a different pain level and how they got through it. Your anxiety may cause you more fear than the injection causes you pain.

I don't think you mentions surgery, but if the topic comes up don't be in a hurry to hand over your feet. Do your research first then make the decision you think is best for you.

P.S. I'd opt for a good pair of running shoes before heels any day. They provide you with good support and help to take the strain off the Plantar Fascia tissue.

Re: First ever pod visit, need wisdom

Julie on 9/02/01 at 09:53 (058777)

John, I think he probably meant that absolutely flat shoes (as in cheap sneakers, with no arch support as well as no heel) aren't a good thing. I think it's more or less agreed that a low heel is best - such as one gets in a good athletic shoe. If he meant high heels as in dress shoes, there would surely be problems in following that advice. I don't think there's any doubt that they lead to shortening of the achilles tendon.

Re: First ever pod visit, need wisdom

wendyn on 9/02/01 at 09:59 (058779)

High heels also shorten the achilles tendons and calf muscles - wearing them could theoritcally take some of the pressure off the PF. A lot of women who wear heels have trouble on the weekends when they switch back to flat shoes - forcing the calf muscles and AT into a strain they're not used to.

Re: First ever pod visit, need wisdom

LauraJ on 9/02/01 at 14:30 (058814)

I agree with the others that a good athletic shoe is better than a totally flat shoe, especially if your feet pronate. Some sales associates know about orthotics and can help you find an appropriate style. I have found that SAS (San Antonio Shoes) are comfortable and accommodate the orthotics. They are not cheap ($84)and I don't know who carries them outside of Scottsdale, AZ, but they have several styles and provide a break from athletic shoes if you need to dress up a bit for the office AND take care of your feet.I was advised NEVER to wear high heels, but then my feet may differ from yours.

Regarding cortisone shots, my podiatrist will not use them on me because my feet have structural irregularities that I've had since birth. Thus the shots would not correct that. Your doctor should have a kind of X-ray machine that gives different views of your feet. That way he/she can tell what's going on inside and base the diagnosis on that as well as a gait analysis. Good luck, and I hope you have less pain soon!

Re: First ever pod visit, need wisdom

Barbara TX on 9/02/01 at 15:59 (058825)

I have to say that switching out of Birks to Danskos with a heel really helped me. Don't know why - I have good flexibilty in my achilles. B.

Re: First ever pod visit, need wisdom

john h on 9/02/01 at 17:18 (058835)

wendy from new jersey: did your doctor tell you how high a heel to wear? the orthopedic surgeon who i recently saw on tv (she also manufactures ladies shoes) said women should not wear heels higher than 2' for good foot health.

Re: First ever pod visit, need wisdom

Wendy in NJ on 9/02/01 at 17:49 (058838)

Thank you all for your wisdom! He didn't mean high high dress shoe heels but a one or two inch heel. I have read and reread Scott's book. I ice and wrap my arches and am an avid reader on here of messages. I stretch my calves and try to rest my feet when possible. I have to share something....I wore my splint all night last night AND tried the Jade twice already today and something has happened with my heel. It feels too good to be true....it used to feel literally like someone was slicing a knife through my heel and today that burning pain was not present except when driving. Hmmm, wonder what it is?

Re: First ever pod visit, need wisdom

Necee on 9/06/01 at 00:14 (059181)

Hi Wendy,
Hope that you are getting some relief from your foot pain. You asked a question about the cortisone shots hurting, well if your Dr numbs your heel first, then you wont feel a thing. I was very apprenhensive, like you I was scared to death of having the shot, but I didn't feel a thing. He put the first numbing shot into the side of my heel, all I felt was a slight sting, nothing bad and then he gave the Cortisone shot, I didn't even know he was giving it, totally pain free. My only concern for you is that you don't have too many of those shots, I've heard that no more than 3 is best. Too many can be very distructive to the fatty pad on your heel.
I only had one series of the shot and since it didn't really help that much, I won't have any more.
Hope that this helps you.
Good luck,
Necee

Re: First ever pod visit, need A NEW DOC

BrianG on 9/02/01 at 08:19 (058759)

Hi Wendy,

I'd be a little concerned about a Pod who is talking surgery on your 1st visit. There is so much to try before you get to that point. Right now you may want to try taping your feet, and looking into a good pair of orthotics. How long have you had sore heels? I'm going to stay aweay from the high heels advice, as I've never heard about that one. Are you sure this is the doc for you? Unless there is a real good reason why you are going to him, I think I'd keep looking. This man is too eager to start cutting, and filling his wallet !! Good luck

BCG

PS Are you working? Your going to want to give your feet a break, no matter what the treatment is.

Re: First ever pod visit, need wisdom

Julie on 9/02/01 at 08:41 (058762)

Wendy, in my view, the first thing any podiatrist should do, before recommending anything, let alone a cortisone shot, is a thorough examination and evaluation of your problem. That should include a gait analysis, where you are watched and possibly videod walking on a treadmill, to determine if there are any biomechanical faults that could be corrected with custom orthotics. It should also include flexibility texting to determine if shortened achilles tendons and calf muscles are contributing to your problem.

All this would be followed by a (hopefully) accurate diagnosis. Is it PF? Is it only PF or are other structures involved? When the condition is diagnosed and its cause identified, the doctor is then in a position to propose a comprehensive package of treatments to address it.

Unless you haven't told us everything, it sounds from your post as though this hasn't happened. But I would rather wait for one of the doctors here to advise you on whether or not to seek out another practitioner.

I think he is right about absolutely flat shoes not being a good idea. But good athletic shoes - at least the ones made for walking/hiking - have an elevated heel, and will offer your feet better support than a dress shoe. (Bear in mind that if it is established that you need orthotics, your shoes have to be able to accommodate them.)

If you're going to stick with this doctor (and even if you aren't) you should educate yourself as much as possible. Have you read the heel pain book yet? Do: it's a storehouse of information, armed with which you may be able to educate him into doing the right thing by you.

Re: First ever pod visit, need wisdom

wendyn on 9/02/01 at 08:47 (058764)

I'd be a little concerned about the recommendation to wear heels. I know that heels made my PF feel a bit better - but high heels can also cause all kinds of other foot problems. Flat shoes are lousy too - but there are lots of good athletic shoes and/or orthotics that should be what you need. I am still looking for decent dress shoes my self - so I can't help you there!

Re: First ever pod visit, need wisdom

john h on 9/02/01 at 09:00 (058766)

doctors: wendy said her doctor advised her to wear heels? is that right? that seems counter to what i have read. maybe a small heel lift? what i thought was the higher the heel the more weight on your toes and the more pull on the fascia? straighten me out here.

Re: First ever pod visit, need wisdom

Pauline on 9/02/01 at 09:30 (058772)

Wendy,
I think Wendyn's post says it all. Reading Scott's book will arm you with information that you need to know before your next visit and also give you conservative treatments that you can try way before you consider surgery.
My opinion on the cortisone is take it slow. No need to rush into injections. If you decide that you want to try it go ahead. You maybe be surprised about the pain. Like child birth everyone reports a different pain level and how they got through it. Your anxiety may cause you more fear than the injection causes you pain.

I don't think you mentions surgery, but if the topic comes up don't be in a hurry to hand over your feet. Do your research first then make the decision you think is best for you.

P.S. I'd opt for a good pair of running shoes before heels any day. They provide you with good support and help to take the strain off the Plantar Fascia tissue.

Re: First ever pod visit, need wisdom

Julie on 9/02/01 at 09:53 (058777)

John, I think he probably meant that absolutely flat shoes (as in cheap sneakers, with no arch support as well as no heel) aren't a good thing. I think it's more or less agreed that a low heel is best - such as one gets in a good athletic shoe. If he meant high heels as in dress shoes, there would surely be problems in following that advice. I don't think there's any doubt that they lead to shortening of the achilles tendon.

Re: First ever pod visit, need wisdom

wendyn on 9/02/01 at 09:59 (058779)

High heels also shorten the achilles tendons and calf muscles - wearing them could theoritcally take some of the pressure off the PF. A lot of women who wear heels have trouble on the weekends when they switch back to flat shoes - forcing the calf muscles and AT into a strain they're not used to.

Re: First ever pod visit, need wisdom

LauraJ on 9/02/01 at 14:30 (058814)

I agree with the others that a good athletic shoe is better than a totally flat shoe, especially if your feet pronate. Some sales associates know about orthotics and can help you find an appropriate style. I have found that SAS (San Antonio Shoes) are comfortable and accommodate the orthotics. They are not cheap ($84)and I don't know who carries them outside of Scottsdale, AZ, but they have several styles and provide a break from athletic shoes if you need to dress up a bit for the office AND take care of your feet.I was advised NEVER to wear high heels, but then my feet may differ from yours.

Regarding cortisone shots, my podiatrist will not use them on me because my feet have structural irregularities that I've had since birth. Thus the shots would not correct that. Your doctor should have a kind of X-ray machine that gives different views of your feet. That way he/she can tell what's going on inside and base the diagnosis on that as well as a gait analysis. Good luck, and I hope you have less pain soon!

Re: First ever pod visit, need wisdom

Barbara TX on 9/02/01 at 15:59 (058825)

I have to say that switching out of Birks to Danskos with a heel really helped me. Don't know why - I have good flexibilty in my achilles. B.

Re: First ever pod visit, need wisdom

john h on 9/02/01 at 17:18 (058835)

wendy from new jersey: did your doctor tell you how high a heel to wear? the orthopedic surgeon who i recently saw on tv (she also manufactures ladies shoes) said women should not wear heels higher than 2' for good foot health.

Re: First ever pod visit, need wisdom

Wendy in NJ on 9/02/01 at 17:49 (058838)

Thank you all for your wisdom! He didn't mean high high dress shoe heels but a one or two inch heel. I have read and reread Scott's book. I ice and wrap my arches and am an avid reader on here of messages. I stretch my calves and try to rest my feet when possible. I have to share something....I wore my splint all night last night AND tried the Jade twice already today and something has happened with my heel. It feels too good to be true....it used to feel literally like someone was slicing a knife through my heel and today that burning pain was not present except when driving. Hmmm, wonder what it is?

Re: First ever pod visit, need wisdom

Necee on 9/06/01 at 00:14 (059181)

Hi Wendy,
Hope that you are getting some relief from your foot pain. You asked a question about the cortisone shots hurting, well if your Dr numbs your heel first, then you wont feel a thing. I was very apprenhensive, like you I was scared to death of having the shot, but I didn't feel a thing. He put the first numbing shot into the side of my heel, all I felt was a slight sting, nothing bad and then he gave the Cortisone shot, I didn't even know he was giving it, totally pain free. My only concern for you is that you don't have too many of those shots, I've heard that no more than 3 is best. Too many can be very distructive to the fatty pad on your heel.
I only had one series of the shot and since it didn't really help that much, I won't have any more.
Hope that this helps you.
Good luck,
Necee