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

PF epidemic/Bay Area ESWT?/BS reimbursement

Posted by Larry H on 1/18/02 at 13:37 (070404)

It seems like everyone I talk to here has or has had plantar fasciitis. Is this an epidemic (if so, why) or just a more common problem than we realize? My feeling all along has been that doctors don't take it seriously, but if it is this common, why not? I have had PF for 2 1/2 years now and am ready to try ESWT, as everything else gives only minimal relief. Does anyone know of a Podiatrist in the SF Bay Area who is doing it? Has anyone had any luck with having Blue Shield California pay for it?

Re: PF epidemic/Bay Area ESWT?/BS reimbursement

Dr. Zuckerman on 1/18/02 at 14:34 (070415)

Hi

We have been using ESWT for the past two years with great pain resolution
I am not aware of any experienced ESWT doctors in your area . If you would like to learn about our ESWT program please feel free to contact Dr. Z at (email removed). We have many patients that fly to our office from
California

Re: PF epidemic/Bay Area ESWT?/BS reimbursement

David C. on 1/18/02 at 17:10 (070437)

Check the Healthtronics web site http://www.healthtronics.com , click on Ossatron for treatment locations in California.

Re: Ossatron now in SF CA Re: PF epidemic/Bay Area ESWT?/BS reimbursement

Donna SL on 1/19/02 at 14:21 (070533)

Larry,

There is now an Ossatron in San Francisco. It is at St Mary's hospital near GG Park I think SM's is at Stanyan, and Hayes. It is also a mobile unit. It think they have had it since Oct. I called Healthrontics, and they gave me the name of around 6, or 7 doctors in SF that have been trained, and certified to perform ESWT. There are also several more in the surrounding suburbs. Only one of the names of the doctors are printed on the Healthronics site so far, so it's important to get the names by calling Healthtronics directly.

Also, Healthtronics said they were out to talk to BS of CA, and said something like they should be approving it. I don't know how true that is but it would be worth checking in to.

I had met one one the podiatrist doing the ESWT whose name isn't published on the site yet last spring. He seems to be an excellent doctor with an extensive, impressive background. He also is an excellent diagnostician, and figured out a problem that I had in two seconds, after going undiagnosed by other doctors for almost two years.

Healthtronics should have his name. He's probably one of the top surgical pods in SF. I don't know if he would want his name published on the board, but his last name starts with J, first name initial is W. His office is right at St Marys. If you really have problems getting his name from Healthronics let me know, and I'll call his office, and ask for permission to publish his name. I may be seeing him in the next couple of weeks, and will ask him if he doesn't mind having his name referred.

Please keep me posted if you decide to pursue this.

Donna

Re: Ossatron now in SF CA Re: PF epidemic/Bay Area ESWT?/BS reimbursement

DR Zuckerman on 1/19/02 at 15:06 (070535)

Donna,
I am sure that this podiatrist won't mind his name being given out by you.
It takes time probaby for the healthronics web site to updated with certified ossatron doctors. Would you call Blue Shield and ask them if ESWT is covered. The code for ESWT plantar fascia is 00020T

Re: PF epidemic/Bay Area ESWT?/BS reimbursement

Ed Davis, DPM on 1/19/02 at 15:55 (070547)

If you do not have luck with BS of California consider the Canadian option.
Sonocur has a treatment center in Vancouver, B.C.
Ed

Re: Thanks Dr. Zuckerman Re: Ossatron now in SF CA Re: PF epidemic/Bay Area ESWT?/BS reimbursement

Donna SL on 1/19/02 at 16:42 (070557)

Dr. Zuckerman,

Thanks for the code. I was going to call Blue Shield next week, and this will help. The woman I spoke to at Healthtronics didn't have one. I'll let you know what I find out.

I'm curious if you know if having a past positive NCV test of the lateral plantar nerve, and the baxter nerve disqualifies me from considering ESWT, even if PF was also diagnosed. I was told it is considered TTS if one of the branches of the post tib nerve are entrapped. I'm around 70% to 80% better than I was last spring from conservative treatments (ART, acupuncture, meds), but would like to be 100%. I haven't had a NCV test since last April. At that time the Dr. WJ I mentioned recommended a cortisone shot, but I declined. I was going to discuss the ESWT possibility when I see him.

As far as doctor names I almost gave the name out of the pod I had been working with on orthotics over the last year, or so when someone asked for his name, but decided to ask first, and he requested that I don't put his name on the board. I'm sort of reluctant now without asking the doctors permission first. There's one doctor on the list that I would absolutely not recommend. Would you like me to email you the name of Dr. WJ?

Donna

Re: Thanks Dr. Zuckerman Re: Ossatron now in SF CA Re: PF epidemic/Bay Area ESWT?/BS reimbursement

DR Zuckerman on 1/19/02 at 19:00 (070564)

I guess some doctors are funny I would think they wouldn't mine . Especialy since you are in plain english giving them business.

Ok here is the story with TTS and ESWT. With the ossatron training and broshure it is listed as
a condition where they don't know the effect of ESWT/ossatron on so they list it is a contraindication.

Here is my experience with plantar fasciitis/ TTS and ESWT. I had one patient who had pf and TTS . I mean really bad pf and TTS. It was my opinion that the the ESWT was a waste of time due to the cause of the pf pain being TTS. There was pain at the insertion of the pf and it was trigger point pain.

The patient wanted to try ESWT his wife was very sick, he couldn't take the time away from his job . So we did ESWT and the result was no relieve . The problem didn't get worse and it didn't get better.

Hear is the problem with trying ESWT. The cost is so high that it is alot of money to try to help when the cause is the TTS. IT's ashame that you cant try ESWT and then no relief do TTS surgery.

Re: Thanks again Dr. Zuckerman Re: Ossatron now in SF CA Re: PF epidemic/Bay Area ESWT?/BS reimbursement

Donna SL on 1/19/02 at 22:46 (070600)

Dr. Z,

Thanks again for your information. Did your patient end up having TTS surgery, or other forms of treatment?

I guess the only way ESWT would be worth trying in my case is if insurance covered it. The only other option is to wait until I visit, or move over to the UK, and try the reflectron at the lower cost. My treating physiatrist isn't against me trying a cortisone shot, and feels it may help with additional improvement.

Also, I found out that there are several doctors in the East Coast that are now doing clinical trials for TTS with the Sonotron machine I had mentioned to you a while back. It's already being used in other parts of the world.

The results I'm seeing so far for TTS surgery don't look very promising in many cases, so I would just keep trying to improve more with the conservative methods. It's just such a long drawn out process, but there doesn't seem to be many alternatives.

Donna

Re: Thanks again Dr. Zuckerman Re: Ossatron now in SF CA Re: PF epidemic/Bay Area ESWT?/BS reimbursement

DR Zuckerman on 1/20/02 at 09:13 (070627)

The patient is living with the TTS. He is on a leave of absense due to his wife's sickness from work so that makes it better. This is a patient that has only one half his knee. He was too young for implant so John Hopkins orthopedic department remooved half the knee and left if that way. I still don't understand how he was able to work with the TTS. I do remember the clinical trials for the sonotron machine..

I don't have much advice. Couldn't hurt to do the local steriod injection

Re: PF epidemic/Bay Area ESWT?/BS reimbursement

john h on 1/21/02 at 10:18 (070749)

With a reported 6 million new cases of PF a year you should not be supprised.

Re: PF epidemic?

Glennx on 1/21/02 at 11:28 (070763)

What about this epidemic observation? I bought a green 4-runner five years back and soon noticed a lot more green 4-runners on the road. So it could be the 'familiarity breeds noticeability' syndrome.

But I also have appreciated the many observations on this board about feet being weakened by shoes that are 'too' supportive, thereby depriving foot muscles and other soft tissues of needed toning, stretching, and exercise.

I wore plain shoes, simple tennies, and bare feet for half a century with no problem. But a few months into wearing Ecco's, more supportive athletic shoes, and Teco sandles instead of going barefoot, I started breaking down. I switched footwear, not because I was having symptoms, but because I was persuaded by the message that more supportive shoes were better for me.

Is it possible to go in reverse? Can we train ourselves back to bare feet and be the better for it? Or once 'broken' are arches forever fatally weakened?

Re: Thanks Dr. Zuckerman Re: Ossatron now in SF CA Re: PF epidemic/Bay Area ESWT?/BS reimbursement

Larry H on 1/22/02 at 13:51 (070885)

Thanks for your great information! I would like the name of Dr. WJ in SF. I will definitely check him out. My email address is (email removed).

Re: PF epidemic?

John h on 1/26/02 at 21:52 (071477)

good question about shoes glenn. I think i really started downhill when I was prescribed hard orthotics. until then Pf was a minor annoyance. now i wear supportive shoes like the Rockport Pro Walker and some of the European shoes with semi rigid orthotics. Sort of afraid to try non supporative shoes. If the science of the cause of PF is continuous micor tears of an inflamed fascia then supportaive shoes or othototics would seem to make sense. To correct some sort of mechanical problem an orthotic would seem to make sense. But what if you have been pronating for 40 years without a problem, develop PF and then are prescribed orthotics to correct the pronation? I notice these day a zillion people as I walk behind them who really pronate as they walk- I mean to an extreme. They are not bothered by PF. The mystery continues.

Re: PF epidemic?

Julie on 1/27/02 at 03:13 (071489)

The answer to that is, I think, that PF is a repetitive motion injury. You can pronate for 40 years and then get PF not out of the blue, but as the cumulative result of pronating for 40 years.

It's the same as the person who 'suddenly' develops a prolapsed disc and acute back pain and says 'I was just bending over to take something out of the oven and this just happened!' It rarely 'just happens', though, it's generally the cumulative result of years of poor body use.

Of course PF can come on through sudden trauma, but in most people it comes on as a result of continued stress over a period of time. All those people you notice who pronate may not have PF yet, but if they go on pronating and wearing unsuitable shoes, they probably will have it eventually.

I cannot believe that wearing properly made shoes with good support can lead to muscle weakness. I can't think of a single reason why that should be so. I think that is the reddest of herrings, but am ready to be enlightened.

Re: PF epidemic/Bay Area ESWT?/BS reimbursement

JudyS on 1/27/02 at 12:19 (071524)

Larry, I remember one of my Podiatrists telling me that what seems to be a PF epidemic actually only began when our society began exercising (running, walking, etc) regularly. Those kind of exercises became the most popular ones right from the start - say, back in the mid seventies?
So, not only does PF affect lots of middle-aged baby boomers, that's the same group that pretty much started the running/walking craze.
I ran for over twenty years before getting PF. However - and here I differ just a bit from the 'repetative motion over time' theory, while I don't doubt for a second that one way PF can be brought on is through cumulative damage, I also think it can be brought on, even in light of years of exercise, through having changed something so simple as the floor one walks on (carpet to hardwood, for instance) or a new pair of running shoes or a new kind of work shoe or a new kind of exercise. Or a new job that has one on one's feet eight hours a day in addition to normal exercise habits. All of those mechanical changes can bring on the PF tendonitis - especially if neighboring muscles, etc. are not as flexible or strong as they could be. Or we can add biological theories related to auto-immune issues, arthritis, etc.!
LaurieR lives just south of the Bay Area, I think, and she really likes her Podiatrist....maybe she'll pass along his name for you.
I don't think anyone has, as yet, determined that there is a single cause.

Re: PF epidemic?

Glennx on 1/27/02 at 12:51 (071526)

Julie,
I recall a post from Dr. Ed to the effect that foot strength in undeveloped countries, where people are often barefoot, is better than our own culture's more pampered feet -- a.k.a barefoot marathon runners.

It sort of seems too like regular strength training. If I had someone spotting my bench presses, always absorbing half the weight with each push, my muscles would not gain as much inherent strength (assuming total pressed weight was my exercising limit).

I totally agree with your cumulative effect argument. And too, life on concrete, living years longer, sedentary lifestyles, extreme exercising, aggressive sports, wearing and adjusting to dozens of different shoes, ignoring trouble signs . . . lots of factors contribute.

For me too, trying to understand something persuades me that I'm doing something about it -- even when I'm too ill-informed to be right. And I will continue to wear supportive shoes. In fact intend on going after some Birks soon, largely based on your's and John H's, and others' recommendations.

Re: PF epidemic?

Glennx on 1/27/02 at 13:08 (071528)

Hey John,
I actively 'pronated' for 55 years without a problem. Then a sudden trauma tore at my fascias. To recover I probably needed more arch support to help lessen the strain on my fascias, and less activity to let them heal. Afterwards I might have merrily pronated on my way the rest of my life. (I needed more flexibility too).

Instead I soon got ice-scraper orthotics that hurt like hell. That doc insisted they were right, and I was too uninformed to insist they were wrong. Two years of ice-scraper abuse later, and a couple of weeks after finding heelspurs (I really haven't managed this well), I connected with Dr. Ed and he's been fitting me into orthotics that are way more comfortable and appropriate -- and he's been encouraging me to get more flexible. But two years of meaningful mal-treatment takes some time to overcome.

Re: PF epidemic?

John h on 1/27/02 at 18:40 (071558)

Glenn: Are your wearing semi-rigid or soft orthotics? I have worn hard.semi-rigid, and soft. Been in the semi rigid for about a year.

Re: PF epidemic?

Glennx on 1/27/02 at 18:54 (071560)

John: While in a sedentary healing mode I'm wearing off-the-shelf Superfeet in my ProWalkers. I'd characterize them as semi-rigid with a good deal of give. I believe Dr. Ed has mentioned them here before.

I had been trying, initially to continue with my ice scrapers, and in recent months with well-fitted semi-rigids. But I've come to appreciate that when my feet are healing and weak, and I'm not active enough to strengthen them, even the semi-rigids are too harsh. I sort of need arch support more than motion control right now.

As I increase mobility I expect to graduate back to the carbon semi-rigids that Dr. Ed fashioned. They're really a nice piece of work.

Re: PF epidemic/Bay Area ESWT?/BS reimbursement

Larry H on 1/29/02 at 12:24 (071793)

I am not sure I agree with the notion of PF beginning when we as a society began exercising regularly. Many people in our society have always exercised regularly as part of their work. Like my father who was a factory worker, on his feet all day, operating heavy machinery, or his father, a farmer. Or my mothers and grandmothers who kept house, took care of kids, worked in the garden and kitchen, milked cows, drove tractors, etc. None of them suffer(ed) from PF.
I think it may have more to do with my generation (baby boomers) having a more sedentary lifestyle until we decided we needed to exercise, and then did it in ways that were hard on the feet, like running and hiking. And I actually was told by one body worker that it may be due, in my case, to sitting all day in front of a computer so that my legs are not being used and stretched in a normal way. I just know that my PF started about 1 1/2 years after I started working almost exclusively in front of a computer. Who knows? Now I get up regularly and stretch them.

Re: PF epidemic/Bay Area ESWT?/BS reimbursement

JudyS on 1/29/02 at 12:31 (071794)

Larry, I think the conversation was not so much about when PF 'started', but rather when did it seem to become epidemic. I think you've hit the target squarely, as some docs have indicated also - it seemed to become 'epidemic' (for lack of a better word?) when we baby-boomers got off our duffs and started the workout craze.

Re: Ossatron treatment in Bay Area

Gurudutt S on 2/14/02 at 19:57 (073740)

I am currently seeing Dr. Lawrence Oloff in Palo Alto, CA. I have PF in both feet. I had my
right foot treated with Ossatron by Dr. Oloff at the Sequoia Hospital in Redwood City last December.
I am scheduled for the left foot in March. So far I have seen some improvement in my right foot
but I am not 100%. Brisk Walking/Jogging seems to hurt my feet still. Being on my feet for a
long time hurts too. Not sure if I need a second treatment or not. I will wait for another month or two
before going for the second treatment.
I have United Health PPO insurance and they are covering 100% of the cost :)

Re: PF epidemic/Bay Area ESWT?/BS reimbursement

Dr. Zuckerman on 1/18/02 at 14:34 (070415)

Hi

We have been using ESWT for the past two years with great pain resolution
I am not aware of any experienced ESWT doctors in your area . If you would like to learn about our ESWT program please feel free to contact Dr. Z at (email removed). We have many patients that fly to our office from
California

Re: PF epidemic/Bay Area ESWT?/BS reimbursement

David C. on 1/18/02 at 17:10 (070437)

Check the Healthtronics web site http://www.healthtronics.com , click on Ossatron for treatment locations in California.

Re: Ossatron now in SF CA Re: PF epidemic/Bay Area ESWT?/BS reimbursement

Donna SL on 1/19/02 at 14:21 (070533)

Larry,

There is now an Ossatron in San Francisco. It is at St Mary's hospital near GG Park I think SM's is at Stanyan, and Hayes. It is also a mobile unit. It think they have had it since Oct. I called Healthrontics, and they gave me the name of around 6, or 7 doctors in SF that have been trained, and certified to perform ESWT. There are also several more in the surrounding suburbs. Only one of the names of the doctors are printed on the Healthronics site so far, so it's important to get the names by calling Healthtronics directly.

Also, Healthtronics said they were out to talk to BS of CA, and said something like they should be approving it. I don't know how true that is but it would be worth checking in to.

I had met one one the podiatrist doing the ESWT whose name isn't published on the site yet last spring. He seems to be an excellent doctor with an extensive, impressive background. He also is an excellent diagnostician, and figured out a problem that I had in two seconds, after going undiagnosed by other doctors for almost two years.

Healthtronics should have his name. He's probably one of the top surgical pods in SF. I don't know if he would want his name published on the board, but his last name starts with J, first name initial is W. His office is right at St Marys. If you really have problems getting his name from Healthronics let me know, and I'll call his office, and ask for permission to publish his name. I may be seeing him in the next couple of weeks, and will ask him if he doesn't mind having his name referred.

Please keep me posted if you decide to pursue this.

Donna

Re: Ossatron now in SF CA Re: PF epidemic/Bay Area ESWT?/BS reimbursement

DR Zuckerman on 1/19/02 at 15:06 (070535)

Donna,
I am sure that this podiatrist won't mind his name being given out by you.
It takes time probaby for the healthronics web site to updated with certified ossatron doctors. Would you call Blue Shield and ask them if ESWT is covered. The code for ESWT plantar fascia is 00020T

Re: PF epidemic/Bay Area ESWT?/BS reimbursement

Ed Davis, DPM on 1/19/02 at 15:55 (070547)

If you do not have luck with BS of California consider the Canadian option.
Sonocur has a treatment center in Vancouver, B.C.
Ed

Re: Thanks Dr. Zuckerman Re: Ossatron now in SF CA Re: PF epidemic/Bay Area ESWT?/BS reimbursement

Donna SL on 1/19/02 at 16:42 (070557)

Dr. Zuckerman,

Thanks for the code. I was going to call Blue Shield next week, and this will help. The woman I spoke to at Healthtronics didn't have one. I'll let you know what I find out.

I'm curious if you know if having a past positive NCV test of the lateral plantar nerve, and the baxter nerve disqualifies me from considering ESWT, even if PF was also diagnosed. I was told it is considered TTS if one of the branches of the post tib nerve are entrapped. I'm around 70% to 80% better than I was last spring from conservative treatments (ART, acupuncture, meds), but would like to be 100%. I haven't had a NCV test since last April. At that time the Dr. WJ I mentioned recommended a cortisone shot, but I declined. I was going to discuss the ESWT possibility when I see him.

As far as doctor names I almost gave the name out of the pod I had been working with on orthotics over the last year, or so when someone asked for his name, but decided to ask first, and he requested that I don't put his name on the board. I'm sort of reluctant now without asking the doctors permission first. There's one doctor on the list that I would absolutely not recommend. Would you like me to email you the name of Dr. WJ?

Donna

Re: Thanks Dr. Zuckerman Re: Ossatron now in SF CA Re: PF epidemic/Bay Area ESWT?/BS reimbursement

DR Zuckerman on 1/19/02 at 19:00 (070564)

I guess some doctors are funny I would think they wouldn't mine . Especialy since you are in plain english giving them business.

Ok here is the story with TTS and ESWT. With the ossatron training and broshure it is listed as
a condition where they don't know the effect of ESWT/ossatron on so they list it is a contraindication.

Here is my experience with plantar fasciitis/ TTS and ESWT. I had one patient who had pf and TTS . I mean really bad pf and TTS. It was my opinion that the the ESWT was a waste of time due to the cause of the pf pain being TTS. There was pain at the insertion of the pf and it was trigger point pain.

The patient wanted to try ESWT his wife was very sick, he couldn't take the time away from his job . So we did ESWT and the result was no relieve . The problem didn't get worse and it didn't get better.

Hear is the problem with trying ESWT. The cost is so high that it is alot of money to try to help when the cause is the TTS. IT's ashame that you cant try ESWT and then no relief do TTS surgery.

Re: Thanks again Dr. Zuckerman Re: Ossatron now in SF CA Re: PF epidemic/Bay Area ESWT?/BS reimbursement

Donna SL on 1/19/02 at 22:46 (070600)

Dr. Z,

Thanks again for your information. Did your patient end up having TTS surgery, or other forms of treatment?

I guess the only way ESWT would be worth trying in my case is if insurance covered it. The only other option is to wait until I visit, or move over to the UK, and try the reflectron at the lower cost. My treating physiatrist isn't against me trying a cortisone shot, and feels it may help with additional improvement.

Also, I found out that there are several doctors in the East Coast that are now doing clinical trials for TTS with the Sonotron machine I had mentioned to you a while back. It's already being used in other parts of the world.

The results I'm seeing so far for TTS surgery don't look very promising in many cases, so I would just keep trying to improve more with the conservative methods. It's just such a long drawn out process, but there doesn't seem to be many alternatives.

Donna

Re: Thanks again Dr. Zuckerman Re: Ossatron now in SF CA Re: PF epidemic/Bay Area ESWT?/BS reimbursement

DR Zuckerman on 1/20/02 at 09:13 (070627)

The patient is living with the TTS. He is on a leave of absense due to his wife's sickness from work so that makes it better. This is a patient that has only one half his knee. He was too young for implant so John Hopkins orthopedic department remooved half the knee and left if that way. I still don't understand how he was able to work with the TTS. I do remember the clinical trials for the sonotron machine..

I don't have much advice. Couldn't hurt to do the local steriod injection

Re: PF epidemic/Bay Area ESWT?/BS reimbursement

john h on 1/21/02 at 10:18 (070749)

With a reported 6 million new cases of PF a year you should not be supprised.

Re: PF epidemic?

Glennx on 1/21/02 at 11:28 (070763)

What about this epidemic observation? I bought a green 4-runner five years back and soon noticed a lot more green 4-runners on the road. So it could be the 'familiarity breeds noticeability' syndrome.

But I also have appreciated the many observations on this board about feet being weakened by shoes that are 'too' supportive, thereby depriving foot muscles and other soft tissues of needed toning, stretching, and exercise.

I wore plain shoes, simple tennies, and bare feet for half a century with no problem. But a few months into wearing Ecco's, more supportive athletic shoes, and Teco sandles instead of going barefoot, I started breaking down. I switched footwear, not because I was having symptoms, but because I was persuaded by the message that more supportive shoes were better for me.

Is it possible to go in reverse? Can we train ourselves back to bare feet and be the better for it? Or once 'broken' are arches forever fatally weakened?

Re: Thanks Dr. Zuckerman Re: Ossatron now in SF CA Re: PF epidemic/Bay Area ESWT?/BS reimbursement

Larry H on 1/22/02 at 13:51 (070885)

Thanks for your great information! I would like the name of Dr. WJ in SF. I will definitely check him out. My email address is (email removed).

Re: PF epidemic?

John h on 1/26/02 at 21:52 (071477)

good question about shoes glenn. I think i really started downhill when I was prescribed hard orthotics. until then Pf was a minor annoyance. now i wear supportive shoes like the Rockport Pro Walker and some of the European shoes with semi rigid orthotics. Sort of afraid to try non supporative shoes. If the science of the cause of PF is continuous micor tears of an inflamed fascia then supportaive shoes or othototics would seem to make sense. To correct some sort of mechanical problem an orthotic would seem to make sense. But what if you have been pronating for 40 years without a problem, develop PF and then are prescribed orthotics to correct the pronation? I notice these day a zillion people as I walk behind them who really pronate as they walk- I mean to an extreme. They are not bothered by PF. The mystery continues.

Re: PF epidemic?

Julie on 1/27/02 at 03:13 (071489)

The answer to that is, I think, that PF is a repetitive motion injury. You can pronate for 40 years and then get PF not out of the blue, but as the cumulative result of pronating for 40 years.

It's the same as the person who 'suddenly' develops a prolapsed disc and acute back pain and says 'I was just bending over to take something out of the oven and this just happened!' It rarely 'just happens', though, it's generally the cumulative result of years of poor body use.

Of course PF can come on through sudden trauma, but in most people it comes on as a result of continued stress over a period of time. All those people you notice who pronate may not have PF yet, but if they go on pronating and wearing unsuitable shoes, they probably will have it eventually.

I cannot believe that wearing properly made shoes with good support can lead to muscle weakness. I can't think of a single reason why that should be so. I think that is the reddest of herrings, but am ready to be enlightened.

Re: PF epidemic/Bay Area ESWT?/BS reimbursement

JudyS on 1/27/02 at 12:19 (071524)

Larry, I remember one of my Podiatrists telling me that what seems to be a PF epidemic actually only began when our society began exercising (running, walking, etc) regularly. Those kind of exercises became the most popular ones right from the start - say, back in the mid seventies?
So, not only does PF affect lots of middle-aged baby boomers, that's the same group that pretty much started the running/walking craze.
I ran for over twenty years before getting PF. However - and here I differ just a bit from the 'repetative motion over time' theory, while I don't doubt for a second that one way PF can be brought on is through cumulative damage, I also think it can be brought on, even in light of years of exercise, through having changed something so simple as the floor one walks on (carpet to hardwood, for instance) or a new pair of running shoes or a new kind of work shoe or a new kind of exercise. Or a new job that has one on one's feet eight hours a day in addition to normal exercise habits. All of those mechanical changes can bring on the PF tendonitis - especially if neighboring muscles, etc. are not as flexible or strong as they could be. Or we can add biological theories related to auto-immune issues, arthritis, etc.!
LaurieR lives just south of the Bay Area, I think, and she really likes her Podiatrist....maybe she'll pass along his name for you.
I don't think anyone has, as yet, determined that there is a single cause.

Re: PF epidemic?

Glennx on 1/27/02 at 12:51 (071526)

Julie,
I recall a post from Dr. Ed to the effect that foot strength in undeveloped countries, where people are often barefoot, is better than our own culture's more pampered feet -- a.k.a barefoot marathon runners.

It sort of seems too like regular strength training. If I had someone spotting my bench presses, always absorbing half the weight with each push, my muscles would not gain as much inherent strength (assuming total pressed weight was my exercising limit).

I totally agree with your cumulative effect argument. And too, life on concrete, living years longer, sedentary lifestyles, extreme exercising, aggressive sports, wearing and adjusting to dozens of different shoes, ignoring trouble signs . . . lots of factors contribute.

For me too, trying to understand something persuades me that I'm doing something about it -- even when I'm too ill-informed to be right. And I will continue to wear supportive shoes. In fact intend on going after some Birks soon, largely based on your's and John H's, and others' recommendations.

Re: PF epidemic?

Glennx on 1/27/02 at 13:08 (071528)

Hey John,
I actively 'pronated' for 55 years without a problem. Then a sudden trauma tore at my fascias. To recover I probably needed more arch support to help lessen the strain on my fascias, and less activity to let them heal. Afterwards I might have merrily pronated on my way the rest of my life. (I needed more flexibility too).

Instead I soon got ice-scraper orthotics that hurt like hell. That doc insisted they were right, and I was too uninformed to insist they were wrong. Two years of ice-scraper abuse later, and a couple of weeks after finding heelspurs (I really haven't managed this well), I connected with Dr. Ed and he's been fitting me into orthotics that are way more comfortable and appropriate -- and he's been encouraging me to get more flexible. But two years of meaningful mal-treatment takes some time to overcome.

Re: PF epidemic?

John h on 1/27/02 at 18:40 (071558)

Glenn: Are your wearing semi-rigid or soft orthotics? I have worn hard.semi-rigid, and soft. Been in the semi rigid for about a year.

Re: PF epidemic?

Glennx on 1/27/02 at 18:54 (071560)

John: While in a sedentary healing mode I'm wearing off-the-shelf Superfeet in my ProWalkers. I'd characterize them as semi-rigid with a good deal of give. I believe Dr. Ed has mentioned them here before.

I had been trying, initially to continue with my ice scrapers, and in recent months with well-fitted semi-rigids. But I've come to appreciate that when my feet are healing and weak, and I'm not active enough to strengthen them, even the semi-rigids are too harsh. I sort of need arch support more than motion control right now.

As I increase mobility I expect to graduate back to the carbon semi-rigids that Dr. Ed fashioned. They're really a nice piece of work.

Re: PF epidemic/Bay Area ESWT?/BS reimbursement

Larry H on 1/29/02 at 12:24 (071793)

I am not sure I agree with the notion of PF beginning when we as a society began exercising regularly. Many people in our society have always exercised regularly as part of their work. Like my father who was a factory worker, on his feet all day, operating heavy machinery, or his father, a farmer. Or my mothers and grandmothers who kept house, took care of kids, worked in the garden and kitchen, milked cows, drove tractors, etc. None of them suffer(ed) from PF.
I think it may have more to do with my generation (baby boomers) having a more sedentary lifestyle until we decided we needed to exercise, and then did it in ways that were hard on the feet, like running and hiking. And I actually was told by one body worker that it may be due, in my case, to sitting all day in front of a computer so that my legs are not being used and stretched in a normal way. I just know that my PF started about 1 1/2 years after I started working almost exclusively in front of a computer. Who knows? Now I get up regularly and stretch them.

Re: PF epidemic/Bay Area ESWT?/BS reimbursement

JudyS on 1/29/02 at 12:31 (071794)

Larry, I think the conversation was not so much about when PF 'started', but rather when did it seem to become epidemic. I think you've hit the target squarely, as some docs have indicated also - it seemed to become 'epidemic' (for lack of a better word?) when we baby-boomers got off our duffs and started the workout craze.

Re: Ossatron treatment in Bay Area

Gurudutt S on 2/14/02 at 19:57 (073740)

I am currently seeing Dr. Lawrence Oloff in Palo Alto, CA. I have PF in both feet. I had my
right foot treated with Ossatron by Dr. Oloff at the Sequoia Hospital in Redwood City last December.
I am scheduled for the left foot in March. So far I have seen some improvement in my right foot
but I am not 100%. Brisk Walking/Jogging seems to hurt my feet still. Being on my feet for a
long time hurts too. Not sure if I need a second treatment or not. I will wait for another month or two
before going for the second treatment.
I have United Health PPO insurance and they are covering 100% of the cost :)