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How much help are strong foot and leg muscles re; recovery?

Posted by Ellen on 2/28/02 at 10:35 (075274)

Hi,
I feel guilty even asking this question since there are so many who are suffering more than I am now.
I have had Plantar Fasciitis for about 3 years and the pain was bad enough for a few months that I could only wear one pair of Mephisto sandals with very soft soles. Anyway, now that I have figured out what NOT to do to aggravate the condition, my feet are much better and I don't usually feel any pain except for the occasional slight twinge once in awhile. I can bicycle if I don't set the resistance on the stationary bike too high (causing too much pressure of the feet on pedals). I was formerly a person who ran 3 miles every other day and of course, I have not run for 3 years. I am extremely wary of returning to running for fear of generating a chronic condition but would like to attempt it to see what happens. My question is; Is there any benefit to strengthening the foot muscles prior to attempting a gentle jog? Is walking on a treadmill a good way to strengthen foot muscles? And does the strength of the upper leg muscles play a role in how well the foot lands? (specifically the Vastus Medialis or other quad muscles?) If there are any guidelines for determining when it's safe to attempt more activity and also what process should be followed I would love to hear. I'm a normal/below average weight and an overpronator who seems to do better without much arch support. I have seen doctors and physical therapists and yes, I would stop running if I felt even a little pain from it.
Thanks for any advice out there from anyone.
Ellen J.

Re: suggest you resume activities cautiously and gradually only

Carole C in NOLA on 2/28/02 at 12:04 (075290)

Ellen, I think that no matter what you are attempting it's best to work into it very gradually when you have PF. It has to be better to gradually start walking more before attempting to jog, rather than just jogging immediately. Wear good shoes and be careful that you are not walking on a surface that is too hard. Some treadmills provide a more 'forgiving' surface than others.

Remember that your PF may not hurt until the next day if you over-do. So, try just a little bit and see how you feel in a day or two. Be cautious so that you don't set yourself back, and remember to ice afterwards. Good luck!

Carole C

Re: suggest you resume activities cautiously and gradually only

Ellen on 2/28/02 at 13:25 (075298)

Thanks, Carol.
I will be very gradual with the process. Hopefully I won't have to ice forever. I'm not sure, but it seems that stress may have been one of the contributing factors in getting P.F. I run a business and am also a wildlife rehabilitator so in summer I'm running around like crazy feeding orphaned baby birds every half hour, cleaning cages, running a business and generally totally stressed. The P.F. seems to flare up a bit when stress levels go up. It would be interesting to see if others have the same experience.
Thanks again,
Ellen

Re: stress and PF

Carole C in NOLA on 2/28/02 at 16:36 (075316)

Ellen, you may have a good point when you relate stress to PF. I got PF for the first and only time in my life, on September 22nd (11 days after the tragedy). Like many Americans I felt depressed and couldn't sleep well for a while after Sept. 11th.

Life went on, and my PF wasn't too bad, but by Thanksgiving and Christmas holiday season my stress level could not have been worse; my life seemed to be falling apart and so many things went wrong that I could not do anything but laugh or cry. I was very depressed although I knew it was situational and temporary. I saw a doctor the day before Thanksgiving and got my custom orthotics on December 10th but my PF was utterly agonizing by then. Now, life has smoothed out, my stress level has lessened, and my feet don't hurt as much.

I'm not really sure which came first, the chicken or the egg. Did the depression and stress cause the PF, or did having PF cause me to become depressed and stressed out? Probably the answer is that it is coincidental, for the most part. But like you, I do wonder.

Carole C

Re: stress and PF

Ellen on 2/28/02 at 18:28 (075323)

Very interesting! I wish I could survey all the PF sufferers and see what portion of them have unsual amounts of stress.
My feeling is that possibly the stress comes first and makes the body more prone to things like P.F. I don't know if stress causes chemical changes that affect the body or if it causes a person to hold their body more rigidly, making them prone to injury.
Of course, feeling stressed after getting PF might then cause a vicious cycle to occur also. I'll wait and see what happens with my foot when all the orphaned baby birds, squirrels, etc. start rolling in during spring/summer. If the PF gets worse, maybe that's a sign that there's a connection. I hope yours is getting much better and that your stress level is still at a low level.
Ellen

Re: stress and PF

Pam B on 2/28/02 at 18:29 (075324)

Hey girls :) I am here to tell you stress does play a part in PF.......I asked my family doc and he told me that anytime you are stressed your muscles tense.......need I say more???????? I know when I am stressed every ailment I have ever known hurts :) wouldnt life be good if we could just eliminate stress somehow.......with all the medical technology today the only thing they can do is give you pills to try.......and the only ones that work are habit forming so they will only give you but so many........this is a crazy world we live in huh????? or is that me that is totally nuts????????? :):):)

Re: stress and PF

Pam B on 2/28/02 at 18:33 (075325)

Also, stress causes the body to release more adrenaline which speeds up the whole process.....I suffer from anxiety and now hypertension so my family doc was telling me some of these things just before my surgery when they put me on beta blockers for the blood pressure......so stress is a nasty bugger that affects the entire body.......

Re: stress and PF

Carole C in NOLA on 2/28/02 at 20:48 (075335)

That makes a lot of sense, Pam. In my case, I was shocked, stunned and in tears for a while after September 11th. Like many of us, I was glued to my TV screen. I had just started to ride my recumbent bicycle, and set it on '10' or whatever the highest tension is, and I was riding it barefoot with the seat way too far back. That was hard on my Achilles tendon as well as on my feet.

I was into a 'no pain no gain' mentality, not stopping when it hurt, and listening to the television news while I rode. The angrier I got at the terrorists, and the sadder I got about the victims, the harder and more furiously I would pedal. Not that I was doing that much exercise by most peoples' standards, but by mine I was.

I've never taken them but people say medications like Zoloft and Prozac work very well and are wonderful for depression and stress. I don't think they are habit forming, but I've never taken any. During the holiday season I was keeping a close eye on my mental state, and figured my depression and stress were a reasonable response to a series of misfortunes including PF that occurred at that time.

Otherwise, I might have asked about those medications. There's no reason to suffer with depression in the twenty-first century, I've read.

Carole C

Re: stress and PF

Ellen on 2/28/02 at 20:51 (075336)

Hi Pam,
All this makes me now wonder if consuming certain things might aggravate P.F. For instance, coffee increases the amount of adrenaline released, I think, which mimics stress if I have my info right. I have sometimes wondered if my PF seems to be worse after too much coffee or tea.
One more thing I discovered tonight (having nothing to do with stress) is that wearing the wrong pair of running shoes for even 1/2 hour can cause problems! I switched to another pair that had been in my closet, put my usual orthotics in them and went to the gym where I just did a little walking around and lifting weights (the usual). Now I'm having to ice my feet because of that. I'm tossing those shoes out for sure.
Ellen

Re: stress and PF

Pam B on 2/28/02 at 21:00 (075337)

Hi Carol, I have tried the following AD's........Buspar,Paxil,Celexa,Wellbutruin and Zoloft, I asked about Prozac but doc said no.......all of them have do side effects......I also suffer from irritable bowel following gallbladder removal and these type meds make it worse......I also suffered from tremors so bad it looked like I had Parkinsons Disease.......I gave up on all of them.......told my doc they just do not agree with me and he also agreed......for now I take xanac as needed......I try not to take them unless I am really really stressed because I hate medication......but sometimes you just have to do whatever to get through the day if ya know what I mean......it is hard when you are born in high gear......my docs exact words a couple weeks ago were 'if I ever had a patient that needed anti anxiety medication, it would be you Pam' we both laughed but we also know it is true.....oh well, we all have our issues huh???? :) and these foot problems add so much to whatever our days already hand out to us.....I am learning though.......you just have to figure out how to live with it and do the best you can.......as hard as it is, we dont have any choice huh??????? and as I have posted before.......WE ARE WOMAN AND WE RULE :) again, sorry guys :):):):):):)

Re: stress and PF

Pam B on 2/28/02 at 21:04 (075338)

I think that alot of things that we dont have a clue about affects our PF and other foot disorders.....even the pods cant be sure if you ask me.....it seems that sometimes even they grasp at straws trying to control our symptoms......
Shoes, oh my god, I have a closet full of them I cannot wear......hubby says I should have a shoe sale :) but I told him you dont know till you wear them for a few hours.......he keeps saying I should wear them in the house for a day or two and take them back but how do you explain to someone that does not suffer from bad feet it does not work that way???????? If you know of one, I am all ears :)

Re: Anxiety

wendyn on 2/28/02 at 21:07 (075339)

Does anyone have any idea of what proportion of the general population receives treatment for anxiety?

10%

20%?

This is a question, not a test!

Re: Anxiety

Pam B on 2/28/02 at 21:11 (075340)

No Wendy, I dont but it sure would be something to research huh??????? Mine began with a management job that I have since given up.....but even after the job was gone the anxiety stayed......if you find stats on it, I would be interested in seeing what the numbers were......I think we would be surprised at how high they are......have a nice evening :)

Re: Anxiety

Carole C in NOLA on 2/28/02 at 21:30 (075343)

Wendy, I don't know how many are *treated* for anxiety, but I found this very informative link in a search engine:

http://www.nimh.nih.gov/anxiety/adfacts.cfm

It says that 13.3% of people suffer from any of the various forms of anxiety, and gives a breakdown by type (panic disorder, and so on).

Carole C

Re: stress and PF

Julie on 3/01/02 at 02:34 (075350)

Stress also lowers the functioning of the immune system, which, in turn affects the body's ability to heal itself.

Re: Anxiety

wendyn on 3/01/02 at 07:29 (075358)

Thanks Carole - I found it interesting that we seem to have a disproportionate number of people here who suffer from anxiety - but maybe it is in that 13% range.

Not a scientific observation of course, because I suppose it's possible that chronic stress contributes to foot pain, or that chronic pain contributes to anxiety, or that people with anxiety are more likely to see out support groups on the web,or that women suffer from anxiety more often than men and we have more women here than men, but it seemed like an interesting observation!

Re: Stress arising from having PF

Carole C in NOLA on 3/01/02 at 08:36 (075364)

Also, the level of anxiety that is of clinical significance (and included in that 13.3%) is probably pretty high, Wendy.

PF can contribute a huge amount to stress and depression. Constant pain is very wearing, even sleeping can be difficult, and knowing our pain is a long term condition makes life seem a bit bleak. Even worse is the fact that many of us normally would deal with unhappy or stressful situations by going out and DOING something about it. When we feel unhappy, it helps to make an effort to get out of the house and participate in life more, and to exercise more, for the purpose of improving one's state of mind. PF makes this approach nearly impossible.

I have found that PF makes me feel very old, like I'm falling apart from age. I know that younger people get it too, but I still feel that way. Doctors just tell us that if we once have had PF, our feet will never be as strong again. Basically, so much for our feet, and we'd better accept it and that is that. So for me, facing one's mortality is also part of PF.

Carole C

Re: Stress arising from having PF

Julie on 3/01/02 at 11:56 (075387)

Carole, that's very true - about facing our mortality, I mean. For me, that's one of the blessings that come with any serious condition: it makes you do that. Good preparation for the real event.

Take heart about the feet, though. My feet ARE as strong as they were before I had PF. When I go to Crete, where the hill walking is very rough and steep, I can do as much as I did in the past. I hope your feet will be the same! Yes, PF can recur, and yes, we need to be aware of that, and back off if our feet start complaining, but it IS possible to resume normal activity, and I'm sure that at the rate you're going, your day will come.

Re: Stress arising from having PF

Monte on 3/01/02 at 13:38 (075403)

Julie...A question for you. First off...thank you for always being present to help answer questions and lend support to scared people...such as me.
I don't know if you know my history, but I have had PF for 14 months. I am 36yrs old. My pain is more diffused throughout the bottom of the feet. They hurt more with standing still than walking...although walking gets uncomfortable. I do all the right things and now have a good doctor. He told me that my recovery starts NOW. He is making me better orthotics than I have and confirmed my diagnosis as only PF...not TTS or PTTD. Did you have this type of general PF or was yours only in the heel? How long did it take to go away and what did you do. He told me he sees 25 people per week with this and even my kind can go away. Dr Z works with him and they did my first ESWT treatment together. Thank you for reading this.

Re: thanks, that is so encouraging!

Carole C in NOLA on 3/01/02 at 13:40 (075404)

Thank you, Julie. That is so encouraging! I knew you were a lot better, but I didn't know that you feel your feet are as strong as before PF and that your hill walking was on the same level of intensity as before. I feel like if anybody's feet can get strong again it would be mine, so what you are saying is even more encouraging than it might at first seem. I don't think I have anything fundamentally wrong with my feet or gait except PF induced by an over-zealous and under-thought out exercise program, combined with terrible shoes and so on, all at once. If my feet heal as well as yours, I could do everything I want to in life without repeating those stupid mistakes.

The past few days I have been feeling almost no pain at all, and my feet feel exceptionally relaxed. Still, they are not yet back to where they were before. It was very discouraging when my doctor essentially told me last Friday that I would have to wear my great big orthotics and humungous SAS shoes essentially for the rest of my life.

I guess I am a rebel. Although I'm not going to ever buy cheap shoes at Payless, because why tempt fate, still it would be nice to be able to eventually wear any of a variety of sensible high quality shoes that don't require a prescription, and to be able to walk a normal distance for a sedentary person my age.

I'm so glad that you post here, Julie, for several reasons but one is that you are no more in your twenties than I am. When I read that you can do hill walking in Crete like you used to do, I started to feel like maybe I'm not done for either, quite yet. I have SO much that I want to do and to experience, before I resign myself to eternity. I don't need to suddenly become an athlete, but there is more to life than sitting with my feet on bags of frozen veggies.

Remember that Blake poem that we all learned long ago, (was it 'Tiger, Tiger Burning Bright, In the Forests of the Night?') that included 'Fight, Fight! against the Dying of the Light!!!'? That's how I feel; I have weathered my MS with triumph and all the determination I can find within me. I am fighting that good fight; I want to prevail now too. I know that I have to get more mobile eventually somehow, for my health. I can't explain WHY I do, but I just sense that is true. It's like the Grim Reaper is toying with me, but I will snatch my life back from him if anyone can.

Carole C

Re: Correction: here's the poem

Carole C in NOLA on 3/01/02 at 14:01 (075405)

OK, wrong poem! That's what happens when scientists try to get poetic. But the FEELING is still there, within me. That's what I remembered, not the words. Anyway, here it the correct poem:

Do Not Go Gently Into That Night
by: Dylan Thomas

Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.

Though wise men at their end know dark is right,
Because their words had forked no lightening they
Do not go gentle into that good night.

Good men, the last wave by, crying how bright
Their frail deeds might have danced in a green bay
Rage, rage against the dying of the light.

Wild men who caught and sang the sun in flight,
And learn, too late, they grieve it on its way,
Do not go gentle into that good night.

Grave men, near death, who see with blinding sight
Blind eyes could blaze like meteors and be gay,
Rage, rage against the dying of the light.

And you, my father, there on the sad height,
Curse, less, me now with your fierce tears, I pray.
Do not go gentle into that good night.
Rage, rage against the dying of the light.

Re: Monte - an answer

Julie on 3/01/02 at 15:32 (075416)

Hi Monte

Yes, I've kept up with your story. It sounds like you've got a good doctor at last, and I'm glad your diagnosis is 'only' PF. But that can be bad enough, I know, and I really hope that you are now well on the way to recovery.

To answer your question about my PF, it was the 'classic' kind: pain on the inside of the heel, at the insertion point, worst first thing in the morning, but also painful when walking, and like yours, excruciating when standing still (which I do a lot of, teaching). It was quite severe at first, but gradually improved with rest, a clever helpful pod, heelspurs.com, icing, my yoga foot exercises, orthotics, Birkenstock Arizonas, never going barefoot, and taping. It took five months to resolve to 95% better, and I'm now (touch wood) perfectly all right, with hardly ever a twinge.

Taping was extremely helpful: I don't know if you've tried it?

I wish you better! Keep plugging, and keep cheerful. Most cases of PF do get better - especially those like yours whose 'owners' are committed to healing.

Re: Monte - an answer

Monte on 3/01/02 at 16:08 (075418)

Thanks Julie. I look forward to being painfree. I have not had a painfree day in the past 14 months. I do tape. I tape 2 strips from ball of foot to heel. Somedays I do low-dye taping across the arches. Which one is better for healing? I think ball to toe rests the fascia better...but it can hurt a little when i walk and the ball of the foot feels like it is pulling. Thanks for responding. Oh..and I also do the excercises you recommended a while ago.

Re: Stress arising from having PF

wendyn on 3/01/02 at 21:31 (075434)

Carole - I find it interesting that in a retrospective view of the last 3 years of my life, my highest anxiety/highest pain times pretty much coincide. As one increases - the other seems to as well.

Another factor may be that when I am healthier, able to exercise, have a normal life - there is less in my life that could promote stress? Who knows. I just think it's an interesting (and unexpected) correlation.

Re: Monte - an answer

Julie on 3/02/02 at 13:43 (075475)

Monte, I haven't tried low-dye taping (in fact I've never been sure what it is), only the two-strip technique, so I can't answer the question. But if your two-strip stuff hurts, and the ball of the foot feels 'pulled' it's possible that your applying the tape too tightly.

I found that if I kept my foot dorsiflexed while putting the tape on, the tension was just right when I stood up and walked. If I kept my foot in neutral, it was too tight, and pulled.

I'd suggest you try taping at different tensions, experimenting till it feels right: supportive but not so tight it hurts.

Re: Stress arising from having PF

Mahatmelissamsa on 3/02/02 at 16:53 (075481)

Thx, Julie, I needed to hear that. I am only 34 and having to cut back on walking...and trying to lose weight (lost only 10 lbs since 9/01 and have like 90 to go!) I wear supportive orthos and got one splint I need to start regularly using for night (for left foot).

I am going to go to my health club to bicycle in place...and my roomate has an extra bicycle I can use (when I am not too chicken to use it!)

It is always nice to read there is a light at the end of the tunnel.

Re: Monte - an answer

Mahatmelissamsa on 3/02/02 at 16:55 (075482)

bbv.cgi?n=75481 I put a response in the wrong area (wrote to you Julie ) and if this e-mails you, I want you to see it.

I only use orthos, no taping. Do you think I can heal just with orthos and stretching? What yoga do you do?

Re: Correction: here's the poem

Mahatmelissamsa on 3/02/02 at 16:56 (075483)

very cool poem! when was that written?

Re: chronology

Carole C in NOLA on 3/02/02 at 19:22 (075499)

Mahatmelissamsa,

Dylan Thomas was a poet of the beat generation. He wrote this poem after his father died in 1952, and he died in 1953, so I guess that the poem was written in 1952 or 1953. He led a very stormy life and it's well worth reading some of the biographies that pop up when you enter 'Dylan Thomas' into a search engine.

Carole C

Re: Mahatmelissama

Julie on 3/03/02 at 03:12 (075513)

Hi

I'm sorry, but I haven't got your whole history in my memory bank, so I can't give an answer to your question about healing with just orthotics and stretching. I'd want to know what else you've done. Also what stretching are you doing?

I teach a simple form of yoga. I try to help people learn to use their bodies correctly, learn to breathe well, and learn to relax. I enjoy practising and teaching the more physically challenging poses, but years of practice and teaching have convinced me that simple is best. What matters in yoga is not how much you can 'do', but the quality of what you're doing to yourself, and the awareness with which you do it, and your awareness of what's going on inside is deeper when you're not trying to tie yourself in knots.

It's all about awareness, really - because yoga is first and last spiritual practice, and the purpose of the physical exercises is simply to make the body healthy, balanced, stable and strong, so that it becomes a vibrant instrument and a receptive environment for spiritual growth.

Hope that answers your question about yoga. I've several times posted instructions for simple exercises for the toes and ankles, which if practised are effective at lengthening out the calf muscles and achilles tendons and strengthening the entire musculature of the feet. If you haven't seen them, do a search on 'Rudy' - I seem to remember that one of those postings was to him.

Be very careful with weight-bearing stretches: they have made lots of people worse.

Re: Stress arising from having PF

Ellen on 3/03/02 at 13:23 (075548)

Hi,
I had to add one more comment to the stress/P.F. connection (or potential connection).
While shopping for a b-day gift, my boyfriend and I parked our vehicle in a spot we had used for 10 years, not knowing that the status of the lot had changed to a private lot for residents only. While in the store we were notified that our vehicle had been towed which, of course, is aggravating. However, what made it really stressful was that we had our dogs in the car (it was a cool Vermont day and we were heading to the lake to take them for a walk ). I didn't show it on the exterior, but inwardly I was freaking out because I didn't know where the vehicle was and therefore if the dogs were OK. We sorted it all out , got the vehicle and the dogs were fine but by the time I got home my feet were in pain. I had even skipped the walk by the lake because I was so stressed. Prior to today I was pretty much in no pain at all. Of course, the pain will go away but I do wonder about the stress/P.F. connection. I'll have to give the dogs some treat other than a walk today.
Ellen

Re: suggest you resume activities cautiously and gradually only

Carole C in NOLA on 2/28/02 at 12:04 (075290)

Ellen, I think that no matter what you are attempting it's best to work into it very gradually when you have PF. It has to be better to gradually start walking more before attempting to jog, rather than just jogging immediately. Wear good shoes and be careful that you are not walking on a surface that is too hard. Some treadmills provide a more 'forgiving' surface than others.

Remember that your PF may not hurt until the next day if you over-do. So, try just a little bit and see how you feel in a day or two. Be cautious so that you don't set yourself back, and remember to ice afterwards. Good luck!

Carole C

Re: suggest you resume activities cautiously and gradually only

Ellen on 2/28/02 at 13:25 (075298)

Thanks, Carol.
I will be very gradual with the process. Hopefully I won't have to ice forever. I'm not sure, but it seems that stress may have been one of the contributing factors in getting P.F. I run a business and am also a wildlife rehabilitator so in summer I'm running around like crazy feeding orphaned baby birds every half hour, cleaning cages, running a business and generally totally stressed. The P.F. seems to flare up a bit when stress levels go up. It would be interesting to see if others have the same experience.
Thanks again,
Ellen

Re: stress and PF

Carole C in NOLA on 2/28/02 at 16:36 (075316)

Ellen, you may have a good point when you relate stress to PF. I got PF for the first and only time in my life, on September 22nd (11 days after the tragedy). Like many Americans I felt depressed and couldn't sleep well for a while after Sept. 11th.

Life went on, and my PF wasn't too bad, but by Thanksgiving and Christmas holiday season my stress level could not have been worse; my life seemed to be falling apart and so many things went wrong that I could not do anything but laugh or cry. I was very depressed although I knew it was situational and temporary. I saw a doctor the day before Thanksgiving and got my custom orthotics on December 10th but my PF was utterly agonizing by then. Now, life has smoothed out, my stress level has lessened, and my feet don't hurt as much.

I'm not really sure which came first, the chicken or the egg. Did the depression and stress cause the PF, or did having PF cause me to become depressed and stressed out? Probably the answer is that it is coincidental, for the most part. But like you, I do wonder.

Carole C

Re: stress and PF

Ellen on 2/28/02 at 18:28 (075323)

Very interesting! I wish I could survey all the PF sufferers and see what portion of them have unsual amounts of stress.
My feeling is that possibly the stress comes first and makes the body more prone to things like P.F. I don't know if stress causes chemical changes that affect the body or if it causes a person to hold their body more rigidly, making them prone to injury.
Of course, feeling stressed after getting PF might then cause a vicious cycle to occur also. I'll wait and see what happens with my foot when all the orphaned baby birds, squirrels, etc. start rolling in during spring/summer. If the PF gets worse, maybe that's a sign that there's a connection. I hope yours is getting much better and that your stress level is still at a low level.
Ellen

Re: stress and PF

Pam B on 2/28/02 at 18:29 (075324)

Hey girls :) I am here to tell you stress does play a part in PF.......I asked my family doc and he told me that anytime you are stressed your muscles tense.......need I say more???????? I know when I am stressed every ailment I have ever known hurts :) wouldnt life be good if we could just eliminate stress somehow.......with all the medical technology today the only thing they can do is give you pills to try.......and the only ones that work are habit forming so they will only give you but so many........this is a crazy world we live in huh????? or is that me that is totally nuts????????? :):):)

Re: stress and PF

Pam B on 2/28/02 at 18:33 (075325)

Also, stress causes the body to release more adrenaline which speeds up the whole process.....I suffer from anxiety and now hypertension so my family doc was telling me some of these things just before my surgery when they put me on beta blockers for the blood pressure......so stress is a nasty bugger that affects the entire body.......

Re: stress and PF

Carole C in NOLA on 2/28/02 at 20:48 (075335)

That makes a lot of sense, Pam. In my case, I was shocked, stunned and in tears for a while after September 11th. Like many of us, I was glued to my TV screen. I had just started to ride my recumbent bicycle, and set it on '10' or whatever the highest tension is, and I was riding it barefoot with the seat way too far back. That was hard on my Achilles tendon as well as on my feet.

I was into a 'no pain no gain' mentality, not stopping when it hurt, and listening to the television news while I rode. The angrier I got at the terrorists, and the sadder I got about the victims, the harder and more furiously I would pedal. Not that I was doing that much exercise by most peoples' standards, but by mine I was.

I've never taken them but people say medications like Zoloft and Prozac work very well and are wonderful for depression and stress. I don't think they are habit forming, but I've never taken any. During the holiday season I was keeping a close eye on my mental state, and figured my depression and stress were a reasonable response to a series of misfortunes including PF that occurred at that time.

Otherwise, I might have asked about those medications. There's no reason to suffer with depression in the twenty-first century, I've read.

Carole C

Re: stress and PF

Ellen on 2/28/02 at 20:51 (075336)

Hi Pam,
All this makes me now wonder if consuming certain things might aggravate P.F. For instance, coffee increases the amount of adrenaline released, I think, which mimics stress if I have my info right. I have sometimes wondered if my PF seems to be worse after too much coffee or tea.
One more thing I discovered tonight (having nothing to do with stress) is that wearing the wrong pair of running shoes for even 1/2 hour can cause problems! I switched to another pair that had been in my closet, put my usual orthotics in them and went to the gym where I just did a little walking around and lifting weights (the usual). Now I'm having to ice my feet because of that. I'm tossing those shoes out for sure.
Ellen

Re: stress and PF

Pam B on 2/28/02 at 21:00 (075337)

Hi Carol, I have tried the following AD's........Buspar,Paxil,Celexa,Wellbutruin and Zoloft, I asked about Prozac but doc said no.......all of them have do side effects......I also suffer from irritable bowel following gallbladder removal and these type meds make it worse......I also suffered from tremors so bad it looked like I had Parkinsons Disease.......I gave up on all of them.......told my doc they just do not agree with me and he also agreed......for now I take xanac as needed......I try not to take them unless I am really really stressed because I hate medication......but sometimes you just have to do whatever to get through the day if ya know what I mean......it is hard when you are born in high gear......my docs exact words a couple weeks ago were 'if I ever had a patient that needed anti anxiety medication, it would be you Pam' we both laughed but we also know it is true.....oh well, we all have our issues huh???? :) and these foot problems add so much to whatever our days already hand out to us.....I am learning though.......you just have to figure out how to live with it and do the best you can.......as hard as it is, we dont have any choice huh??????? and as I have posted before.......WE ARE WOMAN AND WE RULE :) again, sorry guys :):):):):):)

Re: stress and PF

Pam B on 2/28/02 at 21:04 (075338)

I think that alot of things that we dont have a clue about affects our PF and other foot disorders.....even the pods cant be sure if you ask me.....it seems that sometimes even they grasp at straws trying to control our symptoms......
Shoes, oh my god, I have a closet full of them I cannot wear......hubby says I should have a shoe sale :) but I told him you dont know till you wear them for a few hours.......he keeps saying I should wear them in the house for a day or two and take them back but how do you explain to someone that does not suffer from bad feet it does not work that way???????? If you know of one, I am all ears :)

Re: Anxiety

wendyn on 2/28/02 at 21:07 (075339)

Does anyone have any idea of what proportion of the general population receives treatment for anxiety?

10%

20%?

This is a question, not a test!

Re: Anxiety

Pam B on 2/28/02 at 21:11 (075340)

No Wendy, I dont but it sure would be something to research huh??????? Mine began with a management job that I have since given up.....but even after the job was gone the anxiety stayed......if you find stats on it, I would be interested in seeing what the numbers were......I think we would be surprised at how high they are......have a nice evening :)

Re: Anxiety

Carole C in NOLA on 2/28/02 at 21:30 (075343)

Wendy, I don't know how many are *treated* for anxiety, but I found this very informative link in a search engine:

http://www.nimh.nih.gov/anxiety/adfacts.cfm

It says that 13.3% of people suffer from any of the various forms of anxiety, and gives a breakdown by type (panic disorder, and so on).

Carole C

Re: stress and PF

Julie on 3/01/02 at 02:34 (075350)

Stress also lowers the functioning of the immune system, which, in turn affects the body's ability to heal itself.

Re: Anxiety

wendyn on 3/01/02 at 07:29 (075358)

Thanks Carole - I found it interesting that we seem to have a disproportionate number of people here who suffer from anxiety - but maybe it is in that 13% range.

Not a scientific observation of course, because I suppose it's possible that chronic stress contributes to foot pain, or that chronic pain contributes to anxiety, or that people with anxiety are more likely to see out support groups on the web,or that women suffer from anxiety more often than men and we have more women here than men, but it seemed like an interesting observation!

Re: Stress arising from having PF

Carole C in NOLA on 3/01/02 at 08:36 (075364)

Also, the level of anxiety that is of clinical significance (and included in that 13.3%) is probably pretty high, Wendy.

PF can contribute a huge amount to stress and depression. Constant pain is very wearing, even sleeping can be difficult, and knowing our pain is a long term condition makes life seem a bit bleak. Even worse is the fact that many of us normally would deal with unhappy or stressful situations by going out and DOING something about it. When we feel unhappy, it helps to make an effort to get out of the house and participate in life more, and to exercise more, for the purpose of improving one's state of mind. PF makes this approach nearly impossible.

I have found that PF makes me feel very old, like I'm falling apart from age. I know that younger people get it too, but I still feel that way. Doctors just tell us that if we once have had PF, our feet will never be as strong again. Basically, so much for our feet, and we'd better accept it and that is that. So for me, facing one's mortality is also part of PF.

Carole C

Re: Stress arising from having PF

Julie on 3/01/02 at 11:56 (075387)

Carole, that's very true - about facing our mortality, I mean. For me, that's one of the blessings that come with any serious condition: it makes you do that. Good preparation for the real event.

Take heart about the feet, though. My feet ARE as strong as they were before I had PF. When I go to Crete, where the hill walking is very rough and steep, I can do as much as I did in the past. I hope your feet will be the same! Yes, PF can recur, and yes, we need to be aware of that, and back off if our feet start complaining, but it IS possible to resume normal activity, and I'm sure that at the rate you're going, your day will come.

Re: Stress arising from having PF

Monte on 3/01/02 at 13:38 (075403)

Julie...A question for you. First off...thank you for always being present to help answer questions and lend support to scared people...such as me.
I don't know if you know my history, but I have had PF for 14 months. I am 36yrs old. My pain is more diffused throughout the bottom of the feet. They hurt more with standing still than walking...although walking gets uncomfortable. I do all the right things and now have a good doctor. He told me that my recovery starts NOW. He is making me better orthotics than I have and confirmed my diagnosis as only PF...not TTS or PTTD. Did you have this type of general PF or was yours only in the heel? How long did it take to go away and what did you do. He told me he sees 25 people per week with this and even my kind can go away. Dr Z works with him and they did my first ESWT treatment together. Thank you for reading this.

Re: thanks, that is so encouraging!

Carole C in NOLA on 3/01/02 at 13:40 (075404)

Thank you, Julie. That is so encouraging! I knew you were a lot better, but I didn't know that you feel your feet are as strong as before PF and that your hill walking was on the same level of intensity as before. I feel like if anybody's feet can get strong again it would be mine, so what you are saying is even more encouraging than it might at first seem. I don't think I have anything fundamentally wrong with my feet or gait except PF induced by an over-zealous and under-thought out exercise program, combined with terrible shoes and so on, all at once. If my feet heal as well as yours, I could do everything I want to in life without repeating those stupid mistakes.

The past few days I have been feeling almost no pain at all, and my feet feel exceptionally relaxed. Still, they are not yet back to where they were before. It was very discouraging when my doctor essentially told me last Friday that I would have to wear my great big orthotics and humungous SAS shoes essentially for the rest of my life.

I guess I am a rebel. Although I'm not going to ever buy cheap shoes at Payless, because why tempt fate, still it would be nice to be able to eventually wear any of a variety of sensible high quality shoes that don't require a prescription, and to be able to walk a normal distance for a sedentary person my age.

I'm so glad that you post here, Julie, for several reasons but one is that you are no more in your twenties than I am. When I read that you can do hill walking in Crete like you used to do, I started to feel like maybe I'm not done for either, quite yet. I have SO much that I want to do and to experience, before I resign myself to eternity. I don't need to suddenly become an athlete, but there is more to life than sitting with my feet on bags of frozen veggies.

Remember that Blake poem that we all learned long ago, (was it 'Tiger, Tiger Burning Bright, In the Forests of the Night?') that included 'Fight, Fight! against the Dying of the Light!!!'? That's how I feel; I have weathered my MS with triumph and all the determination I can find within me. I am fighting that good fight; I want to prevail now too. I know that I have to get more mobile eventually somehow, for my health. I can't explain WHY I do, but I just sense that is true. It's like the Grim Reaper is toying with me, but I will snatch my life back from him if anyone can.

Carole C

Re: Correction: here's the poem

Carole C in NOLA on 3/01/02 at 14:01 (075405)

OK, wrong poem! That's what happens when scientists try to get poetic. But the FEELING is still there, within me. That's what I remembered, not the words. Anyway, here it the correct poem:

Do Not Go Gently Into That Night
by: Dylan Thomas

Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.

Though wise men at their end know dark is right,
Because their words had forked no lightening they
Do not go gentle into that good night.

Good men, the last wave by, crying how bright
Their frail deeds might have danced in a green bay
Rage, rage against the dying of the light.

Wild men who caught and sang the sun in flight,
And learn, too late, they grieve it on its way,
Do not go gentle into that good night.

Grave men, near death, who see with blinding sight
Blind eyes could blaze like meteors and be gay,
Rage, rage against the dying of the light.

And you, my father, there on the sad height,
Curse, less, me now with your fierce tears, I pray.
Do not go gentle into that good night.
Rage, rage against the dying of the light.

Re: Monte - an answer

Julie on 3/01/02 at 15:32 (075416)

Hi Monte

Yes, I've kept up with your story. It sounds like you've got a good doctor at last, and I'm glad your diagnosis is 'only' PF. But that can be bad enough, I know, and I really hope that you are now well on the way to recovery.

To answer your question about my PF, it was the 'classic' kind: pain on the inside of the heel, at the insertion point, worst first thing in the morning, but also painful when walking, and like yours, excruciating when standing still (which I do a lot of, teaching). It was quite severe at first, but gradually improved with rest, a clever helpful pod, heelspurs.com, icing, my yoga foot exercises, orthotics, Birkenstock Arizonas, never going barefoot, and taping. It took five months to resolve to 95% better, and I'm now (touch wood) perfectly all right, with hardly ever a twinge.

Taping was extremely helpful: I don't know if you've tried it?

I wish you better! Keep plugging, and keep cheerful. Most cases of PF do get better - especially those like yours whose 'owners' are committed to healing.

Re: Monte - an answer

Monte on 3/01/02 at 16:08 (075418)

Thanks Julie. I look forward to being painfree. I have not had a painfree day in the past 14 months. I do tape. I tape 2 strips from ball of foot to heel. Somedays I do low-dye taping across the arches. Which one is better for healing? I think ball to toe rests the fascia better...but it can hurt a little when i walk and the ball of the foot feels like it is pulling. Thanks for responding. Oh..and I also do the excercises you recommended a while ago.

Re: Stress arising from having PF

wendyn on 3/01/02 at 21:31 (075434)

Carole - I find it interesting that in a retrospective view of the last 3 years of my life, my highest anxiety/highest pain times pretty much coincide. As one increases - the other seems to as well.

Another factor may be that when I am healthier, able to exercise, have a normal life - there is less in my life that could promote stress? Who knows. I just think it's an interesting (and unexpected) correlation.

Re: Monte - an answer

Julie on 3/02/02 at 13:43 (075475)

Monte, I haven't tried low-dye taping (in fact I've never been sure what it is), only the two-strip technique, so I can't answer the question. But if your two-strip stuff hurts, and the ball of the foot feels 'pulled' it's possible that your applying the tape too tightly.

I found that if I kept my foot dorsiflexed while putting the tape on, the tension was just right when I stood up and walked. If I kept my foot in neutral, it was too tight, and pulled.

I'd suggest you try taping at different tensions, experimenting till it feels right: supportive but not so tight it hurts.

Re: Stress arising from having PF

Mahatmelissamsa on 3/02/02 at 16:53 (075481)

Thx, Julie, I needed to hear that. I am only 34 and having to cut back on walking...and trying to lose weight (lost only 10 lbs since 9/01 and have like 90 to go!) I wear supportive orthos and got one splint I need to start regularly using for night (for left foot).

I am going to go to my health club to bicycle in place...and my roomate has an extra bicycle I can use (when I am not too chicken to use it!)

It is always nice to read there is a light at the end of the tunnel.

Re: Monte - an answer

Mahatmelissamsa on 3/02/02 at 16:55 (075482)

bbv.cgi?n=75481 I put a response in the wrong area (wrote to you Julie ) and if this e-mails you, I want you to see it.

I only use orthos, no taping. Do you think I can heal just with orthos and stretching? What yoga do you do?

Re: Correction: here's the poem

Mahatmelissamsa on 3/02/02 at 16:56 (075483)

very cool poem! when was that written?

Re: chronology

Carole C in NOLA on 3/02/02 at 19:22 (075499)

Mahatmelissamsa,

Dylan Thomas was a poet of the beat generation. He wrote this poem after his father died in 1952, and he died in 1953, so I guess that the poem was written in 1952 or 1953. He led a very stormy life and it's well worth reading some of the biographies that pop up when you enter 'Dylan Thomas' into a search engine.

Carole C

Re: Mahatmelissama

Julie on 3/03/02 at 03:12 (075513)

Hi

I'm sorry, but I haven't got your whole history in my memory bank, so I can't give an answer to your question about healing with just orthotics and stretching. I'd want to know what else you've done. Also what stretching are you doing?

I teach a simple form of yoga. I try to help people learn to use their bodies correctly, learn to breathe well, and learn to relax. I enjoy practising and teaching the more physically challenging poses, but years of practice and teaching have convinced me that simple is best. What matters in yoga is not how much you can 'do', but the quality of what you're doing to yourself, and the awareness with which you do it, and your awareness of what's going on inside is deeper when you're not trying to tie yourself in knots.

It's all about awareness, really - because yoga is first and last spiritual practice, and the purpose of the physical exercises is simply to make the body healthy, balanced, stable and strong, so that it becomes a vibrant instrument and a receptive environment for spiritual growth.

Hope that answers your question about yoga. I've several times posted instructions for simple exercises for the toes and ankles, which if practised are effective at lengthening out the calf muscles and achilles tendons and strengthening the entire musculature of the feet. If you haven't seen them, do a search on 'Rudy' - I seem to remember that one of those postings was to him.

Be very careful with weight-bearing stretches: they have made lots of people worse.

Re: Stress arising from having PF

Ellen on 3/03/02 at 13:23 (075548)

Hi,
I had to add one more comment to the stress/P.F. connection (or potential connection).
While shopping for a b-day gift, my boyfriend and I parked our vehicle in a spot we had used for 10 years, not knowing that the status of the lot had changed to a private lot for residents only. While in the store we were notified that our vehicle had been towed which, of course, is aggravating. However, what made it really stressful was that we had our dogs in the car (it was a cool Vermont day and we were heading to the lake to take them for a walk ). I didn't show it on the exterior, but inwardly I was freaking out because I didn't know where the vehicle was and therefore if the dogs were OK. We sorted it all out , got the vehicle and the dogs were fine but by the time I got home my feet were in pain. I had even skipped the walk by the lake because I was so stressed. Prior to today I was pretty much in no pain at all. Of course, the pain will go away but I do wonder about the stress/P.F. connection. I'll have to give the dogs some treat other than a walk today.
Ellen