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PF Frustration

Posted by Missy on 3/05/02 at 15:08 (075753)

I have had diagnosed PF for nearly 9 months. I've done the stretches, the ice, new shoes, shoe inserts, taping, Celebrex and 1 cortosteroid injection. The pain has not gotten any better, in fact it has changed. I now don't have that severe pain first thing in the morning, just really sore but by lunchtime I'm in the burning and knife stabbing stage and by the time I go home, my foot hurts so bad I have a hard time standing in the kitchen long enough to cook dinner. My doctor doesn't seem very aggressive. Should I urge him to think about casting. I certainly want to avoid surgery if at all possible but I am so tired of hurting. Any advise out there?

Re: PF Frustration

Carmen H on 3/05/02 at 16:37 (075755)

I would definitely ask for Physical Therapy. You could also get another opinion and see if you are qualified for ESWT.
You will get tons of idea by just reading this message board........
good luck!

Re: PF Frustration

Ed Davis, DPM on 3/05/02 at 21:49 (075786)

Sometimes it is not just which modalities which are done but how the modalities are done and combined that make a difference.
One of the biggest factors in recalcitrant plantar fasciitis is a tight heel cord/achilles. It is important to know your ankle dorsiflexion range of motion. What type of shoe inserts are you using? Shoes?
Ed

Re: PF Frustration

john h on 3/06/02 at 09:06 (075815)

Missy: I would consider switching Doctors if you do not feel you are getting the full attention of your Doctor. What kind of Doctor are you seeing? Is he a General Practioner, Podiatrist, or Orthopedic Foot and Ankle Surgeon? Generally speaking a Family Doctor is not as good at treating a chroic PF problem as one of the above. From your post there are many other treatments available for you. What kind of strethes do you do? What kind of inserts (off the shelf or custom) do you wear, what kind of shoes do you wear?

Re: PF Frustration

BrianG on 3/06/02 at 13:36 (075840)

Don't forget taping, it can help quite a bit.

Re: PF Frustration

Missy on 3/07/02 at 10:38 (075897)

I am currently seeing a doctor of podiatry. I have done towel curls, shin curls, calf streches, slant board stretches. I have tried several off the shelf inserts the problem being that I am very flat-footed and arch supports cause quite a bit of discomfort. I have been wearing Nike or Riddell Air Pac tennis shoes which seem to be the most comfortable and supportive shoes for me. I wear these shoes all the time, I do not go barefooted anymore. I have a return visit to the doctor today, hopefully we will come up with some type of solution!! Thanks for your input!

Re: PF Frustration

Monte on 3/07/02 at 12:02 (075902)

Brian

How do you tape? 2 strip method from ball to heel? or across the arches from ball to heel. is there a difference in the benefit? I know heel to toe takes pressure off the fascia...does the across method do the same?
thanks..monte

Re: PF Frustration

BrianG on 3/07/02 at 16:05 (075919)

Hi Monte,

I normaly use the two strips method, right down the middle of my foot, to the heel. If I know I'll be torturing my feet by standing on them more than usual, I'll use the cross over method, with a couple wraps around the whole foot. Just like my Pod first used on me. It almost works too good, as there isn't much play at all. I usually don't neeed that much tape though. I buy sports tape, 1.5' wide, for the two strips.

BrianG

PS If we could get the Pod's to write a script for it, we could write it off on our tax's :*)

Re: PF Frustration

Monte on 3/07/02 at 16:19 (075920)

Brian

I use the 2 strip down the middle...sometimes it is a little uncomfortable because it pulls on the ball of the foot. What is the cross over method? Is that when you go around the heel to the big toe and then the little toe?

I know what you mean about the expense of taping...i buy it by the box!
Hopefully one day we can look back and smile at all this and say it was worth the money to get better.

Re: PF Frustration

Ed Davis on 3/07/02 at 17:17 (075922)

Orthotics do not have to place a lot of pressure in the arch to be effective, unlike arch supports. Has your podiatrist made you custom molded orthotics? What type of physical therapy has been used?
The shoes you are using may be too soft, that is, they allow the plantar fascial tension to increase too much. I have not seen your feet but most people with plantar fasciitis need a much more supportive shoe.
Ed

Re: PF Frustration

BrianG on 3/07/02 at 21:56 (075932)

You got it. Lastly I wind the tape around a couple times, starting at my fore-foot, back to the arch. The foot really becomes immoble at that point :*)

I hardley ever do it though, except the 6 or 7 times I go bass fishing each summer. Like I sad, 95% of the time, it's just the two strips. And ya, it can tug at the ball of your foot! Good to take breaks from taping, let the skin heal up.

BrianG

Re: Monte - taping

Julie on 3/08/02 at 02:17 (075939)

Hi Monte

I wonder, since you've asked this question before, whether you saw my post a couple of weeks ago. In case you didn't, I'll repeat. If the tape pulls on the ball of your foot, it's possible that you're applying it too tightly. It can take quite a bit of experimentation to get the tension right: too tight, and it pulls and may even hurt; too loose and it doesn't give the support you need.

For me, the right tension was achieved by holding my foot in a gently dorsiflexed position. When I held my foot in neutral, the tape was much too tight when I stood up. Different people may need to hold the foot differently - but you do need to experiment to discover what works for you.

You could also try a different brand of tape. I thought Leuko tape was excellent: strong, supportive, and it held its tension through a full day's activities, unlike some that lose it after an hour or so. It's made in Europe, but you can get it in the States - John H posted a link to a website that offers it.

You need breaks to allow the skin to breathe, as Brian says, so don't leave the tape on overnight. Also, don't let it get wet.

I hope this is helpful.

Re: Monte - taping

Monte on 3/08/02 at 07:35 (075941)

Julie...Thanks. I did read you last post and tried yuor method of flexing my foot while taping and it did help. I don't always tape because I sit at my desk almost all day and my commute to work is only 45 minutes and most of it is sitting on a train. I tape when I hurt alot. I was also interested in taping to play golf. I though I might need a more restricting tape job. I will practice before golf season starts. I practice with paper tape since it costs a little less. I do use the tape that you and John H mentioned. Thanks again

Re: Monte - taping

wendyn on 3/08/02 at 07:49 (075942)

Monte - my doctor recommends plain old hockey white tape. I've used it, it works and it's cheap.

Re: PF Frustration

john h on 3/08/02 at 09:21 (075947)

Monte: When I tape I use two strips toe to heel but I put the tape towards the outer edge of the foot. They do not cross but come together at the heel since I use 2 1/2' tape. I only run the tap up the bac of the heel about 1/2 inch as I found if I run it up to far it causes a little problem with the achilles. I am sold on Leuko tape even though I have to order it.

Re: Monte - taping

john h on 3/08/02 at 09:27 (075948)

Wendy: You Canadians relate everything to Hockey. So you got another gold medal. Monte go for the Leuko Tape-

Re: PF Frustration

Monte on 3/08/02 at 09:28 (075949)

John..I think I tape the same as you with the Leuko tape, except I do not go up the back of the heel. I bought the tape on-line too. Need to order more soon. How tight do you pull the tape? I don't pull too tight, just enough for some refief on the fascia.

Re: Monte - taping

Julie on 3/08/02 at 11:58 (075953)

Agreed, John!

And I agree with you too about not crossing the strips, and not taking the tape too far up the back of the heel.

Re: PF Frustration

john h on 3/08/02 at 12:54 (075960)

Monte I think it was Julie who suggested that I flex my foot up as I apply the tape. That way when my foot goes neutral it is not to tight. I just barely bring it up over the back of the heel. As little as possible. I order it from GNC at $7.95 a roll. Just got 4 rolls in the mail today. They are actually a wholesale medical supplier but have been kind enouhg to sell it to me when I told them I could not find it locally. Once again the fair Julie put me onto this tape. Where do you order yours online? When I first started taping I would remove it by ripping it off very fast as it tickled the bottom of my feet. One day I ripped off a little piece of skin with it so I now remove it more cautiously. I also bought a container of spray adhesive remover from the same company which seems to last forever. I do not tape every day but sort of off and on depending on what I am going to do.

Re: PF Frustration

Monte on 3/08/02 at 14:26 (075966)

John..i actually pay over $12 a roll...what is your website to order from?
I also use something called Cover Roll which is a stretch adhesive gauze like tape that is easy on the skin. I use it under the Leuko tape. That's how they did it to me in PT.

Re: 200mph tape

BrianG on 3/08/02 at 21:30 (075997)

I'm trying to get up the nerve to try duct tape! :*)
I don't bother with paper tape, doesn't hold long enough for me.

Re: Monte - taping

RonC on 3/11/02 at 14:24 (076181)

Monte, I have been reading this message board off and on for the past two months. I also have been taping with the two tape method along the bottom of the foot. I also am getting ready for golf season and the foot that has been diagnosed as PF is my pivot foot (right for right handed swing). Could you describe the additional step of taping that might provide more support.

Re: Monte - taping

Monte on 3/11/02 at 15:07 (076186)

Hey Ron..I have it in both feet. I tape with the 2 strip method. I sometimes switch over the low dye method which entails taping across the sole of the foot from the heel to just before the ball of the foot. This is more of a runners tape job. You have to apply the tape to the outer edge of the foot and pull inwards as you tape. I think the ball to heel method gives the fascia more relief. I am not sure which way to tape to play golf. I have to ask my doctor when i see him again. Soon.

Re: Monte - taping

john h on 3/12/02 at 09:42 (076253)

Ron: I was a golfer but have not played since PF. I have not even tried it. When you swing and follow through you normally come up on your toes on your right foot on follow through (right handed). This would not seem to be good for PF. The more flatfooted you can swing the better for your PF. I just commented the other day that Jose Olathabal had missed two years on the tour with foot problems. I bet it was PF. Heard it was so bad he had trouble walking to bathroom.

Re: Monte - taping

monte on 3/12/02 at 09:50 (076255)

John H...I play as flatfooted as I can. A good tape job is needed in order to play. I made it through 7 18 hole games last year at what i consider my peak with PF. This year, I am think that I feel a little better as far as my pain level. I have also had alot time to stretch. I am going to use a cart all the time. My friends understand the situation. That helps.

Re: Monte - taping

John h on 3/12/02 at 14:51 (076278)

Monte: What I want to know is will it help my slice?

Re: PF Frustration

Carmen H on 3/05/02 at 16:37 (075755)

I would definitely ask for Physical Therapy. You could also get another opinion and see if you are qualified for ESWT.
You will get tons of idea by just reading this message board........
good luck!

Re: PF Frustration

Ed Davis, DPM on 3/05/02 at 21:49 (075786)

Sometimes it is not just which modalities which are done but how the modalities are done and combined that make a difference.
One of the biggest factors in recalcitrant plantar fasciitis is a tight heel cord/achilles. It is important to know your ankle dorsiflexion range of motion. What type of shoe inserts are you using? Shoes?
Ed

Re: PF Frustration

john h on 3/06/02 at 09:06 (075815)

Missy: I would consider switching Doctors if you do not feel you are getting the full attention of your Doctor. What kind of Doctor are you seeing? Is he a General Practioner, Podiatrist, or Orthopedic Foot and Ankle Surgeon? Generally speaking a Family Doctor is not as good at treating a chroic PF problem as one of the above. From your post there are many other treatments available for you. What kind of strethes do you do? What kind of inserts (off the shelf or custom) do you wear, what kind of shoes do you wear?

Re: PF Frustration

BrianG on 3/06/02 at 13:36 (075840)

Don't forget taping, it can help quite a bit.

Re: PF Frustration

Missy on 3/07/02 at 10:38 (075897)

I am currently seeing a doctor of podiatry. I have done towel curls, shin curls, calf streches, slant board stretches. I have tried several off the shelf inserts the problem being that I am very flat-footed and arch supports cause quite a bit of discomfort. I have been wearing Nike or Riddell Air Pac tennis shoes which seem to be the most comfortable and supportive shoes for me. I wear these shoes all the time, I do not go barefooted anymore. I have a return visit to the doctor today, hopefully we will come up with some type of solution!! Thanks for your input!

Re: PF Frustration

Monte on 3/07/02 at 12:02 (075902)

Brian

How do you tape? 2 strip method from ball to heel? or across the arches from ball to heel. is there a difference in the benefit? I know heel to toe takes pressure off the fascia...does the across method do the same?
thanks..monte

Re: PF Frustration

BrianG on 3/07/02 at 16:05 (075919)

Hi Monte,

I normaly use the two strips method, right down the middle of my foot, to the heel. If I know I'll be torturing my feet by standing on them more than usual, I'll use the cross over method, with a couple wraps around the whole foot. Just like my Pod first used on me. It almost works too good, as there isn't much play at all. I usually don't neeed that much tape though. I buy sports tape, 1.5' wide, for the two strips.

BrianG

PS If we could get the Pod's to write a script for it, we could write it off on our tax's :*)

Re: PF Frustration

Monte on 3/07/02 at 16:19 (075920)

Brian

I use the 2 strip down the middle...sometimes it is a little uncomfortable because it pulls on the ball of the foot. What is the cross over method? Is that when you go around the heel to the big toe and then the little toe?

I know what you mean about the expense of taping...i buy it by the box!
Hopefully one day we can look back and smile at all this and say it was worth the money to get better.

Re: PF Frustration

Ed Davis on 3/07/02 at 17:17 (075922)

Orthotics do not have to place a lot of pressure in the arch to be effective, unlike arch supports. Has your podiatrist made you custom molded orthotics? What type of physical therapy has been used?
The shoes you are using may be too soft, that is, they allow the plantar fascial tension to increase too much. I have not seen your feet but most people with plantar fasciitis need a much more supportive shoe.
Ed

Re: PF Frustration

BrianG on 3/07/02 at 21:56 (075932)

You got it. Lastly I wind the tape around a couple times, starting at my fore-foot, back to the arch. The foot really becomes immoble at that point :*)

I hardley ever do it though, except the 6 or 7 times I go bass fishing each summer. Like I sad, 95% of the time, it's just the two strips. And ya, it can tug at the ball of your foot! Good to take breaks from taping, let the skin heal up.

BrianG

Re: Monte - taping

Julie on 3/08/02 at 02:17 (075939)

Hi Monte

I wonder, since you've asked this question before, whether you saw my post a couple of weeks ago. In case you didn't, I'll repeat. If the tape pulls on the ball of your foot, it's possible that you're applying it too tightly. It can take quite a bit of experimentation to get the tension right: too tight, and it pulls and may even hurt; too loose and it doesn't give the support you need.

For me, the right tension was achieved by holding my foot in a gently dorsiflexed position. When I held my foot in neutral, the tape was much too tight when I stood up. Different people may need to hold the foot differently - but you do need to experiment to discover what works for you.

You could also try a different brand of tape. I thought Leuko tape was excellent: strong, supportive, and it held its tension through a full day's activities, unlike some that lose it after an hour or so. It's made in Europe, but you can get it in the States - John H posted a link to a website that offers it.

You need breaks to allow the skin to breathe, as Brian says, so don't leave the tape on overnight. Also, don't let it get wet.

I hope this is helpful.

Re: Monte - taping

Monte on 3/08/02 at 07:35 (075941)

Julie...Thanks. I did read you last post and tried yuor method of flexing my foot while taping and it did help. I don't always tape because I sit at my desk almost all day and my commute to work is only 45 minutes and most of it is sitting on a train. I tape when I hurt alot. I was also interested in taping to play golf. I though I might need a more restricting tape job. I will practice before golf season starts. I practice with paper tape since it costs a little less. I do use the tape that you and John H mentioned. Thanks again

Re: Monte - taping

wendyn on 3/08/02 at 07:49 (075942)

Monte - my doctor recommends plain old hockey white tape. I've used it, it works and it's cheap.

Re: PF Frustration

john h on 3/08/02 at 09:21 (075947)

Monte: When I tape I use two strips toe to heel but I put the tape towards the outer edge of the foot. They do not cross but come together at the heel since I use 2 1/2' tape. I only run the tap up the bac of the heel about 1/2 inch as I found if I run it up to far it causes a little problem with the achilles. I am sold on Leuko tape even though I have to order it.

Re: Monte - taping

john h on 3/08/02 at 09:27 (075948)

Wendy: You Canadians relate everything to Hockey. So you got another gold medal. Monte go for the Leuko Tape-

Re: PF Frustration

Monte on 3/08/02 at 09:28 (075949)

John..I think I tape the same as you with the Leuko tape, except I do not go up the back of the heel. I bought the tape on-line too. Need to order more soon. How tight do you pull the tape? I don't pull too tight, just enough for some refief on the fascia.

Re: Monte - taping

Julie on 3/08/02 at 11:58 (075953)

Agreed, John!

And I agree with you too about not crossing the strips, and not taking the tape too far up the back of the heel.

Re: PF Frustration

john h on 3/08/02 at 12:54 (075960)

Monte I think it was Julie who suggested that I flex my foot up as I apply the tape. That way when my foot goes neutral it is not to tight. I just barely bring it up over the back of the heel. As little as possible. I order it from GNC at $7.95 a roll. Just got 4 rolls in the mail today. They are actually a wholesale medical supplier but have been kind enouhg to sell it to me when I told them I could not find it locally. Once again the fair Julie put me onto this tape. Where do you order yours online? When I first started taping I would remove it by ripping it off very fast as it tickled the bottom of my feet. One day I ripped off a little piece of skin with it so I now remove it more cautiously. I also bought a container of spray adhesive remover from the same company which seems to last forever. I do not tape every day but sort of off and on depending on what I am going to do.

Re: PF Frustration

Monte on 3/08/02 at 14:26 (075966)

John..i actually pay over $12 a roll...what is your website to order from?
I also use something called Cover Roll which is a stretch adhesive gauze like tape that is easy on the skin. I use it under the Leuko tape. That's how they did it to me in PT.

Re: 200mph tape

BrianG on 3/08/02 at 21:30 (075997)

I'm trying to get up the nerve to try duct tape! :*)
I don't bother with paper tape, doesn't hold long enough for me.

Re: Monte - taping

RonC on 3/11/02 at 14:24 (076181)

Monte, I have been reading this message board off and on for the past two months. I also have been taping with the two tape method along the bottom of the foot. I also am getting ready for golf season and the foot that has been diagnosed as PF is my pivot foot (right for right handed swing). Could you describe the additional step of taping that might provide more support.

Re: Monte - taping

Monte on 3/11/02 at 15:07 (076186)

Hey Ron..I have it in both feet. I tape with the 2 strip method. I sometimes switch over the low dye method which entails taping across the sole of the foot from the heel to just before the ball of the foot. This is more of a runners tape job. You have to apply the tape to the outer edge of the foot and pull inwards as you tape. I think the ball to heel method gives the fascia more relief. I am not sure which way to tape to play golf. I have to ask my doctor when i see him again. Soon.

Re: Monte - taping

john h on 3/12/02 at 09:42 (076253)

Ron: I was a golfer but have not played since PF. I have not even tried it. When you swing and follow through you normally come up on your toes on your right foot on follow through (right handed). This would not seem to be good for PF. The more flatfooted you can swing the better for your PF. I just commented the other day that Jose Olathabal had missed two years on the tour with foot problems. I bet it was PF. Heard it was so bad he had trouble walking to bathroom.

Re: Monte - taping

monte on 3/12/02 at 09:50 (076255)

John H...I play as flatfooted as I can. A good tape job is needed in order to play. I made it through 7 18 hole games last year at what i consider my peak with PF. This year, I am think that I feel a little better as far as my pain level. I have also had alot time to stretch. I am going to use a cart all the time. My friends understand the situation. That helps.

Re: Monte - taping

John h on 3/12/02 at 14:51 (076278)

Monte: What I want to know is will it help my slice?