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Sudden onset PF, again

Posted by Walker on 5/16/02 at 15:39 (084176)

Thankyou Dr. Cozzarelli for suggesting that I get an MRI, but my question still remains: Is PF that results from an athletic strain different from PF that happens gradually? I have a sharp pain in my heel that happened as a result of a strenuous tennis match. I presume I've torn the PF where it attaches to the heel. Is this the likely diagnosis?

Re: Sudden onset PF, again

Ed Davis, DPM on 5/16/02 at 15:45 (084180)

Yes, most of the cases of plantar fasciitis that you read about here are cases of 'chronic' plantar fasciitis. There are often biomechanical and occupational considerations involved. PF that is caused by an athletic strain is 'acute' plantar fasciitis. Acute plantar fasciitis is easier to treat but occasionally can proceed to become chronic if under treated.

Your plantar fascia may be torn or just stretched/strained. More info. is needed to differentiate the two. Did you see any bruising and/or swelling?
Ed

Re: Sudden onset PF, again

Sandy H. on 5/17/02 at 09:31 (084290)

What exactly is the difference between chronic and acute? Is it just a useful marker after a certain time frame so doctors can examine biomechanical flaws or does the body give up trying to heal an injury as aggressively after a certain time? It strikes me that many people heal after a year rather than six months but does that mean they had chronic and not acute or what? If the PF heals poorly and with lots of knots is there a point at which the tissue dies and is replaced? All tissue is replaced eventually right?

Re: Sudden onset PF, again

Walker on 5/17/02 at 12:45 (084310)

Thanks for responding Dr. Davis. Finding out my PF isn't chronic (yet!)made my day. No, I don't remember seeing any bruising or swelling. At first I thought I had bruised it, so I bought better shoes and played tennis again the next week, injuring it again. That's when I started to realize it wasn't a bruise. It's been several months since I first injured it, and I have ceased all strenuous exercise, yet the pain remains. Only recently have I found out what my problem is, and only recently have I begun stretching my calf muscle, which seems to help a good deal. Also I've ceased walking barefoot, always wear soft, quality shoes, and have begun icing my heel several times a day.

Re: Sudden onset PF, again

Pamela S on 5/17/02 at 14:06 (084327)

My PF started suddenly (after a dance weekend of 3 days on carpet over concrete). You could even see a blood spot come up to the surface of the skin where I tore it. It's taken me 3 years to get it better. It would have taken less time if I had simply stopped and rested it alot more. If you are prudent, it will get better!

Re: Sudden onset PF, again

Pamela S on 5/17/02 at 14:07 (084328)

If you can feel knots, get ART - it really helps for that problem.

Re: Sudden onset PF, again

Walker on 5/17/02 at 15:41 (084347)

What's ART?

Re: Sudden onset PF, again

Ed Davis, DPM on 5/18/02 at 12:57 (084449)

Sandy:

Think of acute plantar fasciitis as a sprain of the plantar fascia which can occur in an athletic injury. A mild sprain is self limiting. A severe sprain can involve a tear but will eventually heal by itself.

Chronic plantar fasciitis generally involves no specific injury but arises from biomechanical problems which place chronic or repetetive excess strain on the plantar fascia over an extended period of time.
Ed

Re: Sudden onset PF, again

Ed Davis, DPM on 5/18/02 at 13:00 (084450)

Your plantar fasciitis was acute but since it is persisting, I would consider it to be chronic after several months. What treatments have you done so far?
Ed

Re: soft, quality shoes?

Carole C in NOLA on 5/18/02 at 15:33 (084463)

'Soft, quality shoes'?

What kind of shoes? I'm wondering if they provide adequate support and are shoes that are helpful to PF. Maybe if you let us know what kind, it will be easier to tell if your shoes are contributing to the persistence of your PF.

Some people might consider Nike Airs to be soft, quality shoes (for example) but if you go to the 'Inserts, Orthotics, Shoes' board you will find a thread where several of us sufferers and Dr. Ed discuss Nike Airs and conclude that they often are not the best of shoes for PF.

Carole C

Re: Sudden onset PF, again

Walker on 5/20/02 at 09:48 (084660)

As I only last week discovered that I have PF, I haven't done any treatments. I have ceased all strenuous activities, and I have been stretching my calf muscles several times a day, and wearing only Birkenstock and New Balance shoes. I take Ibuprofin when I remember to. From what I've read on these bulletin boards, treatments short of ESWT don't seem to work very well. True?

Re: Sudden onset PF, again

Sharon W on 5/20/02 at 10:28 (084668)

Walker,

That depends on what you mean. Certainly is no one treatment that always works, but there are many different things to try, each of which seems to make a difference for SOME people, but not for everyone. Many people seem to find that these treatments work better IN COMBINATION, than separately. A majority of people with PF DO find relief and recover from it over time if they are relible in complying with 'conservative' treatments (that means anything short of surgery or ESWT). And it sounds like you are off to a good start. Probably the MOST important thing is to find a GOOD doctor, a foot specialist like a podiatrist or an orthopod, and follow his orders and advice but don't be afraid to ask questions. I believe it is very important to be proactive in your own health care. Have you read the Heel Pain Book yet?

-- Sharon

Re: Sudden onset PF, again

Ed Davis, DPM on 5/16/02 at 15:45 (084180)

Yes, most of the cases of plantar fasciitis that you read about here are cases of 'chronic' plantar fasciitis. There are often biomechanical and occupational considerations involved. PF that is caused by an athletic strain is 'acute' plantar fasciitis. Acute plantar fasciitis is easier to treat but occasionally can proceed to become chronic if under treated.

Your plantar fascia may be torn or just stretched/strained. More info. is needed to differentiate the two. Did you see any bruising and/or swelling?
Ed

Re: Sudden onset PF, again

Sandy H. on 5/17/02 at 09:31 (084290)

What exactly is the difference between chronic and acute? Is it just a useful marker after a certain time frame so doctors can examine biomechanical flaws or does the body give up trying to heal an injury as aggressively after a certain time? It strikes me that many people heal after a year rather than six months but does that mean they had chronic and not acute or what? If the PF heals poorly and with lots of knots is there a point at which the tissue dies and is replaced? All tissue is replaced eventually right?

Re: Sudden onset PF, again

Walker on 5/17/02 at 12:45 (084310)

Thanks for responding Dr. Davis. Finding out my PF isn't chronic (yet!)made my day. No, I don't remember seeing any bruising or swelling. At first I thought I had bruised it, so I bought better shoes and played tennis again the next week, injuring it again. That's when I started to realize it wasn't a bruise. It's been several months since I first injured it, and I have ceased all strenuous exercise, yet the pain remains. Only recently have I found out what my problem is, and only recently have I begun stretching my calf muscle, which seems to help a good deal. Also I've ceased walking barefoot, always wear soft, quality shoes, and have begun icing my heel several times a day.

Re: Sudden onset PF, again

Pamela S on 5/17/02 at 14:06 (084327)

My PF started suddenly (after a dance weekend of 3 days on carpet over concrete). You could even see a blood spot come up to the surface of the skin where I tore it. It's taken me 3 years to get it better. It would have taken less time if I had simply stopped and rested it alot more. If you are prudent, it will get better!

Re: Sudden onset PF, again

Pamela S on 5/17/02 at 14:07 (084328)

If you can feel knots, get ART - it really helps for that problem.

Re: Sudden onset PF, again

Walker on 5/17/02 at 15:41 (084347)

What's ART?

Re: Sudden onset PF, again

Ed Davis, DPM on 5/18/02 at 12:57 (084449)

Sandy:

Think of acute plantar fasciitis as a sprain of the plantar fascia which can occur in an athletic injury. A mild sprain is self limiting. A severe sprain can involve a tear but will eventually heal by itself.

Chronic plantar fasciitis generally involves no specific injury but arises from biomechanical problems which place chronic or repetetive excess strain on the plantar fascia over an extended period of time.
Ed

Re: Sudden onset PF, again

Ed Davis, DPM on 5/18/02 at 13:00 (084450)

Your plantar fasciitis was acute but since it is persisting, I would consider it to be chronic after several months. What treatments have you done so far?
Ed

Re: soft, quality shoes?

Carole C in NOLA on 5/18/02 at 15:33 (084463)

'Soft, quality shoes'?

What kind of shoes? I'm wondering if they provide adequate support and are shoes that are helpful to PF. Maybe if you let us know what kind, it will be easier to tell if your shoes are contributing to the persistence of your PF.

Some people might consider Nike Airs to be soft, quality shoes (for example) but if you go to the 'Inserts, Orthotics, Shoes' board you will find a thread where several of us sufferers and Dr. Ed discuss Nike Airs and conclude that they often are not the best of shoes for PF.

Carole C

Re: Sudden onset PF, again

Walker on 5/20/02 at 09:48 (084660)

As I only last week discovered that I have PF, I haven't done any treatments. I have ceased all strenuous activities, and I have been stretching my calf muscles several times a day, and wearing only Birkenstock and New Balance shoes. I take Ibuprofin when I remember to. From what I've read on these bulletin boards, treatments short of ESWT don't seem to work very well. True?

Re: Sudden onset PF, again

Sharon W on 5/20/02 at 10:28 (084668)

Walker,

That depends on what you mean. Certainly is no one treatment that always works, but there are many different things to try, each of which seems to make a difference for SOME people, but not for everyone. Many people seem to find that these treatments work better IN COMBINATION, than separately. A majority of people with PF DO find relief and recover from it over time if they are relible in complying with 'conservative' treatments (that means anything short of surgery or ESWT). And it sounds like you are off to a good start. Probably the MOST important thing is to find a GOOD doctor, a foot specialist like a podiatrist or an orthopod, and follow his orders and advice but don't be afraid to ask questions. I believe it is very important to be proactive in your own health care. Have you read the Heel Pain Book yet?

-- Sharon