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article in today's Baltimore Sun on PF

Posted by elliott on 7/30/02 at 22:58 (091065)

http://sunspot.net/features/bal-to.reimer30jul30.column?coll=bal%2Dhome%2Dcolumnists

Purports to explain why PF is far more likely to affect women. Also claims there are 2 million *new* cases each year (it doesn't say, but I think it means U.S. cases). So don't think you're unique if you have PF; just about everyone has it. TTS is far more original. :-) Another few decades, and it will be 100% of the population. Invest in Dr. Z, cause he'll soon make the S & P 500. :-)

Re: article in today's Baltimore Sun on PF

Necee on 7/31/02 at 01:07 (091077)

Thanks for the info Elliott, maybe we should buy stock in ESWT machines!!!
I've often thought about using an electric cattle prod on my feet when they are hurting!! Sure would be cheaper!!
Happy trails....

Necee

Re: One more thought: is complete rest a sure cure?

elliott on 7/31/02 at 06:59 (091091)

Not that everything in the article should be taken at face value, but it says, 'the only sure cure - complete rest - is next to impossible for those who are most at risk: athletes and mothers.' My question is, is complete rest (foot never hits the ground) indeed a sure cure? If so, how long is necessary for a given level of severity?

Just about nobody will take off two or three months from foot hitting the ground just one month into PF--but if that's a sure cure, maybe that should be recommended, given the potential lifetime trouble. (But what do you do when it comes back? Let's assume the the cause is addressed, e.g. through orthotics). But if, say, after two years of struggling with it, those two or three months will do the trick, it's something to think about. How much was Scott R charging for that hands-free crutch again? :-)

----

Re: article in today's Baltimore Sun on PF

Suzanne D on 7/31/02 at 08:31 (091113)

Thanks for posting this, Elliott. The article brings up many points worth considering. One that I never understood until I began reading on this website was well-stated:

'What women may not realize is that this injury doesn't originate in the foot. That's only where the pain is. Plantar fasciitis has its nexus in the calf muscles that are so abused by our bad shoes and our run-around lifestyle.'

While I never wore high heeled shoes, I know that I wore non-supportive shoes, shoes that were too worn, went barefoot at home, and never stretched. I walked for exercise on hard blacktop, and stood for most of the workday. Being in the majority and not being unique doesn't bother me; taking so long to get better does! :-)

The only thing about total rest is that I would think it must be coupled with stretching, or it would seem that sufferers would get worse - the way I feel after being in bed all night! However, our Carole C. probably did the most effective job of resting as much as possible, and she has progressed the most rapidly of anyone around here, so that probably tells us something!

Thanks for keeping us 'on our toes' with much useful information. I send my best wishes to your father following his open-heart surgery (I think I am correct in that; I believe I read it in another of your messages.)

Suzanne :-)

Re: article in today's Baltimore Sun on PF

Suzanne D on 7/31/02 at 08:33 (091114)

I may have been confusing earlier when I wrote '...One that I never understood until I began reading on this website was well-stated:'. Of course I meant that I didn't understand this principle until I found Heelspurs.com. But the article did a good job of pointing that out and was worth noting, I thought.

Re: thanks for the well wishes

elliott on 7/31/02 at 08:50 (091117)

My father is home (came home just 3 days following quadruple bypass!) and is doing well recuperating. In just a week, he seems just about back to normal, although he still must rest for awhile and get the usual home health visits. The surgeon told our family before the surgery that the odds for success are 98 or 99%. My first thought was 'yeah, sure.' But a research neurologist who lives across the street from me and whose upstart biotech drug company did a study on bypass told me that (barring severe complications going into it) it now really is one of the most successful surgeries out there. I wonder if we could have bypass on our feet! :-)

---

Re: thanks for the well wishes

Suzanne D on 7/31/02 at 09:24 (091122)

Yes, Elliott, heart surgery and other heart treatments seem to really have progressed through the years. I'm glad to hear that your father is doing so well! That's great news!

My father had a triple by-pass when he was 49 years old back in 1974. He was in Louisville in the hospital for a MONTH (We lived 100 miles south of there, but it was the nearest hospital able to perform a by-pass then.) He was then off work for another month or two, I believe. And his was a fairly straight-forward case as far as we knew. But there was no therapy later or exercise, etc. as is now routine, I believe. It's encouraging to see the progress in that area.

Now if there only WERE such a procedure for feet...:-)

Suzanne :-)

Re: article in today's Baltimore Sun on PF

Carole C in NOLA on 7/31/02 at 09:31 (091123)

Suzanne, you are right about having to couple stretching with rest. If you rest a lot (like I did) things tend to tighten up and need to be gently stretched using non-weightbearing stretches like Julie's stretches. Stretching is something that must be done if you rest a lot, in my opinion, because if you let things tighten up then you will surely strain something again and re-injure your feet.

I am pretty happy with my rate of recovery. Some days I feel like I'm completely back to normal, and other days I might feel a little bruised feeling or a little twinge of pain, like a 'one half' on a scale of 1-10, if I over-do.

I still wear good shoes, but then I have enough of them by now to last me quite a few years. I don't stretch any more but I have returned to my full level of activity just like before PF, so maybe all the movement is helping to keep things from tightening up. I do stretch if I feel any foot pain.

Carole C

Re: article in today's Baltimore Sun on PF

john h on 7/31/02 at 09:38 (091125)

Elliott: I have read there are 6 million new cases a year.

Re: One more thought: is complete rest a sure cure?

john h on 7/31/02 at 09:41 (091126)

The subject of complete rest has come up many times. We have had people in wheel chairs for over a year and were not cured. The downside of complete rest is atrophy of muscles and loss of cardiac fitness which may be worse than the disease you are trying to cure.

Re: so the article got the "rest" thing wrong?

elliott on 7/31/02 at 10:09 (091132)

Next thing you'll be telling me is that the 2 million figure is wrong too. :-) Now I'm starting to doubt that women make up the vast majority of cases. :-)

----

Re: but do you believe it?

elliott on 7/31/02 at 10:10 (091134)

I mean, after a short while, there will be more people in the universe with PF than people in the universe. :-)

---

Re: One more thought: is complete rest a sure cure?

Andrue on 7/31/02 at 10:52 (091141)

ISTM that complete rest such as that would result in muscle/tendond atropophy opening the door to further injury. I would have assumed that some level of exercise is needed and that the 'sure cure' would require a balancing act.

Certainly my feet are worse if I completely rest them. My current policy is not to put off doing something that involves using my feet but not to use them without a good reason either. It seems to be working well so far.

Re: One more cure is Dr Kiper's Silicone Orthtics

Ron P. on 7/31/02 at 13:53 (091159)

These liquid orthotics have cured at least 5 of us of really severe PF. It takes some time but a good adjunct to rest & inflamatories. It seems to be the massaging movement that does the trick. He will give you a 5=10 min consultation over the phone. Ask him whats his sucess record is with your specfic heel problem. The number is 800 DRKIPER. Good Luck

Re: anyone have a loaded gun I can borrow? :-) (nm)

elliott on 7/31/02 at 14:21 (091163)

.

Re: Are you planning to shoot yourself in the foot?

Julie on 7/31/02 at 17:16 (091188)

:)

Re: I wish there were a bypass surgery for feet!

Sharon W on 7/31/02 at 17:32 (091191)

Suzanne, Elliott,

I second that one! Even many MDs do not appear to realize how risky foot surgery can be. They are actually quite comfortable with sending patients for surgeries like the heart bypass, which really HAS become almost routine. I know that my own family Dr. was quite scandalized when I proved to her (by bringing in some research on the subject) how low the success rates are for TTS surgery, and how many complications can arise. She had sent various patients to surgeons for carpal tunnel surgery, and had assumed that tarsal tunnel surgery must be roughly equivallent.

Sharon

Re: I wish there were a bypass surgery for feet!

Kathy G on 7/31/02 at 18:30 (091196)

Elliott,

Thanks for the article. I wish I had the nerve to send it several people (like a few I worked with) who seemed to think it PF is no big deal! I, like Suzanne, never wore those stupid high heels with pointed toes. In her case, it was because she was tall in her own right, and didn't need the shoes to add to her height. In my case, it was because I am the biggest klutz in the world and I knew I looked like an idiot in them. I did wear heels, but they were low and wide, and those dumb pointed toes just plain hurt so I avoided them at all costs. Sure worked out well for me, huh? Actually, if I had worn those kinds of shoes, I figure I probably would have developed the PF at a much younger age.

I quite agree that rest cannot be complete and total because at a certain point, atrophy will become a huge problem. Let's hear it for a bypass procedure for the feet! Of course, what would we walk on then, our hands? Nope, I have chronic tendonitis in my hand. How about our elbows?

As to women not stretching, I don't agree that it's just women who don't stretch. I think it's everyone who exercises. Most people just don't take the time to do it because they don't think it's necessary. You just have to watch the professional and college athletes to figure out how essential stretching is.

Hope your Dad continues to progress well. Isn't it amazing what they can do nowadays?

Re: No, my head. Can' t take it anymore. :-) (nm)

elliott on 7/31/02 at 22:41 (091224)

.

Re: the atrophy argument dimishes with the PF duration and severity

elliott on 8/02/02 at 07:37 (091376)

If someone's suffered for, say, a year or two, or even shorter but the case is severe, assuming (and it's a big if) complete rest will work, a few months completely off the foot and then yet another few months of careful rehab due to atrophy would be a small price to pay for a cure. OTOH, if one waits too long, by the time they reach a wheelchair state, it's often too late for rest to work. Then they have permanent atrophy.

---

Re: One more thought: is complete rest a sure cure?

Lara T on 8/02/02 at 08:09 (091386)

Actually, there is a group of people who take two or three months off their feet (some a lifetime) and I've considered joining them before getting some relief from my compression socks - that is those who live in wheelchairs. Two to three months in a wheelchair could be difficult to finagle (particularly those of us in two story homes) but it is often doable if the alternative is awful enough. I have bought a wheelchair to use on vacations for trips to zoos, museums, etc. It's a psychological barrier for me to get in it (I understand much better what it must be like for wheelchair users who are constantly having to look up, and be looked down to, to engage in conversation. It's subtle, but real. However, I've also found people are much friendlier when I'm in a wheelchair).

Also, there is a crutch called the 'I Walk Free' crutch, designed by a farmer who fell from his room. He needed to have both hands free (to tie fences, pitch bale, etc) so traditional crutches were tough. The crutch provides a platform for your knee, and then straps around your thigh & leg. Like most medical devices, it has it's drawbacks too, but it is a viable alternative for many people. And it only works if you want to stay off one foot - not both. I suppose traditional crutches would also keep you off one foot - after you build up your arm strength!

Re: so the article got the "rest" thing wrong?

Ed Davis, DPM on 8/06/02 at 22:36 (091799)

Not sure how they arrived at that figure. Keep in mind that this board puts a bias into our thinking since we are dealing with 'intractable' plantar fasciitis for the most part here. Believe it or not there really, truly are lots of cases that are self resolving or one's that are rapidly cured. My best guess is that IPF (intractable PF) makes up about 10 to 15% of cases.
Ed

Re: article in today's Baltimore Sun on PF

Necee on 7/31/02 at 01:07 (091077)

Thanks for the info Elliott, maybe we should buy stock in ESWT machines!!!
I've often thought about using an electric cattle prod on my feet when they are hurting!! Sure would be cheaper!!
Happy trails....

Necee

Re: One more thought: is complete rest a sure cure?

elliott on 7/31/02 at 06:59 (091091)

Not that everything in the article should be taken at face value, but it says, 'the only sure cure - complete rest - is next to impossible for those who are most at risk: athletes and mothers.' My question is, is complete rest (foot never hits the ground) indeed a sure cure? If so, how long is necessary for a given level of severity?

Just about nobody will take off two or three months from foot hitting the ground just one month into PF--but if that's a sure cure, maybe that should be recommended, given the potential lifetime trouble. (But what do you do when it comes back? Let's assume the the cause is addressed, e.g. through orthotics). But if, say, after two years of struggling with it, those two or three months will do the trick, it's something to think about. How much was Scott R charging for that hands-free crutch again? :-)

----

Re: article in today's Baltimore Sun on PF

Suzanne D on 7/31/02 at 08:31 (091113)

Thanks for posting this, Elliott. The article brings up many points worth considering. One that I never understood until I began reading on this website was well-stated:

'What women may not realize is that this injury doesn't originate in the foot. That's only where the pain is. Plantar fasciitis has its nexus in the calf muscles that are so abused by our bad shoes and our run-around lifestyle.'

While I never wore high heeled shoes, I know that I wore non-supportive shoes, shoes that were too worn, went barefoot at home, and never stretched. I walked for exercise on hard blacktop, and stood for most of the workday. Being in the majority and not being unique doesn't bother me; taking so long to get better does! :-)

The only thing about total rest is that I would think it must be coupled with stretching, or it would seem that sufferers would get worse - the way I feel after being in bed all night! However, our Carole C. probably did the most effective job of resting as much as possible, and she has progressed the most rapidly of anyone around here, so that probably tells us something!

Thanks for keeping us 'on our toes' with much useful information. I send my best wishes to your father following his open-heart surgery (I think I am correct in that; I believe I read it in another of your messages.)

Suzanne :-)

Re: article in today's Baltimore Sun on PF

Suzanne D on 7/31/02 at 08:33 (091114)

I may have been confusing earlier when I wrote '...One that I never understood until I began reading on this website was well-stated:'. Of course I meant that I didn't understand this principle until I found Heelspurs.com. But the article did a good job of pointing that out and was worth noting, I thought.

Re: thanks for the well wishes

elliott on 7/31/02 at 08:50 (091117)

My father is home (came home just 3 days following quadruple bypass!) and is doing well recuperating. In just a week, he seems just about back to normal, although he still must rest for awhile and get the usual home health visits. The surgeon told our family before the surgery that the odds for success are 98 or 99%. My first thought was 'yeah, sure.' But a research neurologist who lives across the street from me and whose upstart biotech drug company did a study on bypass told me that (barring severe complications going into it) it now really is one of the most successful surgeries out there. I wonder if we could have bypass on our feet! :-)

---

Re: thanks for the well wishes

Suzanne D on 7/31/02 at 09:24 (091122)

Yes, Elliott, heart surgery and other heart treatments seem to really have progressed through the years. I'm glad to hear that your father is doing so well! That's great news!

My father had a triple by-pass when he was 49 years old back in 1974. He was in Louisville in the hospital for a MONTH (We lived 100 miles south of there, but it was the nearest hospital able to perform a by-pass then.) He was then off work for another month or two, I believe. And his was a fairly straight-forward case as far as we knew. But there was no therapy later or exercise, etc. as is now routine, I believe. It's encouraging to see the progress in that area.

Now if there only WERE such a procedure for feet...:-)

Suzanne :-)

Re: article in today's Baltimore Sun on PF

Carole C in NOLA on 7/31/02 at 09:31 (091123)

Suzanne, you are right about having to couple stretching with rest. If you rest a lot (like I did) things tend to tighten up and need to be gently stretched using non-weightbearing stretches like Julie's stretches. Stretching is something that must be done if you rest a lot, in my opinion, because if you let things tighten up then you will surely strain something again and re-injure your feet.

I am pretty happy with my rate of recovery. Some days I feel like I'm completely back to normal, and other days I might feel a little bruised feeling or a little twinge of pain, like a 'one half' on a scale of 1-10, if I over-do.

I still wear good shoes, but then I have enough of them by now to last me quite a few years. I don't stretch any more but I have returned to my full level of activity just like before PF, so maybe all the movement is helping to keep things from tightening up. I do stretch if I feel any foot pain.

Carole C

Re: article in today's Baltimore Sun on PF

john h on 7/31/02 at 09:38 (091125)

Elliott: I have read there are 6 million new cases a year.

Re: One more thought: is complete rest a sure cure?

john h on 7/31/02 at 09:41 (091126)

The subject of complete rest has come up many times. We have had people in wheel chairs for over a year and were not cured. The downside of complete rest is atrophy of muscles and loss of cardiac fitness which may be worse than the disease you are trying to cure.

Re: so the article got the "rest" thing wrong?

elliott on 7/31/02 at 10:09 (091132)

Next thing you'll be telling me is that the 2 million figure is wrong too. :-) Now I'm starting to doubt that women make up the vast majority of cases. :-)

----

Re: but do you believe it?

elliott on 7/31/02 at 10:10 (091134)

I mean, after a short while, there will be more people in the universe with PF than people in the universe. :-)

---

Re: One more thought: is complete rest a sure cure?

Andrue on 7/31/02 at 10:52 (091141)

ISTM that complete rest such as that would result in muscle/tendond atropophy opening the door to further injury. I would have assumed that some level of exercise is needed and that the 'sure cure' would require a balancing act.

Certainly my feet are worse if I completely rest them. My current policy is not to put off doing something that involves using my feet but not to use them without a good reason either. It seems to be working well so far.

Re: One more cure is Dr Kiper's Silicone Orthtics

Ron P. on 7/31/02 at 13:53 (091159)

These liquid orthotics have cured at least 5 of us of really severe PF. It takes some time but a good adjunct to rest & inflamatories. It seems to be the massaging movement that does the trick. He will give you a 5=10 min consultation over the phone. Ask him whats his sucess record is with your specfic heel problem. The number is 800 DRKIPER. Good Luck

Re: anyone have a loaded gun I can borrow? :-) (nm)

elliott on 7/31/02 at 14:21 (091163)

.

Re: Are you planning to shoot yourself in the foot?

Julie on 7/31/02 at 17:16 (091188)

:)

Re: I wish there were a bypass surgery for feet!

Sharon W on 7/31/02 at 17:32 (091191)

Suzanne, Elliott,

I second that one! Even many MDs do not appear to realize how risky foot surgery can be. They are actually quite comfortable with sending patients for surgeries like the heart bypass, which really HAS become almost routine. I know that my own family Dr. was quite scandalized when I proved to her (by bringing in some research on the subject) how low the success rates are for TTS surgery, and how many complications can arise. She had sent various patients to surgeons for carpal tunnel surgery, and had assumed that tarsal tunnel surgery must be roughly equivallent.

Sharon

Re: I wish there were a bypass surgery for feet!

Kathy G on 7/31/02 at 18:30 (091196)

Elliott,

Thanks for the article. I wish I had the nerve to send it several people (like a few I worked with) who seemed to think it PF is no big deal! I, like Suzanne, never wore those stupid high heels with pointed toes. In her case, it was because she was tall in her own right, and didn't need the shoes to add to her height. In my case, it was because I am the biggest klutz in the world and I knew I looked like an idiot in them. I did wear heels, but they were low and wide, and those dumb pointed toes just plain hurt so I avoided them at all costs. Sure worked out well for me, huh? Actually, if I had worn those kinds of shoes, I figure I probably would have developed the PF at a much younger age.

I quite agree that rest cannot be complete and total because at a certain point, atrophy will become a huge problem. Let's hear it for a bypass procedure for the feet! Of course, what would we walk on then, our hands? Nope, I have chronic tendonitis in my hand. How about our elbows?

As to women not stretching, I don't agree that it's just women who don't stretch. I think it's everyone who exercises. Most people just don't take the time to do it because they don't think it's necessary. You just have to watch the professional and college athletes to figure out how essential stretching is.

Hope your Dad continues to progress well. Isn't it amazing what they can do nowadays?

Re: No, my head. Can' t take it anymore. :-) (nm)

elliott on 7/31/02 at 22:41 (091224)

.

Re: the atrophy argument dimishes with the PF duration and severity

elliott on 8/02/02 at 07:37 (091376)

If someone's suffered for, say, a year or two, or even shorter but the case is severe, assuming (and it's a big if) complete rest will work, a few months completely off the foot and then yet another few months of careful rehab due to atrophy would be a small price to pay for a cure. OTOH, if one waits too long, by the time they reach a wheelchair state, it's often too late for rest to work. Then they have permanent atrophy.

---

Re: One more thought: is complete rest a sure cure?

Lara T on 8/02/02 at 08:09 (091386)

Actually, there is a group of people who take two or three months off their feet (some a lifetime) and I've considered joining them before getting some relief from my compression socks - that is those who live in wheelchairs. Two to three months in a wheelchair could be difficult to finagle (particularly those of us in two story homes) but it is often doable if the alternative is awful enough. I have bought a wheelchair to use on vacations for trips to zoos, museums, etc. It's a psychological barrier for me to get in it (I understand much better what it must be like for wheelchair users who are constantly having to look up, and be looked down to, to engage in conversation. It's subtle, but real. However, I've also found people are much friendlier when I'm in a wheelchair).

Also, there is a crutch called the 'I Walk Free' crutch, designed by a farmer who fell from his room. He needed to have both hands free (to tie fences, pitch bale, etc) so traditional crutches were tough. The crutch provides a platform for your knee, and then straps around your thigh & leg. Like most medical devices, it has it's drawbacks too, but it is a viable alternative for many people. And it only works if you want to stay off one foot - not both. I suppose traditional crutches would also keep you off one foot - after you build up your arm strength!

Re: so the article got the "rest" thing wrong?

Ed Davis, DPM on 8/06/02 at 22:36 (091799)

Not sure how they arrived at that figure. Keep in mind that this board puts a bias into our thinking since we are dealing with 'intractable' plantar fasciitis for the most part here. Believe it or not there really, truly are lots of cases that are self resolving or one's that are rapidly cured. My best guess is that IPF (intractable PF) makes up about 10 to 15% of cases.
Ed