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Pain keeps on

Posted by carrie on 8/26/02 at 10:20 (093544)

I am at my witts end here, I never thought that the pain could just keep getting worse no matter what. I have been wearing night splints, icing, resting, stretching everything I can think of and that has been advised and it just is not making a difference at all. I am ready to go crazy let me tell ya. I mean how can it just never get better? What should I do at this point? I am really upset because I feel I am going to have to give up living at this point my life sucks. I am not one that can just lay around but this pain is so bad there is not much else I can do. My right foot seems to be getting worse too, even though I have not hardly been using it. The left is about the same as always, my right foot was ok but is steadily catching up with the other one. I just don't know how to deal with this very well.

thanks for listening
c

Re: Carrie

Julie on 8/26/02 at 11:27 (093554)

Hi Carrie

After I read your latest post I searched on your name and have now re-read all your posts over the last couple of months.

Two things have leapt out at me.

In one of your posts you said that your pain is at the BACK of your heel, not on the bottom, and that it doesn't hurt when you walk, but is very tender to the touch. Has it been suggested that you may have Achilles Tendinitis and not Plantar Fasciitis? Perhaps it's time for you to seek out another podiatrist and get some new input.

The other thing that strikes me is the general tone that runs through all your posts - of wanting desperately, and trying terribly hard, to DO something to heal yourself. That's understandable, but sametimes, Carrie, we can 'do' too much. Sometimes, less is more. I get the feeling that you're driving yourself, and that some of the things you're 'doing' may not in fact be very helpful.

For example: in your latest post, you say you're 'stretching everything you can think of'. Are you doing the classic 'wall stretch' that is almost always recommended for PF? If so, it may be doing you more harm than good - even if you do have PF, and even more so if you have achilles tendinitis. But could you please describe exactly what you've been doing - what stretches, how often, and for how long? I've just got a feeling that you may be overdoing the stretching and obstructing rather than furthering your healing.

I could be wrong, but if you'd like to pursue this line of inquiry I'm happy to talk.

Re: Carrie

R C on 8/26/02 at 13:16 (093563)

Have hope. A year ago I thought I would never walk normally again, play golf, hold my infant child, or do all those ordinary things I could do with healthy feet. Today, my PF is gone and I can do anything I want (except daily running for exercise). So therefore try to keep your chin up, and keep working vigorously toward your recovery. Write in and allow us to bear some of your pain whenever you need it.

Re: Carrie

Pauline on 8/26/02 at 15:34 (093585)

Carrie, what a great post from Julie. Sometimes it takes that extra detective work to find out what is really going on. Your posts give others a chance to look in from the outside.

I think Julie gave you very sound advice. A second and sometimes a third opinion is always worth a try.

Patience is one of the first things we learn while suffering with P.F. Unfortunately there is no magic is out there to help with its cure.

I'd follow Julie's advice and seek a second opinion. There is light at the end of the tunnel, but sometimes it take all the strength we have and lots of time to get there.

Keep on posting.

Re: Carrie

carrie on 8/26/02 at 17:50 (093602)

Julie,

Thanks for your input. To be honest with you when you read some of those
posts that were from a few weeks ago things have taken a turn for the worse
for sure. For one thing I went on a trip to Reno Nevada with my husband and
did way too much walking, so I do agree that I have probably hurt myself by
over doing. As far as stretching, I am doing the ones my pod and also my
ortho dr suggested to me. They both seem to feel that I have pf although the
ortho Dr thinks yes it could be the achilles on the left foot, the right one
does not hurt at the back at all only under the heel on the left. It is bad
and agravated if I wear any kind of running shoe. I can only at this point
wear sandals, merrell ones without being a total agony at first. Anything
hurts after a short time no matter what it is. I am unable to find
comfortable shoes. ANyhow in my older post I mention it didn't hurt too much
to walk, well it certainly does now, really really really bad.

Ok so the stretches I am trying are the one where you sit down and take a
belt or whatever you have and put it under your feet and gently pull. The
other one is the wall stretch that you mention, agian these are the ones
that my Dr's have recomended to me. I live in a small town in Idaho so as
far as Dr's go (i also work at the only hospital around here) so I know all
the best Dr's and the ortho and pod I have are the best in this town. So I
don't know, if I cannot believe them what do I do?Do I seem desperate oh
yeah of course I do. I am not one to be able to lay around, not that I am
special but I am a bit of an over acheiver when it comes to exercise, many
many times I have made things worse for myself with my obsession with
working out, so I am doing pretty good this time as far as resting, but
still I am not willing to quit doing everything and besides from what I
understand rest alone will not cure this PF.

So what else would you recomend that I try? I am swimming, I am doing the
stretching probable 3 times a day, in the morning, in the afternoon and in
the evening, maybe 5 minutes, not too long. I occasionaly do pilates which
is stretching, but not weight bearing stretching, mostly gentle stuff that I
am sure is not causing the pain to get worse. If anything is, my guess is
that I am just not resting enough. What to do? I have a job I really like, I
am so depressed that I might not be able to work I don't know what to do.

anyhow thanks for caring.

Carrie

Re: Carrie

carrie on 8/26/02 at 17:59 (093603)

I have already had several opinions from several Dr's so I don't believe my answer lies there at all. I am in a small town in Idaho and am running out of options for Dr's here. Not only that but the ortho and the pod that I have are the best around. If I cannot trust them then who can I trust?

I am super sad and depressed and feeling sorry for myself right now which may not do me any good but oh well, big pity party right now. I just can't believe that one little foot problem can mess up my whole entire life.

I had plans to go to a concert this weekend, I don't see how I can possibly go like this.
oh well, enough of my whining

Re: Carrie

Suzanne D on 8/26/02 at 19:39 (093614)

Dear Carrie,

I am so sorry that you are in worse pain and - naturally - depressed. So many of us can identify with you. Sometimes coming here and letting it out can be the difference in getting through the tough times. Keep posting!

If you haven't already read this link, please take time to read these stretches that Julie, who has written to you in this thread, posted earlier. Thank you, Carole, for providing this link which I am now pasting in this post!

bbv.cgi?n=91080

A year ago, I was in very real pain with each step. I remember the Saturday last September when I went to my daughter's college band parent recognition day. I didn't think I would make it across the field. I took two different pairs of shoes with me. etc. and barely made it. I remember how depressed I was.

There was never a 'magic day' when everything got better. But gradually I did, and now I am looking forward to the same parent weekend next month!

I did most of the things my pod said, but followed Julie's stretches instead of the wall and stair stretches he recommended. I rested as much as I could, iced a lot, taped (still do sometimes), wore Birks and Birk inserts in SAS shoes (still do), took Naproxin, and stretched. I am thankful for my improvement, but it was very slow. It is easy to get discouraged.

Hang in there! I hope you find some improvement soon! I also understand about having a job you love and also need to keep. I am a first grade teacher and have to be on my feet a lot.

Take care,
Suzanne :-)

Re: Carrie

BrianG on 8/26/02 at 21:08 (093621)

Hi Carrie,

Do you think it might be time to jump on a plane, and get a work up at a major hospital? Where you live has really narrowed the doctors that you can see. I'd go somewhere and find a well know doctor, that specializes in your type of injury. Have you thought about it at all? Will your insurance allow it? If not, you may have to use the appeal process.

Good luck
BrianG

PS What concert are you supposed to see?

Re: Carrie

Julie on 8/27/02 at 05:02 (093634)

Carrie

Thanks for your post. You've looked into yourself, and it shows. The answers you need are there within you, and in what you've written. You DO know how to deal with this, and I've no doubt that you will.

First and most important, you seem to realise that you need to slow down a bit. I'm sure you're right that you need to rest more. So do. I know you love your job, and it's a big priority for you to keep it, so of course you want to do everything to make that possible. The best thing now might be to get some time off - several weeks, not a few days - to stay put at home and really give your feet a chance to start healing. Then when you return to work, stay off your feet as much as you can. Working in a medical environment as you do, I would hope that you'd get a sympathetic hearing, and whatever help you need.

You also realise you're an 'over-achiever', exercise-wise. It's a great quality, but you need to use it differently: harness it to activities (and non-activities, like rest) that will really help you to heal. Step back, and have a good look at what you're doing. You've already made an excellent start: you're swimming, which is just about the best exercise there is, cardiovascularly speaking. It's also excellent all-over stretching exercise.

Weightbearing workouts are not the only kind there are! (Write that large, and stick it where you can see it all the time!)

I would suggest that you stop doing the wall stretches. I know that most doctors counsel them for PF, but it beats me why. They're good stretches for the calf muscles when applied correctly to healthy muscle and tendon tissue, but they're unsuitable, in my view, for PF. This is because the calf muscles (the gastrocnemius and the soleus) connect with the achilles tendon, which connects with the plantar fascia: they form a continuum. Applying the wall stretch (or the stair stretch, or any strong weightbearing stretch) to the calf muscles not only pulls on the achilles, it stresses the fascia at its weakest, most vulnerable point, its insertion at the calcaneus. In your case, as you seem to have problems with your achilles as well as with your fascia, the wall stretch is double trouble.

Most people with PF do need to lengthen the gastroc/soleus/achilles complex in order to increase the ability to dorsiflex (bend the foot back) at the ankle, but it has to be done without further injuring the already injured, inflamed fascia. Non-weightbearing exercise is best for this.

Suzanne has posted the link to the yoga foot exercises I wrote up a few weeks ago. Try them consistently several times a day, sitting in a chair, for a few weeks. Do them before you get out of bed in the morning and before getting up after sitting for any length of time.

(To answer the question you asked on that elderly thread, I've practised yoga for 32 years and have been teaching it and training teachers for 15.)

I can't remember if you've tried a night splint. If you have, and found it intolerable, try again. The one sold on this site is said to be very good: more comfortable to wear than others. A night splint is probably the most effective way of applying a gentle, consistent, lengthening stretch to tight calf muscles - if that's a factor in your case.

I agree with Brian that it may be time for you to go out of state for a workup at a centre of excellence. You may need tests to rule out conditions that you and the doctors where you live haven't suspected. You certainly need a full evaluation and an accurate diagnosis - it doesn't sound as though you've had it. Once you're prepared to fly somewhere, the world (or at least the States) is your oyster. I think it would be worth doing. Don't give up on doctors - it sounds as though you just haven't yet found the right one. When you do, you won't feel so in the dark and desperate, because you'll have an informed, knowledgeable ally in your efforts to heal.

Finally -this is getting too long - be patient. That's easier said than done, I know, but perhaps you could at least start thinking of patience as a valuable quality to learn. (It was certainly the great lesson that PF taught me.)

Learn some simple relaxation techniques: that will help you to take things one day, one moment, at a time. It will also help you to stop looking ahead in fear and trepidation at what the future holds. Yes, pain in itself can lead to depression - but so can worry about the future. Be hopeful. You will heal, but it will take time. The journey will teach you a lot about yourself: look forward to that.

Re: Carrie - Pilates

Julie on 8/27/02 at 06:19 (093641)

Carrie, you asked my opinion of Pilates, on another thread, and I forgot to answer. I like it. It's largely based on yoga, which Joseph Pilates practised, and its great contribution is that it targets the muscles (principally the abdominals) that are responsible for supporting the spine and for core (pelvic) stability. It's very precise and controlled, very disciplined.

It's not an alternative to yoga, which is much more than exercise, but it's an excellent exercise system.

Re: Carrie

carrie on 8/27/02 at 09:39 (093657)

Brian

There are many misconceptions people have about Dr's let me tell you all a story that i have been through, long so bear with me.

I lived in California my whole life, I am 38 years old. I moved to Idaho Falls Idaho aout 16 months ago when I got married. I lived in the SF bay area and worked at one of the world renowed medical centers in the world, you all may have heard of it, Stanford University Medical Center in Palo Alto California. Anyhow I went to every freaking Dr there was there, no one and I mean no one, did anything more for me there than they have here. Sure I had the best of the best, but being one who has worked in the medical community for 10 years I know that traveling to another state is most likely not going to yield any miracles, or much more than what I am getting here. It is just the way it is. At least here I did get rid of this PF for almost 5 months, so I know that there is hope. I just have to keep at it. I have done several things that I think will be helpful to me, one is I am gathering up my medical records from every single Dr I have seen regarding this issue, two I am getting my POD to write a letter to get me the ossa tron treatments. He actually is one of only 2 here in IF that knows how to do these treatments and has been succesful at getting several insurance companies to pay for it. Second of all I am getting my orthotics, third I have gotten the handicap placard for temp use on my car while I work so that I can limit the legnth I have to walk into work. Once I am at my desk my walking is limited to small short steps that I can handle ok. If I bring my own food, I can eliminate traveling downstairs to the cafeteria and most of the time I am at my desk. I don't want to give up working even for two weeks if I can avoid it. Financially we can live off what my husband makes, but not the lifestyle I want or am accustomed too, and also I won't ever be able to afford travel if I am unemployed if I did decide to travel out of Idaho for medical care. At this point that does not make sense to do that so I will continue to do what I am and try to remain upbeat. 3 weeks ago I was better, so if I can just get there again that would be a step in the right direction.

I aprreciate all the input and advice and don't want to seem like I am being difficult but lets face it, this PF is just not going to go away overnight and I cannot lay around my house the entire time I am healing it is impossible and not feasable.

The concert I am supposed to be going to is Nickelback and then we were also invited to see Course of Nature, have you heard of them? They are metal bands.

hugs
Carrie

Re: Carrie

carrie on 8/27/02 at 09:52 (093659)

Julie thanks allot for taking the time to give me your feedback. I am wondering if you work? Do you or did you take time off your job and was that really the answer to get better? I feel that for me, staying home is going to impact my life financially and me emotionally so much that I would rather try to find ways of coping with my job in other words making some changes as far as how much and how far I have to walk and other things. I mean for example, I worked over the weekend, I was asked my several nurses to take a patient out, (discharges) wheel them out, I said no, of course explained why so not to seem lazy. This stuff happens all the time, they ask you to help push a bed from the surgery suite or take a patient out. Other than that my job is moslty sitting at a desk and not allot of walking involved. Of course I do have to walk to the bathroom, but then I have to do that at home too. I don't see myself doing too much at work to warrant needind time off, and right now yes, I know they need me allot and it would pose a hardship on them, yes I know, I care too much about other peoples feeling etc, but that is how I am. I also feel that if I can cut the distance I have to walk into the building, once I am at my desk the amount of walking is probably not enough to completely screw me up. My pod told me that rest is not the cure for PF because of the nature of the injury as soon as you get back on your feet you will reinjure it, and also the loss of mobility that comes from not using the feet can be detrimental. I am curious how many people on this board that have desk jobs have actualy had to take prolonged periods of time off of work?

Well as far as stretching I have been doing the stretches that are posted by you and they are good. I mean I walk at the gym to get to the pool too, should I be stopping that as well? I guess I am just confused as to what good total rest will really do me?

thanks again for your post and advice it is appreciated.

hugs
Carrie

Re: Carrie

Julie on 8/27/02 at 10:32 (093667)

Carrie, you're a star. You really seem to be doing all you can to help yourself (I've read your post to Brian as well of course). Just hang in there. I feel in my bones that you may have been over-stretching and I hope that you'll notice a difference, a decrease in the pain, after a couple of weeks of not doing weightbearing stretches.

No, you don't have to rest ALL the time - it's probably impossible anyway. I think you should walk to the pool - but in good shoes. That's another road to travel: what shoes are you wearing? A good look at your footgear -all of it, including the shoes you wear to work - is in order.

What about taping? Have you tried it? It's really worth a go: see part 2 of the heel pain book. There is a section on taping with illustrations and instructions. I found the simplest, two-strip technique extremely helpful.

Yes, I do work: I teach yoga. But of course I don't do that all the time, so my situation was different from yours. I have four weekly classes and I do weekend workshops. While my PF was healing I had to wear my Birkenstocks while standing (by the way, you do know not to go barefoot, don't you?) I cut out all recreational walking, and took taxis and public transport whenever I could.

I'll say it again: I'm sure you will get better because you are really determined to. You're getting the work situation under control, being open about what you can and can't do. That's great. I think you just need to focus on what will help, as you're beginning to do, and let go of the things that - probably - aren't helping, like the wall stretch.

And look at the shoe question. And taping.

Re: Never give up!

BrianG on 8/27/02 at 20:26 (093746)

Nope Carrie, not a metal head :*)
I hadn't realized that you had already seen the best. I really hope you can heal this thing soon, as the longer you have it, the harder it is to cure. Myself, I've run the gamut, done it all. After 9 years, I'm now waiting for my miracle! Keep on fighting for your rights. If your insurance turns you down, file an appeal, go to the highest level. I have to believe that if enough people do it (appeal) the insurance companies will relent. I went through the whole appeal process for an MRI, which I finally got. If I had given up early on, I would never have had it. At least I have the piece of mind to know that I don't have a hair line fracture, or something worse.

Keep at them!
BrianG

PS I'm mostly into oldies and country rock, or pop, what ever it's called. Charlie Daniels, Dixie Chicks, Martina McBride, etc.

Re: Never give up!

carrie on 8/28/02 at 09:13 (093798)

Have you tried the eswt?

Re: Never give up!

BrianG on 8/28/02 at 21:56 (093832)

Yes, Dornier Epos of both heels, in April of this year. It hasn't helped me, but I still believe in the concept. I may get a 2nd treatment at some point.

BrianG

Re: Never give up!

carrie on 8/28/02 at 22:06 (093833)

Tell me what ared dornier epos of both feet? I am going to see my awesome pain therapist, she told me she is so convinced she can help me, I am trusting her, she will do some us sound treatments and if she feels needed the trigger injections. I am willing to these as long as they dont involve the cortisone shots.

I have three teams of specialist helping me and must admit today is and has been a slightly better day. My trick is to bring two pairs at least of shoes with me at weork, this helps alot.

I also feel that the new stretches and the pilates in the am are helping too. If anyone is interested in the pilates I got it is not hard at all and only 20 minutes long. It is by Densie Austin who I love, she is so cute and realistic. The tape has two parts to it, one is for pilates along and one has pilates and yoga and is much harder, and no I make nothing by you getting this tape at all.

hugs brian

Re: Never give up!

BrianG on 8/29/02 at 17:36 (093903)

The Dornier Epos is a high energy ESWT machine. It's mission is to send shock waves through the heel. The fascia is injured by the shock waves, then heals itself (hopefully) :*)

Good luck
BrianG

Re: Carrie

Julie on 8/26/02 at 11:27 (093554)

Hi Carrie

After I read your latest post I searched on your name and have now re-read all your posts over the last couple of months.

Two things have leapt out at me.

In one of your posts you said that your pain is at the BACK of your heel, not on the bottom, and that it doesn't hurt when you walk, but is very tender to the touch. Has it been suggested that you may have Achilles Tendinitis and not Plantar Fasciitis? Perhaps it's time for you to seek out another podiatrist and get some new input.

The other thing that strikes me is the general tone that runs through all your posts - of wanting desperately, and trying terribly hard, to DO something to heal yourself. That's understandable, but sametimes, Carrie, we can 'do' too much. Sometimes, less is more. I get the feeling that you're driving yourself, and that some of the things you're 'doing' may not in fact be very helpful.

For example: in your latest post, you say you're 'stretching everything you can think of'. Are you doing the classic 'wall stretch' that is almost always recommended for PF? If so, it may be doing you more harm than good - even if you do have PF, and even more so if you have achilles tendinitis. But could you please describe exactly what you've been doing - what stretches, how often, and for how long? I've just got a feeling that you may be overdoing the stretching and obstructing rather than furthering your healing.

I could be wrong, but if you'd like to pursue this line of inquiry I'm happy to talk.

Re: Carrie

R C on 8/26/02 at 13:16 (093563)

Have hope. A year ago I thought I would never walk normally again, play golf, hold my infant child, or do all those ordinary things I could do with healthy feet. Today, my PF is gone and I can do anything I want (except daily running for exercise). So therefore try to keep your chin up, and keep working vigorously toward your recovery. Write in and allow us to bear some of your pain whenever you need it.

Re: Carrie

Pauline on 8/26/02 at 15:34 (093585)

Carrie, what a great post from Julie. Sometimes it takes that extra detective work to find out what is really going on. Your posts give others a chance to look in from the outside.

I think Julie gave you very sound advice. A second and sometimes a third opinion is always worth a try.

Patience is one of the first things we learn while suffering with P.F. Unfortunately there is no magic is out there to help with its cure.

I'd follow Julie's advice and seek a second opinion. There is light at the end of the tunnel, but sometimes it take all the strength we have and lots of time to get there.

Keep on posting.

Re: Carrie

carrie on 8/26/02 at 17:50 (093602)

Julie,

Thanks for your input. To be honest with you when you read some of those
posts that were from a few weeks ago things have taken a turn for the worse
for sure. For one thing I went on a trip to Reno Nevada with my husband and
did way too much walking, so I do agree that I have probably hurt myself by
over doing. As far as stretching, I am doing the ones my pod and also my
ortho dr suggested to me. They both seem to feel that I have pf although the
ortho Dr thinks yes it could be the achilles on the left foot, the right one
does not hurt at the back at all only under the heel on the left. It is bad
and agravated if I wear any kind of running shoe. I can only at this point
wear sandals, merrell ones without being a total agony at first. Anything
hurts after a short time no matter what it is. I am unable to find
comfortable shoes. ANyhow in my older post I mention it didn't hurt too much
to walk, well it certainly does now, really really really bad.

Ok so the stretches I am trying are the one where you sit down and take a
belt or whatever you have and put it under your feet and gently pull. The
other one is the wall stretch that you mention, agian these are the ones
that my Dr's have recomended to me. I live in a small town in Idaho so as
far as Dr's go (i also work at the only hospital around here) so I know all
the best Dr's and the ortho and pod I have are the best in this town. So I
don't know, if I cannot believe them what do I do?Do I seem desperate oh
yeah of course I do. I am not one to be able to lay around, not that I am
special but I am a bit of an over acheiver when it comes to exercise, many
many times I have made things worse for myself with my obsession with
working out, so I am doing pretty good this time as far as resting, but
still I am not willing to quit doing everything and besides from what I
understand rest alone will not cure this PF.

So what else would you recomend that I try? I am swimming, I am doing the
stretching probable 3 times a day, in the morning, in the afternoon and in
the evening, maybe 5 minutes, not too long. I occasionaly do pilates which
is stretching, but not weight bearing stretching, mostly gentle stuff that I
am sure is not causing the pain to get worse. If anything is, my guess is
that I am just not resting enough. What to do? I have a job I really like, I
am so depressed that I might not be able to work I don't know what to do.

anyhow thanks for caring.

Carrie

Re: Carrie

carrie on 8/26/02 at 17:59 (093603)

I have already had several opinions from several Dr's so I don't believe my answer lies there at all. I am in a small town in Idaho and am running out of options for Dr's here. Not only that but the ortho and the pod that I have are the best around. If I cannot trust them then who can I trust?

I am super sad and depressed and feeling sorry for myself right now which may not do me any good but oh well, big pity party right now. I just can't believe that one little foot problem can mess up my whole entire life.

I had plans to go to a concert this weekend, I don't see how I can possibly go like this.
oh well, enough of my whining

Re: Carrie

Suzanne D on 8/26/02 at 19:39 (093614)

Dear Carrie,

I am so sorry that you are in worse pain and - naturally - depressed. So many of us can identify with you. Sometimes coming here and letting it out can be the difference in getting through the tough times. Keep posting!

If you haven't already read this link, please take time to read these stretches that Julie, who has written to you in this thread, posted earlier. Thank you, Carole, for providing this link which I am now pasting in this post!

bbv.cgi?n=91080

A year ago, I was in very real pain with each step. I remember the Saturday last September when I went to my daughter's college band parent recognition day. I didn't think I would make it across the field. I took two different pairs of shoes with me. etc. and barely made it. I remember how depressed I was.

There was never a 'magic day' when everything got better. But gradually I did, and now I am looking forward to the same parent weekend next month!

I did most of the things my pod said, but followed Julie's stretches instead of the wall and stair stretches he recommended. I rested as much as I could, iced a lot, taped (still do sometimes), wore Birks and Birk inserts in SAS shoes (still do), took Naproxin, and stretched. I am thankful for my improvement, but it was very slow. It is easy to get discouraged.

Hang in there! I hope you find some improvement soon! I also understand about having a job you love and also need to keep. I am a first grade teacher and have to be on my feet a lot.

Take care,
Suzanne :-)

Re: Carrie

BrianG on 8/26/02 at 21:08 (093621)

Hi Carrie,

Do you think it might be time to jump on a plane, and get a work up at a major hospital? Where you live has really narrowed the doctors that you can see. I'd go somewhere and find a well know doctor, that specializes in your type of injury. Have you thought about it at all? Will your insurance allow it? If not, you may have to use the appeal process.

Good luck
BrianG

PS What concert are you supposed to see?

Re: Carrie

Julie on 8/27/02 at 05:02 (093634)

Carrie

Thanks for your post. You've looked into yourself, and it shows. The answers you need are there within you, and in what you've written. You DO know how to deal with this, and I've no doubt that you will.

First and most important, you seem to realise that you need to slow down a bit. I'm sure you're right that you need to rest more. So do. I know you love your job, and it's a big priority for you to keep it, so of course you want to do everything to make that possible. The best thing now might be to get some time off - several weeks, not a few days - to stay put at home and really give your feet a chance to start healing. Then when you return to work, stay off your feet as much as you can. Working in a medical environment as you do, I would hope that you'd get a sympathetic hearing, and whatever help you need.

You also realise you're an 'over-achiever', exercise-wise. It's a great quality, but you need to use it differently: harness it to activities (and non-activities, like rest) that will really help you to heal. Step back, and have a good look at what you're doing. You've already made an excellent start: you're swimming, which is just about the best exercise there is, cardiovascularly speaking. It's also excellent all-over stretching exercise.

Weightbearing workouts are not the only kind there are! (Write that large, and stick it where you can see it all the time!)

I would suggest that you stop doing the wall stretches. I know that most doctors counsel them for PF, but it beats me why. They're good stretches for the calf muscles when applied correctly to healthy muscle and tendon tissue, but they're unsuitable, in my view, for PF. This is because the calf muscles (the gastrocnemius and the soleus) connect with the achilles tendon, which connects with the plantar fascia: they form a continuum. Applying the wall stretch (or the stair stretch, or any strong weightbearing stretch) to the calf muscles not only pulls on the achilles, it stresses the fascia at its weakest, most vulnerable point, its insertion at the calcaneus. In your case, as you seem to have problems with your achilles as well as with your fascia, the wall stretch is double trouble.

Most people with PF do need to lengthen the gastroc/soleus/achilles complex in order to increase the ability to dorsiflex (bend the foot back) at the ankle, but it has to be done without further injuring the already injured, inflamed fascia. Non-weightbearing exercise is best for this.

Suzanne has posted the link to the yoga foot exercises I wrote up a few weeks ago. Try them consistently several times a day, sitting in a chair, for a few weeks. Do them before you get out of bed in the morning and before getting up after sitting for any length of time.

(To answer the question you asked on that elderly thread, I've practised yoga for 32 years and have been teaching it and training teachers for 15.)

I can't remember if you've tried a night splint. If you have, and found it intolerable, try again. The one sold on this site is said to be very good: more comfortable to wear than others. A night splint is probably the most effective way of applying a gentle, consistent, lengthening stretch to tight calf muscles - if that's a factor in your case.

I agree with Brian that it may be time for you to go out of state for a workup at a centre of excellence. You may need tests to rule out conditions that you and the doctors where you live haven't suspected. You certainly need a full evaluation and an accurate diagnosis - it doesn't sound as though you've had it. Once you're prepared to fly somewhere, the world (or at least the States) is your oyster. I think it would be worth doing. Don't give up on doctors - it sounds as though you just haven't yet found the right one. When you do, you won't feel so in the dark and desperate, because you'll have an informed, knowledgeable ally in your efforts to heal.

Finally -this is getting too long - be patient. That's easier said than done, I know, but perhaps you could at least start thinking of patience as a valuable quality to learn. (It was certainly the great lesson that PF taught me.)

Learn some simple relaxation techniques: that will help you to take things one day, one moment, at a time. It will also help you to stop looking ahead in fear and trepidation at what the future holds. Yes, pain in itself can lead to depression - but so can worry about the future. Be hopeful. You will heal, but it will take time. The journey will teach you a lot about yourself: look forward to that.

Re: Carrie - Pilates

Julie on 8/27/02 at 06:19 (093641)

Carrie, you asked my opinion of Pilates, on another thread, and I forgot to answer. I like it. It's largely based on yoga, which Joseph Pilates practised, and its great contribution is that it targets the muscles (principally the abdominals) that are responsible for supporting the spine and for core (pelvic) stability. It's very precise and controlled, very disciplined.

It's not an alternative to yoga, which is much more than exercise, but it's an excellent exercise system.

Re: Carrie

carrie on 8/27/02 at 09:39 (093657)

Brian

There are many misconceptions people have about Dr's let me tell you all a story that i have been through, long so bear with me.

I lived in California my whole life, I am 38 years old. I moved to Idaho Falls Idaho aout 16 months ago when I got married. I lived in the SF bay area and worked at one of the world renowed medical centers in the world, you all may have heard of it, Stanford University Medical Center in Palo Alto California. Anyhow I went to every freaking Dr there was there, no one and I mean no one, did anything more for me there than they have here. Sure I had the best of the best, but being one who has worked in the medical community for 10 years I know that traveling to another state is most likely not going to yield any miracles, or much more than what I am getting here. It is just the way it is. At least here I did get rid of this PF for almost 5 months, so I know that there is hope. I just have to keep at it. I have done several things that I think will be helpful to me, one is I am gathering up my medical records from every single Dr I have seen regarding this issue, two I am getting my POD to write a letter to get me the ossa tron treatments. He actually is one of only 2 here in IF that knows how to do these treatments and has been succesful at getting several insurance companies to pay for it. Second of all I am getting my orthotics, third I have gotten the handicap placard for temp use on my car while I work so that I can limit the legnth I have to walk into work. Once I am at my desk my walking is limited to small short steps that I can handle ok. If I bring my own food, I can eliminate traveling downstairs to the cafeteria and most of the time I am at my desk. I don't want to give up working even for two weeks if I can avoid it. Financially we can live off what my husband makes, but not the lifestyle I want or am accustomed too, and also I won't ever be able to afford travel if I am unemployed if I did decide to travel out of Idaho for medical care. At this point that does not make sense to do that so I will continue to do what I am and try to remain upbeat. 3 weeks ago I was better, so if I can just get there again that would be a step in the right direction.

I aprreciate all the input and advice and don't want to seem like I am being difficult but lets face it, this PF is just not going to go away overnight and I cannot lay around my house the entire time I am healing it is impossible and not feasable.

The concert I am supposed to be going to is Nickelback and then we were also invited to see Course of Nature, have you heard of them? They are metal bands.

hugs
Carrie

Re: Carrie

carrie on 8/27/02 at 09:52 (093659)

Julie thanks allot for taking the time to give me your feedback. I am wondering if you work? Do you or did you take time off your job and was that really the answer to get better? I feel that for me, staying home is going to impact my life financially and me emotionally so much that I would rather try to find ways of coping with my job in other words making some changes as far as how much and how far I have to walk and other things. I mean for example, I worked over the weekend, I was asked my several nurses to take a patient out, (discharges) wheel them out, I said no, of course explained why so not to seem lazy. This stuff happens all the time, they ask you to help push a bed from the surgery suite or take a patient out. Other than that my job is moslty sitting at a desk and not allot of walking involved. Of course I do have to walk to the bathroom, but then I have to do that at home too. I don't see myself doing too much at work to warrant needind time off, and right now yes, I know they need me allot and it would pose a hardship on them, yes I know, I care too much about other peoples feeling etc, but that is how I am. I also feel that if I can cut the distance I have to walk into the building, once I am at my desk the amount of walking is probably not enough to completely screw me up. My pod told me that rest is not the cure for PF because of the nature of the injury as soon as you get back on your feet you will reinjure it, and also the loss of mobility that comes from not using the feet can be detrimental. I am curious how many people on this board that have desk jobs have actualy had to take prolonged periods of time off of work?

Well as far as stretching I have been doing the stretches that are posted by you and they are good. I mean I walk at the gym to get to the pool too, should I be stopping that as well? I guess I am just confused as to what good total rest will really do me?

thanks again for your post and advice it is appreciated.

hugs
Carrie

Re: Carrie

Julie on 8/27/02 at 10:32 (093667)

Carrie, you're a star. You really seem to be doing all you can to help yourself (I've read your post to Brian as well of course). Just hang in there. I feel in my bones that you may have been over-stretching and I hope that you'll notice a difference, a decrease in the pain, after a couple of weeks of not doing weightbearing stretches.

No, you don't have to rest ALL the time - it's probably impossible anyway. I think you should walk to the pool - but in good shoes. That's another road to travel: what shoes are you wearing? A good look at your footgear -all of it, including the shoes you wear to work - is in order.

What about taping? Have you tried it? It's really worth a go: see part 2 of the heel pain book. There is a section on taping with illustrations and instructions. I found the simplest, two-strip technique extremely helpful.

Yes, I do work: I teach yoga. But of course I don't do that all the time, so my situation was different from yours. I have four weekly classes and I do weekend workshops. While my PF was healing I had to wear my Birkenstocks while standing (by the way, you do know not to go barefoot, don't you?) I cut out all recreational walking, and took taxis and public transport whenever I could.

I'll say it again: I'm sure you will get better because you are really determined to. You're getting the work situation under control, being open about what you can and can't do. That's great. I think you just need to focus on what will help, as you're beginning to do, and let go of the things that - probably - aren't helping, like the wall stretch.

And look at the shoe question. And taping.

Re: Never give up!

BrianG on 8/27/02 at 20:26 (093746)

Nope Carrie, not a metal head :*)
I hadn't realized that you had already seen the best. I really hope you can heal this thing soon, as the longer you have it, the harder it is to cure. Myself, I've run the gamut, done it all. After 9 years, I'm now waiting for my miracle! Keep on fighting for your rights. If your insurance turns you down, file an appeal, go to the highest level. I have to believe that if enough people do it (appeal) the insurance companies will relent. I went through the whole appeal process for an MRI, which I finally got. If I had given up early on, I would never have had it. At least I have the piece of mind to know that I don't have a hair line fracture, or something worse.

Keep at them!
BrianG

PS I'm mostly into oldies and country rock, or pop, what ever it's called. Charlie Daniels, Dixie Chicks, Martina McBride, etc.

Re: Never give up!

carrie on 8/28/02 at 09:13 (093798)

Have you tried the eswt?

Re: Never give up!

BrianG on 8/28/02 at 21:56 (093832)

Yes, Dornier Epos of both heels, in April of this year. It hasn't helped me, but I still believe in the concept. I may get a 2nd treatment at some point.

BrianG

Re: Never give up!

carrie on 8/28/02 at 22:06 (093833)

Tell me what ared dornier epos of both feet? I am going to see my awesome pain therapist, she told me she is so convinced she can help me, I am trusting her, she will do some us sound treatments and if she feels needed the trigger injections. I am willing to these as long as they dont involve the cortisone shots.

I have three teams of specialist helping me and must admit today is and has been a slightly better day. My trick is to bring two pairs at least of shoes with me at weork, this helps alot.

I also feel that the new stretches and the pilates in the am are helping too. If anyone is interested in the pilates I got it is not hard at all and only 20 minutes long. It is by Densie Austin who I love, she is so cute and realistic. The tape has two parts to it, one is for pilates along and one has pilates and yoga and is much harder, and no I make nothing by you getting this tape at all.

hugs brian

Re: Never give up!

BrianG on 8/29/02 at 17:36 (093903)

The Dornier Epos is a high energy ESWT machine. It's mission is to send shock waves through the heel. The fascia is injured by the shock waves, then heals itself (hopefully) :*)

Good luck
BrianG