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Shock of foot impact on ground, a proven cause of P.F.?

Posted by George B on 9/28/02 at 23:28 (096417)

Driving a parcel delivery truck, I get on and off the truck many times a day. The last step of the truck, measures 16.5 inches to the pavement, (compared to 7 to 8 inches, the average height of steps in buildings).
I am absolutely convinced that this daily repetitive action was ONE of the many causes of my Plantar Fasciitis, but I need to prove this in WCB court with medical and/or biomechanical studies. Like many who suffer with this injury, I now have the additional problem of running back and forth looking everywhere for solid proof that I have a legitimate work injury AND heal my feet at the same time. Helpful suggestions to my email would be most welcome. To all, keep hope alive; to the humanitarian of the decade who put this worderful site together, my sincere thanks.

Re: Shock of foot impact on ground, a proven cause of P.F.?

Carmen H on 9/29/02 at 18:06 (096466)

I would say that would be considered a Repetitive Stress Injury.....much like Carpal tunnel. My pf is from RSI but not related to work.
So in my unexperienced opinion...yes i think it could cause it.

Re: Shock of foot impact on ground, a proven cause of P.F.?

George B on 9/29/02 at 19:02 (096476)

Thanks for the feedback Carmen. I agree that PF could be classified as a Repetitive Stress Injury (RSI), unless there is a particular traumatic event, which they say is rare. I'm not familiar with the WCB procedure other than in Quebec, Canada, but here a contributing cause, is considered an acceptable cause nonetheless. Maybe I'll hire a researcher to get the exact studies I need to prove PF in WCB Court. THANKS FOR TAKING THE TIME TO ANSWER and best wishes with your PF. I'm trying night splints religiously for a month to see if there is an improvement. Thanks. Bye.

Re: Shock of foot impact on ground, a proven cause of P.F.?

BrianG on 9/29/02 at 20:44 (096485)

Hi George,

You may want to talk with an attorney also. When I finally got to a point where I could no longer work, I called a lawyer to talk about my options. He told me that I would not qualify for Woker's Comp Insurance (injury on the job) because I did not report my heel pain as work related, to the doctor the very first time I went in to get it treated.

I was quite disapointed, but it worked out for the best as I was able to get Social Security Disability. My lawyer told me the SSD cases that did not involve work injuries, or insurance, were resolved the quickest. I was approved for SSD in 5 months, the minumum waiting period. Just something to think about, in case your pain becomes unbearable.

Regards
BrianG

Re: Shock of foot impact on ground, a proven cause of P.F.?

George B on 9/29/02 at 21:06 (096487)

Thanks for your quick reply and suggestions. With my employer, disability has to be total, (relative to each of the job duties I was performing), but Government disability possibilities in Canada is something I had not considered at all. Thanks! If my PF gets worse, and I don't succeed with the WCB, I'll have this path to explore, instead of the appearance of a dead end every way I turn. Thanks again!!!

Re: Shock of foot impact on ground, a proven cause of P.F.?

scott r on 10/01/02 at 07:41 (096581)

PF can't be caused by impacting the heel. It has actually been used as a cure and why ESWT works. Stress fracture could be caused by impacting. Stepping into the truck high up many times a day is a great way to cause PF because all the weight is on the ball of the foot which causes the fascia to pull away from the heel.

Re: Shock of foot impact on ground, a proven cause of P.F.?

john h on 10/01/02 at 08:26 (096583)

Scott I have read that one of the best ways to rupture or stress the fascia is to push an automobile.That is sort of like doing a runners stretch using all the force you can muster. I think that walking up steep hills is another way to possible stress the fascia as you are pushing off rather hard off the toes and balls of the foot.

Re: Shock of foot impact on ground, a proven cause of P.F.?

George B on 10/01/02 at 23:05 (096665)

I was surprised to read that impact on fascia was thought greater going UP into truck, as compared with impact to ball of foot (and fascia) going DOWN onto pavement. For me going DOWN seems to have velocity and greater impact and weight/stress than going UP, however the suspicion that BOTH could cause PF confirms my hunch. I now must locate biomechanical or medical studies that confirm/support very elevated tearing stress to fascia going up and coming down a high step, (a step the height of average kitchen chair, which is height of last truck step). Thanks Scott for insight that doubles possible work cause of my PF. Legally, great news for court case! Now if I could only stop the pain which I'm told 'will make me stronger if it doesn't kill me first'.

Re: Shock of foot impact on ground, a proven cause of P.F.?

George B on 10/01/02 at 23:19 (096666)

The way you describe the plantar fascia stress triggers makes perfect sense to me. Now season lightly with aging ligaments, that are becoming more rope-like and less rubber-like and voila, hot Plater Faciitis Stew for two. (Gotta keep light-hearted about the pain!)

Re: Shock of foot impact on ground, a proven cause of P.F.?

john h on 10/02/02 at 08:48 (096693)

George: Certainly running up hill is worse for PF than running down hill. It would seem that impact alone would not be nearly as bad as stressing the fascia by pushing off with excess force such as pushing a car, a down football lineman, runners stretch,etc.

Re: Shock of foot impact on ground, a proven cause of P.F.?

George B on 10/02/02 at 09:54 (096709)

John: I simply don't know. But I've found out that sometimes, what I think is a reasonable assumption, isn't actually factual. You'll have to ask a more informed person to find out.

Re: Shock of foot impact on ground, a proven cause of P.F.?

Ed Davis. DPM on 10/02/02 at 20:21 (096758)

Brian:

It sounds like the attorney you had talked to wanted to avoid a potentially difficult case. Perhaps the law is different in your state but the fact that you did not report your heel pain as work related when you first saw the doctor definitely would not disqualify you from filing it as a workers compensation claim. There is no way that a patient can always be expected to know the origin of their problem so I cannot imagine any jurisdiction can hold one to such a standard. Furthermore, the right of individuals to file a workers comp. claim is well protected.
Ed

Re: Ma. is a pain in the butt!!!

BrianG on 10/02/02 at 22:17 (096765)

Hi Doctor Ed,

I have to believe Mass. is stricter on this, then most other states. I sat down to talk with the lawyer and began to explain my case. I told him that I had the pain for about 8 years, he didn't even wait to hear any more. He then interrupted me, telling me what I said above (could not win WC). He said there was no way I could win a comp case. We talked a little more and I asked him if he would take my case as an SSD application. I said he didn't think it was winnable, as he had never heard of anyone getting SSD approval for PF. I then told him I had the full backing of my doctor, and he took the case. He is a well respected attorney in the business community, and I wanted him representing me if at all possible. In the end, he lost out, as I was approved before SSD owed me any back pay. He was going to get 25% of the first retroactive check. Sometimes this is in the thousands. Other times, it comes back to bite them.

He didn't seem bothered not getting a check, he knew there was a chance I'd get approved after the first denial, but before I went before the judge. It was a very slight chance, as only 5% get approved at that stage!!

Regards
BrianG

Re: Ma. is a pain in the butt!!!

Ed Davis, DPM on 10/04/02 at 14:23 (096885)

It would definitely help to have more research relating PF to occupational
exposure.

There are occupational injuries (a defined incident of trauma causing an injury) and occupational diseases (no defined traumatic incident). Occupational diseases include things such as carpal tunnel syndrome and are often lumped into a category termed CTD -- cumulative trauma disorders.
There is absolutely no question in my mind that pF can be a CTD but there is little written on the subject -- sort of amazing when you consider how common the problem is.

WA state will cover PF if it arises as a work related injury but will not cover it as a work related disease. Now, here is the dirty little secret that a number of people have figured out: a relatively minor injury can cause a 'lighting up' of a longstanding condition. An individual can have pF for years, manage to get by, but then has a minor injury: 'I missed a step coming off a ladder and landed on my heel... the pain has gotten much worse since then.' This individual is now covered since the PF has been converted to a work related injury. The doctor must report what the patient states and the 'injury' being minor may or may not be witnessed, noetheless it is usually not challenged.
Ed

Re: Shock of foot impact on ground, a proven cause of P.F.?

Carmen H on 9/29/02 at 18:06 (096466)

I would say that would be considered a Repetitive Stress Injury.....much like Carpal tunnel. My pf is from RSI but not related to work.
So in my unexperienced opinion...yes i think it could cause it.

Re: Shock of foot impact on ground, a proven cause of P.F.?

George B on 9/29/02 at 19:02 (096476)

Thanks for the feedback Carmen. I agree that PF could be classified as a Repetitive Stress Injury (RSI), unless there is a particular traumatic event, which they say is rare. I'm not familiar with the WCB procedure other than in Quebec, Canada, but here a contributing cause, is considered an acceptable cause nonetheless. Maybe I'll hire a researcher to get the exact studies I need to prove PF in WCB Court. THANKS FOR TAKING THE TIME TO ANSWER and best wishes with your PF. I'm trying night splints religiously for a month to see if there is an improvement. Thanks. Bye.

Re: Shock of foot impact on ground, a proven cause of P.F.?

BrianG on 9/29/02 at 20:44 (096485)

Hi George,

You may want to talk with an attorney also. When I finally got to a point where I could no longer work, I called a lawyer to talk about my options. He told me that I would not qualify for Woker's Comp Insurance (injury on the job) because I did not report my heel pain as work related, to the doctor the very first time I went in to get it treated.

I was quite disapointed, but it worked out for the best as I was able to get Social Security Disability. My lawyer told me the SSD cases that did not involve work injuries, or insurance, were resolved the quickest. I was approved for SSD in 5 months, the minumum waiting period. Just something to think about, in case your pain becomes unbearable.

Regards
BrianG

Re: Shock of foot impact on ground, a proven cause of P.F.?

George B on 9/29/02 at 21:06 (096487)

Thanks for your quick reply and suggestions. With my employer, disability has to be total, (relative to each of the job duties I was performing), but Government disability possibilities in Canada is something I had not considered at all. Thanks! If my PF gets worse, and I don't succeed with the WCB, I'll have this path to explore, instead of the appearance of a dead end every way I turn. Thanks again!!!

Re: Shock of foot impact on ground, a proven cause of P.F.?

scott r on 10/01/02 at 07:41 (096581)

PF can't be caused by impacting the heel. It has actually been used as a cure and why ESWT works. Stress fracture could be caused by impacting. Stepping into the truck high up many times a day is a great way to cause PF because all the weight is on the ball of the foot which causes the fascia to pull away from the heel.

Re: Shock of foot impact on ground, a proven cause of P.F.?

john h on 10/01/02 at 08:26 (096583)

Scott I have read that one of the best ways to rupture or stress the fascia is to push an automobile.That is sort of like doing a runners stretch using all the force you can muster. I think that walking up steep hills is another way to possible stress the fascia as you are pushing off rather hard off the toes and balls of the foot.

Re: Shock of foot impact on ground, a proven cause of P.F.?

George B on 10/01/02 at 23:05 (096665)

I was surprised to read that impact on fascia was thought greater going UP into truck, as compared with impact to ball of foot (and fascia) going DOWN onto pavement. For me going DOWN seems to have velocity and greater impact and weight/stress than going UP, however the suspicion that BOTH could cause PF confirms my hunch. I now must locate biomechanical or medical studies that confirm/support very elevated tearing stress to fascia going up and coming down a high step, (a step the height of average kitchen chair, which is height of last truck step). Thanks Scott for insight that doubles possible work cause of my PF. Legally, great news for court case! Now if I could only stop the pain which I'm told 'will make me stronger if it doesn't kill me first'.

Re: Shock of foot impact on ground, a proven cause of P.F.?

George B on 10/01/02 at 23:19 (096666)

The way you describe the plantar fascia stress triggers makes perfect sense to me. Now season lightly with aging ligaments, that are becoming more rope-like and less rubber-like and voila, hot Plater Faciitis Stew for two. (Gotta keep light-hearted about the pain!)

Re: Shock of foot impact on ground, a proven cause of P.F.?

john h on 10/02/02 at 08:48 (096693)

George: Certainly running up hill is worse for PF than running down hill. It would seem that impact alone would not be nearly as bad as stressing the fascia by pushing off with excess force such as pushing a car, a down football lineman, runners stretch,etc.

Re: Shock of foot impact on ground, a proven cause of P.F.?

George B on 10/02/02 at 09:54 (096709)

John: I simply don't know. But I've found out that sometimes, what I think is a reasonable assumption, isn't actually factual. You'll have to ask a more informed person to find out.

Re: Shock of foot impact on ground, a proven cause of P.F.?

Ed Davis. DPM on 10/02/02 at 20:21 (096758)

Brian:

It sounds like the attorney you had talked to wanted to avoid a potentially difficult case. Perhaps the law is different in your state but the fact that you did not report your heel pain as work related when you first saw the doctor definitely would not disqualify you from filing it as a workers compensation claim. There is no way that a patient can always be expected to know the origin of their problem so I cannot imagine any jurisdiction can hold one to such a standard. Furthermore, the right of individuals to file a workers comp. claim is well protected.
Ed

Re: Ma. is a pain in the butt!!!

BrianG on 10/02/02 at 22:17 (096765)

Hi Doctor Ed,

I have to believe Mass. is stricter on this, then most other states. I sat down to talk with the lawyer and began to explain my case. I told him that I had the pain for about 8 years, he didn't even wait to hear any more. He then interrupted me, telling me what I said above (could not win WC). He said there was no way I could win a comp case. We talked a little more and I asked him if he would take my case as an SSD application. I said he didn't think it was winnable, as he had never heard of anyone getting SSD approval for PF. I then told him I had the full backing of my doctor, and he took the case. He is a well respected attorney in the business community, and I wanted him representing me if at all possible. In the end, he lost out, as I was approved before SSD owed me any back pay. He was going to get 25% of the first retroactive check. Sometimes this is in the thousands. Other times, it comes back to bite them.

He didn't seem bothered not getting a check, he knew there was a chance I'd get approved after the first denial, but before I went before the judge. It was a very slight chance, as only 5% get approved at that stage!!

Regards
BrianG

Re: Ma. is a pain in the butt!!!

Ed Davis, DPM on 10/04/02 at 14:23 (096885)

It would definitely help to have more research relating PF to occupational
exposure.

There are occupational injuries (a defined incident of trauma causing an injury) and occupational diseases (no defined traumatic incident). Occupational diseases include things such as carpal tunnel syndrome and are often lumped into a category termed CTD -- cumulative trauma disorders.
There is absolutely no question in my mind that pF can be a CTD but there is little written on the subject -- sort of amazing when you consider how common the problem is.

WA state will cover PF if it arises as a work related injury but will not cover it as a work related disease. Now, here is the dirty little secret that a number of people have figured out: a relatively minor injury can cause a 'lighting up' of a longstanding condition. An individual can have pF for years, manage to get by, but then has a minor injury: 'I missed a step coming off a ladder and landed on my heel... the pain has gotten much worse since then.' This individual is now covered since the PF has been converted to a work related injury. The doctor must report what the patient states and the 'injury' being minor may or may not be witnessed, noetheless it is usually not challenged.
Ed