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PF vs Badly bruised heel

Posted by Mike P on 11/25/02 at 21:14 (101143)

I have been a runner for 6 years and have stopped running for almost 15 months now due to chronic heel pain. I have seen 4 podiatrist, 2 cortizone shots and done everything this site has suggested over the past year...all to no avail. An x-ray revels a heel spur ( which I had before the heel pain). I am contemplating ESWT if insurance will pay. How can I be sure that the pain is PF or a badly bruised heel. The pain is directly in the center of the heel under the fat pad. I have no pain getting out of bed in the AM but chronic pain as I stand all day as a teacher. Now I have gel pads to help with the pain. I would appecaite any comments from a knowlegable source...Thank so much!

Re: PF vs Badly bruised heel

Dr. John Cozzarelli on 11/25/02 at 21:31 (101147)

Hi Mike:

Do you have orthotics? It sounds more like a calcaneal bursitis in the central hydraulic chamber which is in the middle of the heel. The running could have created this problem. Is there only pain directly in the center of the heel? What type of shoes do you wear?

Dr. John Cozzarelli

Re: PF vs Badly bruised heel

Mike P on 11/26/02 at 18:06 (101206)

Hello Dr. John....yes I have been fitted for orthodics and have been wearing them for almost 1 year. Three of the 4 podiatrist that I have seen over the past 12 months have added and taken away from them. One added padding...another sanded down a different area.....just trying to tinker with them. One podiatrist told me to not wear them and just add foam cushioning to my sneakers (that I wear to work). The pain is in the direct center of the heel only...not in the arch or on the side of the heel in my left foot. For the past 3 months, I have been wearing Nike basketball sneakers everywhere with a gel insert for 2 weeks..Most of this fall, I have worn the sneakers with the dr. precribed orthodics. I have not used shoes since many many months ago. I hope this helps....would an MRI pinpoint where the pain is located? Thank so much!

Re: PF vs Badly bruised heel

Dr. John Cozzarelli on 11/26/02 at 20:45 (101216)

Mike:

Either Diagnostic ultrasound or MRI would be of great benefit. Make sure the radiologist reviews foot films on a regular basis. the test is only as good as the technologist. It osunds like a heel bursitis. Get the soft tissue study.

Dr. John Cozzarelli

Re: PF vs Badly bruised heel

Mar on 11/27/02 at 07:13 (101240)

Mike -

Your post is very intersting. My heel pain started exactly like yours and it was assumed that the heels were badly bruised. When ultrasound, icing and rest didn;t help, I got new orthotics and tests were done. By then the pain was all over and I was diagnosed with PF. My pod says I have both bursitis and PF. Get those tests that Dr. Coz recommends ASAP. Mar

Re: PF vs Badly bruised heel

Mike P on 11/27/02 at 18:41 (101286)

Thanks Mar for the post----where are you now in terms of recovery and what have you been doing to tackle PF and heel busitis?

Thanks so much. Mike

Re: PF vs Badly bruised heel

Mar on 11/27/02 at 20:15 (101291)

Mike --

I say get that MRI or diagnostic ultrasound ASAP because you do not want to get where I am. I have had the PF for over a year and it is severe and debilitating. I have done all the traditional treatments that work for most people and also have had 2 ESWT treatments so far. To date, nothing has given me any lasting relief. You need to find out exactly what is going on and get it treated. Mine went on too long before adequate testing because I was being treated primarily for severe pain from bunion surgery. Feel free to email me at (email removed), but listen to the docs and get the tests. Mar

Re: PF vs Badly bruised heel

Dr. John Cozzarelli on 11/25/02 at 21:31 (101147)

Hi Mike:

Do you have orthotics? It sounds more like a calcaneal bursitis in the central hydraulic chamber which is in the middle of the heel. The running could have created this problem. Is there only pain directly in the center of the heel? What type of shoes do you wear?

Dr. John Cozzarelli

Re: PF vs Badly bruised heel

Mike P on 11/26/02 at 18:06 (101206)

Hello Dr. John....yes I have been fitted for orthodics and have been wearing them for almost 1 year. Three of the 4 podiatrist that I have seen over the past 12 months have added and taken away from them. One added padding...another sanded down a different area.....just trying to tinker with them. One podiatrist told me to not wear them and just add foam cushioning to my sneakers (that I wear to work). The pain is in the direct center of the heel only...not in the arch or on the side of the heel in my left foot. For the past 3 months, I have been wearing Nike basketball sneakers everywhere with a gel insert for 2 weeks..Most of this fall, I have worn the sneakers with the dr. precribed orthodics. I have not used shoes since many many months ago. I hope this helps....would an MRI pinpoint where the pain is located? Thank so much!

Re: PF vs Badly bruised heel

Dr. John Cozzarelli on 11/26/02 at 20:45 (101216)

Mike:

Either Diagnostic ultrasound or MRI would be of great benefit. Make sure the radiologist reviews foot films on a regular basis. the test is only as good as the technologist. It osunds like a heel bursitis. Get the soft tissue study.

Dr. John Cozzarelli

Re: PF vs Badly bruised heel

Mar on 11/27/02 at 07:13 (101240)

Mike -

Your post is very intersting. My heel pain started exactly like yours and it was assumed that the heels were badly bruised. When ultrasound, icing and rest didn;t help, I got new orthotics and tests were done. By then the pain was all over and I was diagnosed with PF. My pod says I have both bursitis and PF. Get those tests that Dr. Coz recommends ASAP. Mar

Re: PF vs Badly bruised heel

Mike P on 11/27/02 at 18:41 (101286)

Thanks Mar for the post----where are you now in terms of recovery and what have you been doing to tackle PF and heel busitis?

Thanks so much. Mike

Re: PF vs Badly bruised heel

Mar on 11/27/02 at 20:15 (101291)

Mike --

I say get that MRI or diagnostic ultrasound ASAP because you do not want to get where I am. I have had the PF for over a year and it is severe and debilitating. I have done all the traditional treatments that work for most people and also have had 2 ESWT treatments so far. To date, nothing has given me any lasting relief. You need to find out exactly what is going on and get it treated. Mine went on too long before adequate testing because I was being treated primarily for severe pain from bunion surgery. Feel free to email me at (email removed), but listen to the docs and get the tests. Mar