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My first time orthotics

Posted by Bob B on 1/16/03 at 12:29 (105607)

My orthopaedic surgeon diagnosed my right foot as a ruptured plantar fascia. He sent me (with Rx) to a podiatrist who fitted me with semi rigid orthotics. I also bought some Brooks shoes that are a good platform. These seem to be doing a good job and I can walk some without the excruciating pain. The podiatrist told me absolutely minimize being on my feet for the next 6 to 8 weeks and NEVER go barefoot and never put weight on that foot without the orthotics.
But, as I read the postings on this web site I hear about casts, therapy and other things. Is my treatment incomplete or incorrect?? I've had these over 2 weeks now.
Bob B

Re: My first time orthotics

Mahatmelissama on 1/16/03 at 14:05 (105620)

'These seem to be doing a good job and I can walk some without the excruciating pain.'

Bob, since these orthotics HELP not HURT, I think you are on the right track.

I would say some ultrasound is a good thing and stretching..but not weight baring stretches (beware of the runner's stretch!)

Re: My first time orthotics

Bob B on 1/16/03 at 14:58 (105623)

Thanks for the suggestions about ultrasound and stretching. I will talk to my doctor about this when I see him soon.
Bob

Re: My first time orthotics

Carole C in NOLA on 1/16/03 at 17:55 (105633)

Bob, your podiatrist seems to be saying the right things. Your doctor probably should have prescribed an anti-inflammatory (you might try an over the counter anti-inflammatory if he didn't).

I agree with Mahatmelissama about the gentle stretching. Also, icing the foot helps (put your foot on a bag of frozen peas, which will conform to its shape). I don't know anything about ultrasound and didn't realize it was used for PF. Casts and therapy are helpful to some, but these are not the most common of treatments.

Read the heel pain book on this site, which is very helpful. I hope your feet feel better soon.

Carole C

Re: My first time orthotics

Bob B on 1/16/03 at 18:28 (105638)

Carol C in NOLA,
THANK YOU for the input. The doctor did try two Rx's for inflammation, the last one was Vioxx. Neither did much good. Ice does help but I probably don't do it often enough, and now that you bring it up I will do it more often. Will I ever be anything close to normal again? It runs my life now.
I will read the heal pain book.
Thanks, Bob

Re: My first time orthotics

Carole C in NOLA on 1/16/03 at 23:12 (105661)

Bob,

Chances are very good that you will recover COMPLETELY from your PF. I know it's hard to believe, but 90-95% of PF patients do heal completely, from what the doctors here have told me.

I am completely healed now, and have been for quite a few months. I can live a normal life just as I did before. I can walk and run, and I can wear bad shoes and stand in lines. The only difference from 'before PF' is that I'm more vigilant, watching out for any perceptible twinge of PF pain just in case. I still a little scared of getting PF again, I guess. PF was awful. For a long time I would have been glad just to be able to carry on my daily life. I was in very bad pain and could not do much of anything. But now that is in the past for me, and so there is hope for you too.

Some things that helped me to recover most, are the following (most important to least important):

1) Never going barefoot for even one step or standing barefoot, not even in the shower. Alternating custom orthotics and Birkenstocks, and wearing nothing else except shower shoes in the shower (with a shower stool too, which helped a lot).

2) Resting my feet as much as possible. I made myself be a couch potato for a month or two and didn't do my chores or even go grocery shopping.

3) Gentle non-weightbearing stretching. My C.Ped who made my orthotics told me to sit on my bed with my legs stretched out in front of me, and point the toes of one foot towards my nose (upwards and inwards), while holding the knee down with my hands. Hold for 30 seconds. Then switch legs. If it hurts, don't do it so hard! Point more gently, and don't hold so long, until you can. This was what I did, plus wiggling my toes gently and rotating my feet at the ankle. I did these stretches every time I got out of bed, and also several other times during the day.

Another more complete set of stretches was described in greater detail by Julie in this post: bbv.cgi?n=91080

4) Icing. Bag of peas, foot on the bag until it hurts (5 minutes?) then off for a minute and repeat. Continue for 30 minutes. Do this at least 1-2 times per day.

5) Celebrex. Like you, I found it to be pretty useless.

Another thing that helped: I tried to do less than I thought I could rather than more. It took me a few months to figure this out. For some reason, I was overestimating my capability and then I would re-injure my feet. The repeated re-injuries were delaying my healing.

It takes a lot of self-discipline to just stay off one's feet, in a society where exercise is so closely related to many people's sense of self-worth. But, if you can do it for a couple of months (along with the rest of all of this) you should be well on your way to being healed.

I hope this helps.

Carole C

Re: My first time orthotics

Bob B on 1/17/03 at 12:24 (105687)

Carole
Thanks so much. I am very definately over-doing it. I find it very hard to be a couch potato. But I will try. And I am not elevating and icing enough either. I will do this. And I will start mild stretching and movement excercise. One last question please. What is a shower shoe? does it give any support and stability?
Thanks
Bob

Re: My first time orthotics

Carole C in NOLA on 1/17/03 at 12:40 (105690)

By a shower shoe, I just meant a shoe that is waterproof. You can get Birkenstock shoes like that which might give some support, but when I got PF I couldn't find any that I could look at. So, what I did was to get a waterproof Nike sandal with plastic foam soles about an inch thick. These provide zero stability and zero support, and are generally not good for PF, but I think they are better than standing on the slippery flat bottom of my tub/shower.

I also bought a shower stool at my local medical supply place. I'd wear my shower shoes but shower mostly sitting down except for a minute right at the end when I'd stand up and enjoy the shower; after that, I'd shut the shower off, sit down on the shower stool again, dry my feet off, and put on my Birkenstocks again.

After about six months my feet had healed enough that I could shower normally again.

Carole C

Re: About the resting...

Carole C in NOLA on 1/17/03 at 13:01 (105694)

Bob, I can really relate to not wanting to rest. So far I haven't heard of anybody with PF who finds it easy to be a couch potato. When I got PF, I had just lost 80 pounds and was beginning some serious exercise to get off of a plateau and lose the rest. Sitting on a sofa was incredibly demoralizing and not at all what I wanted either. I felt so sad and hopeless that I spent a lot of time crying. I think in my case it was much harder than for someone of a more or less normal weight, because of all I had gone through to try to lose.

Look at it this way. Your foot is injured and like any other bad injury, it needs to be rested in order to heal.

While you are resting it, the tendons and so on can tighten up from lack of use, and that's one reason why gentle non-weightbearing stretching can be so important.

It's not easy to rest your foot with PF, but you will find dozens and dozens of men (and women) on these boards who didn't have the self-discipline to rest when their feet needed it, and who ended up with chronic PF that stayed around for YEARS. It's your choice.

Life is sometimes so unfair.

Carole C

Re: My first time orthotics

Richard, C.Ped on 1/17/03 at 15:24 (105711)

Hi Bob...
I know it has already been said, but I do believe you are on the right track. Just continue to take it easy. If/when you start stretching, do not over do it. Go slow. I love Brooks shoes, so I think that is a wonderful start.
Richard

Re: My first time orthotics

Bob B on 1/17/03 at 15:50 (105716)

Thank you Richard. I have learned a lot from you people. I appreciate that you took the time to encourage me.
Bob

Re: My first time orthotics

Kathy G on 1/18/03 at 14:46 (105817)

Bob,

I believe, from being active on these boards for about a year or more, that couch potatoes seldom get PF. Now, I'm sure that's not an actual statistic but it has been my finding that all of us who have PF have been physically active. Witness all the runners who have it. It makes it kind of a double whammy - you have to put up with pain and you have to seriously modify your lifestyle.

But many people make a full recovery so take heart and good luck!

Re: My first time orthotics

Carole C in NOLA on 1/18/03 at 19:49 (105848)

But that doesn't mean that you can't return to your normal level of activity once you are fully recovered, as long as 'normal' for you is consistent with a healthy level of activity for someone of your age, weight, and so on. Don't resign yourself to having to be a couch potato forever. Do realize that recovery takes time.

It's true that some or all people with PF DO need to really, really rest a lot for a few months, in my opinion (depending on how long it's been since they got PF). They need to rest not just cutting back on the abuse of their feet, but going beyond that to incorporate zero non-necessary walking. Walk to the bathroom, but don't get up to get a book, for example, because that's not a necessity. This is terribly hard to do.

Carole C

Re: My first time orthotics

Julie on 1/19/03 at 02:35 (105885)

Bob

To all the excellent thoughts you've had, I'd like to add the suggestion that you investigate and try taping. There are instructions and illustrations in the heel pain book, part 2.

Taping helps by supplying the support for the arch that the injured plantar fascia can no longer give. It actually 'rests' the fascia, so it contributes to healing as well as relieve the pain. It's considered by the doctors here that if taping helps, orthotics are needed and will help even more. But my experience, when my PF (now long since healed) was at its worst, that I needed taping plus orthotics, and used them both consistently for several months. There is no doubt in my mind that taping was a major contributory factor to my healing.

If you want to try it, have a look at the instructions in the heel pain book and then come back and ask questions. There's a knack to it, and several points to be made, but I'll wait till you've made a start!

I also want to underscore the need for rest. Nobody who has been active likes being a couch potato, or finds it easy. But PF is a repetitive motion injury (which is why people who use their feet a lot get it) and it needs rest in order to heal. I cut out all recreational and otherwise unnecessary walking for months. It wasn't easy, but it worked, and it will work for you too: you've made a good start.

Re: PS

Julie on 1/19/03 at 02:37 (105886)

Care with stretching. Active people tend to overdo it. No weight-bearing, no runners/wall stretches, no stair hanging. If you click on the word yoga here (I hope it turns into a link) you'll be taken to a long post of mine giving instructions for some simple yoga foot exercises that have helped people here.

Re: My first time orthotics

Bob B on 1/19/03 at 10:11 (105915)

Kathy,
Thank you so much for the encouragement. Hearing from all you people out there has helped so much.
Bob

Re: PS

Bob B on 1/19/03 at 10:19 (105916)

Julie,
I really appreciate the info you gave me. I have already found that I must limit my foot excercise to just ankle movements. Any stretching of even the smallest amount causes a bad reaction within hours. I think I will try the taping. Their was no URL for the yoga.
Again, thank you
Bob B

Re: PS

Julie on 1/19/03 at 13:04 (105931)

Bob, just click on the word Yoga here or in your own post, and it will take you to the exercises I mentioned.

Glad you've discovered for yourself how counter-productive aggressive stretching can be!

Re: PS

Bob B on 1/19/03 at 13:31 (105934)

Julie, THANKS!
I got it ok. The problem was that it did not come as a URL on the e-mail. I had to go to the posting to see it as a URL. I have already tried these a little and they feel GOOD. Thanks so much
Bob B

Re: PS

Julie on 1/19/03 at 14:15 (105936)

That's good, Bob. Keep it up, and do come back to me with any questions.

Re: My first time orthotics

peter f on 1/20/03 at 16:02 (106051)

Bob-listen to carol-she always gives good advice and is right-95% do recover-I am almost better after 2.5 yrs-ESWT really did help but so did rest-I mountain biked on it for 2 yrs and looking back that was so stupid-my breakthrough was to stop blaming my feet for ruining my life-I realised that I wasnt giving THEM a break rather than the other way round-think of it like tennis elbow , frozen shoulder etc-most do get better -it just seems like bloody ages .

Re: My first time orthotics

Carole C in NOLA on 1/20/03 at 16:12 (106055)

Peter, thank you! That was very sweet of you to say, and it encourages me to stay around here and try to help people.

I haven't really had even a twinge of PF pain in quite a while now, but the memory (or should I say nightmare!) of PF lingers. The thought that others may be stuck in that mire of depression, pain, immobility, and hopelessness haunts me, and so I come back to try to help however I can, maybe with tips that worked for me or trying to dish out a little hope when I can.

I'm not someone who knows it all and I probably made every mistake possible on the way to recovering from PF. Maybe someone who reads my posts may benefit from what I learned about my own feet, and somehow recover faster than they otherwise would have.

Carole C

Re: My first time orthotics

Bob B on 1/20/03 at 17:47 (106068)

Thank you Peter - I do not know what I did to my foot. It worked fine for 60 years! It just started hurting early last Sept. and kept getting worse. Finally in December I could take it no more. I could barely walk and the pain was unbearable. I got orthotics the 30th of December and I can actually walk. Problem is, I don't really know how good they are because Carole has me sitting on my butt! I am not having much pain at all now. I do get around the house 95% pain free. I am optimistic. I appreciate your and everyone else's help! And I have been taking Carole's advice. She has given me a lot of information. Bob

Re: My first time orthotics

Bob B on 1/21/03 at 00:23 (106106)

Carole,
You are right. You have helped me very much I Thank you!
Bob B

Re: My first time orthotics

Mahatmelissama on 1/16/03 at 14:05 (105620)

'These seem to be doing a good job and I can walk some without the excruciating pain.'

Bob, since these orthotics HELP not HURT, I think you are on the right track.

I would say some ultrasound is a good thing and stretching..but not weight baring stretches (beware of the runner's stretch!)

Re: My first time orthotics

Bob B on 1/16/03 at 14:58 (105623)

Thanks for the suggestions about ultrasound and stretching. I will talk to my doctor about this when I see him soon.
Bob

Re: My first time orthotics

Carole C in NOLA on 1/16/03 at 17:55 (105633)

Bob, your podiatrist seems to be saying the right things. Your doctor probably should have prescribed an anti-inflammatory (you might try an over the counter anti-inflammatory if he didn't).

I agree with Mahatmelissama about the gentle stretching. Also, icing the foot helps (put your foot on a bag of frozen peas, which will conform to its shape). I don't know anything about ultrasound and didn't realize it was used for PF. Casts and therapy are helpful to some, but these are not the most common of treatments.

Read the heel pain book on this site, which is very helpful. I hope your feet feel better soon.

Carole C

Re: My first time orthotics

Bob B on 1/16/03 at 18:28 (105638)

Carol C in NOLA,
THANK YOU for the input. The doctor did try two Rx's for inflammation, the last one was Vioxx. Neither did much good. Ice does help but I probably don't do it often enough, and now that you bring it up I will do it more often. Will I ever be anything close to normal again? It runs my life now.
I will read the heal pain book.
Thanks, Bob

Re: My first time orthotics

Carole C in NOLA on 1/16/03 at 23:12 (105661)

Bob,

Chances are very good that you will recover COMPLETELY from your PF. I know it's hard to believe, but 90-95% of PF patients do heal completely, from what the doctors here have told me.

I am completely healed now, and have been for quite a few months. I can live a normal life just as I did before. I can walk and run, and I can wear bad shoes and stand in lines. The only difference from 'before PF' is that I'm more vigilant, watching out for any perceptible twinge of PF pain just in case. I still a little scared of getting PF again, I guess. PF was awful. For a long time I would have been glad just to be able to carry on my daily life. I was in very bad pain and could not do much of anything. But now that is in the past for me, and so there is hope for you too.

Some things that helped me to recover most, are the following (most important to least important):

1) Never going barefoot for even one step or standing barefoot, not even in the shower. Alternating custom orthotics and Birkenstocks, and wearing nothing else except shower shoes in the shower (with a shower stool too, which helped a lot).

2) Resting my feet as much as possible. I made myself be a couch potato for a month or two and didn't do my chores or even go grocery shopping.

3) Gentle non-weightbearing stretching. My C.Ped who made my orthotics told me to sit on my bed with my legs stretched out in front of me, and point the toes of one foot towards my nose (upwards and inwards), while holding the knee down with my hands. Hold for 30 seconds. Then switch legs. If it hurts, don't do it so hard! Point more gently, and don't hold so long, until you can. This was what I did, plus wiggling my toes gently and rotating my feet at the ankle. I did these stretches every time I got out of bed, and also several other times during the day.

Another more complete set of stretches was described in greater detail by Julie in this post: bbv.cgi?n=91080

4) Icing. Bag of peas, foot on the bag until it hurts (5 minutes?) then off for a minute and repeat. Continue for 30 minutes. Do this at least 1-2 times per day.

5) Celebrex. Like you, I found it to be pretty useless.

Another thing that helped: I tried to do less than I thought I could rather than more. It took me a few months to figure this out. For some reason, I was overestimating my capability and then I would re-injure my feet. The repeated re-injuries were delaying my healing.

It takes a lot of self-discipline to just stay off one's feet, in a society where exercise is so closely related to many people's sense of self-worth. But, if you can do it for a couple of months (along with the rest of all of this) you should be well on your way to being healed.

I hope this helps.

Carole C

Re: My first time orthotics

Bob B on 1/17/03 at 12:24 (105687)

Carole
Thanks so much. I am very definately over-doing it. I find it very hard to be a couch potato. But I will try. And I am not elevating and icing enough either. I will do this. And I will start mild stretching and movement excercise. One last question please. What is a shower shoe? does it give any support and stability?
Thanks
Bob

Re: My first time orthotics

Carole C in NOLA on 1/17/03 at 12:40 (105690)

By a shower shoe, I just meant a shoe that is waterproof. You can get Birkenstock shoes like that which might give some support, but when I got PF I couldn't find any that I could look at. So, what I did was to get a waterproof Nike sandal with plastic foam soles about an inch thick. These provide zero stability and zero support, and are generally not good for PF, but I think they are better than standing on the slippery flat bottom of my tub/shower.

I also bought a shower stool at my local medical supply place. I'd wear my shower shoes but shower mostly sitting down except for a minute right at the end when I'd stand up and enjoy the shower; after that, I'd shut the shower off, sit down on the shower stool again, dry my feet off, and put on my Birkenstocks again.

After about six months my feet had healed enough that I could shower normally again.

Carole C

Re: About the resting...

Carole C in NOLA on 1/17/03 at 13:01 (105694)

Bob, I can really relate to not wanting to rest. So far I haven't heard of anybody with PF who finds it easy to be a couch potato. When I got PF, I had just lost 80 pounds and was beginning some serious exercise to get off of a plateau and lose the rest. Sitting on a sofa was incredibly demoralizing and not at all what I wanted either. I felt so sad and hopeless that I spent a lot of time crying. I think in my case it was much harder than for someone of a more or less normal weight, because of all I had gone through to try to lose.

Look at it this way. Your foot is injured and like any other bad injury, it needs to be rested in order to heal.

While you are resting it, the tendons and so on can tighten up from lack of use, and that's one reason why gentle non-weightbearing stretching can be so important.

It's not easy to rest your foot with PF, but you will find dozens and dozens of men (and women) on these boards who didn't have the self-discipline to rest when their feet needed it, and who ended up with chronic PF that stayed around for YEARS. It's your choice.

Life is sometimes so unfair.

Carole C

Re: My first time orthotics

Richard, C.Ped on 1/17/03 at 15:24 (105711)

Hi Bob...
I know it has already been said, but I do believe you are on the right track. Just continue to take it easy. If/when you start stretching, do not over do it. Go slow. I love Brooks shoes, so I think that is a wonderful start.
Richard

Re: My first time orthotics

Bob B on 1/17/03 at 15:50 (105716)

Thank you Richard. I have learned a lot from you people. I appreciate that you took the time to encourage me.
Bob

Re: My first time orthotics

Kathy G on 1/18/03 at 14:46 (105817)

Bob,

I believe, from being active on these boards for about a year or more, that couch potatoes seldom get PF. Now, I'm sure that's not an actual statistic but it has been my finding that all of us who have PF have been physically active. Witness all the runners who have it. It makes it kind of a double whammy - you have to put up with pain and you have to seriously modify your lifestyle.

But many people make a full recovery so take heart and good luck!

Re: My first time orthotics

Carole C in NOLA on 1/18/03 at 19:49 (105848)

But that doesn't mean that you can't return to your normal level of activity once you are fully recovered, as long as 'normal' for you is consistent with a healthy level of activity for someone of your age, weight, and so on. Don't resign yourself to having to be a couch potato forever. Do realize that recovery takes time.

It's true that some or all people with PF DO need to really, really rest a lot for a few months, in my opinion (depending on how long it's been since they got PF). They need to rest not just cutting back on the abuse of their feet, but going beyond that to incorporate zero non-necessary walking. Walk to the bathroom, but don't get up to get a book, for example, because that's not a necessity. This is terribly hard to do.

Carole C

Re: My first time orthotics

Julie on 1/19/03 at 02:35 (105885)

Bob

To all the excellent thoughts you've had, I'd like to add the suggestion that you investigate and try taping. There are instructions and illustrations in the heel pain book, part 2.

Taping helps by supplying the support for the arch that the injured plantar fascia can no longer give. It actually 'rests' the fascia, so it contributes to healing as well as relieve the pain. It's considered by the doctors here that if taping helps, orthotics are needed and will help even more. But my experience, when my PF (now long since healed) was at its worst, that I needed taping plus orthotics, and used them both consistently for several months. There is no doubt in my mind that taping was a major contributory factor to my healing.

If you want to try it, have a look at the instructions in the heel pain book and then come back and ask questions. There's a knack to it, and several points to be made, but I'll wait till you've made a start!

I also want to underscore the need for rest. Nobody who has been active likes being a couch potato, or finds it easy. But PF is a repetitive motion injury (which is why people who use their feet a lot get it) and it needs rest in order to heal. I cut out all recreational and otherwise unnecessary walking for months. It wasn't easy, but it worked, and it will work for you too: you've made a good start.

Re: PS

Julie on 1/19/03 at 02:37 (105886)

Care with stretching. Active people tend to overdo it. No weight-bearing, no runners/wall stretches, no stair hanging. If you click on the word yoga here (I hope it turns into a link) you'll be taken to a long post of mine giving instructions for some simple yoga foot exercises that have helped people here.

Re: My first time orthotics

Bob B on 1/19/03 at 10:11 (105915)

Kathy,
Thank you so much for the encouragement. Hearing from all you people out there has helped so much.
Bob

Re: PS

Bob B on 1/19/03 at 10:19 (105916)

Julie,
I really appreciate the info you gave me. I have already found that I must limit my foot excercise to just ankle movements. Any stretching of even the smallest amount causes a bad reaction within hours. I think I will try the taping. Their was no URL for the yoga.
Again, thank you
Bob B

Re: PS

Julie on 1/19/03 at 13:04 (105931)

Bob, just click on the word Yoga here or in your own post, and it will take you to the exercises I mentioned.

Glad you've discovered for yourself how counter-productive aggressive stretching can be!

Re: PS

Bob B on 1/19/03 at 13:31 (105934)

Julie, THANKS!
I got it ok. The problem was that it did not come as a URL on the e-mail. I had to go to the posting to see it as a URL. I have already tried these a little and they feel GOOD. Thanks so much
Bob B

Re: PS

Julie on 1/19/03 at 14:15 (105936)

That's good, Bob. Keep it up, and do come back to me with any questions.

Re: My first time orthotics

peter f on 1/20/03 at 16:02 (106051)

Bob-listen to carol-she always gives good advice and is right-95% do recover-I am almost better after 2.5 yrs-ESWT really did help but so did rest-I mountain biked on it for 2 yrs and looking back that was so stupid-my breakthrough was to stop blaming my feet for ruining my life-I realised that I wasnt giving THEM a break rather than the other way round-think of it like tennis elbow , frozen shoulder etc-most do get better -it just seems like bloody ages .

Re: My first time orthotics

Carole C in NOLA on 1/20/03 at 16:12 (106055)

Peter, thank you! That was very sweet of you to say, and it encourages me to stay around here and try to help people.

I haven't really had even a twinge of PF pain in quite a while now, but the memory (or should I say nightmare!) of PF lingers. The thought that others may be stuck in that mire of depression, pain, immobility, and hopelessness haunts me, and so I come back to try to help however I can, maybe with tips that worked for me or trying to dish out a little hope when I can.

I'm not someone who knows it all and I probably made every mistake possible on the way to recovering from PF. Maybe someone who reads my posts may benefit from what I learned about my own feet, and somehow recover faster than they otherwise would have.

Carole C

Re: My first time orthotics

Bob B on 1/20/03 at 17:47 (106068)

Thank you Peter - I do not know what I did to my foot. It worked fine for 60 years! It just started hurting early last Sept. and kept getting worse. Finally in December I could take it no more. I could barely walk and the pain was unbearable. I got orthotics the 30th of December and I can actually walk. Problem is, I don't really know how good they are because Carole has me sitting on my butt! I am not having much pain at all now. I do get around the house 95% pain free. I am optimistic. I appreciate your and everyone else's help! And I have been taking Carole's advice. She has given me a lot of information. Bob

Re: My first time orthotics

Bob B on 1/21/03 at 00:23 (106106)

Carole,
You are right. You have helped me very much I Thank you!
Bob B