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bruising around plantar fascitiis points

Posted by michelleF on 5/10/03 at 14:47 (118238)

I am unfortunately a 'classic' plantar fascitiis case: teaching job where I stand on feet all day, supinated fet, high arches, obese from recent & rapid weight gain, middle-age woman... with typical symptoms before the injury day. I had a sudden onset of severe symptoms after a day of significantly increased activity. My foot seemed to 'pop' at the heel/arch, and then I couldn't walk on it. I went to hospital after foot 'popped.'

I don't doubt the diagnosis of plantar fascitiis; however, I am wondering about the amount of bruising on both heel and the ball of the foot. Does the bruising indicate a 'rupture'? What is difference between a rupture and a tear to this ligament? More importantly, is the treatment any different? Most importantly, ow long should I be off this foot?

It's been four days since I went to hospital, and I'm out of med's (anti-inflammatories) after today. I still can only put partial pressure on the foot, and I'm suppose to go to work on Monday. Ha! I can't stand for 30 minutes let alone 8-10 hours...

Thanks in advance.

Re: bruising around plantar fascitiis points

Ed Davis, DPM on 5/10/03 at 14:53 (118240)

A rupture and a tear are the same thing. What treatment other than anti-inflammatories was provided? A cast will allow a reasonable amount of ambulation without terrible discomfort.

The upside to a tear of the plantar fascia is that that amounts to the equivalent of surgically cutting the plantar fascia and, as such, can lead to a long term cure. Like, a plantar fascia release, the healing time can occasionally be lengthy but can be helped with PT, proper shoes and orthotics.

Re: bruising around plantar fascitiis points

michelleF on 5/10/03 at 15:38 (118243)

At the hospital I was prescribed
acetaminophen with codeine #3- 12 tablets for 4 days
indomethancin 50 mg/3x/day- 15 tablets for 5 days
icing to reduce swelling
no prolonged standing till Monday
I have not seen a primary care or a podiatrist. I'll have to take off another day to see one, and this is part of my dilemna.

Depending on how long prognosis is to heal, I am considering applying
for worker's compensation . I teach middle school, and we spend 3 days each year at Skycroft doing hands-on activities. My injury occured while supervising basketball game after a day spent hiking through woods. There shouldn't be a problem with applying for workers' compensation, but I definitely need to give my school a heads up if I am going to have to be out for more than one or two more days.

If the plantar fascia has separated, how long will it take till I can stand without pain. My commute is over 3 hours, and I stand for more than 6 hourse a day so I need to be somewhat realistic about whether I can do this. There is no way I feel up to it now. Any suggestions? How long does this usually take? If I took the rest of the week off would that do it?

Additional Self-Treatment
I went ahead a purchased a night cast from this footdoctors.
I also went ahead and purchased new 'running' shoes with good arch support. I had let old shoes get 'flat'...
VERY gentle stretching using my hands to massage...

Anyway, I really appreciate you responding so quickly,
Thank You,

Re: bruising around plantar fascitiis points

Ed Davis, DPM on 5/12/03 at 13:38 (118416)

Since the injury was acute, it is likely that you should have little trouble getting the claim accepted by worker's comp.

Wow -- you have a long commute! Where do you live? Consider having a cast placed. This is a situation in which a well molded fiberglass cast does a better job than the removable 'casts.' I would place the cast on in a fashion that the fascia is in a relaxed position, adding planty of padding to the bottom to make walking easier. One concern is that if a cast is not used, hobbling will aggravate the problem, make it hard to get around, cause postural symptoms (back) and may make falling easier to occur. The cast need only be on for 2 1/2 to 3 weeks then follow with PT, orthotics...

If you commute by car, a cast can make driving a challenge if it is your right foot but possible if it is your left foot. I can understand the need to try to work but don't force the issue -- you need to take care of yourself and allow time for recovery.

Re: podiatrist says plantar fascia rupture- and I'm in cast...

michelleF on 5/15/03 at 12:14 (118851)

Thank you for your help. I did go see the doctor. I tore the plantar fascia ligament apparently at the heal and at the arch point. I am out on worker's comp and in a soft cast and boot for another week.

Tuesday, I'll go back to be reevaluted to see if MRI and surgery are necessary. Everyone is being hesitant to put a specific recovery time. Would give at least a 'ballpark' figure? I'm already stir crazy.

Thank you again,