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Achilles Tendonities... and now Plantar Fasciitis

Posted by Mary B on 11/21/03 at 03:22 (138203)

I am not having fun with this! The pain I have first stared about 2 1/2 months ago. I noticed if I stepped wrong or was on my feet too much, my foot started to hurt. Each day it got worse and worse. Finally it was at the point where I could barely walk by the end of the day. So I went to the doctor, and he prescribed me anti-imflamitory pills and an anti-imflammitory gel. I went back a week later, the A.Immflammitores weren't working and my foot was feeling worse, around the bottom of my heel. The X-Ray didn't show any abnormalities at all. So he referred me to physio, although there most likely would be a wait to get in. Durning my 1 month wait... the pain spread through the back of my ankle and up half way up my leg as well as the sides of my heel. The doctor said I most likely had Achilles Tendonitis. Which was really strange considering I was not very active and it's a more common injury in athletes. The pain was almost unbearable, so he prescibed me a walking air boot & crutches to help me get around. So I finally got into physiotherapy, and I have gone to 5 sessions. They have used Ultrasound, laser, inferential, T.E.N.S (Transcutaneous Electrical Nerve Stimulation ), ice, and an at home program of stretching and icing. I noticed about 1 week ago that the pain was starting become less in the back of my ankle around the achilles tendon and started to get worse and more sharp and painful in the bottom of my heel. My physiotherpist thinks that this may be the beginning of Plantar Fasciitis and/or a heel spur. So she is going to start treating them both as if I have Plantar Fasciitis as well as Achilles Tendonitis. The pain hasn't lessened, and seems to be getting worse! I guess I'll have to see how physio helps, if at all....

Has this happened to anyone? Does anyone know as to how maybe Plantar Fasciitis may cause Achilles Tenonitis and vice-versa? Can you relate in anyway? I'd like to hear from you, if not thank you for listening to what's going on with me.

Re: Achilles Tendonities... and now Plantar Fasciitis

Carole C in NOLA on 11/21/03 at 07:17 (138206)

Mary, I had plantar fasciiitis (PF) and pretty bad Achilles tendonitis along with it. My doctor told me that they often appear together as a sort of 'syndrome'. I suppose that is because various tissues are connected. If one gets strained, it pulls on the other and both Achilles tendon and plantar fascia get inflamed and sore. If you pull back on your toes (very gently so you don't hurt yourself more), you can feel how that pulls on both your Achilles tendon and your plantar fascia.

I'm not an athlete either; in fact I'm older, quite obese, and had just lost 80 pounds which was about half of what I needed to lose. I had decided to add exercise to my regimen to help with the weight loss, so I bought an exercycle. In my case it was determined that the cause of my PF and Achilles tendonitis was overly enthusiastic and injudicious use of the exercycle.

If you recently started a new exercise regimen right before getting these problems, it might be the problem. However, lots of people get PF for other reasons, such as a gait in which the feet pronate (turn inwards during the gait) excessively.

There are a lot of simple things you can do at home to help your PF to heal. Here's a list of them. Sorry in advance for the unsolicited advice! My intentions are the best.

First, I'd recommend reading the heel pain book which is a free webpage on this website.

A very crucial self treatment is Julie's Yoga stretches. If you click on the word Yoga that should take you to a description of them.

Rest is another basic treatment too. Try not to do anything that hurts and try not to overdo.

Custom orthotics have been helpful for some of us, and Birkenstock shoes have been helpful to even more of us. Try the Birkenstock 'Arizona' model, or possibly the 'Boston' model.

Don't ever stand or take even one step barefoot until the pain is gone. Wear shower shoes in the shower, or get a shower stool.

If you are in a lot of pain, try icing your feet; a bag of frozen peas works well because it conforms to the shape of your foot.

Be sure to come back to these message boards with any questions or just to read. It's very helpful. Good luck, and I hope your feet feel better soon!

Carole C

Re: Achilles Tendonities... and now Plantar Fasciitis

Kathy G on 11/22/03 at 09:26 (138348)

That's great advice from Carole, Mary. I have nothing to add except that I, too, had achilles tendonitis along with PF and still have bouts of it. When I developed it, I already had PF, but without heel pain, and bad pain in my calf. When I went for physical therapy, whatever they did caused me to have heel pain, along with everything else. I dropped PT and followed what Scott's book suggests and I have gotten better, although I'm not back to my former self. But not to worry, the majority of people with PF eventually gets back to normal, or almost normal, activity levels.

When I got PF, I was active in that I was working a job that required that I stand. I, foolishly, was just as active outside of work, and still trying to keep up my exercise regime, although it had become just walking because of the foot problem. Apparently one doesn't have to be an athlete in order to get achilles tendonitis. We just hear about the athletes who have it.

Hurts like crazy, doesn't it?

Good luck and remember that there is light at the end of the tunnel!

Re: Achilles Tendonities... and now Plantar Fasciitis

Mary B on 11/22/03 at 14:31 (138374)

Thank you for all your advice... I appreciate it...

Yes it hurts like crazy, I'm getting frustrated by not being able to do anything without getting a lot of pain. The same thing happened to me, the heel pain came after I started physiotherapy. Do you think there is maybe something physiotherapists do that irritates that area to cause more pain? I am willing to give anything a chance and want to try physiotherapy for longer to see if it helps in the long run. I think they only do 12 sessions where I am going then probably send you on your way. I guess I stick around for them and then see where the pain takes me afterwards... It really sucks, and I'm trying to get better before May next year, because it's my wedding and I want to be able to walk down the aisle without limping!!!

Re: Achilles Tendonities... and now Plantar Fasciitis

Dr. Z on 11/22/03 at 14:50 (138375)

I just read an article that ionophoresis is very effective for Achilles tendonitis that has just started or is in the acute stage. The definition of acute is less then three months. If the problem is a tendonosis it won't help. ESWT is very effective when the AT is in the chronic or tendonosis stage

Re: Achilles Tendonities... and now Plantar Fasciitis

Carole C in NOLA on 11/22/03 at 14:55 (138376)

I don't know anything about physiotherapy, Mary, since I didn't have any. Maybe Kathy or someone else can answer that question.

It takes a long time to get over PF. My recovery was very definitely hastened by the treatments I described. The treatments for Achilles tendonitis are pretty much the same as for PF, except I think adequate gentle stretching is probably even more important for us. By 5 months I was leading a normal life and could have survived a wedding without limping (especially if I could have sat down at the reception), and by 9 months I was essentially pain free (as long as I don't do anything really stupid). I really worked hard at the treatments, though, and gave them a much higher priority in my life than most people are willing to do.

It might be good to start thinking about possibly changing to more supportive shoes between the wedding and the reception or maybe sitting during most of the reception. (?) I am not much of a fashion guru but I'm thinking of white Birkenstock Grenadas with pretty toenail polish might be fine for your reception, the formal photos would already have been taken, and nobody would probably notice. If they did, you could tell them that they are easier to dance in.

Carole C

Re: Achilles Tendonities... and now Plantar Fasciitis

nancy s. on 11/22/03 at 16:06 (138387)

mary, apparently like a whole bunch of folks here, i also had achilles tendonitis with pf (the a.t. began about 10 months after the pf).

it's interesting that dr z read an article about iontophoresis helping achilles tendonitis. i had six months of physical therapy, and quite a bit of iontophoresis during it, and i am positive that it did help.

have you had this as a part of your therapy, or is it available to you?


Re: Achilles Tendonities... and now Plantar Fasciitis

Mary B on 11/22/03 at 17:36 (138392)

what is ionophoresis? I've never heard of it before

Re: Achilles Tendonities... and now Plantar Fasciitis

Suzanne D. on 11/22/03 at 21:24 (138401)

I'm sorry, Mary, for your pain! You have been given some excellent advice here; there is really nothing more I could add. I did want to tell you, though, that my daughter got married last April, and her dress was so long that no one could tell what type shoe she had on. She is short, and the dress could not be altered as it had lace around the bottom, so she wore heels to make it just come to the floor. But you could not see the shoes. If you don't already have your dress, maybe you can make sure that it is long and full (if that's the type dress you like!). Then you really won't have to worry about the shoes showing and can just be beautiful and enjoy the day! :) I like Carole's idea of the white Grenadas at the reception.

Take care, and I hope you enjoy planning your wedding!
Suzanne :)

Re: Achilles Tendonities... and now Plantar Fasciitis

Kathy G on 11/23/03 at 08:19 (138446)


Well, this is far from a technically perfect description, but iontophoresis, or ionto, as most people refer to it, is done by rubbing an inflamed area with a cortisone-type substance and then using ultrasound on the area so that the substance is properly absorbed. Someone like Dr. Z would just cringe at that explanation so I'm going to paste an expanation from about.com that's much more technical.

They tried it on my calf and I had several treatments on my hand for Deqervain's tendonitis. It didn't work for me but my husband knows a woman who swears it cured her PF. By and large, I don't think I've heard anyone on these boards swear by it but maybe I missed it.

Here's the much more scientific explanation:

What is Iontophoresis?
Iontophoresis is an effective and painless method of delivering medication to a localized tissue area by applying electrical current to a solution of the medication. The diagram below illustrates the basic mechanism. Like electrical charges repel. Therefore, application of a positive current will drive positively charged drug molecules away from the electrode and into the tissues; similarly, a negative current will drive negatively charge ions into the tissues.

Re: Achilles Tendonities... and now Plantar Fasciitis

nancy s. on 11/23/03 at 08:28 (138449)

kathy, the way i received iontophoresis was this:

my p.t. put cortisone-soaked patches on my most inflamed areas, and the patches were connected via wires to a machine that delivered electric current, sending the cortisone through the skin into the affected areas.

it sounds like there's more than one way to do this, which i didn't know. but the version of ionto that i received was very helpful to me. i had it for about three months, twice a week.


Re: Achilles Tendonities... and now Plantar Fasciitis

Mary B on 11/23/03 at 14:25 (138476)

Yah i've had that.. that's the first treatment I get at my physiothearpy appointments... my physiotherapist calls it ultrasound. But it's that weird gel stuff with the ultrasound machine. So far it's not helping but I have to give it more time.

Re: Achilles Tendonities... and now Plantar Fasciitis

Dr. Z on 11/23/03 at 16:07 (138483)

Not the same thing
Ionophoresis is where a steriod medication is transfered into the tissues via a electrical current. Ultrasound is using superfical sound waves to stimulate blood flow to the tissue. Hope this clear up the two different treatment. They can be both used during the same phyical therapy session

Re: Achilles Tendonities... and now Plantar Fasciitis

nancy s. on 11/23/03 at 17:13 (138485)

thank you, dr z. Your description of iontophoresis is what i understood it to be. i also had ultrasound, which, as dr z says, is different. my own personal experience was that the ionto was much more helpful than ultrasound -- but for anyone considering either, keep in mind what i was dealing with: bad pf in one foot; medium to bad achilles, peroneal, and post tib tendonitis in both feet.

i hope this helps mary or others.


Re: Achilles Tendonities... and now Plantar Fasciitis

Mary B on 11/23/03 at 20:45 (138511)

Is this life inferential or T.E.N.S because I've had this as well...???