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It's not PF!!!

Posted by R C on 12/05/03 at 17:37 (139440)

Well, I just had an interesting follow-up with my doc today. After four weeks of complete rest, I had expected significant improvement, but unfortunately that was not the case. When I quizzed my doc about it, and went over exactly what hurts and when, we arrived at the following conclusions:

(1) My PF, which started four years ago with the 'classic' symptoms, has long since healed completely. There is not one shred of pain with the finger poke test anywhere.

(2) We've isolated the discomfort to one of the muscles that attaches to the heel, pretty close to the insertion point of the plantar fascia. The discomfort becomes a raging pain when I stand on one foot (the bad one), and focus my weight on the front quarter of the foot with the big toe. Seems that I injured that muscle.

I subsequently looked up the name on the internet, and I think it is the adductor hallucis muscle, where it attaches to the heal. The doc says he has never seen a case like this, and doesn't know what to do.

My guess is that complete rest is less likely to work (and indeed the last attempt did not help), and that I need to think of some exercises that will work the injured muscle - something not as demanding as standing and walking.Anyway, that at least gives me something to try.

If anyone out there has any insights, please holler.

Re: It's not PF!!!

Ellen on 12/05/03 at 20:48 (139452)

Hi RC
Had you tried the Foot Trainer? I have been using that to gently stregthen the foot muscles and it seems to work nicely.
Ellen J.

Re: It's not PF!!!

Jen L on 12/06/03 at 16:12 (139494)

RC,
Do you mean when you dig your fingers in your heel and don't feel any tender point, it proves that your P.F. is completely gone? From time to time I cannot find the tender point at insertional point by finger pressures but as soon as I increase activity by a few minutes the P.F. pain/discomfort returns. Perhaps being not in medical field I have great difficulty with foot anatomy, when I look at the picture I feel puzzled. I cannot locate the tender point of my foot on the drawing. How do you or your doc distinguish between the insertional point pain and a muscle pain, especially as you said the muscle is close to the insertional point? Many people have arch pain or bottom of foot pain with or without heelpains, but they still think it's because of the Plantar fasciitis.
Excuse me for being in doubt. I do hope yours is not P.F. anymore.
Jen

Re: It's not PF!!!

R C on 12/06/03 at 17:18 (139495)

Jen L., for good pictures, look at http://www.foottrainer.com/foot/ (this is not an endorsement of any products sold at that site).

The doc and I ruled out PF using several criteria. One was the finger poke test (no pain). Another was for me to indicate when and where there is pain (complicated details). This included isolating certain muscles along the medial edge of the foot and my recalling the history of the injury there. And finally we took into account the things that did help or didn't help. I don't think we can rule out PF by the finger poke alone.

I did have classic PF at one time -- the bottom of my heel felt like someone had hit it with a hammer. Or that I had been walking with a rock in my shoe at that spot for about 200 years. That particular injury has cleared up.