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1st appointment... so far, so good.

Posted by goose on 6/15/04 at 11:46 (153075)

I haven't had chance to read the other threads but I am anxious to here about Elyse and others experiences.

My first visit did not include treatment, so I can't comment on that just yet. I can tell you that Dr. Sandell is extremely professional, knowledgeable and optimistic (and young)! He specializes in chronic pain and sports injuries. He explained in great detail how the body is connected: he took a thorough history, analyzed my gait on the tread, and tested my flexibility (determined I have some serious tightness in right hip flexor, left glut and right calf). We discussed how and why TFM works and it really makes a lot of sense. My orthodics are okay for now. He says that part of the treatment is to stress the PF, including doing some running! I told him I didn't believe it would happen and he said instead of talking about it he would just show me. I might need a more flexible orthodic at that point. He says I have a mild-moderate case of PF (which shocked me!) as I just have scar tissue near the heel area.

I have my first real appointment on Friday and then three next week. I even met John from MN in the lobby and he criticized my red Birks ( I had my New Balance in my bag)! I will keep you all posted but I have a very good feeling about this. Time will tell!

former runner, age 26, onset 4/03, atypical pain

Re: 1st appointment... so far, so good.

Elyse B on 6/15/04 at 12:02 (153077)

wow that is something. This guy really believes he can cure you and get you back running. I wish my guy was as confident that I would up and running in no time. Did he give and estimate on how many treatments you would need? That is important to probably a lot of us who would fly out there if this guy put's his money where his mouth is.

Re: 1st appointment... so far, so good.

Elyse B on 6/15/04 at 12:11 (153079)

one more thing, why would he want to stress the PF and have you do running? That makes me a bit confused.

Re: 1st appointment... so far, so good.

John from MN on 6/15/04 at 12:18 (153083)


Sorry if I criticized your Birks, I had no ideal what they were. Three months ago all I could wear were running shoes and could not even think about wearing anything else due to the severe pain. I have been shoe deprived for the past 5 years. I am thinking about wearing my cowboy boots again.

If Dr. Sandell said you have a mild-moderate case of PF you should be in good shape by the end of summer.

Re: 1st appointment... so far, so good.

goose on 6/15/04 at 12:44 (153091)

John from MN,

All will be forgiven, if this treatment helps :)

I would love to see you at the clinic in your cowboy boots. Giddy up!


Re: 1st appointment... so far, so good.

Dorothy on 6/15/04 at 14:31 (153102)

Very exciting! Good luck... We are all pulling for you and waiting and watching with you...

Re: 1st appointment... so far, so good. 2nd try

Robert J on 6/15/04 at 16:50 (153120)

On the business of stressing the PF and doing some running, that is very similar to the recommendations of Dr. James Rainville at Harvard who developed the rehabilitation clinic for chronic bad backs. Greenville believes that injured soft tissues, including muscles, tendons, and ligaments, can get trained into reporting pain and will sometimes continue to do so even after the original injury is healed. This training is the source of many chronic bad backs, he believes. The way out of this dilemma, he says, is to exercise the soft tissues and re-train them into reporting normal responses. When exercise commences, the tissues initally may report higher levels of pain than when they were being 'rested,' but fairly soon they will be re-trained and the pain will fade away.

This sounds almost too good to be true, I know. And Rainville only deals with bad backs, not bad feet. But, when you think about it, the soft tissues of the bottom of the foot are similar to the lower back in that both contain a complex mix of muscles, nerves, ligaments, and tendons.

In any case, I am using myself as a guinea pig for this idea. I am now two weeks into a regime of fairly vigorous strenghtening exercises and daily exercise walking and/or bicycling. The strenthening exercises alone last for about a hour each morning. I also use a stretching regime that takes another half hour. I get up at 5:30 am to get started....

And, after two weeks, I am better. Much better. Not cured, but better. Like Goose, I am an atypical PF person of 2.5 yrs duration. Once upon a time I was a runner.

I would be curious to know what the good doctor says about his exercise recommendation and whether it jibes with Rainville's. In any case, good luck with your experiment.

Re: 1st appointment... so far, so good.

Pauline on 6/15/04 at 16:59 (153121)

Thank you and Elyse for posting. I wish the very best results for both of you and to be honest cannot wait to see the comparison between each approach as you both make progress.

Re: 1st appointment... so far, so good. 2nd try

Pauline on 6/15/04 at 17:10 (153124)

What a good and interesting post. The question I have is that we are told not to push through the pain, but apparently you did.

Did you experience more at the beginning of your program and how did you work through it? Did you start out daily or work into a daily program?

This approach is certainly different from everything we've been hearing, but it sure sounds like it's working for you.

Re: 1st appointment... so far, so good. 2nd try

Marty in SLC on 6/15/04 at 19:06 (153135)


When it comes to feet I'm not sure this is a good test but time will tell. However I do believe that this is a great thought and point after one has surgery on their feet. The feet are still going to tell you there are sick even though they my not be.


Re: 1st appointment... so far, so good. 2nd try

Elyse B on 6/16/04 at 07:12 (153151)

Robert that is contrary to everything I have heard about PF and resting and not running. I am giving myself one week off and then I am starting to run/walk again. I am going biking tonight which does not seem to bother me. My issue is the orthotics. I have 2 pairs and I am back to wearing regular shoes because the orthotics are uncomfortable. I will post about how I do.

Re: 1st appointment... so far, so good. 2nd try

Dorothy on 6/16/04 at 11:19 (153173)

Robert -

My inclinations are with your plan. I have a 'back' history and I know the old recommendations were to rest, immobilize - just like the current recommendations for PF. However, those recommendations were found to be bad for back health (and general body health). When I had acute back episodes, most of the up to date information was for exercise, not rest, and I think I got better because of it - but, man oh man, it takes 'determination'. Now, even more recently, there is evidence that the exercise should be even more vigorous and weight-resisting.
I think the theory behind the work that you described (Dr. Rainville?)can be seen to be related to the work that Dr. Sarno has done - that too often gets simplistically described as 'it's all in your head' (incorrect description).... having to do with pain messages/fear/response/interpretation of pain messages and so on. They seem to be complementary theories.
Anyway, I respect and applaud your courage and fresh thinking; I have a good feeling about your potential for good outcome - and I am looking forward to reading your posts.

As an aside, about a year ago or so, there were one or two posters here who were going to try to increase their exercise and to walk barefoot (I amy not be remembering their plans accurately and I do not recall WHO it was so this comment is pretty close to WORTHLESS! but - maybe someone else will remember) and other plans to really 'up' their vigorous movement with PF. I wonder what they did and what happened??? Anybody know???

Re: Guinea Pig

Robert J on 6/16/04 at 12:23 (153174)

I will definitely keep you posted about my progress, or lack of it. In case anyone is interested in Rainville's theory and his rehabilitation clinic at Harvard, there was an article in the New Yorker awhile back. A week or so ago I posted a link to that article. Just to clarify one point, I am not going whole hog on this. For one thing, I am not running but walking. My strengthening exercises started modestly and are building progressively. I am trying to measure each exercise so I know how fast I am increasing the stress. For example, I started with ten heel lifts. I am now up to 60 heel lifts with the front of my feet on a two-by-four and my heels dropping to the floor. On the walking, I started with a pitiful 5-minute walk and am now up to 15 minutes.

Also, I had stopped taping after 2.5 years, and just this week stopped using some off-the-shelf orthotics on the theory that taping and orthotics are sort of like back braces: good for a short time after an injury but ultmately weakening to the soft tissues. Abandoning these left me a little breathless, but so far no ill effect.

As for the pain reaction, it has been muted, much to my suprise. In the very beginning I got a mild uptick in the dull, achey feeling. In the past, that would have been a signal to me to back off. But I kept going this time, and the aching actually fell below its 'normal' level.

Pauline, I was most interested in your comment that you once had a bad back and eventually recovered through exercise rather than rest. I also had a bad back and had the same experience. That's a big reason why I decided to experiment with Rainville's approach. Hey, if it works for backs it just might work for feet.

A couple of last points. I am an atypical PF person, so I'm not sure that my experience will mean much for those who have classic PF. Also, because of my back history, I KNOW that my muscles, tendons, and nerves can go into a chronic pain response and that progressive exercise can 're-train' those soft tissues away from the pain response. I have no idea how many other PF sufferers are in that category.

Finally, I ain't cured yet. I am much better, but the jury is still out. I will let you know.

Re: Guinea Pig

Dorothy on 6/16/04 at 15:07 (153184)

Robert - Unless I have missed a post of Pauline's that says something otherwise, I believe you addressed your note to Pauline in error - regarding her back and exercise vs. rest. Those comments were from me and that was my experience and I am Dorothy, not Pauline. It is only important to the extent that one's experiences and identifying information matter here; otherwise no problem. Just didn't want you to think you had something in mind attributed to Pauline that should not be.
For example, Pauline is highly involved with questions about ESWT and podiatrists vs. orthapedic surgeons and I am not at all. I am a fan of the Detroit Pistons and John H.s snake reports, but Pauline has not written on those. I have recently had hives and in the past various other afflictions and maladies, some just unpleasant, some downright life-affecting. It is my back and my history regarding my back that I wrote about. I would not be able to say one single thing about Pauline's back, except that I hope it is healthy.

Re: Guinea Pig

Pauline on 6/16/04 at 15:35 (153187)

What can I say. Your eloquent description to correctly identify each of us is terrific. Lord knows being considered 'high profile' I have already had enough attributed to me.

I love your posts and I think most of us would sincerely miss them so don't ever think of leaving.

P.S. In case your asked, my back is ok:*

Re: Guinea Pig

Pauline on 6/16/04 at 15:46 (153188)

Now to respond to Robert's post. I have had some experience with back pain from time to time and yes the treatment was exercise. I was put on rest and ice for 24 hrs. Then anti-inflammatories and heat for about 3 days before beginning P.T.

There they RXed various exercise to strengthen the muscles and I still do them today.

Speaking from my own personal experience with back, dislocated shoulder and pooly tracking knee caps the answer was alway exercise.

Dr. David Collon from Henry Ford Medical Center has developed an extensive and very aggressive exercise program for his knee and leg surgery patients. Many are professional athletes, some college who are injured through play. His program has put them back on the field quickly and in much better shape to play again.

I think they are finding exercise is the key to mobility and better healing.

Make no mind about the mix up in names. It all works out. The important thing is that you keep posting because we all learn from eachother.

Re: Guinea Pig

Robert J on 6/16/04 at 17:21 (153193)


Whoops, sorry about that. And I will mark you down for any future questions on hives or John H's peculiar Arkansas snake hobbies.