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Plantar Fasciitis

Posted by Megan on 6/20/04 at 06:58 (153534)

Twelve years ago when I was in my thirties I developed the classical symptoms of PF. Severe foot pain on arising in the morning (or in the night), as well as, each time I stood from a sitting position. I could literally only hobble along and felt like a 90 year old.

Enter the Podiatrist....and custom made orthotics (along with a few exercises) and within two weeks I felt like a new woman. The orthotics were replaced every two to three years as required.

Last year during summer (2003 January, February - Southern Hemisphere) I became a bit slack wearing the orthotics and a couple of months later started to experience the recognisable pain of PF. I quickly became religious about wearing the orthotics again but it made no difference.

Since then despite podiatrist visits, cortisol injection to the left foot (worst), new high quality shoes, new orthotics, exercises etc the pain has persisted.

My Podiatrist has also persistently said that I have Ligamentous Laxity of the ankles, (I have 'double-jointed' fingers and thumbs as well). Also I have an Adrenal Gland condition which requires long-term steroids.

So my question is, why is this PF being so much more stubborn this time to get on top of the pain?

I am on the verge of needing to leave my job as a neonatal nurse because of the terrible foot and leg discomfort I am experiencing.

Re: Plantar Fasciitis

Ed Davis,DPM on 6/20/04 at 17:49 (153561)

Make sure that you have the right shoegear to wear with the orthotics. Also try an intense course of PT: deep tissue massage, ultrasound, interferential therapy, taping 3 times a week, giving it at least 3 weeks to judge whether it is working. What dose of steroids are you taking? ESWT may be an option if the above does not help. In theory, steroid use is a contraindication to ESWT BUT if the dose of steroids you are taking is designed to bring you up to a normal level (as opposed to a 'therapeutic' anti-inflammatory level) then I feel that that contraindication does not apply in your situation.

Re: Plantar Fasciitis

Megan on 6/21/04 at 06:51 (153575)

Thankyou Ed for your response.

Footwear as suggested by podiatrist and checked by him after purchase.

I am on 6mgs of Prednisolone as a 'replacement' dose for genetic adrenal insufficiency - therefore not a therapeutic dose. Need to stress dose at times of illness/injury etc.

Will pursue your suggestion of PT. Is the deep tissue massage of the foot or the calf, or both?

Regards Megan.

Re: Plantar Fasciitis

Ed Davis, DPM on 6/21/04 at 19:28 (153652)

Deep tissue massage is primarily of the plantar fascia but may include the calf if the achilles area is tight.

Re: Plantar Fasciitis

Megan on 6/21/04 at 19:32 (153653)

Thankyou sooooo much Ed.

Have already booked an appointment for this afternoon with a PT. I ran the treatment modes past them that you suggested and seems he does them all -although the receptionist hesitated and was then not too sure whether they did the taping. We'll see.