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Physical therapy for PF

Posted by John King on 7/16/04 at 15:38 (155627)

I am getting PT for PF. I really have to wonder if these therapists know what they are doing. My feet hurt much worse after doing all these exercises and stretches. I limp out and my feet hurt for days. Is this the way it is supposed to be?

Re: Physical therapy for PF

John from MN on 7/16/04 at 15:47 (155631)

PT is good, but you must address the scar tissue in your fascia. Your pain will not get better until you fix this.

Re: Physical therapy for PF

Steve G on 7/16/04 at 17:42 (155637)

It could be that the PT is causing you problems. When I discussed PF with a PT I was seeing for my back, he outlined a pretty aggressive stretching plan. And as many people on the board have noted, aggressive stretching can aggreviate the problem. These days, I get all my stretching via my nightsplint. You might discuss this concern with the therapist or hold off on the PT for awhile

Re: Physical therapy for PF

Marty in SLC on 7/16/04 at 18:12 (155644)

unless they know what their doinng it can cause problems like inflamation but not to scare you off, just it can happen.

Re: Physical therapy for PF

john h on 7/16/04 at 18:39 (155651)

I am actually about 10 days of pain level 1 after 4 weeks of PT. This is about as good as I have been in some years. No aggressive stretching mostly foot strengthing exercises and stretching the calves. Ultra sound and some electrical stimulation. What ever is going on I will take it and not look back. I have had this bilateral disease for 10 years so any improvement is monumental in my case. What remains to be seen is this permenent?????????????????????

Re: Physical therapy for PF

Dorothy on 7/16/04 at 18:56 (155655)

John H -
You know, John, this experience you are describing comports with that research study that (I think it might have been you who posted it) was posted here a month/two/three ago about strengthening the muscles of the feet being the key, moreso than the usually recommended stretching and moreso than other treatments. Do you recall this? I wouldn't even know how to begin a search here in order to bring it forward and re-post it - but I remember the gist of it.
Good news for you; enjoy it while you can and we will all join you in hoping it IS permanent. Wouldn't that be great?? It's possible, you know. Do you feel hopeful?? Optimistic (ever so cautiously?)??
There have been several things in your life of late that could be factors:
increased exposure to Sarno, PT, strengthening, trip to back facility w/some hope there.....and the other factors you mentioned. Who knows which and how much?? I wish I had printed out your strengthening exercises that you posted recently. How do you think the Foot Trainers fit into a regimen like this??

Re: Physical therapy for PF

To John H on 7/17/04 at 07:11 (155668)

Specifically what foot strengthening exercises and stretching are you doing. After 10 yrs your progres is great and gives hope to us all.

Perhaps you ought to confirm what ultrasound and elec stim you're also having.


Re: Physical therapy for PF

john h on 7/17/04 at 09:33 (155674)

I indeed have had PF bilateral for almost 10 years. Have travelled to N.J and St Louis for ESWT treatments (4 on each foot) and done all the conventional and non conventional things (except Yoga which I still think is a good choice not for just you foot but your whole body).

I have now been in physical therapy for 4 weeks going three times a week. I have two more weeks on my prescription. The therapist at the begining said he thought he could help me or improve my condition but said after having it 10 years he would never make any promises. He is in his mid 30's and an intelligent guy. Only one University in Arkansas provides a 4 year degree in PT which he attended. He then worked for a large Sports Medicine Clinic before going out on his own last year. He did all the foot orthotic casting for the Sports Clinic and seems to have a better than averange understanding of foot biomechanics and has spent some time observing me walk, looking at my foot wear on my shoes. He quickly picked up that after my heel strike and I roll my foot inwards (slight pronation) I tend to not let the roll go all the way to the big toe. I suspected that as I hav hallux limitus and when the great toe goes up it causes pain. This developed about the same time as my PF and could be a contributor. He wants to post up my existing orthotic to help me accomodate this (no charge).

I do have about 5 minutes of ultra sound on each foot at each session. I always thought this was for deep heat but he said no. I have 15 minutes of electrical stimulation with the electodes placed one on the achilles and one where the fasia attaches to the heel at the area of the pain. He said in school they were taught this can help break up scar tissue. He uses a setting that I tell him is most comfortable. I always do some calf stretches with both bent and straight knee. Holding them for 30 seconds each. It is very difficult to explain the foot strengthing exercises. Some involve using weights (adjustable) with a strap on my foot and pivoting on the heel left and righ while sitting on a bench. I also find the balancing on one foot on a thick soft rubber pad really causes you to use every muscle and tendon in your foot and ankle. I think I could pass a sobriety test now if I was stone cold drunk as I have improved my balance. I am now at least 10 or more days of pain level of 1. When I walk 2-3 miles it may be a pain level of 2 but quickly goes away. He does about 5 minutes of cross friction massage mainly becausse I asked him to. I have had periods over the years where I showed some good improvement including after ESWT but I have never been able to hold that improvement. This is just my 10 day almost pain free experience so let us look at this a month or two or three from now and see if this has really helped me or just a momentary pause in PF pain. I think physical therapy has always been a proven treatment for many injuries. It probably will not cure many people with PF but then it may help some of you. I will let you know how it is proceeding in the future. P.S. One thing to throw in this mix is I have very much been in Birk Sandals for the past month or more except when walking distances so this could also play a part in my recent good feelings.

Re: Physical therapy for PF

john h on 7/17/04 at 09:42 (155675)

Dorothy: I am very cautious after all these years as I have had these ups and downs before. I think the Foot Trainer would be excellent for some foot exercises and actually described it to the Physical Therapist. I am thinking of ordering one. You are right when you find hope in anything it can only help you with other problems in your life. All I know for sure my feet feel good this morning. I will mow the yard in my birks (not safe or recommended) when I think it is hot enough like maybe 95 degrees. I do remember posting some info I found on strengthing the foot but do not maintain a file so will have to search aroung. I think loose calf and hamstring muscles and strong feet can only be good for any foot problem or back problem.

Re: Physical therapy for PF

Cindy W-A on 7/17/04 at 10:17 (155676)

John H: Thanks for the info on the physical therapy you're receiving. I'm thinking about finding someone in California and it's good to hear what you're PT is doing that's helping. I just received the Foot Trainer and have used it a few times. Too soon to tell if it's helping but the exercises seem good and I'm going to keep at it. I also wear Birks all the time right now as they're my most comfortable shoes.

Re: Physical therapy for PF

John King on 7/17/04 at 10:17 (155677)

I had PT yesterday and my feet are sore and I don't need this kind of pain. I have had chronic PF for many years and I took a chance on this PT but I have doubts. Anything that makes it hurt worse is not good in my book because it reduces my mobility for days. I think I am going to tell these people to pound sand and just go back to taking it easy on my feet. The theories always sound good until you can't walk the next day. I have had it with PT.