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Anyone have problems with inserts causing PF to worsen?

Posted by cjsw on 8/04/04 at 23:20 (156957)

I was diagnosed with PF over a month ago. The doctor said to try the Dr. Scholl's inserts and if they didn't work, he'd make a custom orthotic. My problem doesn't seem to be getting better....in fact worse....and I've been doing everything he told me....exercises and stretching, don't go barefoot, and wear the inserts. It just seems like I am getting worse. I'm going to try going without them tomorrow to see what happens. Just wanted to know if anyone else found inserts to make the condition worse?

Re: Anyone have problems with inserts causing PF to worsen?

Carole C in NOLA on 8/04/04 at 23:40 (156960)

Make an appointment to see your doctor, and get him to make a custom orthotic for you! If you have been wearing these inserts for several weeks then it sounds like probably they aren't working. They don't work for everyone, which is why your doctor suggested a custom orthotic as the next step. Custom orthotics are expensive but if you are lucky and get good ones, they can make all the difference.

Be careful not to overdo the stretching, since that can make things worse, too. Good luck and let us know what he says when you see him next time.

Carole C

Re: Anyone have problems with inserts causing PF to worsen?

Julie on 8/05/04 at 00:44 (156961)

You may be overdoing the stretching, or doing the wrong stretches. What are you doing? The weight-bearing exercises still recommended by doctors - the wall stretch, the stair-hanging stretch - have made many people worse. Non weight-bearing exercise is effective, and is unlikely to do harm.

Also, you need to know for what purpose you are exercising. For example, tight calf muscles is certainly a contributory cause of PF, and when this is a factor stretching them can help, but if your calf muscles aren't tight it may not be necessary to work at stretching them. On the other hand if your foot muscles are weak, you need exercises to target that. Two suggestions: investigate the Foot Trainer at http://www.foottrainer.com (this website also has a good explanation of 'wrong' exercises for PF) and look at the yoga foot exercises (click on the word yoga and you'll be taken to them) that I've described here.

And read the heel pain book to give you a better understanding of plantar fasciitis and conservative treatments for it.

If your doctor is not a podiatrist, ask him to refer you to one. You have not had PF for very long, which means that you have a good chance of reasonably quick recovery with the right diagnosis and treatment plan, but it helps to have the input of a doctor whose speciality is feet.

Re: Anyone have problems with inserts causing PF to worsen?

Richard, C.Ped on 8/05/04 at 08:46 (156966)

I think it is because of the Dr. Scholl's. You must limit the fascia from stretching and pulling while standing or walking. An off the shelf cushion like that will not target the problem.

Also, if the fascia is very sore, stay away from a hard plastic orthosis unless there is a good amount of cushion used with it.

Be careful with stretching. I do not really tell the people I see to stretch.

Re: Anyone have problems with inserts causing PF to worsen?

Sherry on 8/05/04 at 11:27 (156979)

I am on my third pair of orthotics. The are hard, and have caused a problem with my left foot recently. My right foot is my problem. I still think orthotics are a mixed blessing. The work for some.


Re: hard orthotics

Pete on 8/06/04 at 18:42 (157104)

Can never understand how pods can suggest hard orthotics for pf when the fascia is so inflamed in the first place. Some good cushioing is needed as well or they are pretty useless. Had 2 pairs of hard ones myself which I never wore once.

Re: hard orthotics

Ed Davis, DPM on 8/07/04 at 11:26 (157146)

In the 'ideal' world, patients whould probably pass through a series of orthotics, starting with softer, more forgiving devices to progressively more controlling devices. Since that is not realistic, the best compromise is to start with a soft pref-fab device and get the inflammation and strain down with PT (including taping) and then go to a semi-rigid orthotic with a soft top cover. That is the most cost effective formula that has worked in the majority of my patients. This is where the phrase 'medicine is an art' comes from in that the trick is to get the right balance of comfort and support at the right time. It is also why I have mentioned that no one modality is often used successfully in solo but that success often comes from the 'strategic' application of several modalities in unison, working in 'harmony' to move patients toward the cure. The PT/stretching/massage cannot work well if the patient walks on the foot after treatment with inadequate support and adequate support cannot be provided until the inflammation and tightness have been calmed down. This is also why it is difficult to study the effectiveness of individual modalities such as ESWT because, the studies look at the efficacy of each modality but don't reflect the 'real world' where successful modalties are being combined to obtain the desired end effect.