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Physical Therapy

Posted by Lana on 9/20/04 at 14:40 (160202)

I am thinking about doing physical therapy for my chronic PF. I wanted to find out more details about it before I schedule an appointment. If you had physical therapy, can you please let me know what exactly did they do, for how long and how often, and also if it made you feel better?

I would really appreciate your responses.

Re: Physical Therapy

john h on 9/20/04 at 17:35 (160209)

I just completed about 15 visits to a certified Physical Therapist. Including stretching of the foot,calves,etc. Some TFM and electrical stimulation. In the end no help. I actually had about 10 more visits scheduled on my Doctor's orders but cancelled as it obviously was not helping. This is not to say it want help you but no luck here.

Re: Physical Therapy

Tina H on 9/20/04 at 20:53 (160225)

Hi Lana- I think the Physical Therapy is helping me althogh I am 8 weeks post ESWT so I'm not really sure. The thing that I liked about having PT is that he actually evaluated my biomechanics and felt my pf problem is essentially due to inflexibility and really tight muscles. It was helpful for me to have someone show me stretches, also the stretches he does during the session are much more agressive than I could do alone. He also knows how to do them properly as to not damage the achilles tendon which seemed to be a problem when I was trying to elevate the level of stretching. I personally know of 2 women, runners who went to this physical therapist with bad pf and were cured. I really don't think it can hurt if it's a reputable practioner and it might really help you. Let us know how you make out. Tina

Re: Physical Therapy

R C on 9/21/04 at 07:56 (160246)

I have to carefully qualify my answer. I have tried PT as a direct treatment of my PF. This involved 3 visits per week for 4 weeks. I repeated this with a different therapist over a year later. In neither case did I experience even a shred of improvement. In fact, because of their reliance on weight bearing exercises and stretches, the condition actually got worse. Later, I also did PT after having my foot in a cast. Here the PT was for restoring the strength and flexibility in my ankle, which had become stiff from immobilization. I avoided all weight-bearing exercises and stretches. In this limited situation the PT did its work, though I have to credit the cast + crutches for the improvement of my injured foot.

Re: Physical Therapy

Kathy G on 9/21/04 at 08:06 (160249)

My experience with physical therapy was very negative. I was experiencing severe Achilles Tendonitis and burning in my arches and PT was my idea. I knew that my Pod didn't really think I should do it but I was desperate and I pitched the idea and he said he'd give me a referral.

While going for PT, I experienced heel pain for the first time, probably due to the wall stretches and stair hanging and other weight bearing exercises they had me do. They even managed to aggravate an atypical Morton's Neuroma that hadn't hurt me for years.

My referral was for more visits but I didn't go back after maybe two weeks. For me personally, PT was not the answer for PF.

Re: Physical Therapy

Cindy W-A on 9/21/04 at 11:11 (160256)

I've been going to physical therapy - stretching against the wall, towel crunches, golf ball massage, ultrasound, deep tissue massage and electric stim - 2 times a week for the past 7 weeks. I seem to be improving but it's slow. I started using the foot trainer about the same time and do the towel crunches and golf ball massage, as well as Julie's yoga and a few other sitting foot exercises, on a daily basis. I also rest so it's hard to know how much of my improvement is really due to the physical therapy. I think the deep tissue massage helps the most. I've had PF about 10 months with no morning pain.

Re: Physical Therapy

Cyndi T. on 9/21/04 at 12:55 (160260)

I have been having physical therapy for the last six weeks and my plantar fasciitis is almost cured. The key is finding the right physical therapist who can address and treat the biomechanical cause. I tried PT at a different location several months ago with no results. They were only giving me exercises primarily for my feet and calves, with no regard for the real cause of the problem, which in my case was my hips. Since then, I finally had the great idea to get a consultation with an expert...(since PF is an athletic injury)...so I went to see the Medical Director of the Houston Marathon! What a difference! He was very thorough and spent two hours with me at my initial visit. It was discovered that my hips were not level, I had weak piriformis muscles, and weak instrinsic muscles in the foot. He gave me a prescription for PT. The place I go for PT is probably the best in Houston. I was told that I couldn't cure my PF without correcting the misalignment in my hips, which contributes/causes the problem. In fact, the physical therapist said that the pelvis is involved in most cases of PF that she sees. Every day I am doing pelvic tilts, piriformis stretching, iliocostalis stretching, and hamstring stretching, in addition to various foot exercises. On my last three visits with the PT, my hips are now level, and my feet are better too. I am using the bicycle, elliptical trainer, and gazelle. I go back to my doctor next week, and will probably be released from further therapy and will just continue with a home exercise program. If you live in or near a big city that hosts a marathon, I suggest that you call and find out who their 'medical director' is. If not, go to a serious running store and ask who they recommend. With all due respect to another frequest poster of exercises, I would have never gotten better by just wiggling my toes back and forth! Sorry!

Re: Physical Therapy

Julie on 9/21/04 at 13:43 (160263)

You make an important point, Cyndi. There are PTs and PTs, just as there are podiatrists and podiatrists. Finding a good one, one that will be a real help, may take some looking around. You've clearly found a good one and I'm glad for you.

So the question 'Will physical therapy help?' is not a question to which there is a definitive answer. It depends on the skill, experience and knowledge of the physical therapist. And the compliance of the patient.

The yoga foot exercises that I have posted do much more than 'wiggle the toes'. But no, they won't fix a spinal misalignment, if that is where the problem is stemming from. I'm sorry if the practices haven't been as helpful to you as they have to others, but - with all due respect - there's no need to shoot the messenger.

Re: Physical Therapy

Sher on 9/21/04 at 13:56 (160264)

I went through 3 months of physical therapy 3x a week and it didn't do a thing for my PF. What it did do was deplete my wallet of a $25 co-pay for each session. Each session was about 45 minutes and 20 of those minutes were on the electronic stim machine. I've been told that the machine is a classic ripoff and believe it. It's a good way for them to get $$$ without doing anything. When I got the bill and saw the breakdown for the PT I could not believe my eyes - It was so expensive for someone to just bend my ankle around and hook me up to this machine.

What did seem to help a whole lot more were the twice a week sessions of ART therapy by a well known chiropractor. At least I felt better after the therapy. In the end, it didn't make the PF go away, it just became a little easier to cope with. And the ART made the rest of me feel just all around better.

Re: Physical Therapy

walterl on 9/21/04 at 17:04 (160275)

Physical therapy worked for me post epf surgery on my right foot. The Therapists where great, they showed me how to 'properly' stretch and strengthen my pf/foot. After the surgery there is obviously scar tissue and pt helped break it up. My left foot is bothering me and I went to PT for 8 weeks 2x per. I cannot say it did nothing because my pain level was around a 5 to 6 before (1-10 10 being highest pain level) and during it was between 0 and 3. Now it's back to 5 to 6 about two weeks post PT. Both times the PT did stretching, massage, ultra sound, and Ionotophoresis (changing up med's 1/2 way through). I'll see my Dr on the 27 Sept.

Re: Physical Therapy

francesc on 9/21/04 at 23:04 (160311)

hi lana,

i went to PT twice for PF. the first time, he concentrated on the 'traditional' approach for therapy and it really did not help at all. i did a lot of exercises, stretching, and got the electrical stimulation. apparently, this usually works for most cases of PF but, it didn't work for me.

i went back again a few months later to try and again and this time, i made a bigger improvement. my therapist tried some different approaches this time and did a lot more deep tissue massage of my calves (he used the Trigger Point Workbook by Davies). anyway, surprisingly, this made a tremendous difference in the PF in one of my feet.

so this is what i would say: make sure you find a good therapist who is willing to look beyond the traditional methods. i was so pleased that my therapist took the time to really look into alternate things to try. he was always looking out for me and that meant a lot more to me than my podiatrists who were really not very helpful at all.

also, my podiatrists gave me the impression that i had high arches. but, my therapist said they weren't high. they were an average arch and my feet were quite normal biomechanically. also, my therapist who i've seen for my back problems thinks that my back and hip problems (i have a rotated hip) may be contributing to my PF. he was always adjusting my pelvis to see if it helped.

hope this helps and hang in there.


Re: Physical Therapy

Lana on 9/22/04 at 10:22 (160337)

I just wanted to thank everybody who responded to my questions about physical therapy. Your answers were really helpful. I called several physical therapists to find out what exactly they are doing for PF and I did not get any answers from them. They all wanted me to come to the office to do evaluation. I scheduled an appointment with one of them. Will see...

BTW, I have tried Julie's Yoga stretches and they are very good, much better than the stretches that my podiatrist showed me. Thank you Julie!

Re: Physical Therapy

Julie on 9/22/04 at 11:31 (160344)

I'm glad they've helped you, Lana.

It's a good sign that the PTs you called wanted to see you before committing themselves. I hope you will find a good one. If the first one you see isn't the right one for you, keep trying.