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Two months post-op question

Posted by Pat on 1/01/05 at 20:10 (166378)

I had EPF with bone spur removal on 11/3 - I've been pretty much staying off my foot for the past two months but I have to go back to work on Monday and my final appointment with the POD is on Tuesday. I have several problems that I would like comments on - the first is whether I should be doing stretches and if those toe stretch things are enough. The second is about my orthodics - my surgery foot is still swollen so I can't get the orthodic in my shoe. If I wear the orthodic on the left foot I am lopsided. The problem is that when I put my shoes on and walk (say to do grocery shopping) I am in alot of pain by the time I get back to the house. I don't knw if it's because I need the orthodics or what. My 'good' foot (I had EPF on that foot ten years ago) is starting to hurt from putting so much pressure on it (the outside edge) because I know I'm not using any support. My surgery foot is still sore. If I wear slippers it's not bad but if I wear shoes after about 15 minutes (maybe it's the swelling) I'm in alot of pain and can't wait to take them off. Any comments would be appreciated. My surgery foot just feels sore (like a bruise or something) in different places and I know it's because my feet are biomechanically messed up but I'm not sure what to do at this point.

Re: Two months post-op question

Mike C on 1/01/05 at 21:48 (166381)

Heel spurs are virtually never painful and the plantar fascia has a very important biomechanical function and should nver be cut.
The heel pain is best treated by regular stretching of the calf to improve ankle motion. Calf tightness and decreased dorsiflexion are the cause of irritation to the plantar fascia. If stretching (3 times daily for 6 to 8 weeks) does not improve the pain surgery may be considered. This would consist of lenghtening of the gastrocnemius tendon (one of two tendons that become the Achilles tendon) this increases ankle range-of-motion and unloads the plantar fascia. This surgery is performed on high level athletes without causing a functional deficit.

Re: Two months post-op question

april l on 1/01/05 at 22:46 (166384)

I stretched every day, several times a day, 1/2 hr. to one hour at each sitting. Everytime I sat down to watch TV I stretched. I also massaged my foot every chance I got. I also walked as much as possible. Yes, it was painful, but i did it anyway. My doctor had me in physical therapy right away. He sent me to an aggressive therapist and I screamed a few times during the deep massages. He never even let up! My doctor was glad to hear that. In the PT's office there is a sign that says 'Tortures R Us'. No kidding!

Re: Two months post-op question - April

Pat on 1/02/05 at 08:05 (166396)

Hi Aprill,
I remember reading your past posts but I forgot when you had the surgery and I'm wondering how you're doing now. I go to the doctor on Tuesday so I'm going to ask him about Physical Therapy. I have been massaging my foot but maybe not as often as I should. The foot looks great except for a little swelling but it's just sore and I know it's probably due to the way I walk (I have some neurological problems). I'm wondering what exactly they did when you went to therapy and where they were doing the deep massages. They did some to me (in the arch) before I had the surgery when I was in PT and while my foot feels alot better I was just wondering what else I can do because I want this soreness GONE! LOL!

Re: Two months post-op question - April

april l on 1/02/05 at 09:34 (166402)

I had the surgery 16 months ago. In PT, the therapist usually spent an hour and a half working with me. The massages were of the plantar fascia. For the most part I enjoyed the massages. First, when I got there He would have me stand on this slanted board that stretched my calf and achilles. Then various exercises and stretches. One was standing on a rocking board on one foot (alternating good with surgical), rocking back and forth to strengthen my ankle and foot muscles. Also used a trampoline...balancing on one foot at a time, a challenge! Stretching on stairs, picking up marbles with my toes, lifting weights with my foot, etc. after about 45 mins, he would do the massage, then ultrasound on the incision site, and last he used this electronic stimulation thing that felt like pins and needles being stuck in my foot. When I first went after the surgery, the only thing i could do is slight stretching of my foot towards me, pulling it with a scarflike material. My foot was extremely sensitive at that point and it felt like electrical shocks going up my leg when i even slightly pulled my toes forward. I was very scared, thinking i had nerve damage but eventually that stopped. I just kept stretching. This physical therapist was the same one I saw for many months prior to the surgery (in hopes of avoiding the surgery altogether), so he knew me and was familiar with what was going on with my foot. I went once a week for about three months.

Re: ps

april l on 1/02/05 at 09:56 (166403)

Also, i walked alot. My car broke down so many times and I had to take buses to get to classes, which required me to walk about 2 miles just to get to the stops. It was about 2-4 months after the surgery. For personal reasons I had to get to these classes so even tho I was still not working I toughed it out and many times the roads and sidewalks were ice and snow covered which was a walking challenge. My foot and ankle definately got a work out! Once I even walked the two miles through snow up to my knees, as the sidewalks had not been plowed after a snowstorm! I was very determined (unlike my usual self, lol)I think anger sometimes propels you forward because it did for me. I was angry, and sick and tired of all the pain and suffering and feeling homebound, trapped, immobile. In the back of my mind I still hear my former pod saying 'use it or lose it' That was probably the only good thing that guy ever said to me!

This is my experience, and I know that some of the doctors here would probably cringe to hear it, but it worked for me. I didn't baby my foot. I had a simple EPF (lol, my foot), and the spur was not removed. I imagine there would probably be more trauma if your spur was removed, plus having a bone fracture. So I'm not saying you should go out and do what I did. Just don't give up, and on the days when it seems so disappointing, don't forget that it's normal for it to take a long time. I'm always amazed when people post here in a panic, thinking the surgery was a failure after only 3 or four months. Every doctor who does this surgery should be telling their patients 6 months to a year to heal.

Re: Two months post-op question - April

Pat on 1/02/05 at 12:29 (166409)

Thanks April. I'm going to ask about the physical therapy when I go to the doctors on Tuesday. I went the whole PT route before the surgery but my problem is that I have balance problems as well as some neurological short circuiting in my legs and it's hard to stretch things out. I know my damn calf muscles hurt and I would love it if someone could massage them but since I live by myself that's not going to happen unless I pay for it. LOL! I went to the grocery store this morning and by the time I got back I was hurting. It's a good thing it's winter and the weather is lousy anyway otherwise it would be worse staying in the house but I'm just tired of my feet hurting. They're more sore than anything. I'm almost thinking if I should ask for an MRI to make sure nothing else is going on but maybe I'm just jumping the gun. And the fact that I'm a wimp when it comes to pain is not helping! LOL!

Re: ps - April

Pat on 1/02/05 at 12:34 (166410)

Hi April,
Thanks for your advice and encouragement. I guess I'm just getting scared because when I had the first PF surgery from hell ten years ago I was in so much pain etc. you wouldn't believe. I don't know what the heck the doctor did but when I moved to another state and had the records transferred he had doctored the records to show I only had an incision on one side of my foot and he actually cut both sides of my foot. So after dealing with that ten years ago I'm just seeing to much into every little ache and pain. I know it does take time but tomorrow I have to start back at work and that stinks. I have a sit down job for the most part but I'm in a different place every day dragging my briefcase and laptop and when you're already not steady on your feet all that added crap doesn't help. Plus I know when you get older you heal at a slower rate. I really didn't realize how slow you tend to heal. On the plus side I started a diet/healthier way of eating on January 1st. I figured that I may have problems next year but I won't have all this wait on top of it. I can't even imagine having to trudge through the snow and stuff you did. I use to do it when I lived in NYC but I didn't have the feet problems then. I know we all do what we have to do but it's easier said than done. Thanks for your post. I'll keep you updated after I go to the doctor on Tuesday. Pat

Re: Two months post-op question

JonQ on 1/04/05 at 18:11 (166500)

Hang in there it gets better. I had surgery done on my left heel in Oct. 04. It was the best thing that couldv'e happen to me. In the past I had the ESWT and that was a waste of my time and insurance. I want you to know that it gets better. Please continue with your stretching exercise at your own pace. The one thing I did was if it hurt I stopped. I think what really helped me was that my doctor put me in a cast with no weight bearing for 10 days after the surgery. I continued with my daily activities during this time. He also put me in a walking boot for 2 weeks. It will get better.

Re: Two months post-op question

Pat on 1/04/05 at 21:07 (166512)

Thanks JonQ = the problem is when you're going through this you feel like it will never get back. I went for my followup visit today and the Pod looked at the xrays and my foot and said everything is progressing normally and I will have pain off and on for a while. He wants me to see him once a month until I tell him that I'm o.k. so that's a plus. I have also begun massaging my foot with sports creme before I go to bed and that seems to help. But when I feel like I'm overdoing it I stop. Up until now I've more or less been in the house but next week I go back to work physically (I worked at home for the past 4 weeks) so that's a little scarey but I'll just have to take it easy.

Re: Two months post-op question - JonQ

Pat on 1/12/05 at 20:59 (167004)

Thanks JonQ - I've read your message several time and I am trying to think positive but it's so hard because it feels like my feet hurt all the time. It's not like the PF pain but it's more like a sore type of feeling that just hurts! I do spend alot of time resting my feet at night and this is the first week back at work but I had so much before the surgery (I was in a cast for 6 weeks due to a stress fracture) and I'm just tired and want it to all go away. Thanks for your post.