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Plantar fasciitis and tarsol tunnel

Posted by Darlene on 1/13/05 at 07:25 (167024)

Hello I would like to know if you have bilateral tarsol tunnel and plantar fasciitis as shown by an EMG and an xray which problem should be treated first? I have tarsol tunnel and fibromyalgia and many other things but as far as having the tarsol tunnel and plantar fasciitis I cannot even stand my ankle and about 6 or 7 inches above to be palpated. So which should be treated first or is there a treatment that can be done simultaneously? Thank you

Re: Plantar fasciitis and running

Ed Davis, DPM on 1/08/05 at 20:52 (166730)

katdoc:
I have lots of patients who run through plantar fasciitis. It is not ideal to do so but if you are willing to treat the plantar fasciitis intensively it can be done most often. One must seek the help of a sports medicine oriented podiatrist who is capable of rendering the needed treatment to keep you on your feet.
Ed

Re: Plantar fasciitis and running

marre on 1/08/05 at 22:43 (166758)

I am a marathon runner and I tried to run through my PF. It didn't work for me! The pain would go away when I ran but would return full blown afterward. I ended up cross training (swimming, bike, elliptical). I think I made it worse by trying to run on it. I couldn't run a fall marathon, but there will always be others..

If you can run through yours, good for you. I'd be curious about Dr. Davis' methods for running through it. Mine is 99% better and I am starting to run again. Due to all the cross training, I didn't lose fitness. I'm terrified of it coming back again, though--it's a most frustrating and annoying injury. Good luck.

Re: Plantar fasciitis and running

Julie on 1/09/05 at 06:54 (166765)

You have not been running for very long. I would suggest that you need to face the fact that your training is very likely to be the cause of your problem, and that continuing to run will very likely make it worse. I have been reading these boards for more than four years and I could not begin to count the number of people who have said 'I ran through the pain and it was a terrible mistake because now my PF is chronic'.

You obviously love running and do not want to give it up, but you are not a professional athlete: you do not HAVE to run to get the exercise you need. Everyone needs exercise, whatever we weigh, and there are loads of alternative ways of exercising. It's best to avoid weightbearing exercise, apart from necessary walking. Swimming is best, because it is non-weightbearing and is unlikely to do you further damage. If you can swim, and if there is a pool you can go to, that is what I'd suggest. Upper body work with weights has also been all right for others here. Some like the recumbent bike; others have found it irritates the fascia.

You will also need specific exercises for your feet. Have a look at the yoga foot exercises and at the PF Stretch (click on the links). Whatever anyone tells you (and that includes doctors) avoid the weightbearing stretches often advised for PF: they are too strong and can do more harm, as many (though not all) have found.

Take time to read the heel pain book on this website. It is free, and full of useful information that will enable you to make the best use of your time when you see a podiatrist.

Good luck.
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Re: Plantar fasciitis and running

Ed Davis, DPM on 1/10/05 at 10:41 (166846)

Julie:
Your recommendations definitely represent the ideal approach. I have some hard core triathletes in my practice who will not take 'no running' for an answer yet have been able to treat them effectively but with significantly more effort. I had one triathlete who ran 13 miles before each ESWT session. Her 'compromise' was that she normally would do more mileage. What really makes on a 'sports medicine' physician is the willingness to work with athletes in a manner in which they minimize their downtime. It is a different paradigm as the concept of rest is adverse to many such individuals.
Ed

Re: Plantar fasciitis and running

Julie on 1/10/05 at 11:03 (166849)

Indeed, Ed, and yes of course it's a different paradigm, and my advice too would be different for athletes (who won't take 'no running' for an answer). But I responded as I did to this lady, because she isn't an athlete and is running for exercise to lose weight. She doesn't have to run, and her excess weight is probably adding to the strain running is putting on her feet. I didn't want her to become another 'I ran through the pain and am sorry' statistic.
.

Re: Plantar fasciitis and running

DonnaG on 1/13/05 at 17:09 (167070)

I just wanted to say that when my pf first started, I had been power walking for about 8 months. I went to a pod and he ordered orthotics for me, put me on Vioxx, and told me to go ahead and walk. I continued with very little pain because of the meds. It was a HUGE mistake. I think I continued to damage the pf and finally, after about 6 months, the pain was there even with the meds. I changed drs, but it was too late. I am not sure, but I may have done irreversable damage to my foot. To date, nothing that has been recommended has really helped. I began walking for the same reason that you are running. I have done pretty well keeping my weight off by using a stationary bicycle. It does not seem to hurt my heel. Good luck.

Re: Plantar fasciitis and running

katdoc on 1/31/05 at 20:26 (168213)

I decided not to run through the pain. I did try it once but realized it just created too much pain when not running. I honestly have not been doing other exercise at this time because I am trying to figure out what exercise to do. I never learned how to ride a bike, don't have access to a stationary bike and don't have access to a pool so I feel very stuck. I have visited a podiatrist who confirmed the diagnosis of PF and gave me an injection two weeks ago of Kenalog directly into my foot and started me on Piroxicam once daily. At my recheck appointment one week later, he directed me to ice my foot nightly in addition to increasing the piroxicam three times during the week. The icing seems to irritate the injury more and the piroxicam does not seem to be helping. The next step that the podiatrist mentioned would be to get fitted for orthotics, which my insurance does not cover and I cannot afford at this time. Should I be seeking a second opinion from another podiatrist? This podiatrist has been in the same facility for 25 years and does not seem to be keeping up with his continuing education from my perspective therefore I am not sure if there are additional treatments that I should be seeking. I am very frustrated overall. Thanks in advance for any help that you can offer.