Plantar fasciitis orthotics or not ?

I've done all the stretching , golf ball , ice , heat etc etc etc for a few months now but the pain is getting worse if anything ?? It's also starting in my left foot now so if I sit down for half hour or so I get up and walk like a twaddling cripple !! I booked to see a podiatrist 9 weeks ago and got my appointment last Thursday ........3rd January !! ( nhs !) anyway I was wondering if it's worth buying orthotics and also which type ? Arch support or heel gel pad ??? Anybody got a clue ?? Or can anyone recommend any they've used as there are loads on eBay with vast differences on price range , also I believe I'm an overpronater do I buy trainers to suit and still use the inserts ?
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Comments

  • I thought I had PF but it turned out to be Achilles Tenintious ( can't spell it), make sure it is PF. Have you seen a GP yet ?

  • I had some orthotics which were from a podiatrist, but not particularly custom made, and they enede up making my pf worse. So i went to a pod who got custom orthotics made - not cheap! - but of has now gone, after having it for aaaaages. I can't speak for those you buy out of a shop, but of course they are pretty generic, so might not work. Just make sure they don't make your foot worse if you go that way. Oh and you don't need to take the trainer inserts out with orthotics...
  • Jack

    In the meantime do all the stretches, calf, achilles and the plantar tendon if it does not cause too much pain, keep on at it .. the tightness of the plantar is usually carried on up through the leg

    Some gentle massage too to get the blood circulating

    If you can speak with Cona, he is comnig out the other side with this at the moment

    I narrowly avoided a big issue with it after AT but avoided if

    Lee, I think and I may be wrong that some orthotics do require the insert to be taken from the trainer but follow the advice of the Pod on this one and I would err on the side of caution from buying off the peg ones and just take the enforced rest as a sign

  • CJS - Apart from getting to the bottom of what caused my PF, the best thing was taping my feet. There's quite a few instruction videos around on how to do it.

    Until you've seen the pod, I'd avoid buying orthotics. They may say you'll do okay with off the shelf ones but they could make things worse. FWIW, I have custom orthotics (2/3 length) but I still got PF. image 

  • Hi ive had snags with my feet for three-year,tried both custom and off the shelf,none seemed to be a long term solution.stretches and strengthening with some taping have helped loads. Warming the feet and stretching before you get out of bed I find helps alot.it's all trial and error with pf but good luck with the recovery.on my bad days I tend to cycle instead of running.
  • Some interesting replies here and a couple of things I wouldn't agree with which I suppose goes to prove what a tricky condition PF can be.

    Don't bother going to your GP. A GP is trained to make general diagnoses he/she is not a foot specialist. Your podiatrist is. All a  GP will do is tell you to stop doing anything that hurts and recommend pain relief - neither of which  is at all constructive.

    If you can afford them, custom othotics are the way to go as they are made to fit your feet exactly. You can't necessarily wear trainer inserts with them - I certainly can't with mine.

    PF can be referred pain from the calf. Stretching might not make much differerence if that's the case, you have to get deeper by which I mean prodding around your calf muscle until you find the small area that is so painful your eyes will water. Once you've found it massage it several times a day for as long as you can bear the discomfort. You should see an improvement.

  • Meant to say I've worn my orthotics with and without the insoles. The orthotic sits on top of the insole so the insole just acts as a bit of cushioning.  I had my orthotics adjusted recently and for whatever reason, the orthotics are comfortable without the insole at the moment. 

  • If you can, find a podiatrist and physio who work together, as the podiatrist will deal with your foot biomechanics (a lot of physios, myself included, are quite happy to tailor basic orthotics which will work for 90% of biomechanical problems but if the issue is more severe then a podiatrist will generally be a better option to cast your feet for bespoke rigid or semi-rigid insoles) and the physio with any issues higher up the kinetic chain.  Plantar fasciitis and Achilles problems are often associated with dysfunctions in the low back and pelvis, and with neuromuscular tightness in the leg; and for a complete resolution of a long term problem you need to get all the underlying issues sorted out.

     Also, when you do see your podiatrist, make sure you take your running shoes as they'll be able to tell you whether they're suitable.  Most podiatrists recommend wearing neutral shoes with orthotics, otherwise you'll get a double amount of correction if you wear a stability shoe and that may be too much and lead to irritation of other structures.

  • Screamapillar you're a bit harsh on GPs there, no they're not specialists but they're not clueless either.  My GP was very good, cortisone injections to start the healing process and advice to resolve the issue that caused the PF. He recommended getting my shoes checked (they were ok), rest and seeing a podiatrist, which I did and I got some custom orthotics. This appears to have stopped the PF pain.

    Nellmead the advice I was given was that I'm ok with stability shoes with my orthotics, no point throwing some new £90 shoes away, but to buy neutral next time. I'm just gettin gto used to the orthotics, they're two weeks old, but I must admit though that they are more comfortbale in some less supportive shoes.

  • Thank you for all the advice , the appointment in January can't come soon enough as this has been driving me insane for many months now , I'm sick and tired of people saying " oh I had it once , you just have to run it off, run through the pain !" in the first days yes it was possible to run through it as the pain soon disappeared once up and about , but now the pain is a lot more severe and it's there constantly and now just the thought of running and the pain just knocks me sick ! Though I suppose different people have different scales of pf ? I'm only 38 and I'm walking at snail pace like an old man !!
  • Hi i have had orthotics fitted and was told to have neutral trainers and to take out the insole.  they did not work for me, but that's not to say they wont for you. the best thing i have found is sport messages find a good one and they will find all the tight spots, as it may be tight in other areas which makes your condition worse. the deeper the better i find.
  • hey Trevor Griss, i am athelete and i was also feeling the same pain that time.Sometimes my breathe is stucked because of  plantar fasciitis pain and then some suggest me Dr arche and it really give me relief.i Suggest you to try this once.You can check its further details fron its plantar fasciitis websites.
  • Have used shop- bought orthotics (orthaheel sports) to go into flat- soled shoes, slippers, etc, which would otherwise make things worse - probably worth  a try in any non- running shoes that exacerbate the problem. Tried taping feet for long runs, too, and on days when I knew I'd be on my  feet a lot- definately helped.

    Custom made orthotics seem to be a bit hit or miss- hope your pod turns out to be worth the wait!

    PS, I agree that GP often isn't best source of advice for running related injuries- it's very much the luck of the draw- certainly not part of basic GP training.

  • I did my planta fascia in a race in 2008 (had pain in it for months but didnt have a clue what it was before it eventually tore). Anybody who says run through the pain needs shooting, planta fasciatus will not go away without treatment...It put me out of action for a year. When I started running again it was not long before the pain returned. Having been out for so long I wasnt prepared to risk another injury so went to see a podiatrist. She had me stand infront of her, took one look at my kipper like flat feet and said, "there is your problem"....She asked if I got pain elsewhere, knee, back, hips? I have had pain in the base of my back for 20 years after sport, have always suffered knee problems too.....

    She sold me a £26 pair of off the shelf Orthotics (only available to order via registered podiatrists) and said just run normally, problems will sort themselves out in 2 weeks....I genuinely thought she was nuts....2 weeks later all signs of planta fasciatus gone and despite mileage of 50+ miles a week it has never returned, neither have I ever had back pain again....

    In terms of running shoe choice and to wear with or without inserts I can only advise you to do what works for you. I was told to try neutrals but I found the ride way to soft and my foot ached like mad. Motion controls were like wearing blocks of concrete. In the end I settled with a stability shoe (Nike Air Triax 13) and have never looked back.

    Treat this thing seriously, without that visit to the podiatrist I suspect my running career would have ended permanently

  • what area your from Mr Sparra?
  • Warrington , Cheshire
  • can recommend a good POD in Derby but maybe a bit too far away for you.
  • I was out for two years with the bugger - I made the typical beginner's mistake, too many miles too soon and too fast and without any stretching etc.  My problem was exacerbated by the fact that I have an abnormally high pain threshold, so continued months after I should have as I wasn't really aware of the pain.  But then I wasimage.

    I wear custom-made orthotics but my pod has adjusted mine for the PF.

    I was a gnat's wotsit away from PF tendon surgery, but I did recover.  The one thing that no-one's mentioned is a night splint:  I had cortisone injections and had a splint made for me.  I'd ruptured tendons in the other foot and had tendon replacement surgery together with bone repositioning so I went back to the same specialist who made my splint (giving me one that I could walk on).  He advised me to wear the splint as much as I could in the house, then, when out, varying heel height (I'm a laydee, so easier), but the best were a pair of cowboy boots with cuban heels 2" or so.   He explained that it's more difficult to heal the tendon when you're constantly wearing flat heels, which may explain why it's more difficult for chaps to get rid of it - you can't wear the heels that we can.

    I also had that sonic massage stuff at the physio - in fact, all the physio that I did for months was just massage.  Then gradually exercises etc.

    I still stretch every day, calf, pf etc and roll a rounders ball under my feet BUT I've gone from being unable to walk put my foot down to mara training.

    So, it is possible to recover.

    + 1 for not having great confidence in GP - mine told me that I'd fractured my heel and sent me off for an xray.  When it came back negative, she just told me to take some "mild" painkillers.

  • my PF stopped me for 6 months in Jan this year, time out and orthotics cured me and im now on 25 mile a week, training for London 2012. Patience is the key!!!!
  • I've read this discussion with some interest. I'm a Podiatrist. Just a few quick comments. You should never have surgery for plantar fasciitis for the simple reason that the procedure that is performed actually weakens the foot further and pre-disposes the foot to further PF at some point in the future. Secondly you should never have a cortisone injection into your foot for several reasons.  Injections are usually done blind so are you really getting the cortisone into the correct area. Cortisone only masks symptoms, a diagnosis of the underlying pathology is more powerful than whacking a steroid injection into your heel image. NSAIDS/painkillers are pointless, by the time you've got PF it's too late for them to be effective. Never have an X-ray for PF, you'll probably find a calcaneal spur which believe me or not is a perfectly common finding, you should always have a soft tissue scan Ultrasound or MRI to determine which structures in your feet are damaged. Finally, orthotics, they do help and should cure PF. But, they are written to a prescription, which is unique, you REALLY REALLY need to understand WHY your foot is going wrong and then the orthotic can be tailored to correcting the dysfucntion. Every anatomical structure in your foot has a job to do, if it fails your foot fails, understanding why it fails is key. Mis-understanding leads to incorrectly prescribed orthotics and failure! Just a few quick thoughts.
  • Andrew , a few weeks ago I couldn't stand the pain any longer so decided to try and wear my work boots for work instead of my trainers . The pain that evening was really bad but the next day the pain was minor ! So I tried wearing the boots again and my feet were great until late afternoon they started to ache . I carried this on for a week and the heel pain virtually went completely only occasionally coming back . I was almost considering cancelling my podiatrist appointment as I feel stupid going now when the pain is minimal , BUT now I feel I have pain in a different part of heel , the outside , and also if feels as if I'm wearing a ski boot , I feel like there is pain in heel and now in ankle but it also feels like I have lost movement in the ankle ?? If that makes any sense ?? Hard to explain in a message !!
  • Also if it is now an ankle problem will the podiatrist send me away to go and see someone who deals with ankles ?
  • Cpt Jack, the chap who sorted me out is a foot and ankle specialist, but I had to go privately as the local NHS were useless.  My cortisone injection was done following MRI scan where X marked the appropriate spot on my foot.

    They may be able to advise you of someone in your area, when I moved from London to Hampshire and couldn't make it into London, they were able to refer me to someone more local, from whom I've had excellent service.

    You could try them to see if they know anyone, though I appreciate it it's a bit of a long shot.

    Perhaps Mr Ryals could suggest someone.

  • I've still got my appointment on 3rd of jan at Warrington rugby stadium so hopefully that will all go well , especially if they deal with the Warrington players I would imagine if they can't sort it then they may point me in right direction , I'm just hoping that after most of the year being in pain they can sort it !!
  • Just a few quick responses.

    Captain Jack,

    It may sound harsh mate but learn from your experiment! What it should teach you is that footwear is a misunderstood tool that we can use to help treat foot pain. So, your foot type will respond to a firm stiff shoe, have you had your running shoes checked, are they compatible with your mechanics? No disrespect meant if I sound a little straight to the point! Podiatrists are specialists of the foot and ankle, so a good Pod should be easily be able to help you. It what happens at the ankle what controls the rest of the foot image The pan you describe is probably medial calcaneal aphohysists, which is not PF, it's an inflammation of the medial septum of the plantar fascia and achilles tendon as it inserts into the medial calcaneal tubercle of the calcaneal bone. It mimics PF and as a consequence is often misdiagnosed, and shed loads of time is wasted with NASIDS, GP appointments etc etc. ( hope this helps). 

    Jeepers,

     the "foot and ankle specialist" is an orthopaedic surgeon who takes an interest in feet. All Podiatrists can order and interpret diagnostic imagining (X-rays/MRI etc) and give cortisone injections, it's not that specialised!! Its basic Podiatry.  I'd be more than happy to recommend someone but I dont know where Cap JAck lives. 

    Andy Ryals - Podiatrist

  • Andrew Ryals wrote (see)

    Jeepers,

     the "foot and ankle specialist" is an orthopaedic surgeon who takes an interest in feet. All Podiatrists can order and interpret diagnostic imagining (X-rays/MRI etc) and give cortisone injections, it's not that specialised!! Its basic Podiatry.  I'd be more than happy to recommend someone but I dont know where Cap JAck lives. Andy Ryals - Podiatrist
    Well, I guess I know a bit more about him than you do, but he only operates on feet and ankles, hence my use of the term "specialist", so we'll just have to disagree on that point.
  • I think the fact that he introduces himself as a consultant orthopaedic surgeon on your link says it all. He has an interest in foot and ankle surgery, he's trained to operate on any bone in the body.
  • Feels like back to square one !?!?!? Did a 4 hour bike today and can barely put any weight on my heels now I'm home and sat down for an hour ??? To say I'm pissed right off is a mild understatement , thought I was starting to get somewhere by changing my footwear and now cycling is bringing back on ??
  • Cpt.. if you look through previous thread on here concerning PF injury you will see that I too have been suffering from it for nearly 6 months now and just like you and the rest of us suffering to say I am feeling p ed off would be an understatement.

    I have tried resting it, brought the night shoe, which I am still using, brought 2 books that were recommended

    and although reluctantly now had 6 physio sessions at £40 a visit and I still can see no improvement so I might now knock them on the head.

    However the support I have had on here as been just phenomenal and its been really appreciated.The books have also been worth buying as they both contain useful information and on your point about cycling which I too do it says that if you cycle rather than use clipless pedals you should use flat ones and use the flat of your foot as using the toes can exacerbate your PF problem so I hope that you find the info useful.

    I will post this also on the other thread as well but I am now wondering whether it would cause any further damage to the PF if I bind it up with tape, which the physio did on my last visit, and as this relieves the pain and start to at least go for short runs.As anyone tried this !

    This must also be the worse time of the year to be unable to run because of an injury because the papers are full of how to get fit in the New Year and as we all know there is no finer way of doing this than going for a run.

    Happy New Year everyone and may it be injury free.

  • Richard Worrall 4 - please could you let me know the name of the podiatrist in Derby that you recommend? Many thanks
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