plantar facilitis what now

i have just been diagnosed as having a heel spur after xrays and await to see the physio i am in a lot of pain first thing in the morning and a dull ache all day can anyone help my doctor has advised to lay of the running until the physio has had a look
has anyone got pf or had it what did you do?
i am down to run the liverpool half marathon in october and will be applying for london next year
any suggestions will be gratefully accepted
colin
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Comments

  • Colin

    there are loads of posts on this so check out archives.

    Basically:
    1 get your shoes checked if you have had them for 300-500 miles they need replacing. they should also be assessed to whether they offer adequate support. Support is the key

    2 Stretch your calves, gently but thoroughly. do this for 3-4 mins 5 times per day

    3 fill a 0.5L of evian or similar and freeze and roll your foot over this for 10 mins 2-3 times per day

    4 dont walk bare foot ever! wear supportive shoes at all times, morning till night, indoors or outdoors. no slippers flipflops sandals etc

    5 get a product like orthoheel from Boots, preferably the regular version for day-to-day shoes and the sports version for runningshoes/walking shoes etc. These 2 pairs will cost you approx £40.

    6 The physio wants to be doing soft-tissue massage (painful but good) and some taping. Ultrasound and other electrical therapies are out of the "fake it and bake it" school.

    7 if no/little/not enough relief after 6-8 weeks get a recommendation for a Podaitrist
    Think carefully before agreeing to a steroid injection
  • thanks lawrence certainly given me a lot to think on
    colin
  • I recently had this and was worried I'd be out of the feelfine 10K this sunday, but I'm healed now. Here's what I did:

    The first thing is to rest completely until the pain is gone. This is difficult but worth it. Taking ibuprofen three times a day for a week or so helps, as does taping your foot at bedtime with a splint to keep the foot flexed. I used a big comb and sports tape! Ice every morning and night--fill a water bottle 3/4 with water and freeze, then roll it under your foot.

    It took me just over two weeks to recover, but it worked.
  • thank lucrece will do
  • Lucrece - would you mind expanding on the big comb thing?
    I've use a welly which I cut holes in for ventilation but still found too hot. So I tried a tip from RW where I tape a metal set square to the side of my foot. This is a vast improvement but I'm having trouble turning over in bed so I'd welcome any other suggestions.
    Real night splints seem so expensive.
  • Debbie, I mean I literally used a hair comb the size of my foot. I flexed my foot and put the comb underneath, then taped the whole foot with sports tape. I slept like that for about 2 weeks and it wasn't really uncomfortable; the worse part was ripping the tape off in the morning.

    Let me know if this doesn't answer your question. I hope you feel better!
  • Lucrece - I'm stunned you cured it in 2 weeks - I've had it since April. Don't you even get a twinge now?
    I understand your splint method now but I have an allergy to the tape. I have to wear a tubigrip, then I tape the set square to that with parcel tape. I've bought some tape today which is supposed to be strong and low allergy so I'm going to try that tonight, just taping under my toes and securing to my shin. Not tried this before but I'm sure it will be the most comfortable if it holds. Have also modified my welly in case plan A fails.
    Thanks for the good wishes!
  • Debbie, the first time I had it for months. It was so depressing, they even put me in a soft cast. I was lucky this time. I think I was so determined to run this 10K (which I did this morning, pain free), that I healed! And yes, I do get twinges which worry me.

    You may want to check out Dr. Philip Maffetone's book, The Maffetone Method. He talks a lot about injury in there. I bought his book during my last bout of PF and followed his advice when I resumed training. I realized what was causing my PF: not enough of a warm-up. I would literally sprint out the door. Now I go at a very slow pace for the first 12 minutes or so. Sounds obvious, but warming-up and cooling down really do prevent injury.
  • Well done on the 10K - can you lend me some of that healing power? Incidentally, do you tape your foot when you run?
    I'm guilty of not warming up either, I must confess, but I don't really run that fast so I've never worried about it. I suspect my PF was caused either by my trainers losing their cushioning cos I'd had them too long, or my enthusiasm for my new cross-trainer where I went on it almost every day for 5 weeks then came down with PF.
    Thanks for the book advice - I've made a note of it and I'll go and check out Amazon etc. later.
    Hope your twinges soon subside.
  • Nope, I don't tape my foot for running. I do think my first bout of PF was caused my shoes that should have been replaced.

    I don't run that fast either, which means in the warm-up you have to walk or run sloooow. But even training like that I managed the 10K in 63 mins.

    Let me know if you get the book and what you think about it!

    (Sending healing vibes your way...)
  • boing!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
  • boing boing boing
  • Just read about your problem. I had the same thing and ended up not running for 5 months because I continued to use it whilst still injured. Ended up at a sports podiatrist and he fitted me with orthotics. I haven't had any foot problems since then. My advice would be to see a sports professional. Good luck with the running and hope to see you in London 2005.
  • thanks amazing i have seen a physio who has prescribed stretching, ice and ibruprofen, have been doing it for a week tried running twice both for 3 miles ok when running but afterwards in a lot of pain have another session this friday hope she can advise me what are orthotics are they expensive and where do i get them

    Colin
  • You may not need them but it's worth asking about anyway.

    The podiatrist I went to discovered (not unusually apparently) that one leg was longer than the other. I have one orthotic which is very built up and another which is slightly built up. I have to wear them all the time in all shoes which is a little difficult during the summer cos i can't wear them in sandals. I always wear them in flat shoes and running shoes and down the gym. Hope you can resolve your problem without them cos they cost lots! With consultation, fitting and the orthotics it was nearly £200. You should insure them against damage and apparently they last about 2 years. Any others you get in future won't cast as much, just order another the same. Your shoes will need to be neutral as stability shoes with orthotics will over correct the problem. In the log run (no pun intended) quite an expensive problem but running pain free is worth it.

    Good Luck
  • By the way what Lawrence recommended about never going bare footed and all his other advice is sound as well. If a professional recommends you need a podiatrist, that's the best route but all of Lawrence's advice is what I was told as a first action. It's good to have lots of information and the injury archive is a good source of information as well.

    Hope to see you in London, pain free!
  • Now I am really confused having briefly read everything here on the topic. My PF problems started after giving birth to my son who is now 13 months old. It has been very bad for the last 6 months or so. I am about 1 stone heavier since the birth of my son. I have not run for about 2 years and then I ran for about 10 months and absolutely loved it. I am not sure what to do. Would love to run again but not sure my body would cope. Have problems with my knees. I am sure a lot of it is to do with excess weight, pregnancy, b'feeding etc. Also, I had my trainers for too long as well. I have a hospital apt. booked for end of Aug for cortisone injection. Bit worried. Any advice?
  • Try a sports physio. It must be a better alternative if you can discover a reason for it in the first place and treat that. In a previous thread someone did say to use injections as a last resort. I haven't had injections so can't comment.

    How did the birth create your problem or is that just coincidence?
  • Thanks for the advice - I will try to find a good sports physio. It is not the birth that has created the problem but rather the pregnancy and extra weight whilst pregnant and wearing flat shoes etc. most of the time. Apparently, quite common after giving birth.

  • People Im a Podiatrist

    Do everything I said, its exactly what I would want from a patient presenting to me with plantar fascial pain.

    If you are thinking about orthotics try Orthoheel 1st.

    Stretch, rest, ice, stretch, ice and stretch some more. It can take a few weeks to kick in.
  • Orthaheel - 3 for 2 in Boots at the moment but I don't know how long for. Regular are £21.99, Sports are £23.50. I got some at the weekend despite my reservations about orthotics and they've helped loads when I'm walking. It still hurts to touch though and the pain has moved round to the inside but that may be just cos I'm not used to them yet. It's my own fault as I've been wearing them constantly and their website advises taking them out for an hour or two at first. The trainer ones are more comfortable - no problems getting used to them - it's the regular ones for my sensible shoes which get a bit uncomfortable after about 7 hours. Worth trying for less than £50 for 3 pairs. And if you play your vouchers right you can get over a fiver's worth of Advantage Points!
  • Debbie dont you ever follow advice ;-)

    Glad you've had a change of heart on orthotic-type treatment, sure you will get better and better now.
  • Lawrence - nope, never! Had this theory that the sooner I got used to them, the sooner I'd be better. Good job I wear a night splint or I'd have worn them in bed too, sellotaped to my soles!
    They've made an amazing difference in just 6 days. In fact the pain has reduced so much I'm tempted to go for a run at the weekend - oops, there I go again - was told on Tuesday not to run for a fortnight ;-)
    One bit of advice I had which differs from yours is that the physio told me to walk barefoot around the house to give my feet a rest from the orthotics.
    Got a cortisone injection booked for a month's time just in case the orthotics fail me. Hope I'm OK by then though. (quivers at the thought of all that pain)
  • Hi all.

    I have posted a few times in various threads on PF.

    My update:

    1. Ran 50 miles per week for 12 weeks but I do overpronate badly.
    2. Got Injured on Weds 4 Aug
    3. v painful next day
    4. saw physio 1 wk later
    5. Diagnosed exactly as I knew, PF
    6. Iced and massaged with iced water bottle and tennis ball under foot for a week 4 times a day (before I saw physio).
    7. Started exercises with theraband to stengthen soleus calf muscle
    8. Physio advised me last Tuesday (13 days after injury) to run for 5-10 mins to test it
    9. Ran 25 mins tonight, nervously and slowly, without pain or reaction.

    Take it easy....do what they say. I should not have run that long so soon but I have walked for quite a bit within the past 7 days so I felt I had a 'head start'.

    I feel happy I can do it again, albeit not confidently yet. However, frustrating as it is, I do NOT want to be injured like that again where I cannot walk and want to be able to run again, if not as competitively.

    If you feel any pain, that is the body's way of saying STOP. Don't run through it. If you don't have pain, go for it, but build it up s-l-o-w-l-y.

    Keep it up guys, best of luck, and keep posting. I am getting there.



  • Debbie

    rest from the orthotics? if they are comfortable or you have gotten used to them just wear em. It'll be resting your fascia's that matters, thats what the orthotics do. Remember orthotics are a good thing that make you better not a punishment for naughty children ;-)
  • Lawrence - the problem was that my heel was very sore to touch after I'd been wearing them for 4 days. However, the pain was more medial than underneath so I didn't notice it whilst walking around. Therefore, the physio felt that the orthotics may have been irritating my foot so he advised me to take them out occasionally.
    I feel like I could wear the trainer ones all the time, it's the harder ones that are uncomfortable. However, as it's the weekend I'll be in my trainers anyway so we'll see.
    BTW, pain is quite bad today, which is disappointing as I thought I'd turned the corner :-(
  • Lawrence -

    Why no cortisone injection (you said this earlier)?

    Also, I have bought the Orthoheel you mentioned. I have had two other products from Scholl and met with one of their podiatrists who recommended each one. They helped at first and then it went back to how it was and then some. Hence, the doctor is now suggesting an injection with an ultrasound at the same time. Do U think I should cancel the injection and ask my doctor for a night splint or something else instead?



  • hi people, havent posted on here for some time but i'm back and feeling positive. Had pf March 2003, didnt listen to anyone and tried running through it. Dr told me to rest, didnt listen, it got worse. Eventually went to a podiatrist who insisted I had an x-ray in April this year. I now have a heel spur but am back running. Problem is I gained 2 stone because I stopped running so found it hard to motivate myself to start again. i have always had problems with my left knee so dont know if this contributed to the pf in the beginning.
  • Bitch (That sounds like I'm being really nasty!)- don't you have any pain any more? If not, when did the pain disappear?
    Are you getting treatment for your knee? Will you need treatment for your heel spur?

    Sorry for being so nosey!
  • Debbie, i get the odd bit of pain but thats in both feet and not where the pf was, i think its because i am overweight and running again (every other day). Have stopped road running and am trying xcountry. No pain when I work in the gym or do an aerobics class. The pain went about June time but if I have a niggle, i dont run!! Havent been to doctor about knee, i've had this problem since i was 15 - possibly an injury i picked up from a horse accident and aggravated by tooooooo many years riding.
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