Heel pain syndrome/plantar fasciitis/bursitis

[Dave Chandler]

Hi,

I've been struggling with bursitis/plantar fasciitis in my
heel now for over a year. After running for 25 years
heavily, I've not run now for 8 months. I've seen slight
improvement after the following treatments: use of a night
splint, anti-inflammatories, 2 injections at the side of the
foot, physical therapy, shock-wave therapy, massage, taping,
stretching and strengthening, orthotics, etc. MRIs and X-
Rays are normal. Although I have plantar fasciitis and a
heel spur, the prominent feature has always been the
bursitis, which developed after the PF. The pain is in the
center/back of the heel and the PF is noticeable, especially
in the morning. I feel pain if I put my heel down when
walking barefoot and often when wearing shoes as well. As I
said, there has been improvement, but it's not disappeared
and I don't feel ready to run yet. I've been using an indoor
trainer (bike) religiously to maintain fitness, but
obviously my goal is to return to running. Just wondering if
anyone out there has experienced such a chronic injury in
this area and if there's anything else I could be doing.

Thanks in advance--Dave

[Doug Freese]

Dave Chandler wrote:
> MRIs and X-Rays are normal. Although I have plantar
> fasciitis and a heel spur, the prominent feature has
> always been the bursitis, which developed after the PF.
> The pain is in the center/back of the heel and the PF is
> noticeable, especially in the morning. I feel pain if I
> put my heel down when walking barefoot and often when
> wearing shoes as well. As I said, there has been
> improvement, but it's not disappeared and I don't feel
> ready to run yet. I've been using an indoor trainer (bike)
> religiously to maintain fitness, but obviously my goal is
> to return to running. Just wondering if anyone out there
> has experienced such a chronic injury in this area and if
> there's anything else I could be doing.

Dave, I should just use the phone but let's try here in case
some others can benefit. Some time back Dr. Doug(not me but
the local foot doc we both use) diagnosed me with PF and we
followed some standard stuff including three cortisone
shots. It did not do the trick and I brow beat him for am
MRI which showed and inflamed bursa in the same heel area
where the fascia joins the heel. After the MRI we opted for
an orthotic with the heel scooped out - almost like a donut.

The orthotic took the pressure off the bursa and allowed it
to completely heal. In still wear this orthotics to this day
and have a boat load of miles and races with them.

In my case the MRI showed the bursa inflamed yet your MRI
shows nothing from what I read above. I know MRI's are good
but at times not invincible with heels as with knees.

Anyway, ask Dr. Doug to look up my case and see if there are
any similarities and would a scooped heel be of some value.
If is really is PF I don't think this solution would help.
If it's really a bursitis then maybe. If you want to cover
this in more detail give me a call at home.

--
Doug Freese "Caveat Lector" dfreeseS@NOBShvc.rr.com

[Doug Freese]

Dave Chandler wrote:
> MRIs and X-Rays are normal. Although I have plantar
> fasciitis and a heel spur, the prominent feature has
> always been the bursitis, which developed after the PF.
> The pain is in the center/back of the heel and the PF is
> noticeable, especially in the morning. I feel pain if I
> put my heel down when walking barefoot and often when
> wearing shoes as well. As I said, there has been
> improvement, but it's not disappeared and I don't feel
> ready to run yet. I've been using an indoor trainer (bike)
> religiously to maintain fitness, but obviously my goal is
> to return to running. Just wondering if anyone out there
> has experienced such a chronic injury in this area and if
> there's anything else I could be doing.

Dave, I should just use the phone but let's try here in case
some others can benefit. Some time back Dr. Doug(not me but
the local foot doc we both use) diagnosed me with PF and we
followed some standard stuff including three cortisone
shots. It did not do the trick and I brow beat him for am
MRI which showed and inflamed bursa in the same heel area
where the fascia joins the heel. After the MRI we opted for
an orthotic with the heel scooped out - almost like a donut.

The orthotic took the pressure off the bursa and allowed it
to completely heal. In still wear this orthotics to this day
and have a boat load of miles and races with them.

In my case the MRI showed the bursa inflamed yet your MRI
shows nothing from what I read above. I know MRI's are good
but at times not invincible with heels as with knees.

Anyway, ask Dr. Doug to look up my case and see if there are
any similarities and would a scooped heel be of some value.
If is really is PF I don't think this solution would help.
If it's really a bursitis then maybe. If you want to cover
this in more detail give me a call at home.

--
Doug Freese dfreese@hvc.rr.com

[Me Again?]

Stop whining you frikin pansy, and go run a 30 miler.

Dave Chandler <davemail@hvc.rr.com> wrote in message
news:<eNgec.10718$mX.4731632@twister.nyc.rr.com>...
> Hi,
>
> I've been struggling with bursitis/plantar fasciitis in my
> heel now for over a year. After running for 25 years
> heavily, I've not run now for 8 months. I've seen slight
> improvement after the following treatments: use of a night
> splint, anti-inflammatories, 2 injections at the side of
> the foot, physical therapy, shock-wave therapy, massage,
> taping, stretching and strengthening, orthotics, etc. MRIs
> and X-Rays are normal. Although I have plantar fasciitis
> and a heel spur, the prominent feature has always been the
> bursitis, which developed after the PF. The pain is in the
> center/back of the heel and the PF is noticeable,
> especially in the morning. I feel pain if I put my heel
> down when walking barefoot and often when wearing shoes as
> well. As I said, there has been improvement, but it's not
> disappeared and I don't feel ready to run yet. I've been
> using an indoor trainer (bike) religiously to maintain
> fitness, but obviously my goal is to return to running.
> Just wondering if anyone out there has experienced such a
> chronic injury in this area and if there's anything else I
> could be doing.
>
> Thanks in advance--Dave

[Bethowmuch]

I've had a couple bouts of what seemed to be plantar
fascitis and resolved both with home remedies passed on by
people on this n.g. Hopefully you'll receive some helpful
replies from some of them.

[Crafty Counterp]

Doug Freese <dfreese@hvc.rr.com> wrote in message news:<4079CD02.4020308@hvc.rr.com>...
> Dave Chandler wrote:
> > MRIs and X-Rays are normal. Although I have plantar
> > fasciitis and a heel spur, the prominent feature has
> > always been the bursitis, which developed after the PF.
> > The pain is in the center/back of the heel and the PF is
> > noticeable, especially in the morning. I feel pain if I
> > put my heel down when walking barefoot and often when
> > wearing shoes as well. As I said, there has been
> > improvement, but it's not disappeared and I don't feel
> > ready to run yet. I've been using an indoor trainer
> > (bike) religiously to maintain fitness, but obviously my
> > goal is to return to running. Just wondering if anyone
> > out there has experienced such a chronic injury in this
> > area and if there's anything else I could be doing.
>
> Dave, I should just use the phone but let's try here in
> case some others can benefit. Some time back Dr. Doug(not
> me but the local foot doc we both use) diagnosed me with
> PF and we followed some standard stuff including three
> cortisone shots. It did not do the trick and I brow beat
> him for am MRI which showed and inflamed bursa

> in the same heel area where the fascia joins the heel.
> After the
MRI
> we opted for an orthotic with the heel scooped out -
> almost like a donut.
>
> The orthotic took the pressure off the bursa and
> allowed it to completely heal. In still wear this
> orthotics to this day and have a boat load of miles and
> races with them.
>
> In my case the MRI showed the bursa inflamed yet your MRI
> shows nothing from what I read above. I know MRI's are
> good but at times not invincible with heels as with knees.
>
> Anyway, ask Dr. Doug to look up my case and see if there
> are any similarities and would a scooped heel be of some
> value. If is really is PF I don't think this solution
> would help. If it's really a bursitis then maybe. If you
> want to cover this in more detail give me a call at home.

hey doug, do you wear orthotics all the time, or just when
running?? i've pretty much conquered my pf with simple arch
supports and one cortisone shot, but i'm afraid to go
without the supports. this is kind of annoying around the
house and such. do you ever go barefoot or without supports?
i'm wondering if one can completely "heal" from pf or if
it's something that can be repeatedly aggravated. i feel a
slight twinge every now and then, but that could be
psychosomatic.

[Doug Freese]

crafty counterpuncher wrote:

>
> hey doug, do you wear orthotics all the time, or just when
> running??

Just when running. I my last case I was never sure I had PF,
at least proven by any film. By the time they did the MRI
only the bursitis appeared. For a few months I wore the
orthotics all the time including pee breaks in the middle of
the night. I was so happy to be back at running and did not
want to take any chances. I then weaned myself from my non
running shoes.

I still wear them running because they also make some
pronation corrections. It's possible that I could wean
myself from them completely but frankly, I don't want mess
with what works. Contrary to those people that fret the
extra weight, and extra ounce in each shoe over 50 to 100
miles is meaningless.

> i'm wondering if one can completely "heal" from pf or if
> it's something that can be repeatedly aggravated. i feel a
> slight twinge every now and then, but that could be
> psychosomatic.

This is hard one to answer. I had a case of PF when I first
started to run and healed completely. I think is safe to
assume that when we run for hours and hours even on trails,
we tend to push every part of our bodies to the Nth degree.
I'd still play it safe until some months go by and you can't
recall any twinge.

In the mean time I'd do some strengthening exercises to make
your fascia stronger. Take a look at
http://www.pponline.co.uk/encyc/0180.htm

--
Doug Freese "Caveat Lector" dfreeseS@NOBShvc.rr.com

[Dot]

crafty counterpuncher wrote:

>
> hey doug, do you wear orthotics all the time, or just when
> running?? i've pretty much conquered my pf with simple
> arch supports and one cortisone shot, but i'm afraid to go
> without the supports. this is kind of annoying around the
> house and such. do you ever go barefoot or without
> supports?

You might try clogs from Haflinger or Steggman (nfi). Cork
insoles mold to your feet - slippers with arch supports,
sorta. Uppers are wool. Last is shaped like most people's
feet - with the big toe (inside edge, not the center) being
the furthest most point. http://www.comfortableshoes.com/manufacturer-
view.cfm?Manufacturer=7 http://www.comfortableshoes.com/manufacturer-
view.cfm?Manufacturer=35

I've been using them for 4 or 5 years now, I think. I had PF
and AT pretty badly about 5 yrs ago (before I started
structured running and had any clue about body parts and
injuries), and have used these since. FWIW, I still use the
3/4 length orthotics fit by a podiatrist back then in all my
shoes. (side note: I'm still not sure that's the best
orthotic for me based on PT diagnosis, but PT decided not to
change the orthotic after he said he was going to.
Experiment still in progress.)

I don't go barefoot in the house (except maybe some really
hot summer days), but will barefoot walk and some drills
in my lawn - temperatures permitting (like today :) but
had to watch for the snow drifts in part of the yard). I
feel that helps strengthen the foot. The soft, uneven
surface of lawn is fine; the hard, even surface of a floor
is a problem for me.

I've also done drills in my cross-training class where we
are running (forward, backward, sidways, etc) in socks on
floor exercises mats (like used in gymnastics) or
trampolines or whatever (but not hard floors), and that
didn't seem to be a problem this year - after having done a
bunch of exercises prescribed by PT for my AT. Last year it
was a problem while I was still rehabbing. I think those
drills help strengthen after healed, but are too much in
initial stages of healing, although it was mostly AT related
issues last year.

However, I treat both AT and PF as something to be
continually on guard against. There's so many environmental
and trail conditions I haven't run under - not to mention
duration, that I'm just afraid of them rearing their head
again if I'm not wary. Nah, I'm not paranoid.

i'm wondering if one can completely "heal" from
> pf or if it's something that can be repeatedly aggravated.
> i feel a slight twinge every now and then, but that could
> be psychosomatic.

I'm guessing how much support you need in long term may
depend on what caused PF in the first place (structural or
functional). Functional can probably be resolved by healing
and exercises, but structural issues may need something like
orthotics or arch supports.

I've done some of the drills in Doug's PP online page, but
also do some others, although mostly for the AT (closely
related). I try to strengthen foot and ankle function.
Things like unweighting one foot, and pulling yourself
across floor by contracting toes on other foot, and
repeating for each foot. I've also done calf lifts with
opposite foot dorsiflexion barefoot in the lawn (also helps
my shins - I've got tight hams, calves, but really weak
shins). I also massage feet and ankles nightly as well as
ankle rotations, write alphabet with feet, etc.

Dot

--
"Success is different things to different people" -Bernd
Heinrich in Racing the Antelope