Plantar fasciitis

Discussion in 'Health Nutrition and Supplements' started by HellonWheels, Apr 3, 2006.

  1. HellonWheels

    HellonWheels New Member

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    I have been a cyclist for years, and after a lapse, I returned to it in 2001. I also began daily stationary cycling, 60-90 mins a day. In all these years, NO foot or leg problems.

    A few months ago, after we decided to move, I began doing, in addition to all my cycling and working out, lots of packing, moving stuff, boxes, etc. As a result (it seems), I have developed a nasty case of plantar fasciitis which is forcing me to a podiatrist for the first time in my life (I'm 46).

    Does anyone else have this? I was a runner years ago and never got this, even though the online websearching I've done on PF say mostly runners get it, cyclists supposedly rarely do. I feel like a cripple...first thing in the AM I need my mom's old walker to get the the bathroom...after about 2 mins it goes away, then returns later in the day. I'm using arch and heel gel inserts in my shoes, icing the heel with cold soda cans....walking with a cane when it gets really bad....help!
     
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  2. ebola

    ebola New Member

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    I had this about 2 years ago, and although it's not a problem now, I still occasionaly feel it in the never-quite-100%-healed way a niggling injury seems to work.

    I had wondered if it had been caused initially by wheeling around junctions, one foot clipped in taking my weight, the other pushing on the ground... or even by wearing cycling shoes during the day after cycling in. At the time i'd just taken up treadmill running too. I discovered i was an extreme over-pronator too - which was most likely the root cause.

    It seems fine now - it's certainly never recurred to the same extent as in the initial weeks ('stonechip' type sharp pain) - but it's basically one of several things that keep me from keeping up serious amounts of running. Hence my focusing on Cycling.

    How long have you had it? - for me it was nasty (limping around like a cripple) for a few weeks, and after that was just something to be aware of rather than a serious problem - but really only getting 'back to normal' after about a year.

    For the initial months I tried to stick to heal-push cycling & crosstrainers (keeping the foot flat) .. i actually think i did manage to jog a little.
     
  3. lumpy

    lumpy New Member

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    I had quite a case of it myself. What helped the most was custom orthotics from a podiatrist, and to a lesser extent, anti-inflamatories (ibuprofen). Stretching the calves and hamstrings seemed to help a bit too.

    hope this helps!
     
  4. balletto

    balletto New Member

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    Oddly enough, it was various moving activities that triggered my multi-year battle with this evil, evil malady. I was affected in my right foot off and on for years, and then my left foot.

    What worked to (eventually) cure me:

    1. inserts for all of my shoes, eg) Dr. Scholls DynaStep's.
    2. a regular program of hamstring stretches
    3. a pair of merrell shoes, eg:
    http://www.merrell.com/Shop/Detail.aspx?NavID=FT-O-HIK&PID=10423
    ...with the vibram soles.
     
  5. Leon

    Leon New Member

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    I had the same problem the following worked for me.

    1. Ice, place a cup of water in the freezer. Roll your foot over it.
    2. Flexibility in the calves is a must, Stretch your calves frequently. I use to curse red traffic lights. Now I see them as an opportunity to stretch my calves.
    3. Orthotics in my shoes.
     
  6. turk6681

    turk6681 New Member

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    I developed posterior tibal tendonitis from running. I have flat feet and running wasn’t very good for them. I had custom orthotics made for my running shoes and they were worth every penny (all 38,500 pennies).

    I did the same treatment that everyone else has suggested:

    • I would stretching my calf and hamstrings before and after exercise. Tight hamstrings will cause a lot of problems in the calf and ankle area.
    • I would ice immediately following exercise for 15 to 20 minutes
    • I took a double dose of Aleve for a month (6 per day) as recommended by my physical therapist.
    I started cycling and stopped running five days per week. Now I cycle twice per week and run twice per week.

    My foot still doesn’t feel 100% these days but there isn’t any real pain. I think I need to start wearing orthotics in my cycling shoes too. Does anyone else wear orthotics in their cycling shoes? If so, what brand?
     
  7. tommyadrian5

    tommyadrian5 New Member

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    I had this back in college when i was skiing alot. God it sucks, but other than getting good orthotics or insoles (superfeet works for me) there isn't much you can do about it other than wait for the calcium buildup to dissapate.
     
  8. ranosb

    ranosb New Member

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    What do you mean by waiting for the calcium buidup to dissapate? Bone spurs are forever, no? Unless you have surgery in the foot I believe. Am I wrong?





     
  9. RickF

    RickF New Member

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    Bone spurs are not necessarily forever. Bone and calcium deposits are in a constant state of flux with new material being laid down while the old is reabsorbed. The problem is that it is a very S L O W process.

    The folks who have surgery are the ones who are unable or unwilling to wait the year or two that it will take to resolve or who never fixed the underlying cause so that the equilibrium will swing towards the resorption side.

    I developed plantar fasciitis and a heel spur about 20 years ago from standing on a ladder for prolonged periods of time. With proper fitting shoes and custom orthotics, it did clear up. Cycling shoes with rigid soles will help to relieve the stress on the foot while riding so that the injury can heal.
     
  10. ranosb

    ranosb New Member

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    Did you ever have to go on crutches during your treatment? How long did it take to see improvement in healing in your foot?
    Thanks
     
  11. RickF

    RickF New Member

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    I was never on crutches, but I did get steroid and local anaesthetic injections in the feet on three occassions. The local anaesthetic worked immediately, but lasts for only about 12 hours. The primary purpose of the local anesthetic was to show that the steroid was being injected in the correct place. The steroid took a few days to start working, and the relief lasted for about a week to ten days. After the third injection, the pain did not return.

    Also, during that time, I had custom orthotics made. While I was waiting for the custom orthotics, I wore a heel cup and generic arch suppors. Also, I did not stand on a ladder and walked up and down stairs with the entire foot on the stair, rather than just the ball of the foot.

    My feet did not bother me for about 18 years after the initial episode. Then, about two years ago, they started bothering me again. My old orthotics were well past their prime, so I had new ones made. Again, within a few weeks of wearing the new orthotics, the pain went away. This time, I did not need any steroid injections.

    I only ride for 15 to 20 miles three days per week, although I am gradually increasing that. So far, cycling has not bothered my feet nearly as much as walking did. Most orthotics only go up to the ball of the foot, but it is possible to have whole foot orthotics made. I asked my podiatrist about these and whether they would be better for cycling than the ones that stop at the ball. It turns out that he is also a cyclist, and agreed that next time, I should get the full foot orthotics. I can feel the front edge of the orthotic under the ball of my foot when I pedal, but it does not bother me too much. As soon as my insurance company will pay for a new pair, I am going to have whole foot orthotics made for me.
     
  12. ranosb

    ranosb New Member

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    Thanks for the reply.

    How long did it take for the pain to resolve?:D
     
  13. RickF

    RickF New Member

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    IIRC, about six to eight weeks after I started wearing the orthotics the first time. I also had three rounds of steroid injections two weeks apart, so it had resoved a few days after the last steroid injection. Was it the steroid injections, the orthotics, or both? Who knows?

    The second time was much quicker, because I got new orthotics shortly after the pain started rather than waiting for several months like I did the first time. I figure 18 years between episodes is not too bad. Now I know, though, that the orthotics should have been replaced after 8 to 10 years instead of waiting 18 years.
     
  14. ranosb

    ranosb New Member

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    6-8 weeks? Its been 6 months and I still have pain. How long did you wait to get treatment?
     
  15. RickF

    RickF New Member

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    The first time I waited six months or longer to get treatment. I figured it would go away on its own, which it did not. The second time, I only waited about two weeks because I recognized what it was, and I knew that it probably would not go away on its own. Also, I was not cycling during the recovery period the first time. My only aerobic exercise at the time was swimming. The second time I was cycling, but only about an hour per day, three or four days per week. Cycling did not bother me nearly as much as walking did. I could cycle for an hour, but I could not walk longer than five minutes.

    To set the record straight, though, I am never completely pain free. At my age, I expect that I will never be completely pain free. Something is always hurting. On the other hand, if the pain does not restrict my activity in any way and I do not have to take any medication to control the pain, then it is a good day. The plantar fasciitis is the least of my problems 99% of the time; however, during those two periods, it did restrict my activity. Those first few steps after getting out of bed in the morning were the worst.

    In addition to the orthotics and steroid injections, stretching the calf is important for long term control of plantar fasciitis. The difficulty, though, in the acute phase is that it is difficult to stretch the calf without putting further strain on the plantar tendon. That is beyond my area of expertise, but a podiatrist or physical therapist should be able to offer suggestions.

    The heel bone is being pulled in one direction by the Achilles tendon, and in the other direction by the plantar tendon. The Achilles tendon is always going to win, because the gastrocnemius muscle is stronger than all of the muscles in the foot combined. The pull by the gastrocnemius on the heel is what potentiates the strain on the plantar tendon.

    Plantar fasciitis, which is inflammation of the fascia srrounding the plantar tendon, and heel spurs, which are calcium deposits caused by the body's reaction to the inflammation, are the result of the chronic stress on the plantar tendon. Reducing the inflammation, which is achieved by local glucocorticosteroid injections (e.g., hydrocortosone, prednisone, etc) and systemic non-steroidal antiinflammatory agents (e.g., aspirin, ibuprofen, etc) or in really severe cases, systemic glucocorticosteroids, is the first step in relieving the symptoms. Reducing stress on the plantar tendon through use of orthotics and heel cups (the heel cup is incorporated into the design of my orthotics) and stretching the gastrocnemius muscle is necessary to allow complete healing and prevent recurrance.

    Cycling without adding stress to the plantar tendon is another trick. Good, rigid sole cycling shoes, along with the orthotics should help to relieve the stress on the tendon. Whether that is enough relief to permit healing is another point that is beyond my area of expertise. Again, a podiatrist, orthopaedist, or physical therapist who specializes in sports medicine would be the best one to give specific advice.
     
  16. ranosb

    ranosb New Member

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    Thanks again for your reply.

    Its been 6 months for me, but I did try crutches for 2 weeks, and relative rest for 3 months(ony walking indoors, little walking) with ice, meds and streching but I think the flip flops and the other sandals that had a 3/8" heel for indoors is whats preventing mine from healing, they don't have arch support.
    Anyone know if Birkenstock sandals provide arch support? Im wearing NB motion control shoes 1122 w/ superfeet blue inserts now, and im going to a pod next week...
    :cool:
     
  17. aacliment

    aacliment New Member

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    Birkenstocks do provide some arch support. You have to make sure though that they fit properly.

    I have had PF when i started to get active again after many years of being inactive. Aside from all the good advice on orthotics ans other stuff, I have an exercise that my Dr. gave me that helped a lot.

    In a sitting position place a towel flat under the bad foot. You then pull the towel towards you just by curling the toes of the bad foot with out moving the whole foot. Hope this helps.
     
  18. Shula

    Shula New Member

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    [lang=fr]Bonjour,

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  19. RobinfromBoston

    RobinfromBoston New Member

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    Hey Hell...

    Wow. Sounds like a really severe case of PF. You've gotten alot of good advice! I'm a massage therapist and see lots of people with this condition. Have you given massage therapy a shot? Many times, we develop trigger points in our calves that will tighten everything up and add to the pain of PF. I know you mentioned that you stretch your calves but until the trigger points are 'erased', stretching isn't all that effective. If you do decide to try massage therapy, find someone who does neuromuscular work and sports massage. Good luck! Sorry that you are in so much pain!!
     
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