I think that's the gist of it, but among the many facts and figures, along with a healthy dose of the doctor's theory, I was struck by the statement that reduced circulation may have something to do with this breakdown of tissue. I wondered if years of orthotics might have contributed to that process, since they are so confining (i.e.: how much ischemia does it take to reach a tipping point?).
I'd like to add that when my Morton's Neuroma is being treated with prolotherapy, all 3 prolo docs that I have seen also gave injections to the PF while they were at it because that would strengthen the foot as a whole and all things relate and affect one another.
My point: you have to try prolotherapy to see if it can shorten it for you, how else can you know? I am not a salesman by the way, just want to help.
Also, taking anti-inflammatories prevents the laying down of new collagen which eventually looses the water molecule and shrinks connective tissue, ice also is bad !!!!
I found this link for PF and prolotherapy this morning and share, watch the video
I am not a salesman, just trying to help :-)
A quick update on my situation: Last week I started ASTYM treatments. After three sessions I've seen very positive results. I'm very far from being back to normal from a full running schedule perspective. But after just 9 days my pain level is reduced and I've been able to increase my running - albeit a small amount.
"Kick off your high heel sneakers, it's party time."
-- From the song FM by Steely Dan
A very interesting debate on Plantar Fasciitis.
I believe it is very important, to stress again, the importance of determining the Exact Cause of Plantar Fasciitis (PF is a symptom, not a primary pathology). Once the cause of PF is established, an effective intervention can be determined.
The reason so many authors give, which appears to be, conflicting suggestions on how to treat PF, is because different causes of PF are treated differently. So once again, if I may emphasize without sounding condescending, ´"First determine the cause of PF, then determine the therapy".
I developed PF last summer playing tennis - two hours at a time several times a week. From the onset, my pain was in the arch, not the heel. My regular physician diagnosed the described pain as PF and he gave me a series of stretching exercises. His big emphasis was on stretching the calf muscle because I pronate when I walk. I did the exercises but never felt the burn or stretch in my calf that I was suppsoed to - at least not in the leg corresponding to the foot with PF. After about two months of no tennis, no running, the PF was still there. Since it was not so serious I just let it go hoping that my inactivity would allow things to heal. Jump forward six months - no improvement, in fact an increase in pain in my arch from just every day activities.
I went to a chiropractor who used ultrasound to cure a rotator cuff injury and saved me from surgery. He used a variety of treatments: ultrasound, heat, laser, electric foot massager. No improvement.
I went to a sports podiatrist - he was compeltely baffled by my symptoms. No heel pain even if he pressed as hard as he could on my heel, (but the pain was excruciating when he flexed my foot and pressed on the PFT in my arch) no trouble stretching my calf, no pain when barefoot, but a very noticable pronation when I walk. He also noticed a slight upward tilt on my big toes - causing a stretch of the PFT. He recommended not doing any stretching exercies - long and the short after six weeks with no improvement he gave me a corticosteroid injection which did absolutely nothing. He also recommended arch support orthotics which hurt like the dickens when I wear them. Going barefoot with no support is the most comfortable for me - again contrary to "normal" PF sufferers.
I don't know whether to stretch or not stretch -neither seems to work and my symptons remain atypical. I do have morning pain but again it is in the arch not my heel. I started going for acupressure foot massage - hurts a great deal during the massage but seems to be helping????? - perhaps just wishful thinking. I am greatly dismayed to notice that I am starting to develop the same symptoms in my othjer foot now as well. I am often on my feet for long periods of time and this seems to exacerbate things. Wearing Shape-ups seems to help but I can't wear them all the time. I have both an MD and a physical therapist in my family and neither have encountered PF where the pain is exclusively in the arch area. Does anyone else have arch pain? Could this be something other than PF???
There is an old joke in Chinese medicine that goes something like, "he's the kind of doctor who works on the foot by treating the foot." That is, most healthcare professionals tend to focus on symptoms, rather than causes. One of the main symptoms of Gastrocnemius dysfunction is pain in the arch of the foot. You can work on that arch all day and never make the pain go away, and it is often mistaken for PF. The stretch might work in a mild case, but would be more likely to have a negative effect, or no effect at all.
thanks for the sugegstion about GD - having done a little bit of research on this, it seems that my symptoms might be more consistent with that diagnosis than with plantar faciitis. However, I do not feel any knots or tenderness in my calf. Supposedly, massaging the trigger points in the gastrocnemius will elimiate the pain in the foot arch - but how does one find the trigger points? I have read that it is uncommon to develop PF in both feet - is this also true of gastrocnemius dysfunction? I am now developing the same symptons in my right foot so whatever I am doing seems to be causing more trouble than it is resolving.
longaminama.. It is normal for legs to follow one another in a domino effect, as the stronger leg begins to compensate for the weaker one. The TrPs for arch pain tend to be in the medial head a few inches down from the back of the knee, around the height of the bulge this muscle makes, at roughly 7 o'clock (right leg) viewed in cross section from above the knee. You may fish around and find no palpable lumps, but some TrPs are quite tiny and often numerous. I would say to proceed with caution so as not to irritate it further, using a lotion of some kind to get the best definition of what is under the skin. It may take a few weeks of consistent 2xDaily treatment to get results in some cases, building in some rest days as you would with any workout.
Sit in a chair that has space under it (office, kitchen, etc), one which you can slip your foot underneath so the Gastroc faces upward. The knee should be flexed at an acute angle, so you can rest the foot upside-down on the floor (toes to the rear, with the sole of the foot upward). The leg and foot should be resting, with no muscles flexed. You should be able to easily reach the back of the calf with your thumbs. In this position, the Gastroc will be as relaxed as it can be, and you can probe more deeply into the softened muscle, feeling more detail.
Follow a few minutes of slow, short, firm, measured thumb strokes to the area, with some pressure from your palm to flush it out. Then, perform a gentle stretch of the Gastroc, the muscle best being stretched when the knee is straight and foot dorsiflexed. Do not assist the stretch with your hands or any surfaces, etc. Let the muscles on the other side of the joint do the work. Do a set of 10 short, 2-second stretches (no more than 2 seconds each). After a few weeks max of this treatment, it should be ready for more vigorous exercise. The longer this pain pattern has persisted, the longer it may take for the tissue to be re-educated (in neuromuscular terms). I would start with the most recent problem, to gain the necessary confidence to tackle the older one.
The foregoing procedure is meant for rehabilitation purposes only, not for maintenance. Overdoing soft tissue therapies can make things worse.
An EDIT with more detailed info on trigger points. Not the scientific treatise I wanted, but it will do as a primer. Please note that if you follow the links, Dr. Kuttner's technique differs from mine, but is evidence based...http://www.massage-glasgow.co.uk/trigger-points.html
This one is directed at the medical audience, and is a bit much for the average athlete. I find the precision amusing, but they are attempting to nail jello to the wall here. Trigger point theory is still a ways off from being settled science, but certainly explains a lot of mysterious and chronic pain syndromes...http://www.webmanmed.com/triggerpt.html
Unfortunately, the usual crosstraining alternatives of biking and swimming can both perpetuate TrPs in the Gastroc, because of repetitive motion, or keeping the muscle in a shortened state with a flutter kick, respectively. I also think we ought to discuss the pronation problem, because there are muscular, biomechanical, and skeletal issues that deserve to be covered, if you've got the time.
One more thought.. If your tennis included an overhead serve as classically taught, I can see how that would aggravate the Gastroc. Tennis was my first love in sport (after childhood), but as an aging marathoner, I'm pretty sure that it would cripple me now.. Still, I watch the Grand Slams when I can, and sometimes I still think I can get out there and play those guys lol...
Hi all, New to the forum here. I developed Plantar Fasciitis in my right foot while training for a marathon last February. Treated it with ice, stretching, etc. Went to a sports podiatrist to rule out any other injury. Used a night splint and the sock that keeps your foot extended. Eventually agreed to have one cortizone injection. The running store I go to recommended that I change shoes to for some additional stability, which I did. I have never had issues with pronation in the past. Had significant improvement and was able to return to running a few weeks later, working back up to three miles with almost no discomfort, but had to bag the marathon. After a few weeks (and a light week of running), I had a flare up again. With rest, ice and stretching it got much better, but each time I tried to run it flared up again (nothing like the original episode I had). I took almost three months off from running and ran about 3 miles a couple weeks ago. My heel hurt for about 3 days after that (again nothing like the original episode, but probably a 3 or 4 on a scale of 10). I have not run since. Any suggestions of what to do from here......really want to get back to running, but don't want to cause any damage. Any suggestions/recommendations would be appreciated.
You are going to see a 180 degree turn around in medicine in the coming years about icing an injury, cortisone and stretching....................look up prolotherapy, it is a permanent cure for PF. I am not in the medical business, I am not trying to get a commission, just dispensing a truth, unbelievable how a mistruth can survive for so many years amongst so many intelligent people.................very sad.
I have been diligently following your advice and the original pain in my right foot seems to have largely been alleviated.I am continuing to massage this area as I seem to feel numerous "knots" or hard strands of muscle fibers. Not knowing exactly what this muscel tissue should feel like, I may be wrong and these hard spots are normal. In any case, I am back to playing tennis on a regular basis and notice no new pain or soreness in my right foot.
The pain in my left foot, however, is getting worse (although not from tennis - just from wearing shoes and standing for long periods of time). I find it much more difficult to massage this leg in the manner you described - my left hand and thumb are not as strong and I cannot as easily access this area of my left calf. The pain is also somewhat different and more persistent. However. my gut feeling is that it is an expression of the same problem I had/have on my other side. Will continue trying to effectively massage this side as well.
Thanks for the good advice, especially since my psuedo-health insurance is refusing to pay for any treatment of any kind!
I was suffered Plantarfasciitis for many years and i think chronicPlantar fasciitis is the sameproblem, the painfull reaction of the body for the injury of the plantar fascia, which is the flat bond of tissue which is connected to the heel bone and when this liagnent is became inflammed.I think, it can be treated as proper diagonsis and treatment through machinary.I used a Machinary instrument, which is really help for the cure of .
Message was edited by: dwm082 (removed marketing link)
I've been suffering from Plantar fasciitis for 5 years now and I'm pretty desperate. My pain is in the heel of both feet and has been since day 1. I've been using orthotics, I massage, stretch and ice (all the standard recommedations) but I've never made any real progress. Stretching, yoga and relaxation helps to soften the pain and is very useful, but I feel like I'm a long way from a cure - if such a thing is possible.
My pain comes on most quickly from standing in one place, much more so than from walking. In some ways, I feel like walking helps to loosen things up a bit. 30 minutes of standing in one place = serious pain that can last for 2 days. 60 minutes of walking = slight inflammation that usually disappates after 12-24 hours.
I've had ultrasound, MRI and x-rays taken on my feet and also on my lower back too. Nothing has really been discovered except for the presence of some mild achiles tendonopathy. Podiatry, osteopathy, remedial massage and chiropractics have all played a part in my treatment over the last 5 years.
I haven't run for years now. My activities are regular body-boarding (which is excellent - cold surf reduces inflammation whilst keeping me very active) yoga, pilates and some weights. I'm a healthy 37 year old in every other respect, but this PF has taken so much away from my life.
I really don't know where to go from here, so if anyone has any advice for me, I'm all ears.
This thread is pretty dusty and some things have transpired for me since I commented here. I think it's fair to say my PF is cured. I say "think" because I still have an issuewith my foot - but it's not the bad PF I fought for so long.
Over the years various things I've done seemed to deliver "step-wise" improvement. It's hard to point to just one thing which was the magical cure. The things that seem to have helped the most:
* Wearing *flexible* orthotics *temporarily* to get the acute healing of the tissues done. "Temporariy" doesn't mean short. I think it took 6 months before I could start weaning myself off of them. Think of it like putting an arm in a sling: Extra support temporarily to promote healing, but then you get out of it.
* Get out of the orthotics SLOWLY. I started with just 15 min each day and took it up from there.
* ASTYM. That helped a lot.
* Loosening of the calves. Notice I'm not saying stretching. I think it's fair to say more and more research is showing stretching does little good - and my do some harm. Foam rolling or massage, on the other hand, can loosen things up and relieve some of the tension on the heel.
* Switching to an everyday shoe with as-low-as-possible heel-to-toe drop. Get the heel closer to the ground and that helps lengthen out the calves.
* Changing my form from long strides / heel striking to a more compact, land-under-the-hips form.
* Walking (with a little running thrown in) barefoot outside. I mean real barefoot - skin to ground. Just walking outside provided so much foot stimulation I'm convinced it put the foot muscle development into overdrive. It actually develops the hips, too. My first few outdoor barefoot walks caused me to get sore hips - because I'm sure they were working harder since I couldn't just plant my foot without thinking.
The core work you're doing I think is really important. If you can - just take off your shoes and go for short walks outside. Hopefully you'll notice a difference.
"Kick off your high heel sneakers, it's party time."
-- From the song FM by Steely Dan
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