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5753 Views 17 Replies Latest reply: Sep 2, 2010 12:16 PM by ~Coach Dave~ 1 2 Previous Next
~Coach Dave~ Expert 43 posts since
Feb 17, 2009
Currently Being Moderated

May 4, 2010 10:49 AM

Orthotics, stretching & night splint out the window...

I've been treated for PF for approximately a year and a half now.  Treatment: regimen of ibuprophen, stretching, night splint, new shoes, orthotics.  From what I've read on this site and the Net my treatment was par for the course.  My PF cleared up and I began training (over training) for a half and was sidelined with shin splints.  During my shin splint rehab I reinjured my left foot [I believe it was from walking on my heels too much and a lot of upper calf exercises].  Shin splints cleared up but PF came back in a new form - omnipresent pain just forward of my left heel in the arch.  It ranged from constant dull pain to sharp pain.

 

I laid off the running completely, continued seeing my foot doc, continued stretching, orthotics, meds, swapped shoes, shot in heel, researched Morton's Foot, etc.  Daily gym workouts consisted of cross-training (bike), abs and stretching - staying completely away from running didn't yield any relief.

 

In a desperate and last ditch effort to avoid a cutting procedure, I decided to go back to square one.  I removed my orthotics and stopped stretching my calf/achillies.  My feet took about a week to adjust and the pain lessened.  I continued to sleep with my night splint but wasn't getting any relief so I dumped that; pain levels dropped again.  Aside from my 2140s, I'm just about back to where I started almost a year and a half ago!!!

 

Is it possible that all the remedies I instituted actually added to the problem?  Can I actually overstretch an injured foot causing more damage or inadvertantly prolong the healing process?  Could it be that my orthotics helped at first but my foot has adjusted and I no longer need them?

 

I'll stop short of saying that my foot pain has cleared up completely.  I still "notice" my foot after runs but for where I was two months ago, this is a 1000% improvement.  I'm curious if anyone else has had a similar experience or has any insight as to why my remedies seemingly led to continuous pain...





2011 Frederick Half 1:53:15

  • Haselsmasher Legend 520 posts since
    May 25, 2009

    Damien Howell, a PT who frequents these boards, advocates exactly what you're saying:  That some cases of (fill-in-the-blank:  PF, Piriformis Syndrome, etc.) are a result of OVERstretching.

     

    Your story is a very interesting example of that possible scenario.

     

    Congrats!

     

    Jim





    "Kick off your high heel sneakers, it's party time."

    -- From the song FM by Steely Dan

  • Damien Howell Legend 312 posts since
    Feb 27, 2008

    D.Snipes, yes I have seen similar observations.  Take a look at Stretching Delays Time to Recovery, Foot Posture - Foot Pain, Should you stretch it out, and Arch Support, Orthotics, Shoe Inserts - Use and Abuse.  When I started running coach's would say "don't drink water when you exercise you will get cramps".  Well that coaches myth was blown out the window by the money made by Gatorade.  You could consider that the coaches myth "that you need to stretch to prevent injury and treat injury needs to be thrown out of the window.  I am not one who believes in conspiracy, but Willie Sutton said follow the money.  Who makes money from prescribing stretching exercises?  The concept of evidence based medicine is slowly becoming the standard.  Christie Aschwanden wrote a very interesting article discussing why evidence based medicine is not widely accepted.  In her article she discusses the controvresey of evidence based medicine regarding mammogrophy, but also discusses the evidence relative to Ibubrofen and long distance running.

     

    I do believe the manner in which you run plays a significant role in the development and alleviation of injury.  Take a look at Shin Splints - Shock Absorption and Stride Length, and Powerful Treatment for Running Injury. A common running form fault which I believe is often related to heel pain and shin pain is too long a stride.

    Damien Howell PT, MS, OCS - www.damienhowellpt.com  

  • lovetorun27 Rookie 4 posts since
    Feb 13, 2010
    • So relieved after reading your post!! I actually had my husband read your post and he thought it was me that had posted. I've been struggling for about a year and a half  with PF and I'm so frustrated with the whole thing. I am a runner and have not been able to run since last summer. I have had therapy, 3 cortizone shots, custom orthotics, night splint, massages, vitamins, stretching, chiropractic care,muscle resistant visits, and have spent  hundreds of dollars on shoes. I bought some Dansko shoes for work because they are recommended and suppose to be really good for your feet. They kept hurting me, but I kept thinking "they are suppose to be good for my feet." I finally quit wearing them. I have been told to not go barefoot at all and that if I'm in the house to wear shoes. I sometimes think I feel better barefoot (not that the pain has ever gone away.) I haven't found a shoe that feels half way decent. ugh! I'm starting to doubt all of the remedies and am thinking of taking your approach. I have researched the surgery and the results do not look very promising. I'm just so frustrated by this whole condition because everything that I have tried has not worked for me. I have talked with people with PF and researched it on-line and it seems like most people that have it just deal with the pain/discomfort. I want to be able to run again and be painfree.
  • lovetorun27 Rookie 4 posts since
    Feb 13, 2010

    D. Snipes,

    Yes, kudos to my husband for putting up with this whole PF thing. It's been quite a downer for the whole family considering that we are so active. What shoes are you wearing during the day, and what shoes are you wearing when you run? Since you threw all remedies out the window, how long did it take for you to start feeling some improvement? I'm really curious about your "come back" because I haven't heard many success stories.

  • Designeer Pro 125 posts since
    Jan 28, 2010

    ligaments have probably stretched, isn't the PF a large tendon or ligament like structure?  You want inflammation so don't ice and no anti-inflammatories, and no stretching, tightening things is what you want....these are the doctrines of prolotherapy, revolutionary, game changing. Sorry to be controversial.

  • grid-rider Legend 235 posts since
    Sep 5, 2009

    You had me until I read .......Kickball.......

  • Designeer Pro 125 posts since
    Jan 28, 2010

    Prolotherapy does not do its work by mechanically (running) re-injuring the ligament.  It injects an irritant that the body reads as damage and thus the billion year old evolutionary collagen fix is laid down..................our hope lies in when this begins to really integrate and dry out, shrinking and tightening the ligament.  So if you have read this, you'd instinctively know that some movement like walking would help things move along but putting the ligament to the test while all this is happening is like adding chaos to an organization effort.  Your choice.

  • Haselsmasher Legend 520 posts since
    May 25, 2009

    That's outstanding news.  It's fantastic you're able to build up like that.  Congratulations!

     

    My quick update:  I started ASTYM treatments about 3 weeks ago and they've made a HUGE impact.  I've been discussing with my PT the phenomena that Plantar Fasciitis, after a while, becomes Plantar Fasciosis.  If I understand things correctly, when it reaches this point, the inflammation is gone, but the pain emanates from the tissue having degenerated and being weak.  In this mode the tissue *needs* exercise to strengthen and rebuild itself.  That seems to support your experiences, DS, with being able to ramp back up.

     

    Keep it up!

     

    Jim





    "Kick off your high heel sneakers, it's party time."

    -- From the song FM by Steely Dan

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