Plantar Fasciitis

[pacemaker]

Hey guys, since I opted to play League footy at 17 instead of U17s / colts footy a few years back I have had a devastating run with Injuries. First with OP, then shin splints, ITBS and knee bursitis. But lately the one which has been giving me the most problem is Plantar Fasciitis in both feet. All was progressing well after 6 months of having the injury with rest, massage, rolling the foot on a rolling pin, wearing orthotics and stretching of the plantar and calves. But last week I had a thought that I wasn't doing enough to strengthen the injury and decided to do the marbles pick up with my toes and put it in a cup. First time I did this it was fine but then next day when I did it with the same amount of marbles my right foot re-injured itself. It's been 50 odd hours since and I am sure after 4 days the pain will go away. But has anyone here had this and if so what methods did they find worked best for them? How long did it take for them to get over. I know it is a rare injury but many of mine have been has anyone successfully got rid of Plantar Fasciitis in a year or a bit more?
Cheers

 

[vast]

Im no expert but have been diagnosed with this. Basically I got it from bad shoes and not resting the foot properly. But to me it sounds like you are doing too much recovery exercises and perhaps not resting your feet enough.

Those exercises will help but probably not as much as easing the pressure. Also what helped me is wearing cushioned runners at home, this is something
the doc recommended to me, as its very easy to re-inflame the tendon. As you know it takes a long time to recover coz its almost impossible to stay of your feet for long enough periods in our daily routine.

 

[RichyRich]

I have had this before and a cortisone injection and rest (along with what you are already doing) fixed it quick smart!

 

[RipItUp]

Shocking injury this is.
First got this injury when i was about 13 yrs old back in year 8. Didnt really know much about it back then so i just kept playing Football, cricket and doing school sports (Athletics) and played through the pain.

Got to about under 15's and then had it basically all the time from game day and training so i ended up giving away my sports

Now im 20 and its the biggest regret i have not seeking help for it back then, Though in saying that I run 5km a day now and dont have any problems with it.

 

[cptkirk]

i find hard to think you got injured from picking up marbles

are you sure it's simply not post workout pain? they are very sensitive muscles, especially when contracted like a marble pick up has it, something it doesn't do at all really, not that isolated at least

 

[pacemaker]

i find hard to think you got injured from picking up marbles

are you sure it's simply not post workout pain? they are very sensitive muscles, especially when contracted like a marble pick up has it, something it doesn't do at all really, not that isolated at least

Its not post work out pain. I remember when I first got it 6 months ago and it is that sort of pain and I have had it like that for 3 days now with putting ice on it as well.

I Probably won't do any strenghening work outs with it anymore and just let it rest and continue to massage / stretch the area as this was working for me but felt a strenghening activity might speed up recovery but it has made it worse.

Might consider the Injection in both feet in 2 months time if doesn't recover from this set-back

 

[cptkirk]

do you have pronated feet? tight glutes/hips?

try:

- stretch peroneal/gastroc/achilles/soleus complex
- improve ankle mobility
- train in barefeet
- strengthen tibialis anterior
- increase fish oil intake

 

[ezrida]

Hi
I have plantar fasciitis myself for a few months now. My podiatrist prescribed me with Custom made orthotics which did not work at all. [FONT=&quot]I understood that treatment efficiency is very individual. If something works for one it may not work for the other. There are many treatment techniques that you can try. [/FONT]There are Taping techniques that I find very useful. There are a few more self-care techniques that I got from this informative website:
[FONT=&quot]http://www.plantar-fasciitis-elrofeet.com/How_is_Plantar_Fasciitis_Treated[/FONT]
[FONT=&quot]Take care & Good luck[/FONT]

 

[TruBlues]

If you have been diagnosed with all the conditions that you claim to have suffered from then I would say you have some biomechanical issues which are predisposing you to lower limb injuries. I.e it is possible you have a problem with your hip/pelvic/lower back biomechanics which is causing increased physiological demand on the tissues distally.
If you don't get this sorted out then you will be at increased risk of recurring injury in the future particularly given your age.

I would go and get your biomechanics/posture assessed and see if there is something that can be done to help prevent further injury in the future and also help deal with your current issue of plantar fasciitis.

Also plantar fasciits doesn't tend to be as acute an injury as you described and is typically at it's worst first thing in the morning due to the inflammatory nature of the condition and will typically be most tender on the inside aspect of the sole of the heel.

Hope this advice is helpfull

 

[pacemaker]

do you have pronated feet? tight glutes/hips?

try:

- stretch peroneal/gastroc/achilles/soleus complex
- improve ankle mobility
- train in barefeet
- strengthen tibialis anterior
- increase fish oil intake

Wouldn't training in barefeet make it worse?
I do take fish oil for my OP pain from time to time so I will get back on this and will probably buy some more tripple action of Glucosamine and chondroitin and MSM which i found useful

Hi
I have plantar fasciitis myself for a few months now. My podiatrist prescribed me with Custom made orthotics which did not work at all. [FONT=&quot]I understood that treatment efficiency is very individual. If something works for one it may not work for the other. There are many treatment techniques that you can try. [/FONT]There are Taping techniques that I find very useful. There are a few more self-care techniques that I got from this informative website:
[FONT=&quot]http://www.plantar-fasciitis-elrofeet.com/How_is_Plantar_Fasciitis_Treated[/FONT]
[FONT=&quot]Take care & Good luck[/FONT]

Nice website, funny enough I didn't come across this one I don't think.

If you have been diagnosed with all the conditions that you claim to have suffered from then I would say you have some biomechanical issues which are predisposing you to lower limb injuries. I.e it is possible you have a problem with your hip/pelvic/lower back biomechanics which is causing increased physiological demand on the tissues distally.
If you don't get this sorted out then you will be at increased risk of recurring injury in the future particularly given your age.

I would go and get your biomechanics/posture assessed and see if there is something that can be done to help prevent further injury in the future and also help deal with your current issue of plantar fasciitis.

Also plantar fasciits doesn't tend to be as acute an injury as you described and is typically at it's worst first thing in the morning due to the inflammatory nature of the condition and will typically be most tender on the inside aspect of the sole of the heel.

Hope this advice is helpfull

Well I agree with you with the biomechanical issues as I could put my body under great stress and strain before I got Osteitis Pubis then everything went to shit. I have seen the best in Australia to get the OP fixed and put back into place so unless it is my back that is out of order I can't see any other problems

 

[cptkirk]

only closed chain exercises in the gym, not impact stuff...will give your stabilisers a good going over and to support the prime movers and also great for proprioception

 

[dr nick]

If you have been diagnosed with all the conditions that you claim to have suffered from then I would say your inner chi is out of whack which is predisposing you to lower limb injuries. The yin and the yang are out of balance creating disharmony which is affecting your tissues and muscles distally. I.e it is possible you have a problem with your 'Qi' and your 'Bagua'

I would advice you to get your mind, body and soul assessed and see if there is something that can be done to improve your inner health and wellbeing and help deal with your plantar fasciitis.

I would also go and get your fung shui assessed and see if there is something that can be done to help prevent further injury in the future and also help deal with your current issue of plantar fasciitis.

you should see your local osteopath.

Hope this advice is helpfull

 

[pacemaker]

Hey Dr Nick

What do you mean by inner chi? yin and the yang? Qi and Bagua?

Yeah I think it is time to see someone who can try and figure out why all these injuries are occuring, rather than just seeing people to fix a certain one injury when it happens.

 

[cptkirk]

it's ancient chinese medicine focusing on pressure points or something, i've read a little bit about it but not sold

 

[pacemaker]

Captain Kirk

What do you mean by only closed chain exercises in the gym, not impact stuff? Is this only using gym related exercises as connected to a machine?

 

[kaydub]

Im not a huge fan of Osteos, ones I have seen just tell me stuff is out of alignment and thats the problem so they crack,pull,crack to get things back in line.. On a skeleton dummy things line up, in the real world peoples bones and muscles arent perfect..

All the ancient chinese tea/chi wont help your foot in the slightest if you arent doing proper rehab of it (RICE)

Get a physio to strap your foot structurally to shorten the distance between toes/heel which will relief plantar fascia when stepping on it. 1 major problem with this injury is you are putting pressure on it with every step potentially reinjuring it. So having it properly strapped as long as possible will help it heal.

If its just an acute problem lots of calf stretches, ice for 20 mins at a time with a frozen water bottle on the ground rolling back and forth, taping and ease back into running again very slowly. Gently rolling a golf ball laterally across your foot back and forth helps as well. If you are gonna medicate for it with voltaren take it orally not the gel as the skin on your foot is pretty thick and it wont penetrate as well (so ive been told).. I would increase amount of fish oil taken for a week before going overboard with NSAIDS..

If its ongoing maybe look at getting an orthotic but this just treats the symptoms and doesnt solve the mechanical problems your foot is facing (over-pronation, tight calves, etc..). There are strengthening exercises you can do if not in any pain, stretch with your toes against the wall is one.

Good luck, it can be a long painful injury.

 

[cptkirk]

exercises where you push yourself away from the floor so start with split squats and squats, deadlifts, single leg deadlifts

if you can, also try reverse lunges, walking lunges and step ups

these will wok your stabilisers so tey start to carry their share of stress through the leg, machine exercises won't do this

 

[TruBlues]

Im not a huge fan of Osteos, ones I have seen just tell me stuff is out of alignment and thats the problem so they crack,pull,crack to get things back in line.. On a skeleton dummy things line up, in the real world peoples bones and muscles arent perfect..

All the ancient chinese tea/chi wont help your foot in the slightest if you arent doing proper rehab of it (RICE)

Get a physio to strap your foot structurally to shorten the distance between toes/heel which will relief plantar fascia when stepping on it. 1 major problem with this injury is you are putting pressure on it with every step potentially reinjuring it. So having it properly strapped as long as possible will help it heal.

If its just an acute problem lots of calf stretches, ice for 20 mins at a time with a frozen water bottle on the ground rolling back and forth, taping and ease back into running again very slowly. Gently rolling a golf ball laterally across your foot back and forth helps as well. If you are gonna medicate for it with voltaren take it orally not the gel as the skin on your foot is pretty thick and it wont penetrate as well (so ive been told).. I would increase amount of fish oil taken for a week before going overboard with NSAIDS..

If its ongoing maybe look at getting an orthotic but this just treats the symptoms and doesnt solve the mechanical problems your foot is facing (over-pronation, tight calves, etc..). There are strengthening exercises you can do if not in any pain, stretch with your toes against the wall is one.

Good luck, it can be a long painful injury.

I think you will find Dr.Nick is taking the piss out of osteopaths. There are alot of poor osteopaths out there who treat using methods with very little evidence basis. One case in point is cranial osteopathy which most likely gets results due to placebo. On the other hand there are many good osteopaths out there who don't just rub and crack and genuinely consider the biomechanics of the patient to provide treatment and exercise advice to improve their posture and biomechanics.

Each of the musculoskeletal disciplines have there good and bad points and each have good and poor practitioners depending on the individual. Even mainstream medicine has it's good and bad. They possess the ability to save lives which no other profession can claim and on the other hand many of their drugs have potentially serious side-effects such as NSAID's.

In the end all that matters is that the practitioner, no matter what discipline, is able to improve the quality of life of their patient.

In regards to kaydub's point on strapping, I have no problem with this in the short term to releive pressure on the plantar fascia and allowing it to heal. However, you need to ask yourself what is the reason the plantar fascia became injred in the first place. If it is a result of trauma then biomechanical issues are not a problem. If it is a result of biomechanical issues such as increased pronation you need to look at long term solutions such as retraining posterior tibialis to improve supination, addressing the sub-talar joint or looking at either the hip or the knee to see if something is causing excessive internal rotation reulting in excessive pronation. Orthotics may help, but I believe there are other ways to address these issues.

 

[dr nick]

meh,

I think your better served looking at the talo-navicular joint, retraining peroneus longus to improve dorsiflexion of the foot in conjunction with tibialis anterior, throw in some more heavy sounding words and remember to protect tendo calcaneus as it can often be the crux of the problem.

Alternatively you could go to a physiotherapist who will focus on specific exercises whilst leaving out the anatomo mumbo jumbo.

and FWIW, don't listen to these alternative therapy types who will try to scare you off with these "serious side-effects" in taking NSAIDS. Alternative therapists don't really weigh up the pros and cons of things, but i would advise unless you have got some serious kidney or gastric ulcer issues then taking a nurofen is perfectly safe. They are indicated in plantar fasciitis and will help relieve the inflammation. If you don't control the inflammation you could end up requiring splints, injections and surgery in severe cases.

 

[TruBlues]

meh,

I think your better served looking at the talo-navicular joint, retraining peroneus longus to improve dorsiflexion of the foot in conjunction with tibialis anterior, throw in some more heavy sounding words and remember to protect tendo calcaneus as it can often be the crux of the problem.

Alternatively you could go to a physiotherapist who will focus on specific exercises whilst leaving out the anatomo mumbo jumbo.

and FWIW, don't listen to these alternative therapy types who will try to scare you off with these "serious side-effects" in taking NSAIDS. Alternative therapists don't really weigh up the pros and cons of things, but i would advise unless you have got some serious kidney or gastric ulcer issues then taking a nurofen is perfectly safe. They are indicated in plantar fasciitis and will help relieve the inflammation. If you don't control the inflammation you could end up requiring splints, injections and surgery in severe cases.

You are taking what I said out of context. I agree that NSAID's can be taken safely, and at times are a necessity. As you alluded to they can be unsafe in particular circumstances such as gastric ulcer and serious kidney conditions also in the person who takes medications metabolised in the kidneys such as methotrexate. One problem though is that many medications are manufactured by private companies who consider money making a priority over patient safety hence the development of COX-2 inhibitors such as VIOXX in an attempt to counter-act the adverse effects of COX-2. I wonder what the family of those who suffered cardiac problems as a result would have to say. Even mainstream medicine would agree with this. I am not anti medical profession but I am not gullible and consider all medical interventions on their merit. A great example of modern medicine is vaccinations and being able to cure previously debilitating and life threatening injuries.

Also, practitioners who lack a good knowledge in anatomy will often shy away from actually thinking about the problem at hand and just memorise what thye have heard or been told is the answer i.e. Transverse Abdominis activation and core stability and the classic example of vastus medialis obliquus in patella tracking syndrome. Anyone can memorise exercises to prescribe.

It is the easy option to ear bash what osteopathy has to offer. FWIW osteopaths study pharmacology at university so our profession is designed to appreciate the importance of medical intervention.

 

[swiftdog]

Use this website:

http://www.essa.org.au/index.php?q=node/47


Osteos, Chiros and Physios are good at what they do and definitely help people however when it comes to prescribing exercise post-treatment they just don't have the proper knowledge base for it. I've been told that GP's are now beginning to refer to Exercise Physiologists as opposed to other proffesionals. My chiro as it is tells me he also refers to EP's now for the reasons mentioned above and believes that EP's are the most qualified to prescribe exercise. I know that at the Vic Rehab centre a multi-disciplinary team works together to help a patient. The problem is that for people in all of the above professions want to help you get better, but they want to be the ones to do it. If there's someone better equipped to help you they won't tell you about it for the most part.

I'm an EP advocate (possible career path for me if it wasn't already obvious) but they do have their drawbacks. An EP won't diagnose a condition (at least, they don't at Vic Rehab), they'll assess patients and treat them appropriately. An Ep's strength lies in treatment where I'd say a Physio's strength lies in their ability to diagnose. In a perfect world all of these professions could work together but money makes the world go around. This isn't meant to be a bashing of Osteo's and the like, so I hope it hasn't come across that way.

 

[TruBlues]

Use this website:

http://www.essa.org.au/index.php?q=node/47


Osteos, Chiros and Physios are good at what they do and definitely help people however when it comes to prescribing exercise post-treatment they just don't have the proper knowledge base for it. I've been told that GP's are now beginning to refer to Exercise Physiologists as opposed to other proffesionals. My chiro as it is tells me he also refers to EP's now for the reasons mentioned above and believes that EP's are the most qualified to prescribe exercise. I know that at the Vic Rehab centre a multi-disciplinary team works together to help a patient. The problem is that for people in all of the above professions want to help you get better, but they want to be the ones to do it. If there's someone better equipped to help you they won't tell you about it for the most part.

I'm an EP advocate (possible career path for me if it wasn't already obvious) but they do have their drawbacks. An EP won't diagnose a condition (at least, they don't at Vic Rehab), they'll assess patients and treat them appropriately. An Ep's strength lies in treatment where I'd say a Physio's strength lies in their ability to diagnose. In a perfect world all of these professions could work together but money makes the world go around. This isn't meant to be a bashing of Osteo's and the like, so I hope it hasn't come across that way.

You put your point across very well swiftdog. The alternative therapies definately have their part to play. In an ideal world it is my belief that combining physio, osteos and chiros into one profession would be the way to go but this is obviously never going to happen. I agree with you in regard to exercise physiologists being best equipped to handle exercise prescription as this is obviously their field of expertise. Having said that physio therapists play a big role in rehabilitation and this is highlighted by the role they play in post-surgical recovery particularly in the hospital setting.

Speaking from the view of an Osteopath I believe our skills lay best in our hands on treatment. I believe we spend more time providing hands on treatment and probably do more study in anatomy and biomechanics given the extra year of university training. Alternative therapies have their place in patient care and GP's can't do everything and most of the time it is in the best interest of the patient to undergo a multidiscplinary conservative management before going under the knife.

To say that osteopaths are no good, and that treatment is not backed by scientific research is just false. In the end we are primary health care practitioners who recieve training from general practitioners in medical examination and therefore refer if needed.

damnant quodnon intelligunt

 

[Pepi]

Use this website:

http://www.essa.org.au/index.php?q=node/47


Osteos, Chiros and Physios are good at what they do and definitely help people however when it comes to prescribing exercise post-treatment they just don't have the proper knowledge base for it. I've been told that GP's are now beginning to refer to Exercise Physiologists as opposed to other proffesionals. My chiro as it is tells me he also refers to EP's now for the reasons mentioned above and believes that EP's are the most qualified to prescribe exercise. I know that at the Vic Rehab centre a multi-disciplinary team works together to help a patient. The problem is that for people in all of the above professions want to help you get better, but they want to be the ones to do it. If there's someone better equipped to help you they won't tell you about it for the most part.

I'm an EP advocate (possible career path for me if it wasn't already obvious) but they do have their drawbacks. An EP won't diagnose a condition (at least, they don't at Vic Rehab), they'll assess patients and treat them appropriately. An Ep's strength lies in treatment where I'd say a Physio's strength lies in their ability to diagnose. In a perfect world all of these professions could work together but money makes the world go around. This isn't meant to be a bashing of Osteo's and the like, so I hope it hasn't come across that way.

I don't share this opinion. The difference between physios V osteo/chiro are that physios are experts at exercise prescription. If anything, this is a physios expertise. And by exercise prescription I mean specific exercises to rehab an injured athlete. Not prescribing exercises for a perfectly healthy client (which an EP might be better at). Because as you mentioned a physio has more of an idea about diagnosis and assessing injuries to obtain a diagnosis, i think they are then better at prescribing exercises as they understand the exact mechanics of the injured area and exactly what needs to be done to get it back to 'normal'.

 

[cptkirk]

i got a knee thing goin on, just a slipped ligament or something and need it knocked back in...anyone got a physio or similar in st kilda/south yarra area?

 

[Pepi]

i got a knee thing goin on, just a slipped ligament or something and need it knocked back in...anyone got a physio or similar in st kilda/south yarra area?

Slipped ligament? Knocked back in? I can't tell if you are being serious...but i would probably go to the physio at olympic park there