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Plantar fasciitis!

Discussion of medical or rescue topics related to climbing and mountaineering.
 

Re: Plantar fasciitis!

Postby Greg Enright » Thu Jun 02, 2011 8:12 am

I have had success with taping the bottom of my foot with sports tape. Four or five strips from the Achilles to the toes. It really shouldn't help, but it does. I put the tape on in the morning, and rip if off after work. It will really help if you are climbing ladders all day.
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Re: Plantar fasciitis!

Postby foweyman » Thu Jun 02, 2011 11:13 am

dskoon wrote:Hey, thanks everyone for the insightful replies. Much appreciated.
Well, a little more experimenting, and, seems the pain is definitely on the heel, toward the back, and deep. Was over at a friends and rubbed my heel on the ball of the chair, and pain! Gonna follow Hyadvetures advice for the immediate time, and begin the rolling and stretching techniques. Got a tennis ball under there right now, and though it's a bit painful, kinda feels good too. Ice, yeah, will try that too, though this acupuncturist I talked with in the pool(ah, she was sooo nice), suggested heat is good. Probably the combo of heat and ice.
I don't think it's my arch, and though I"m not sure, I don't think it's the Achilles, though that hurts when I stretch the calf, as mentioned. Definitely hurts on the heel, especially when pressure is applied. Like right about now with the tennis ball. . . :x Gotta work through this I guess. . .
Again, thanks for all the replies.
Anything more is also appreciated.


Pain on the heel "toward the back and deep" doesn't sound like PF, where the pain would be on the front of the heel and arch area. The "deep" pain could be a symptom of a hairline or stress fracture of the calcaneus (heel bone) or a sprain of the joint between the calcaneus and the talus. A fracture would treated with rest, (immobilization?) and heat. A sprain: ice after exercise (to reduce swelling and further soft tissue injury), heat later (to encourage circulation and healing), and your choice of NSAID (non-steroidal anti-inflamintory drugs): ibuprofin, asprin etc.

STRETCHING WILL NOT HELP EITHER INJURY AND COULD EASILY MAKE THEM WORSE.
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Re: Plantar fasciitis!

Postby dskoon » Thu Jun 02, 2011 4:23 pm

Good suggestions and insights again. Thanks all.
Foweyman, I hear your concerns about it maybe being something else. Spose I should at least get it looked at, though I try and avoid the Dr.'s office if at all possible. When I said "deep pain in the heel," I really meant that it's the heel area that is sore. Rubbing the heel/arch area with a ball last night seemed to help a bit, and I'm going to try some of the suggested stretching exercises for now. Gently, of course, very gently.

G. Enright: I hadn't heard that about putting tape on; I'll give it a try as well. Thanks again.
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Re: Plantar fasciitis!

Postby MoapaPk » Thu Jun 02, 2011 4:50 pm

The distinction between heel spurs and plantar fascitis is sometimes vague. I really had heel spurs, and the pain definitely felt a bit forward of the heel, near the bottom of my foot. It was most intense when I woke up in the morning; that is supposedly a distinguishing characteristic.
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Re: Plantar fasciitis!

Postby dskoon » Thu Jun 02, 2011 5:18 pm

MoapaPk wrote:The distinction between heel spurs and plantar fascitis is sometimes vague. I really had heel spurs, and the pain definitely felt a bit forward of the heel, near the bottom of my foot. It was most intense when I woke up in the morning; that is supposedly a distinguishing characteristic.


Yeah, mine is definitely a bit sore in the morning. Rubbing the ball on it right now. . . Pain seems to be in the heel area, in the middle and toward the back. Good suggestion, Moapa. Might just have to go get it checked out, though, as mentioned, I tend to want to work through this stuff on my own. But, probably smart to go in and have someone check it out.
Thanks.
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Re: Plantar fasciitis!

Postby silversummit » Thu Jun 02, 2011 6:12 pm

I developed this condition in both feet about 5 years ago and it got so bad that I could only wear one pair of shoes to work and had to stop hiking completely. Finally had tendon release surgery on the worse of the two feet and the relief was instantaneous (in the recovery room relief) with recovery complete in about two weeks. I'm no spring chicken either!

I do wear ortho inserts some of the time but being the 'vain female I am' :roll: they don't work in many of the shoes I have for spring and summer. And they do wear out fairly quickly with our very good insurance NOT covering 1 penny of them!

It does help to stretch your Achilles tendon as often as you can especially when you wake up but my doctor says that exercise is only a temporary respite for a chronic condition.

Good luck!
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Re: Plantar fasciitis!

Postby Hyadventure » Thu Jun 02, 2011 7:18 pm

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Re: Plantar fasciitis!

Postby Steve Pratt » Thu Jun 02, 2011 10:00 pm

dskoon wrote:
Steve Pratt wrote:The treatment for plantar fasciitis can be as complicated as you want to make it, but it doesn't have to be a big production. This is what i tell my own patients: You can get significant improvement just by not going barefoot. Always, always, always wear shoes with adequate arch support and heel padding. This includes around the house, in the bathroom, everywhere. I would do that for two weeks and only pursue more complex interventions if that fails. I have saved a number of my patients a Podiatry consultation just with that simple intervention.


Thanks, Steve. I take it you're a Dr. or PT?
I actually usually do wear some sort of shoe all-around, though I like being barefoot(usually only in the summer, on a beach or somewhere).
I even wear a pair of crocs when at home, on the carpet. This ball under the foot, with a slow rotation, feels pretty good though.
What else, Steve?
Thanks.


That's too bad. I was hoping you were the type to go barefoot on hardwood floors. But if you are already wearing Crocs or something like that around the house then you've done the easy stuff.

I would suggest adding a steady dose of an anti-inflammatory pain reliever, such as Aleve (one pill twice a day, need it or not) and warm soaks twice a day. Many commenters have recommended good arch supports (start with an over-the-counter insert and progress to a special-made orthotic if needed) and I will suggest that as well. You can also add a 1/4" felt heel pad which can reduce the tension on the plantar fascia (may need to shop around to find one).

Ultimately, the key is patience. The plantar fascia, like all "gristle"-type structures, has relatively little blood flow compared to muscle or bone. It will heal very slowly. I remember Scotty Pippen missed an entire season with the same problem.

Good luck!

(PS: I am not a Podiatrist, but I am a primary-care doc. A good Podiatrist will give you a much more sophisticated opinion)
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Re: Plantar fasciitis!

Postby dskoon » Thu Jun 02, 2011 10:25 pm

Good stuff! Thanks again, Steve.
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Re: Plantar fasciitis!

Postby foweyman » Fri Jun 03, 2011 1:26 am

MoapaPk wrote:The distinction between heel spurs and plantar fascitis is sometimes vague. I really had heel spurs, and the pain definitely felt a bit forward of the heel, near the bottom of my foot. It was most intense when I woke up in the morning; that is supposedly a distinguishing characteristic.


Exactly, which is why the OP's pain doesn't sound like PF. Heel spurs are calcium deposits at the origin of the plantar fascia on the front of the heel caused by chronic excess tension on the fascia. Often the spurs cause pain before the rest of the fascia does. Chronically tight calves (common in runners) are an often overlooked cause of heel spurs and PF. The tight calves pull on the heel (calcaneus) which in turn pulls on the plantar fascia. A vigorous massage of the calf muscles is often a successful treatment for spurs and PF.
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Re: Plantar fasciitis!

Postby rockymtnclimber » Fri Jun 03, 2011 6:23 am

I've had all sorts of problems, pretty similar to what you describe. Plantar fasciitis, tendonitis in both achilles (really bad case, starting at age 16), tendonitis in my knees, and IT band syndrome. The cures: plenty of ibuprofen, lots of rest (sorry!), and good stretching.

Then, once the inflamation has gone down, the key is building up the strength. In that regard, my advice will be different than most people on here. Spend a lot of time barefoot! Feet get weak because shoes "support" them. Feet are plenty good at supporting themselves if we build them up like we should. I've used orthotics, and Superfeet, and supportive shoes, and they all seemed to help somewhat. But since switching to FiveFingers for a lot of my time, including my new running program, I've had none of the problems I used to. I do get some muscle soreness when I push things, but that's what happens when you work out. As for all of the overuse injuries I used to deal with, I haven't felt a thing!

Yeah, it's the entirely opposite school of though. But if a 200+ lb guy can start running 4 miles at a time with none of the problems he used to have, there's got to be something to it, right? And it's a whole lot cheaper!

Best of luck! I know none of it is fun.
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Re: Plantar fasciitis!

Postby dskoon » Fri Jun 03, 2011 6:41 am

Good post there, RockyMountain.

yeah, I've thought about the Fivefingers(quite the name, eh?), but for more as a camp shoe/slipper than anything else.
I do hear what you're saying about building up the feet, etc. by being barefoot. I believe my problem began by wearing some shoes that the insole/liner had flattened out in them, thus causing me to . . . who knows? Walk gingerly. That's when I first felt the pain, a couple of months ago. So, quit wearing the shoes. Actually improvised and added more insole thickness. But, didn't wear the boots much after that. Then, this one just seemed to come outa the blue. Probably began with those boots, and then just exacerbated the condition with hiking, etc. Now, doing what I can.
Time for some Vitamin I and bed. Thanks.
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