plantar fasciitis

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Hi, I have had this for over a year now in both feet. First I was told to roll my foot over a can or stand on the stairs with toes on the step and lower and raise my heels, none of this helped. Another two months past and was back at the doctors due to the pain in both feet under Neath and on the outside of my left foot and in the back of my heels about an inch from the bottom. I shuffle like I'm an 80yr old but i am only in my 30s. I was referred to an orthapedic surgeon with suspected Plantar fasciitis, finally saw him and was told that he suspected I had Achilles tendonitis so would not be giving me cortisone injections in my heels. Was reffered to another hospital to see another orthapedic consultant, he had xrays done on both of my feet and they didnt show up anything and and neither did the ultrasound scans. Was told to carry on doing the exercises with leg crossed on top of my other leg and with one hand behind my heel while other hand pulls my toes as far as I can towards my knee. I have to do this 10 times for about 10 seconds each time then repeat on my other foot. So I have had Plantar and Achilles ruled out but as they don't know what's causing the intense pain I am getting they will not be treating me any further but have given me a 3 month appointment, it will not be made for me but if I am still in pain in 3 months they will see if anything is now showing up on scans or will do an MRI scan. After the 3 months if I have not gone back it will be referred back to my doctor, so I had 3 appointments at this hospital which is over 1hr 30min away and no better of now than when I started.

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11 Replies

  • Posted

    An MRI should have been done as a first line of examination.

    Has anyone suggested the muscles & tendons under your calves leading down to your feet - Flexor Hallucis Longus Muscle & Flexor Digitorum Longus Muscle.

    I'm on a 6month program of heal raises and inversions non-weight bearing and with a terra-band to strengthen these. There is also Tarsal tumnnel syndrome!

    • Posted

      Hi Ray, the consultant told me he could find nothing wrong with my Achilles so ruled out tendonopathy and told me me Plantar Fascia is very tight so to carry on doing my exercises. Told me it may be in the early stages so not showing up on ultrasound or xrays so he can not treat me for something that does not show up! That's all the info he gave me. Thanks for your reply really not sure where to go from here.
    • Posted

      But it may not be the achilles tendon but the other ones which run under the foot and are part of the inversion eversion process.

      Every medical person I've been to says the PF is too fibrous a material to benefit from stretching and I've been doing it for 17 years with no progress.

      They cut mine to release teh tension but that made it worse - since now they are saying it wasn't PF at all.

      What/when did you first notice it? There must have been a first day when you said "ouch that hurts"!

    • Posted

      Hi Ray,

      I can remember the day's well I was at work and had just bought a new pair of shoes,  I thought that they were really comfortable but after a week of wearing them my feet would ache like mad. I would get a couple of hours into work and as I'm in retail and on my feet all day I was finding it very hard to stand. My feet would feel hot but the pain would run under my arch to the back of my heels, it felt like I had a stone digging in the underside of my heel. The pain has always been present since the start and hurts when I wake up and try to walk and throught the day and  by the end of the day I'm shuffling along. The pain is more persistent in my heel but at the back of my heel about an inch up but if I bend my foot to the sky I can feel it pulling all around the back of my ankle and up my foot. Have tried painkillers ,antiinflammatory tablets, creams and various insoles gel by scholl and orphotic ones to raise my arch but have had no success with any of it. Was thinking of buying aircast boots and and a pair of crutches as by the end of the day I can hardly walk. Thanks for your reply I really appreciate your input.

    • Posted

      Interesting that yo ucan remember an exact day - for me it was 2:05 pm on August 17th 1998 - warming up for a rugby match. felt like a tear in both arches - played the match (was being paid and didn't want to let Gatty (coach) or the team down. Never recovered. Now suggested the sharp pain was infact a tendon injury.

      You say yo uremember the day but it was after a week of wearing that your feet would ache. Other than the week bit & the sharp pain I had initially -your description is similar to mine. I just can't help wondering is it more than PF.

  • Posted

    Hey Rich50170,

    Trust me...we all understand the maze you've been put thru...but an MRI is important since an XRay just really shows bone and mass, and is not definative on muscles and tendons etc. Its very hard to find a good Podiatrist who really listens and will take the time to really test you. But if you like this Dr....I would not wait 3 months.  Do what he said but go back in 1 month and be insistent about your condition. You are Sooo young so this is really affecting your life I am sure, as it does with all of us, but there are so many different levels of pain and intensity with PF and i have it severely myself but just in my left heel.  Let me ask you...does it feel like your heel is walking on rocks? Or sometimes pencils? Is it just your heel pad and around the edges of the heel or does it affect other parts of your foot? They say PF is worst in the morning and then gets better but that is not true for me...mine gets worse as the day goes on and the more I am on it. Anyway true PF is usually just the heel and the nerves around the sides and back can get aggravated too. You've got to find a shoe or insole....some kind of padding that allows you to walk in a shoe if you work. I no longer work....I had some circulation issues too but I could never have worked with my PF anyway and sometimes it had me just about bedridden!! I dare say mine has improved lately bc now I'm on oxygen and it has improved my tissues and my PF is managable, but only if I wear Croc type shoes bc they cup my heel instead of having my foot hit the ground flatly.  Keep asking questions and sharing on here and reading other's posts as its very informative and everyone is different. Its a maddening condition..I know..but stay in prayer about it bc He's the only 1 that can really heal you!   Gina

  • Posted

    Hi.  I'm a New Zealand physiotherapist; I've been treating this sort of problem for 30 years.  I really don't find them difficult, but you have to do two things that don't seem to happen in the U.K. much.  (1) You have to treat the tight calf as well as the tight plantar fascia/plantar muscles (PF).  The calf muscles attach through the Achilles tendon to the back of the heel bone (calcaneus).  Then the PF and plantar muscles run from the front of the heel bone down to the ball of the foot.  So you can regard it all as one stretchy muscle/tendon running from the back of the knee, around the corner where the heel is and along to the front of the foot.  It's this whole unit that gets tight enough to tug on the bony anchors and start off the inflammation and pain.  It could equally strain in the calf muscles or Achilles tendon, but in this case it's the PF.  If you loosen the whole thing off, the pain at the specific bit settles down.  (2)  But the PF is so tough you have to use massage for this loosening - not for any relaxation effect, but because someone's fingers working longitudinally through the tissues have enough leverage to actually stretch them.  It's like using a rolling pin on a patch of pizza dough.  It's excruciating if the patient has ticklish feet!  Get someone to do this about once every five days - needs time to settle. The whole calf/PF unit also needs stretching - stand with feet parallel, feet shoulder width apart, balls of feet up on a 40mm thick piece of wood or anything similar, and lean forward until it really pulls. Hold that for a total of four minutes, once or twice a day.  Steroid really shouldn't be necessary - it's a strong anti-inflammatory but won't clear the tightness/scarring causing the irritation and then the inflammation in the first place.  Cheers, Steve August.
    • Posted

      Steve, I've had PF (or so they thought) for 16 years. i've done everything you mention - absloutely no use!

      The surgeon said I had tight calf muscles and that was pulling on the calcaneous as you say so he did a half PF release and a gastro release - that was 5 years ago - made it worse (about 10 times worse as measured by the time I can walk before pain stops me). Latest orthopod says it was never PF but the H L muscle & tendon and the FDL tendon etc. "flat foot deformity stage II" he says. On program directed by a physio he uses for 9 weeks now and going on for a total of 6 months before I go back to the doc.

      Another doc (before this one) suggested tarsal tunnel syndrome but nerve conduction tests could not find anything. Nevertheless there is tingling around the tarsal tunnel and also some pain where the tendon goes round the ankle into the foot and some further down the plantar aspect of the feet.

      The recent specialist says there is only 3 things holding the foot in place - Fascia, ligaments & Tendons and certainly no indication of ligaments. No visible damage to PF on MRI - not even evidence of the operation which cut it! Some inflamation of the tendon above the ankle - the previous doc saw this as tarsal tunnel inflammation (and he is a sports specialist - the doc to the Irish Rugby team!, not that that makes him correct).

      Oddly when I take oxychontin - I can walk for up to an hour and a half almost pain free without the crutches with no after effect (maybe two days a week). Addictive drug I'm told so under supervision for this as a way to see if mobility helps the situation. Strange that as long as I walk within this time frame there is no real problem - couldn't take a second tablet as that then doesn't prolong the benefit. All this suggests a nerve issue as well as the potential problem with the Flexor Digitorum Longus Muscle, Extensor Hallucis Longus Muscle and associated tendons.

      So many on this site seem to have similar issues to me - I'd love to know if I'm on the correct path - I'll keep going for the 6 months and report anything that happens.

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