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Plantar Faciitis/Achilles tendonitis

dcopas78

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Well tomorrow I have an appoint scheduled for a podiatrist to get both of my feet checked out. I started having trouble with my left Achilles tendon about a year ago. It would come and go at first. A few stretches, some rest and some ibuprofen seemed to do the trick. Last summer it become more of an everyday, or at least everyday I was on my feet a lot, problem. I started favoring my right foot as a result. Now, my right foot has severe pain if do 5-6 miles hiking. The heel gets so tender, I can't put any weight on it hardly, even with padded insoles. At first the recommended stretches would loosen it up and relieve the pain. Now, my heel is painful non-stop 24/7. It gets worse with just moderate activity. I guess the good news is, the left Achilles barely gives me trouble anymore, but my right foot is a mess.

My question is, if it turns out to be worst case scenario, has anyone on here had to have surgery for plantar fascia release? If so, what kind of recovery did you have?

I am hoping the doc can get me straightened out and I still get to elk hunt this fall. Hopefully, there isn't any surgery. Knowing my luck, I will probably draw both my New Mexico 1st choice and the Kentucky bull tag :rolleyes: If that is the case, unless my foot is near to falling off, I'm going elk hunting anyways!
 
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I had a moderate case of PF that I was able to resolve with rest and lots of stretching. Given the tendonditis and the PF, I would look really hard at what you do for stretching. Odds are pretty good that these originated because of tight hips/hamstrings in conjunction with either poor fitting shoes, excessive workouts, etc.

I wish you the best of luck, it sucked when I had it and it wasn't to the extent yours was.
 
I don't have anything specific about Plantar Fasciitis, but Airlocksniffer's advice, and the article he linked to in the Achilles Thread basically cured my Achilles pain.

Eccentric heel drops twice a day, straight leg in the morning and bent knee in the evening. Took about a month and I continue to do them to stave off any achilles issues from progressing.

I hope your foot gets better.
 
I had plantar fasciitis several years ago. I had to stand on an inclined ramp several times a day to stretch and had a brace that I wore while sleeping. I haven't had much trouble out of it since. I still stand on the ramp to stretch from time to time.
 
I have had tendonitis since I was 14 (24 now). I do not know how it compares to PF but for me I had extreme pain in my ankles all the time. After wrongful diagnosis from dr's they finally got it right with tendonitis. I am not sure what form it is since that was some time ago. But they molded my feet and made me custom orthotics for my shoes. At first they were really uncomfortable but after that it is hard to go a day without them. They have reduced my ankle pain to almost nothing. They also help keeping my spine in check since I have bad neck and back pain almost daily since I was 16. I m not sure if that is an option for you to try before getting surgery or not but something id ask.

Jamen
 
Went through a bout of PF a year ago for about 6 months. Tried everything, stretching, sleeping in a PF boot, anti inflammatory. Ended up with a cortisone shot. It will make you cry like a baby, but the next day it sure feels good. Have not had another problem.
 
Are you icing? I had PF about 5 years ago, and I did most of what was mentioned above, but also rolled my foot over a frozen racquet ball. I just poked a hole in it, squeezed the air out, held it underwater while it refilled with water, and threw it in the freezer. I would take it out every morning and evening on the deck and rolled my heel over it. sucked at the time, but it did help it heal.
 
My suggestion is to try everything you can to avoid the surgery. About 15 yrs ago my wife had PF in one foot, had the surgery, then developed it in the other foot, had a different surgery procedure in that foot. Recovery was long and painful for both. It kept creeping back in both feet, lots of stretching and icing has controlled it over the years. I think in most cases the stretching and icing can take care of it without surgery but it will take time, patience and dedication. Using a frozen water bottle to roll your foot on works well. Also, you need one (or two) of the boots/braces to sleep in, these keep your foot in a stretched position throughout the night. Keep stretching and icing, it's a long slow road but it can eliminate getting cut on and still having the problem. I have several friends who've been diagnosed with PF and were able to work through it as described. Also, you need custom orthotics, which once you're use to them you'll be switching them out in every shoe you put on. In summary, avoid the surgery and get to stretching. Best of luck, because it does suck, bad.
 
No planter relief surgery here. Cortisone shot.
Stretch and ice.
Get new shoes or try as many different shoes to get your feet right.
It can be corrected without surgery.No custom crap, just PT.

If your Achilles goes, you wont be going anywhere.
Yes on achilles surgery.
 
Thanks for the comments. I have been icing and stretching for the past several weeks, as well as taping it up with KT tape (awesome stuff BTW). The KT tape helps more than anything. I believe that a cortisone shot would do wonders. I had one several years ago for elbow tendonitis and haven't had any problems since. I think I just have WAY too much inflammation in there for the conventional stretching and support job to do much other than some temporary relief. I'm probably going to be facing a big ole needle tomorrow, and just praying for the best. I think once the inflammation leaves, the stretching and icing will definitely start to have some affect. In true Copas fashion, like my father before me, I probably just let it get waaaay to out of hand. :eek: I appreciate the advice received.
 
IMO Cortisone is just a mask for the symptoms. One of my co-workers has been getting shots in his wrist for carpal tunnel and the shots used to work great, now hardly at all. You don't get a headache because you are lacking aspirin. My struggles with Achilles tendinitis were brought under control by heel drops and lots of rolling out tight calves with 'The Stick'. My 0.01.
 
I've had PF twice. Tried every remedy - even the quacky ones. Researched it, asked friends of mine who were elite runners at the time and had top notch medical care. Visited a couple foot specialists. Bottom line is there is no universal cure. It's different for everyone. The commonalities were that inflamation was big problem. They all found a way to stretch out that tendon that runs from your heel to the big toe. They all had to lay off running for at least 6 weeks and they all either had orthotics made or found some kind of insert for their shoes which they wear all the time.
Cortisone gave temporary relief but is not the cure. Unless they had a deformity like a bone spur surgery didn't solve it and was a lengthy and painful recovery for those who tried it.
After a lot of frustration, my own solution came almost by accident: I stepped barefoot on a heavy extension cord on a hard floor and it crossed infront of my heel and felt great as I stood on it. The only relieve I had in a while and i kept experimenting with things to step on with my weight on it and force that tendon to stretch.
Abt a month later I stepped (barefoot) on computer pad that they had at a shoe store which read the profile of your foot. The salesman came out with two different inserts: one for running shoes which was more aggressive and one for dress shoes. Haven't had a problem since. I put them in my hiking boots also.
When I run now I always step on the foot roller and force the arch to stretch out and I do the heel drops on a step until I feel the Achilles and calf stretch out. As long as I do that I am good to go. Whenever I don't wear the inserts I start to have problems, especially out bird hunting.
Good luck
 
Had isolated Achilles tendinitis a few years ago after a marathon. Wore a boot for two weeks or so with high dose anti-inflammatories (naproxene I think) and it healed up fine. Not sure about it with combo of plantar fasciitis. Conservative ortho who doesn't jump right to surgery is best bet.
 
Take this for what it's worth. I have also been experiencing achilles pain in my left ankle/heal. I hike 4-5 times per week in the mountains near my home in NH.The terrain here is rocky and steep in places. There is a fair amount of impact on the feet. Rest is great for the heal, but not great for my mental or physical condition. So I don't want to stop. I visited my chiropractor last week for a hip and shoulder adjustment and mentioned my achilles. After examination, he told me that one of the bones on the top of my foot was pushed in and down. He made a very simple adjustment. To my great surprise, the pain decreased by about 75% in a day. Obviously, I am planning a follow up visit soon. I think it will require several visits at first and then maintenance visits. It's not the complete cure but it was huge.

It's also worth pointing out that this chiropractor is outstanding. I drive over an hour to his office. He's that good. Best of luck. That kind of stuff is difficult and annoying.
 
I would recommend strongly against surgery. The people I've see who have had it haven't really made any gains, as was mentioned in another comment. Try a lot of activity modification, conservative->aggressive treatments for a while before you let anyone near that fascia with a scalpel. I think in many cases manipulation can be helpful. Also consider some functional dry needling (look for folks trained by kinetacore) for the lower extremity.

A holistic approach, looking for why the tendon flared up in the first place, is going to be key. Don't focus treatment only at your foot, but look at the entire kinetic chain. Good luck.
 
I just got back from the doc. The good news is, she isn't "scapel" happy. She wants to try reducing the swelling in both feet, with the right foot being priority because it is way worse than the left. She said normal plantar thickness is .20-.40 mm and mine is .69 mm. I also have two extra bones in each foot that are the contributing factors. On each foot, there are bones that are putting pressure on my posterior tibial tendon, which doesn't allow my arch to be supported correctly. She thinks that we can correct it with proper PT and anti-inflammatory medication, ice, etc. I received the first dose of cortisone today and I start prescription naproxen. It is actually called Accessory Navicular Syndrome and it causes both the Achilles tendonitis and the plantar faciitis development. Once swelling is down, I get my own custom shoes. Thanks for the comments, now I just got to get it taken care of.
 
I realize this is an old thread, but I figured I'd throw this out there. I have PF. My doctor had molds of my feet sent off and they made me a pair of custom orthotics that slip in my shoes. They were $300, but my insurance covered them. Since then, I bought a pair of Powerstep insoles for my hunting boots. I believe you can get a pair now for around $30. They seem to work just as good as the orthotics.

I hope this helps someone.
 
Yeah, I have the orthotics. I ended up tearing the peroneus brevis tendon in my foot. The doctor performed PRP injections in it and the Plantar Fascia on August 16. I was worried that I wouldn't be hunting this year, but the PRP injections have worked miracles. I have been in PT since Sept. 1 for both the tendon and the fascia and I have my last visit today. I'm leaving for New Mexico Monday and I should be fine. I still have fascia pain somewhat but it keeps getting better every day. The tendon tear is doing good, just a little ankle pain every once in a while. Best of luck with the PF. It is really hard to get rid of sometimes.
 

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