Plantar fasciitis, please help!

Bee

Barefooters
Jan 20, 2016
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I'm a female, 23 years old. I've always had a healthy, active lifestyle without overdoing anything.Than suddenly, when I started to work on a farm, it started. During the first few months, I had only pain after standing up from sitting and in the morning, but I could work happily on my feet all day. But I nevertheless show it to a podiatrist. Her answer: orthotics (over the counter) and diclofenac. But it was just getting worse. Soon I couldn't walk for more than an hour. Than I got a sitting job and in half year, the pain was over. But I couldn't use anymore any shoes I wanted, only high heeled ones. Later I started to work on my feet again. The pain was back, first it didn't stop me doing anything but from last april i could only work on painkillers. I got costume orthotics and cushioned shoes, no help. In october i got a book, called "plantar fasciitis survival guide", which basically talked about trigger points and doing self massage. First it seemed it will work, but the pain didnt go away. Next thing, one session of yoga with aggressive stretching. Was better for a day or two, but than it got worse. I didnt go back, it just hurt me more. Next solution: chiropractor. He did 2 sessions of dry needling, which helped a lot, than graston. After graston, I was really sore for a few days, but eventually the pain went away. The chiro said I should stop using orthotics, instead I should put only a heelcup into my shoes. I tried for a day or two, but my feet started to hurt again, so I put back. Later I did lots of walking. Pain started to come back a bit, so I did golf ball rolling, very intensively, which hurt me a lot. Back to chiro, graston, cold laser, next day feeling better, but still not OK, soon I took out my orthotics. First day felt good, but than I felt more and more pain. Chiro says it's normal, my body is getting used to the changes. He said not to put back the orthotics, just tough it out for a few days/weeks. I left my orthotics on Saturday, now the pain is really bad, I don't know what to do? Tough it out? The orthotics didn't help for sure, but it seems my body is too much used to them. I'm also thinking about trying Rolfing. Sounds good, but I found mixed opinions on the internet. My first concern is that it will be too aggressive. Aggressive deep tissue work never helped me,just made things worse. I don't need that. But for example the "sock doc" Dr Gangemi recommends it and the rolfer I asked (with 20+ years of experience ) claims they don't do it that aggressively and if something hurts, they stop. It's intense, but shouldn't hurt. Many people claim it's quackery, which is also true for the Graston and the dry needling, but those are supported by anecdotal evidence and lot's of people praise it, Rolfing seems to have less positive feedback. But still, for me only alternative medicine remained, since conventional methods all failed or made my condition worse. I'm depressed, I'm hurting, can't live like this anymore! Please help!
 
I'm not a doctor so I don't know if it's appropriate for me to offer some thoughts. But I will anyway. :) I have very flat feet and fought HORRENDOUS PF for a very long time. So at the high level - I've been where you are. (I'll jump to the ending for me: I used to be in rigid orthotics and now I'm out. I used to run in Motion Control shoes and, although I'm not really running much any more, when I do, it is in minimal non-supportive shoes. And I go barefoot *100%* of the time I'm in my house which is totally hardwood floors. My feet are strong and healthy and totally pain free.)

I've been through Rolfing. The reputation of it being deep and aggressive is old and does not apply now. It is an image that is very hard for the method to shed. It was uncomfortable at times. The practicioner does not use any sort of lotion or oil - so sometimes it feels like the skin is quasi-ripping. She told me that is part of the process of loosening up the fascia. I can't say I noticed a big difference after having it done. I wouldn't call it quackery. But I also am not a big flag waver of it.

I don't think Graston is quackery either. I had ASTYM - which is basically the same thing. They're both a scraping technique with the intent of doing some micro-damage to the underlying tissues. The intent of this is to get your body into healing and rebuilding mode. Gua Sha is the Eastern medicine version. (I'm sure Gua Sha enthusiasts will talk of other benefits as well. I'm not trying to pigeon-hole Gua Sha as simply a scraping technique.)

Long-term (> 3 weeks) of Plantar Fasciitis is actually Plantar Fasciosis. Where "itis" is an inflammation "osis" is a degeneration. So my understanding (again - I'm not a doctor) is that if it has been going on for a longer than 3 weeks any of the protocols to reduce inflammation are not of much use. You have to rebuild the tissue to get it strong and reduce pain. The ASTYM I had helped immensely in my case. It wasn't the only thing necessary but it was a major help.

The thing that took me a long time to piece together in me resolving my issues were the impact of the CALVES on Plantar Fasciitis/osis. I would be foam rolling them a lot - and probably also working on strengthening them. Mainstream PF treatment focuses on the foot - because that's where the pain is. But really look at the calcaneous in anatomy diagrams. If the calf is tight it is pulling on the calcaneous.....which in turn pulls on the PF. The calves must be loosened up to relieve tension on the PF.

Re: orthotics. For me I had to get out of them SLOWLY. It was not a just "stop wearing them". I think when I started I took them out for 30 min. If I could go a few days at that level and things felt OK then I'd increase that time some and go a few more days. Sometimes I just kept adding time every few days. Sometimes things felt a little wonky and I'd hang at that time amount for extra days until things felt better. You'll figure out a pace - but it's a big shock, after your feet are used to them, to just take them out.

I did quite a lot of barefoot walking (totally barefoot) outside as part of my rehab/strengthening. I also did totally barefoot running - although to be fair I did it for strengthening and form development. I didn't do true barefoot running on a long-term or ongoing basis. But I MASSIVELY advocate getting outside with absolutely nothing on your feet. And I'm not talking grass. Go on asphalt, concrete, rocks, etc. The street outside our house is chip-seal. That is REALLY a wakeup call when barefoot.

Lastly, this exercise has gotten a lot of positive response. Based on what I learned this seems like it would be a REALLY good exercise. I learned of it after I went through my issues - so I can't comment on what it would have done for me.
http://well.blogs.nytimes.com/2014/09/15/heel-pain-treatment/

Good luck. You'll get through it. It just takes perseverance.

Jim
 
One of the docs should be with you shortly. :)
 
The problem with plantar fasciitis is that everyone is looking at your feet, but not perhaps the other reasons the problem exists. We treat many of these cases successfully and most of them are actually gait issues, or problems with the way you walk, the way your core functions and the result is tight legs and you are hitting the ground hard with each step.

The chiropractors use of dry needling and graston can be helpful, but how you use these techniques and how you think through the problem can be a game changer. Has your chiropractor evaluated your hips, and how you move. How about a 30 second gait analysis on a treadmill? That can be quite helpful.

Self examination tips for gait problems are standing on one leg then the other. Is one side easier. When you squat, do you lose your balance and fall over. These are signs of core and gait problems.

Hope that helps

Dr C
 
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Thank you for the answers. I didn't have fait analisys. I live abroad and I'm going to the only person in the country who does graston. So I don't have too many options. He didn't see me walking, but examined my whole body, not just my feet. Squatting is not a problem, standing on my left feet is slightly harder than my right.
 
Other question: is it possible that I caused fat pad atrophy by pressing hard with the golf ball? I have pain in the middle of the heel in a spot when I press on it.
 
You may consider reading my book Cheating Mother Nature available on Amazon, as a soft cover or kindle. It can help you understand you and guide you to people who may best help you
 
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Bee,

abroad as in Europe? if so there are plenty of practitioners you can go to. one awesome one in Europe is DNS. dynamic neuromuscular stabilization. they focus on the core and diaphragm. problems with the core translate to problems with extremities. if you seek you shall find. chiros and physical therapists use this as well as other systems to evaluate and train the core to the feet. FMS, SFMA, Prague school, Voijta, and a few others. they aren't always listed on websites so ask if they have learned any of the afore mentioned techniques or others.

i myself have ankle problems and find the harder i work my core the more the ankle feels stable. it's a process but you can get relief quickly.

good luck
 
Follow up: my chiro recently really started to push for orthotics. He claims I should use his orthotics, my original ones are not good. On Wednesday I'm going to someone else, who does applied kinesiology. He said he uses orthotics, but agreed that most issues can be solved without. That's a progress I guess... I really hope he helps, if not, I h a very no other options left in this country. Is there anyone I can show his website in pm to tell what do you think about him based on his website?
 
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Follow up: my chiro recently really started to push for orthotics. He claims I should use his orthotics, my original ones are not good. On Wednesday I'm going to someone else, who does applied kinesiology. He said he uses orthotics, but agreed that most issues can be solved without. That's a progress I guess... I really hope he helps, if not, I h a very no other options left in this country. Is there anyone I can show his website in pm to tell what do you think about him based on his website?
Where are you located? Have you tried posting in the Chapter closest to you? You may have to join it to do so.
 
I'm a female, 23 years old. I've always had a healthy, active lifestyle without overdoing anything.Than suddenly, when I started to work on a farm, it started. During the first few months, I had only pain after standing up from sitting and in the morning, but I could work happily on my feet all day. But I nevertheless show it to a podiatrist. Her answer: orthotics (over the counter) and diclofenac. But it was just getting worse. Soon I couldn't walk for more than an hour. Than I got a sitting job and in half year, the pain was over. But I couldn't use anymore any shoes I wanted, only high heeled ones. Later I started to work on my feet again. The pain was back, first it didn't stop me doing anything but from last april i could only work on painkillers. I got costume orthotics and cushioned shoes, no help. In october i got a book, called "plantar fasciitis survival guide", which basically talked about trigger points and doing self massage. First it seemed it will work, but the pain didnt go away. Next thing, one session of yoga with aggressive stretching. Was better for a day or two, but than it got worse. I didnt go back, it just hurt me more. Next solution: chiropractor. He did 2 sessions of dry needling, which helped a lot, than graston. After graston, I was really sore for a few days, but eventually the pain went away. The chiro said I should stop using orthotics, instead I should put only a heelcup into my shoes. I tried for a day or two, but my feet started to hurt again, so I put back. Later I did lots of walking. Pain started to come back a bit, so I did golf ball rolling, very intensively, which hurt me a lot. Back to chiro, graston, cold laser, next day feeling better, but still not OK, soon I took out my orthotics. First day felt good, but than I felt more and more pain. Chiro says it's normal, my body is getting used to the changes. He said not to put back the orthotics, just tough it out for a few days/weeks. I left my orthotics on Saturday, now the pain is really bad, I don't know what to do? Tough it out? The orthotics didn't help for sure, but it seems my body is too much used to them. I'm also thinking about trying Rolfing. Sounds good, but I found mixed opinions on the internet. My first concern is that it will be too aggressive. Aggressive deep tissue work never helped me,just made things worse. I don't need that. But for example the "sock doc" Dr Gangemi recommends it and the rolfer I asked (with 20+ years of experience ) claims they don't do it that aggressively and if something hurts, they stop. It's intense, but shouldn't hurt. Many people claim it's quackery, which is also true for the Graston and the dry needling, but those are supported by anecdotal evidence and lot's of people praise it, Rolfing seems to have less positive feedback. But still, for me only alternative medicine remained, since conventional methods all failed or made my condition worse. I'm depressed, I'm hurting, can't live like this anymore! Please help!

1. Keep barefooting.
2. Get a night splint. This helped me a ton. My PF went away completely after wearing it every night for a month.
 
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I have a night splint, but doesn't really help.

Hmm. Well, it's likely something more complicated. Mine worked for me, but everyone is different. I'm sorry if I came off as cavalier.

Look, I'm totally unable to run at the moment as I'm coming back from a stress fracture in my foot, so I certainly sympathize.
 
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You could be dealing with tarsal tunnel decompression of some other nerve compression if it is not plantar fasciitis.