Nightmare PT (long, sorry)

[Selkie]

I have been suffering---emphasis on suffer---with plantar fasciitis for four weeks. Saw the ortho who put me into PT. Well, the PT sessions were limited to extremely painful deep muscle massage on my foot, calf, and IT band. She showed me one stretch targeting my pereonis longus (sp?), and even though my heel still hurt like a xxxxx, she had me doing one-legged balances on a wobble pad, something she stopped at my insistence after that made it worse. Apparently, the bones in my foot/ankle weren't in the right place, so she was trying to get them in position. In addition, I have limited ankle/foot mobility.

I still have bruises on my IT band and calves, and it's been more than a week since my last session.

Long story short, after five sessions, I stopped going. I repeatedly told her it was worse and I also told her that besides my painful heel, the only place where I felt tightness/discomfort was my glute/piriformis and behind my knee. She told me that it would have to get worse before it got better. I called my doctor, spoke to his nurse who was not surprised that it was worse due to the massage. I'm now on prescription strength Aleve. It still hurts but still seems to slowly be improving. Weirdly, the heel/calf pain isn't as bad when I stand/walk, but it hurts more when I touch/massage it.

I've limited my activity to biking (on the trainer only) and swimming. The only walking I'm doing is what is necessary, but I have quite a hike to/from my car at work. I had been wearing a Strassburg sock, which helped at first, but switched to a traditional night brace (that seems to be helping somewhat). 'm icing my foot, stretching calves/piriformis, using a foam roller on calf/piriformis, massaging w/a spikey massage ball/stretching the fascia on my affected foot. Also, I'm wearing Superfeet insoles, which the doctor instructed. I'm even wearing sneakers at work. :)

Is there anything else I should be doing to speed my recovery? I have a follow up with the ortho in a couple weeks. I'm not/not going to do a cortisone shot, which he did NOT encourage, and he told me that he refuses to do surgery for this affliction.

[7rider]

Ouch.

So sorry to read this. This stinks.

Not sure what to say as you're doing just about everything I could think of - and then some. Just want to say I hope it heals up soon. PT is a b***h sometimes.

[shootingstar]

I'm not a health care professional and hope others will jump in. But I am a bit confused.

Isn't sometimes that is alleviated by customized orthotics?

About 25 years ago, I started to experience pain when walking only after half an hr. in running shoes. I knew something was wrong...and went to podiatrist.

Anyway, really bad that PT experience. Hope you heal soon! :(

[Veronica]

OUCH! I have no advice, but I hope it all heals up soon! Do good vibes count? :)

Veronica

[jessmarimba]

I know two people who had surgery for plantar fasciitis already this year. Not saying that should be your method of treating it, but that I'm surprised (as scalpel-happy as we are) that he refuses to treat it with surgery. They're both back running and are pain-free.

Fortunately, I've never had to deal with it, so all I can do is wish you luck! It sounds like you're doing everything right at this point. I hope it heals quickly.

[limewave]

So sorry for your experience :( I hope you are able to recover soon!

My experience with plantar fasciitis is that it is a long recovery. It takes time. I kept a tennis ball under my desk and by the couch so that I could roll it under my foot throughout the day. I also did a lot of calf stretching. A tight calf can really aggravate PF. I believe I took 2 weeks off of running altogether while I focused on stretching and rolling--several times each day.

Then I slowly started walking and jogging, keeping my miles low. I didn't start running distance (over 4 miles) for 3-4 months. But I was able to heal the PF and haven't had an issue since (that was 2 years ago).

I also know some people that have had surgery for PF and are back to running. But in my opinion, if can rehab myself, even if it takes 5-6 months of reduced mileage or even eliminating running altogether in favor of cycling, walking, swimming, etc--it is well worth avoiding surgery.

[Trek420]

Apparently, the bones in my foot/ankle weren't in the right place, so she was trying to get them in position.

I'm not a PT, no medical experience or training. Can you get a referral to one of these PT's?

http://www.mckenziemdt.org

[Irulan]

Just curious, since I've been through "it got worse before it got better" deep tissue massage. Did the practitioner give you a time frame or estimate for when you could expect to turn the corner? This kind of deep work can really be a drag, but I'm wondering if you bailed too soon on it, discomfort or not?

[Wahine]

While deep tissue massage should be painful in the muscle groups being treated, it should aggravate the pain that you came in complaining of. What I mean by that is if the deep tissue work is on the calf, I'd expect your calve to be sore for anything up to a week, but your heel pain should be at least a bit better.

Sometimes, if there is a nerve being irritated somewhere in the lower quadrant, (that's the fancy phrase we use to describe everything from your low back/buttock down to your toes) then you can be sensitive to the deep tissue work and it won't help. In fact it will usually aggravate your symptoms.

It's not unusual to have heel or foot pain that is coming directly from nerve irritation elsewhere, or is indirectly related to something else in the lower quadrant due to compensation. I would second getting a second opinion and a McKenzie therapist, as suggested above, would be a good place to start.

[Selkie]

Thanks, everyone, for the replies/suggestions! Good vibes definitely help. :-)

The good news is that I seem to be improving and could walk to my car after work yesterday without really bad pain. Weirdly, the fascia is very sore but I'm no longer having intense pain in my foot or arch. Massaging it with my little nubby ball helps. I think I'm starting to get better, so I'm going to keep up what I've been doing and be very very conservative in limiting my weight bearing activities.

If I don't continue to improve, I will ask the doctor for another script for PT when I see him on the 21st. Then I'll search for/consult with a McKenzie therapist.

Thanks again---I deeply appreciate all the responses. When diagnosed, I accepted the fact that it was going to be a long road to recovery. PT was making it so much worse, however, and that treatment set me back.

Wahine---The deep massage made my foot much worse (she massaged it, in addition to my calf and my IT band). My pelvis is tilted/torqued slightly, so my right leg is slightly shorter than my left. The PT didn't think the leg length discrepancy was an issue, even though I pointed out to her the tightness in the right leg from my glute to my ankle. In addition, the entire right side of my body is stronger than my left, which I guess is normal. I have to be very careful not to slouch to the right side when I sit.

Quite honestly, I don't care if I ever run again. I just want to be back to normal. I miss walking my dogs!

[7rider]

Saw this on Active.com and thought of you, S.
You are probably already doing most or all of these - but thought it was a pretty good piece.

8 Exercises to Prevent Foot Injuries (http://www.active.com/running/Articles/8-Exercises-to-Prevent-Foot-Injuries.htm)

[Selkie]

7, Thanks!!!

[lovelygamer]

I have suffered this before and regularly struggle with joint pain. I feel for you. I tried the needle treatment. It hurt SO SO SO bad and didn't help. It eventually went away for me naturally. At the time I was losing weight and I think that helped (just in my case). Who knows? It seems to be a really hard issue to treat.

I am sorry you are going through this but am glad to hear you seem to be getting better after your therapy mishap. Some therapists definitely don't always make the best decisions for you. I've been through a lot of therapy also, and have seen both the good and the bad. Only you knows what you can handle and what your limits are. I'm sure you made the right call. Good Luck.:o

[ezrida]

Is there anything else I should be doing to speed my recovery?

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 - so I stopped it. I understood that treatment efficiency is very individual. If something works for one it will not always work for the other. I decided that if something does not feel right to me, I am not going to use it.
I have found Taping for plantar fasciitis very useful. Taping helps to relieve the pain, keeps your foot from getting injured again and helps you get through your daily routine and exercises. There is a good web-page explaining the subject in this informative website-
http://www.plantar-fasciitis-elrofeet.com/plantar_fasciitis_taping.html
Take care & Good luck

[Raiza]

I definitely second the taping and the direction in the link above is good. I had plantar fasciitis from wearing a hard orthotic and used taping, rest, and some icing to help. Took about 3 months before it went away completely.

For taping, use a wrap like pre-wrap before applying the tape. It'll spare your skin.

[Selkie]

I've thought about taping, but 1) I was worried about my foot skin; 2) I'm a swimmer so I will have to reapply/remove/reapply/etc; 3) I'm afraid that it will make the muscles used to it and ultimately, make rehab longer (like wearing a splint).

I am optimistically hopeful. The pain is much much reduced today, almost gone, even after swimming 4,000 yards this morning. I just woke up from a long nap and it still feels super. :-) I won't be pushing it so I don't have any set backs.

I treated myself to this: http://www.amazon.com/Slant-Adjustable-Incline-Stretch-Position/dp/B002ZDURJ4/ref=sr_1_1?ie=UTF8&qid=1339258990&sr=8-1
Excellent investment. Makes a huge difference because I can now definitely feel the stretch in my calves.

[Artista]

I had my ankle and foot taped off and on for a few weeks. The adhesive is strong enough to withstand several showers and swims. I absolutely second the suggestion to use a "base tape" to protect your skin because the athletic tape sticks so strongly. I still had to work the base tape off of my skin in the shower with lots and lots of soap. Don't use oil to get it off. The oil made the adhesive separate from the tape and the adhesive stayed on my skin. Yuck!

I wouldn't worry about becoming dependent on the tape. The tape provides some support for overworked soft tissues and allows them to calm down so that they can begin healing. Think of it like a band aid that protects a cut while it begins to heal. You don't have to wear the band aid until the cut is fully healed.

On the other hand, it sounds like you're making progress. No need to tape if it isn't bothering you badly.

[Selkie]

It's odd that neither the PT nor the doctor recommended taping. You ladies aren't the first to suggest it, though!

Since I'm improving, I'll forego it. However, if the urge to take a real walk overcomes me, I'll try taping.

[featuretile]

I had plantar fasciitis some years ago. It was quite excruciating, especially when I would wake up in the morning or after sitting for awhile. I don't want to sound like an advertisement, but I went to The Good Feet store and got some orthotics and put them in my shoes. No walking barefoot, no slippers, no sandals. After a few weeks the pain went away. I wore them for a year or so and now as long as the shoe that I have has some arch support, I am fine. I sent some friends there, and they all got better. One friend had custom orthotics, but these worked better. One thing about custom orthotics is that they don't fit in all shoes. These are thin plastic and fit in most shoes, even dress shoes, so you don't skip wearing them. They cost less than custom, too. So, I did not do all the PT and massage and I got better. This is the website to see if there is a store near you. http://www.goodfeet.com/locations/ Hope you get better!