Planta Fascitis

[MedicineMan]

Thought I would give a brief summary of what is happening with my feet. Thinking that as hiker/backpackers, others here on this site may someday enjoy plantar fascitis.
I'm one of the 6million who entered the medical community seeking remedy for this innocous yet often debilitating condition.
As some of you know it arrives randomly, leaves randomly, can vary from an irritant that lasts a week, a month or a lifetime. In rare cases those suffering from p.f. can end up in a wheelchair.
The treatment scheme goes like this:
1. physical therapy---stretching the calf muscle until you think you can stretch it no more and then stretching some more
2. drugs: non steroidals are the norm and you can minus Viox now
3. steroid injections--directly into the fascia where it meets the heal cup, now this is a pain you will never forget when he/she fishes the needle around in your foot to deliver the steroid (betamethasone valerate) into several spots
4. orthotics

I have failed all of the above and now in contention (eg submitted to insurance and praying for coverage) for Ossatron therapy

5. Ossatron--machine which bombards the heel cup and attaching fascia with high energy sound waves....much much akin to lithotripsy in kidney stones (been there too)....wont be able to walk for a week afterward, will be able to hobble lightly around the house/work week afterward, no hiking for 2+ months post. 80% success rate
6. Open radical surgery--- physically separating the plantar fascia from the heel cup.....if Ossatron fails.

So I'm off the trail until Spring at the earliest. If I'm one of the rare who end up housebound with p.f. I'll have a drawing here at WB for gear.

If any have any questions let me know and I'll try my best to answer.

[Pencil Pusher]

Geez, that sounds rather painful. I remember a thread on this subject from a while back. Well I wish you the best for whatever the future holds for them feet. Aren't you the kayaker? That's an interesting way to see the scenery while resting the dogs.

[peter_pan]

MM,
I had chronic PF when I retired from the Army. It actually started a couple years prior. After about 10 years of a more restful lifestyle it dissapeared. I still take it easy, no more running, for fear it will come back. Bottomline is, that if this is chronic, it can take a long time to reverse its painful ways. Good luck. PP

[MileMonster]

Wow, sorry to hear that. I hope the next therapy works for you.

[HikeLite]

Med Man,

May I ask your body weight, footwear type, and typical pack weight?

[Lone Wolf]

I went through the same s**t 2 years ago. When it first started I could not walk for a couple of days. The one thing that helped me and gave almost immediate relief was Superfeet insoles. I swear by them now.

[jlb2012]

I've had PF seriously a couple times - what worked for me was to be real careful in the morning so that I did not tear it again and then very slowly stretch it out until I could put my foot flat on the floor. It may be that Superfeet help some but I have had some minor PF even with Superfeet. What Superfeet really helped me with was the achilles tendonitis - have not had any problem with that since I started using Superfeet.

One option that I have not tried but that sounds good is a sock like thing that you wear at night - there is a strap at the toes end that connects up to another strap above your calf - the effect of it is that your calf remains stretched slightly (toes up heal down) while you sleep thus reducing the chance of reinjuring in the morning.

[Skyline]

Sorry to hear the bad news, HOI. I know from your posts here and on the PATC Trails Forum you spend a lot of time hiking and doing trail maintenance around SNP and south. This is gonna hurt more than your feet. Best wishes for a full recovery.

[jlb2012]

Sorry for the misunderstanding Skyline - I am not subject to PF at the moment although I do have a heal that the bottom of which is a little sore when I first step on to it but it is not serious. My bigest problem right now is recovering from the Sipsey trip - serious case of bursitis (shoulder) and tendonitis (elbow) from all the sawing I did. I must be getting old - a weeks worth of blowdown work and I'm out of action for a month - sigh.

[JoeHiker]

I run a lot. Multiple marathons per year and a lot of mileage. Two years ago, I developed PF. It was pretty bad. I tried the tennis ball, I tried heel pads, I tried PT, I even tried wearing those nighttime socks (e.g. http://www.thesock.com). This went on for almost a year and nothing worked.

Finally, I recalled reading that the cause of PF was usually tight calves. I became religious about stretching and massaging my calves. I'd sit there 15 minutes before a run massaging and stretching. Then I'd stop a few minutes into the run and stretch some more. Never made any exceptions.

Immediately, I began noticing improvement. Within a few days I was running without pain. Within a week, I didn't feel any pain even in the morning when I got up. Within a month, I'd almost forgotten I ever had it.

It takes a lot of time and patience and if your PF is really bad it probably won't help as much, but give it a try.

[Footnotes]

MedicineMan,

I am sorry to hear of your problem. I had PF for 2 1/2 years. I also had tried everything. I had the injections in my heel three times. I did the $300 orthodic thingy and I did stretching religiously. Out of all of it I believe the stretching was the most help, but for me not a cure. My doctor recommended against surgery so in desperation I tried one of the "night boots" that keeps your foot in a position that keep the calf muscles stretched at night. I had two different boots. The first was just too uncomfortable to sleep in. The second one was just what I needed to supplement regular stretching. It took 5 months with this combinations, but it worked for me. Hope you find some relief.

Foot Notes

[MedicineMan]

Stretching religeously is what gets me now from the car and into work but each step is a pain.....without stretching there is no cure for P.F. and in my case no mobility.
Superfeet are in the boots, and I wear LLBEAN Crestas (around 600 trail miles)....but many months ago in an effort to go lighter I switched to Vasque Breeze for 180 trail miles, the orthopod thinks the switch could have been a factor.
I weigh 189, 6'1", typical pack weight for winter trip 3 days is 28pounds including food and water.

I post on the Ossatron afterwards and as I heal up...it is certainly a strange phenom compared to a sprain or a cut.
I'm not whining anymore considering One Leg and others but you all know how it is when you love to do something and its taken away, so my fingers are crossed but at the same time I been paddling a lot more.

[Litefoot]

A long, slow stretch of my calves first thing in the morning and rather expensive custom orthotics fixed my wagon.

[Frosty]

many months ago in an effort to go lighter I switched to Vasque Breeze for 180 trail miles, the orthopod thinks the switch could have been a factor.

A factor in cause or cure?

[MedicineMan]

and I loved them, saved 1pound over the Crestas but alas they werent for me per all indications...you know its all in the genes....

[tlbj6142]

Finally, I recalled reading that the cause of PF was usually tight calves. I became religious about stretching and massaging my calves.

What sort of stretching? Just the calf or do you pull back on your toes as well? For the calf stretch do you do the "hands on the wall, one foot forward and lean" thing? Or the put your toes up the wall a few inches and lean into the wall?

Messaging the calf or the arch of the foot??

My calves (the "fat" part of my calf) rarely feel tight, but my lower hamstrings certainly do.

[Big Guy]

Medicine Man: Sorry to hear of your continual foot problems. Hope the insurance approves your treatment and you have a speedy recovery. Would love to meet you on the trail one day.

[MedicineMan]

Man its good to here from you, was talking abou you the other day...remembering the Pancakes from Aunt Jemima on The Priest....thanks for the encouragement and yes true surgery will be next if the Ossatron fails....that will make a total of approx 13K for all treatment allocations.
I'll give you a call someday but maybe not to talk about P.F.!!!

Thanks to all who have wished me luck. I never ever said I wanted to hike the entire AT but now almost halfway done it has crossed my mind that someday I might actually make it to Maine.
I told Baltimore Jack that after my youngest heads off to school I would like to have finished the AT and consider a thru of the PCT, funny, now a 10min. stroll in K-mart and I look like an 88year old with one foot on a banana peel and the other in the grave...pitiful

I cant describe the stretches but when I do them I do them until it hurts and then push some more, and more and more until the calf muscle is in spasms...it feels wonderful for a little while, then I sit down and after 10 mins get up and the pain is there in full force.

I'll keep all posted on the Ossatron (lithotripsy).

[Suzanne]

I found your comments on what is called orthopedic lithotripsy here in Australia. I have just had my second treatment, and am wondering how you are getting on. It is very difficult to stop walking etc for the 2 months that I also have been advised to stop all weight bearing activity. Luckily I have a a25 metre swimming pool where I can do some exercise each day.
So I wonder if you could let me know how you are getting on?
I am fascinated with this web site that simply came up when I did a search for lithotripsy. I suspect that my husband and I would like a hike on your appalachian trail!!

[MedicineMan]

(spent a little time in NZ)....now about the plantar and the lithotripsy, you'll get a kick out of this...
I missed a doctors appointment-my fault, then last week I called to see if the ossatron had been approved by insurance...they said yes just waiting on the hard copy and then she asked if i wanted to schedule an appointment...i said no that i would call next week to see when we could schedule ossatron...the following week i called and they said i missed an appointment.....and they havent called back or really responded to my calls to them....typical arrogant american md's....
so i am now shopping around for another orthopedic physician, but this time it should go quicker since i was already approved for ossatron....

so to answer you querry I havent had the lithotripsy as of yet, still jumping through hoops....no fair dinkum here I'm afraid.