plantar fasciitis?

buzz3d269
buzz3d269 Posts: 87 Member
in Fitness and Exercise
Hi all. I have an appointment with a podiatrist on Monday, but thought I would pick your brains before then...

Since about a month ago, I've been suffering from pretty bad pain in my right foot. It's sort of in the middle, near the arch, and progressively gets worse through the day (when I wake up there is no pain, it's towards the end of the day it comes on). I'm also getting pain on the top of my right foot, on the right hand side, that happens when I'm sitting or lying down later in the day.

I'm not a runner - I've regularly been walking 10000 steps per day since December. If it's getting towards the end of the day and I haven't made my step count, I'll jog in place in front of the TV. My main pair of shoes are memory foam sketchers.

I went to the podiatrist earlier this week, and after watching me walk he determined that I have pronation of the feet (I think!) and I would need custom orthotics (approx aud $700) to fix it. I queried the pain on the top of my foot and he organised for an X-Ray & ultrasound. The ultrasound technician said I had plantar fasciitis, my appointment to get the official "diagnosis", and see what the X-rays showed is on Monday. I've been doing exercises to help plantar fasciitis for a few weeks now, since when the pain first really started, and am continuing to do them.

My questions: does the pain I described sound like plantar fasciitis? Most of the accounts I've read talk more about heel pain, and excruciating pain. Mine is bad, but if can walk through it.

Does anyone have any experience with custom orthotics? Does that price seem reasonable, and did they help with your plantar fasciitis? Am I going to be able to use them with my fav memory foam sneakers??

Do you think the jogging on the spot in front of the TV caused it? I've stopped all extra exercise for now till I talk to the doc, but it's frustrating, just when I'm starting to get into it!

Replies

  • QuietBloom
    QuietBloom Posts: 5,413 Member
    Wow, that sounds expensive.

    If you pronate, you are going to need a stability shoe. Go to your nearest running store and have them do a gait analysis and fit you with a proper shoe. IMHO, you don't need expensive custom orthotics, you just need to have the right kind of shoe. I also was fitted with expensive custom orthotics due to knee pain, but it turns out that using a stability shoe when I ran was all I needed. Those expensive orthotics are just collecting dust.
  • ninerbuff
    ninerbuff Posts: 48,956 Member
    Sounds like it. Lot of massage and icing after will help. Realize that weight and inactivity are usually a direct cause of getting it, so keep moving with caution (no jumping or high impact till pain recedes) and stay on calorie deficit to lose weight.

    A.C.E. Certified Personal and Group Fitness Trainer
    IDEA Fitness member
    Kickboxing Certified Instructor
    Been in fitness industry for 30 years and have studied kinesiology and nutrition
  • Cherimoose
    Cherimoose Posts: 5,208 Member
    Plantar fasciitis usually (but not always) hurts more after rest. And it never hurts on the top of the foot. Wait for the x-rays.

    Walk in shoes without a raised heel. Most shoes, including yours, have an elevated heel, which is ergonomically incorrect (you can verify this with your podiatrist). Low heeled shoes include Keds, Converse, and most skateboard shoes.

    And before buying the orthotics, try a pair of over-the-counter insoles like Superfeet, Powerstep, etc.
  • StraubreyR
    StraubreyR Posts: 631 Member
    What I have found helpful for plantar fasciitis is superfeet green insoles. About $30 or so, amazon carries them. I have them in all my shoes. Also ice and stretching. When my plantar fasciitis is acting up, it feels like the bottoms of my feet are bruised, and it's especially bad in the morning.
  • CarolinkaCjj
    CarolinkaCjj Posts: 622 Member
    A vote for the Dr Scholl's inserts specifically for plantar fasciitis. Plus flexing and stretching. It is a bag of suck - for a while, I thought I would fall when I would get up in the night to go to the bathroom. Bought some inserts, wore them to jazzercise, stopped on the way home to buy more. Now I don't wear shoes without them.
  • chad_phillips1123
    chad_phillips1123 Posts: 229 Member
    My PF doesn't hurt on top, does hurt more towards the heel, and usually gets better through the day with activity/stretching (really hurts if I let it rest completely after some activity). Sometimes it flares up more than others. I'd say wait and make sure what the xray's say.

    Even after that I'd try Dr. Scholls shoe, arch, or heel inserts before spending that much on custom orthotics.

    Also, not sure what exercises you're doing, but using a tennis ball and running my foot over it, usually really helps my PF! If you haven't tried it you may want to give it a shot.
  • 22452245
    22452245 Posts: 4
    I feel your pain, literally. I was diagnosed with Plantrars Fasciiatis in June after a sudden onset of heel pain in April that was not showing any improvement. Although your symptoms are different than mine, my symptoms were not the typical symptoms I discovered on the internet either. I have no arch pain what so ever just heel pain.

    I have found that Fit Flops sandals or any shoe with a slight raised heel with a foot bed designed to offer some support has been helpful. Due to flat feet and over pronating in my ankles I have worn custom orthotics since I was a child. But when it comes to sneakers I don't use my orthotic, I find I get better results from a good sneaker that offers ankle support. But everyone is different.

    I have been seeing a physiotherapist for the past 8 weeks and am only know starting to see improvements. Keep up your stretching and if an exercise really hurts, avoid it until your doctor tells you otherwise. That is how I got in this mess, my heel was hurting one day and I thought I would "work it out" by pushing through my workout the next day. Big mistake!

    Good luck, hope you are back to normal soon!
  • nisijam5
    nisijam5 Posts: 9,964 Member
    I have tight calves and that causes the heel pain. I had it for over a year and then started getting massages on my lower legs and feet. It made all the difference.

    True PF takes a year to heel with exercises and ibuprofen therapy.
  • danibrosseau
    danibrosseau Posts: 45
    Mine is recurring.. the thing I find that helps most is taking 3/4 full plastic water bottles, freezing them, and rolling them under each foot for ten or so minutes at a time. Massage.. and icing.. all in one. :)
  • lokepa
    lokepa Posts: 204 Member
    Plantar fasciitis usually (but not always) hurts more after rest. And it never hurts on the top of the foot. Wait for the x-rays.

    Walk in shoes without a raised heel. Most shoes, including yours, have an elevated heel, which is ergonomically incorrect (you can verify this with your podiatrist). Low heeled shoes include Keds, Converse, and most skateboard shoes.

    And before buying the orthotics, try a pair of over-the-counter insoles like Superfeet, Powerstep, etc.

    To piggy back... I suffered with Plantar for almost three years while working two full time jobs, both having me on my feet all the friggin' time!... the most pain was always when I woke up... could barely stand until I warmed up a bit... so it doesn't sound like that's what you're going through...

    As an aside... I tried icing, soaking, and all kind of exercises to relieve the pain... what finally did it was yoga. Who'da thought downward dog would be a godsend!
  • wozkaa
    wozkaa Posts: 224 Member
    I had it years ago, and never had pain on the top of my foot. The Dr I saw was useless and said to just learn to manage the pain (WTF?)..
    A friend told me to try a Physiotherapist, which I did. I only saw them twice, as they gave me a lot of different exercises to do, mainly strengthening my arches and stretching my calves. They also gave my foot some ultrasound therapy to try and loosen up the tendon. I worked a deskjob, so when it was bad i would put a frozen water bottle under my foot and roll it. Every time I got up, I stretched. Standing at the copier or fax? Stretch. I wore my nikes to work (My boss was fine as he knew it was health related), sometimes with my foot strapped as the physio did.
    I used the Scholl inserts and avoided hard shoes like the plague. Keep your feet warm.
    I followed the Physio's instructions and was pain free in about 4 months. I had been in pain for about 12 months prior to getting it checked.
    To still get exercise on the weekends, I cycled.
    Good luck. Hope you get it sorted out soon.
  • spoiledpuppies
    spoiledpuppies Posts: 675 Member
    I've dealt with PF for years and have worked with many podiatrists, sports doctors, and physical therapists. I tried most everything including custom orthotics. I kept listening to the advice to wear really supportive shoes/inserts. It was only when I gave up and decided to trust in the theory of minimalist shoes that I'm able to run again. (The idea is that supportive shoes/inserts inactivate muscles that are natural for our movement. So going minimalist lets our bodies operate as they were meant to.) I use Merrell Bareform shoes and just did a 10K last week. I still have heel spurs that developed from the PF, but everything is manageable
  • nisijam5
    nisijam5 Posts: 9,964 Member
    As an aside... I tried icing, soaking, and all kind of exercises to relieve the pain... what finally did it was yoga. Who'da thought downward dog would be a godsend!

    Yes, it's not just the foot exercises - it's stretching the calves!!
  • earlnabby
    earlnabby Posts: 8,171 Member
    Mine went away when I started doing foot/calf stretches. I would stand on a step (as though I was going up) with just my toes and a little of the ball of the foot gripping the step. Then I would slowly drop my heels as far as I could and hold for a count of five, then slowly raise up on the tippy toes and hold for a count of five. I did this in sets of ten on a daily basis. The pain went away in a couple of weeks.

    The pain on the top of your foot sounds like what I was getting when I was sick (severe anemia) which caused edema in the feet and lower leg. It felt closer to a muscle cramp across the top of the foot than anything. I never saw anyone about it because it stopped when the edema went away.
  • buzz3d269
    buzz3d269 Posts: 87 Member
    Thanks so much for all of the replies :)

    I think what I'm going to do is see what the podiatrist says on Monday regarding the X-rays and ultrasounds. If he still believes it's plantar fasciitis, and that the custom orthotics will fix it, I will still hold off for now, and try a few other things (provided he says that not having the customs won't make it worse down the track). Will try some cheaper insoles, and heading to the running store and getting their opinion too.

    Will continue to do the exercises - the one that the podiatrist showed me is very similar to this: http://www.wikihow.com/Stretch-Your-Calves. I've also been doing the heel drop on stairs thing, and walking around on my tippy-toes. Will try the tennis ball/frozen bottle of water suggestions too, thanks!

    It's interesting that flat shoes were mentioned - today and yesterday I've been wearing some (brand new) vans that are very flat, and my foot pain is a lot lower. When the pain started happening, I dug into my cupboard and went through all of my runners, and ended up exercising in a pair of skater shoes that were huge and bulky, but minimised the pain considerably.

    Definitely continuing to eat at a deficient, and will check in with podiatrist about whether jogging on the spot is ok to continue to do. I am going to lose this weight regardless, it's just annoying that it's come at a time when I'm serious about doing something about it. In months/years gone by, this would be enough to make me sit on the couch with my dessert and give up, but I am determined now lol.
  • DataSeven
    DataSeven Posts: 245 Member
    My diagnosis came a couple of years ago. My heel pain was concentrated more on the inside of the heel rather than the middle or outside part. It was also a lot worse in the morning, or at other times when I'd been off my feet for a while and get up again. It's the inflamed ligament or whatever that would hurt and be stiff until I stretched it out again by walking on it for a bit. For me it was as much to do with the heel feeling 'stiff' as being painful.

    I was advised by my Dr. never to go barefoot, so I wear a pair of crocs around the house, which has been controlling it for me ever since. I also lost 50 lbs which is continuing to help my feet and knees. She also gave me a Rx for some orthopaedic sneakers, which my provincial MCP doesn't cover, and my supplemental health plan at work didn't cover either, so I ended up paying full price for them. (New Balance brand sneakers. Expensive, but well, WELL worth it)
  • Fuzzipeg
    Fuzzipeg Posts: 2,301 Member
    It could be that your posture is not all it could be. I have made use of arch supports in the past which are probably similar to those you were quoted an arm and a leg for. They are insoles which fit in the shoe and help you stand and walk in the correct posture. These do not need to be overly expensive but all things are relative. I paid UK £ 10 for heal and arch light weight ones or £20 for something more substantial. These are generally available from the chemist, probably your drug store.
  • JJinWI
    JJinWI Posts: 197 Member
    My 11 yr old daughter's custom orthotics were quoted at $800. Ridiculous. Her feet are still growing. You got some good advice above in managing it. Good luck!
  • ryall70
    ryall70 Posts: 519 Member
    I have PF in both feet. I have done everything except surgery. Custom inserts are expensive and they did help but they do not totally correct the problem & you have to wear them in all shoes basically. I was told to never go barefoot due to high arches.
    The best thing I ever did was losing weight. This takes pressure off of course.
    I would think twice if they offer cortisone shots. It is a temporary solution and triggered weight gain for me. I had 6 shots, 3 in each foot.
    Concrete floors are very hard on this problem also!!!
  • GoodLittleEater
    GoodLittleEater Posts: 53 Member
    Here at least, x-ray technicians are not supposed to diagnose, even though they see sometimes what is wrong from seeing similar results all the time. Plantar fasciitis just means "inflammation of the plantar area" so it's really confirmation of a symptom. That being said, it usually hurts more in the morning, or after non-activity, and I have suffered from it like many others who have already chimed in.

    Here's my question for you: What is the dysfunction higher up, in the pelvic/trunk area that is causing this pronation down below? And how can you address it with myofascial release and Pilates? These are the questions you need to ask. The foot is being blamed but if you haven't had a professional do a full body analysis you won't be addressing the cause. Feet don't just pronate alone with the rest of the body in good health and alignment.
  • littlekitty3
    littlekitty3 Posts: 265 Member
    I've dealt with it and ran a marathon with it. I don't recommend that haha. But this is what I did to alleviate the pain and strengthen the foot and surrounding area.
    First and foremost, if you can get a hold of electroshock/wave(whatever they want to call it anymore) therapy, do it. It works wonders on a lot of the tendonitis I had.
    Next is to get a boot/special sock that keeps the foot in a flexed position all night so that it doesn't tighten as soon as you wake up.
    Keep shoes off in the house (idk I was told to do that and I am the type of person that never takes shoes off for some reason)
    Get a golf ball and roll your foot on it, it might feel like there's bubble wrap or something (best description I can give).
    Wrinkle a hand towel up with your toes.
    Pick marbles out of rice with your goes.
    Do ankle strengthening exercises if you also had ankle problems in the past (especially Achilles/IT band issues in the past.)
    Stretch your calf also
    Stretch the bottom of your foot by flexing the foot and bending the toes back far enough to feel a stretch.
    Get better shoes/orthotics, especially if you're on your feet a lot.

    I have also experienced pain on the top of my foot when I had PF. It could be a variety of things for this, either your arch is too high or your shoes are too tight.
    PF is normally at the bottom of the foot. Sometimes you can get it in the heel (also could be a bruised fat pad).
  • Cherimoose
    Cherimoose Posts: 5,208 Member
    Here's my question for you: What is the dysfunction higher up, in the pelvic/trunk area that is causing this pronation down below?

    Over-pronation often originates in the feet. For example, here's an interesting study showing that children are more likely to have flat arches if they wear shoes vs. walk barefoot:

    http://www.ncbi.nlm.nih.gov/pubmed/1624509

    Anyway, i'm interested to hear what the podiatrist says on Monday.
  • halleymw
    halleymw Posts: 246 Member
    You can't diagnose plantar fasciitis from an xray. You may have a heel spur, but many people with no pain at all can have a heel spur. The us could show thickening of the area so could conceivably help with the diagnosis, but the symptoms certainly do not go along with the diagnosis. PF is mostly a clinical diagnosis. OTC arch supports are just as effective as $700 ones, so unless your insurance covers it I would not buy one for PF. If there is another diagnosis, then a custom orthotic might be worth while.
    Mike
  • stuart160
    stuart160 Posts: 1,628 Member
    Morton's Neuroma is what it sounds like you may have
  • tabithalobster
    tabithalobster Posts: 14 Member
    When I had PF it was worse first thing in the morning - in fact I could barely bend my foot to walk when first getting out of bed. It loosened up during the day. doc suggested heel insoles, and advised it wiuld improve, but over several months. I used gel insoles, and it has improved over last few months so now it has almost completely gone.

    Reading your post I am so grateful for our NHS here in the UK!
  • runner359
    runner359 Posts: 90 Member
    I would try other options first before buying $700 orthodontics. The exercises are important to do consistently, google this. Also you can get these plantar fasciitis "boots" from most drugstores. The are for sleeping in and will help. It takes time to work through this so don't expect results in a couple weeks.
  • GoodLittleEater
    GoodLittleEater Posts: 53 Member
    Over-pronation often originates in the feet. For example, here's an interesting study showing that children are more likely to have flat arches if they wear shoes vs. walk barefoot:

    http://www.ncbi.nlm.nih.gov/pubmed/1624509

    Anyway, i'm interested to hear what the podiatrist says on Monday.
    [/quote]

    That's very true that shoes at a young age can affect our development. I guarantee you your feet alone are not the only thing affected. Especially if you've been demonstrating pronation since childhood.
  • ironman1431
    ironman1431 Posts: 22 Member
    Hi,

    Your symptoms do not sound like PF. PF is typically worse in the a.m. when you first step out of bed, then eases up a little throughout the day. Pain on the top of the foot is not PF.

    Whether you pronate, or supinate, have flat feet or high arches, it does not mean you require custom orthotics, or a stability shoe or whatever. IMO, custom orthotics should only be used in cases of extreme biomechanical issues/anomalies (pes planus, pes cavus etc.), or leg length discrepancies. Typically in my practice, 90% of the injuries to the lower extremity are from overloading the tissues (your body will adapt to the stresses put through it provided those stressed do not exceed its capability to adapt), or poor movement patterns, and/or weakness somewhere else along the chain (hips, knees etc.).

    Sounds like you may be overdoing it and not resting adequately? Additionally, the research evidence (i.e. Randomized blinded trials, unbiased, published research in medical journals) for custom foot orthotics is not very robust for long term injury prevention in "normal" anatomical feet (unless you have a heel spur, or other medically diagnosed anatomical anomaly), nor does it suggest that custom orthotics are necessarily better than over the counter. Think of it this way, if you broke your arm, you wouldn't spend the rest of your life in a cast, so why rely on foot orthotics long term for this bout of foot pain?

    I would get a couple of second opinions from various health care providers before you spend $700 on something you may not necessarily need. Good luck
  • thinbeautifulnonsmoker
    thinbeautifulnonsmoker Posts: 12 Member
    Yes, it sounds like plantar fascitis. You can get it in the heel or the arch and it sounds like you have it in the arch. I had a case of it which I resolved in 1-2 months by 1) staying off of it for a brief period (a few days) 2) changing to minimalist shoes and going barefoot as much as possible intermittently with 3) wearing some special socks called Feetures (which are amazing !!) and using some over the counter arch supports which cost less than $20. I did not see a doctor, I merely researched it on the internet and then took steps to solve it -- and it worked. Now I can run or walk without pain. I still use the minimalist shoes. It is often an injury that is a result of overweight and maintaining a healthy weight is the best long term solution. :)
  • buzz3d269
    buzz3d269 Posts: 87 Member
    Thanks for the continued replies :)

    So, I saw the podiatrist yesterday morning. He has told me that he doesn't believe it to be plantar fasciitis, he said that the ultrasound showed a slight inflammation (about 4.1 instead of the normal 4), but not enough to call it plantar fasciitis.

    He believes that it is overpronation, and that custom orthotics is the only way to correct it. He also believes that the pain that I'm getting on the side and top of my foot is unrelated - the ultrasound showed a small cyst (possibly ganglion? can't remember, he is mailing me a copy of the report, but I don't have it yet). The small cyst is apparently nothing to worry about, but is likely what is causing that pain. Normal treatment is to get it aspirated off.

    For now, I have held off on the custom orthotics, I just don't have that spare cash hanging around. I have gotten a referral off him to see a clinic that specialises in fitting running shoes to runners, apparently it involves meeting with a podiatrist who will analyse how I run on a treadmill etc. This is something I was thinking about regardless, as I've felt for a while that as I'm getting more active, I should get some decent shoes. I may also use this as a "second opinion" to see what they think about the overpronation and the cyst - knowing now that pain in both parts of my foot is not because it's about to break in half(!) etc means it's bearable until I figure out what to do...

    Thanks again for all the replies, I will continue to do a lot of the exercises and relief techniques mentioned regardless!

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