Orthotics, heel spur, plantar fascitis, achilles pain

Hi All,

I only joined up today and sitting here watching the marathon on the Olympics and feeling (angry) and frustrated at my current health...

I'm posting to see if anyone can offer me any other advice or has suffered similarly

I got orthotics (at first half ones) about ten years ago because i had plantar fascitis in both feet at the time. Interferential eased the pain and to be honest I didn't notice the orthotics doing that much. Since then I've had one knock-on injury after another from calf cramping, more fascitis, shin splints, and now a heel spur on my right heel. I now have full orthotics.

I was told I over pronate and my arches weren't supportive (I don't have flat feet) ....

I'm now at a chirporactor who has said as a physio did previously I should perhaps try life without the orthotics and go for the running shoes that have the pronation support. I wish I'd listened to that about 3 years ago.

I now fine myself in immense daily pain, first thing in the morning cannot put full weight on my right foot at all as it cannot support my body and walk on the outside of the foot to avoid the pain that is on the inside.

I cannot see a way out of this back to being able to run even 2 miles twice a week!!! I think I'm going to be offered cortisone but the way I see it I need to build up my calves, achilles and plantar AWAY from the orthotics. I have paid for treatment from physio, osteopaths, and now chiropractors over these last ten years....I'm so down about this (I'm only 42) but feel physically older. I had to fight to get my right knee x-rayed and they only did my right heel because i had the orthopaedic appointment anyway.

Is there anyway back from this to allow me to run even once a week for a couple of miles?

Sorry for the length of post am just at my wits end :O(

PS - I just watched how one of the Kenyan runners runs she seems to run inwards with her knees together and toward the inside of her foot - now she's a professional athlete I refuse to believe that I cannot achieve something!

Brenda I sympathise with you because I too have been suffering from a pain in my PF for a very long time now.Like you I have been to a few experts to try and resolve the problem and having tried them years ago without any success I expected the last one to recommend ortotics to me. Thankfully because they can be expensive he didn't do that and instead told me to continue to wear the Boots support insoles I was using and gave me a set of calf stretches to carry out.I was meant to return to him for a leg massage but to be honest any treatment to me seems to cost too much so I didn't.  So I can only recommend that you too carry out a programme of calf stretches as well and hope that helps resolve the problem.

To maintain some level of fitness I now cycleas much as I can and given this weather its easy enough to do but as the Summer draws to a close it will be much harder to do and to be honestI really much prefer the freedom of running and its a nightmare not being able to. Good luck.

Thanks Ted,

If it was just one thing I think I could cope, but given that it has gone on so long....well it wears you down. I am using arc trainer and cycles in the gym instead of running. It's a vicious cycle too (pardon the pun) that if you don't exercise you put on weight and i have always found running the best to combat that...

Anyhow I looked up a video for stretches for a heel spur, the worst is first time in the morning so I will try the towel stretch even though i try to flex my foot ...it's just the fact that i am literally one legged for about a minute I cannot put weight on my foot.

Anyway, again, thank you for your reply sorry for another (unintended rant!)

:O)

Have you tried the stair stretch? Also look up 'active isolation stretching.' The current thinking is that static stretching for 10-20 seconds is counterproductive in certain injuries. I had PF some years ago; it's a sod to get rid of but it usually goes with a lot of patience and correct treatment. I would avoid cortisone as this is often a transient treatment. (I know people who've had this and its worked initially only for the problem to re-occurr some months later) Also, avoid 'building up' the calves as you say. Stretch only, strengthening exercise will only exacerbate the problem. As far as orthotics go, I fully believe in them, they worked for me. I believe that the arch needs to be supported when running as the fascia tends to flatten out on impact. In the meantime let the imflammation die down with ice, anti-imflammatories and massage, then research the above, introduce stretching gently, don't be over-enthusiastic and be patient. All I can say is that it worked for me in the long run. (pardon the pun)

Hi Brenda, I'm so glad I've just found your post.  I'm not sure I can help but I wanted to add my sympathies, and my best wishes for getting it all sorted eventually   I am in a similar position to you - though it's not been going on quite that long.

I'm a bit worried because I'm reading your post thinking that I'm on the verge of the same long term problem as you and it doesn't sound too promising!  I started getting heel pain badly about 3 months ago, though I'd had it on an off for a while and rest made it better previously.  I'm sure I have both plantar fasciitis and achilles tendonitis/tendinopathy.  Did the xray you had diagnose a heel spur?  I've seen a GP and I've also paid money for sports therapist who has massaged and given stretches, which I've done.  I'm not sure that either of these options has really got me anywhere so far.  I've also iced, rolled with a bottle, stretched my calves etc.

The sports therapist gave me some squishy heel insoles but perhaps gel ones would be better?  You say 'you're not sold' on them - it seems there are different opinions on this - has anyone any other thoughts?  I imagine this may be what I'm offered next.

I'm also really worried about getting back running at all. Can anyone advise how you can tell when these things are better?  A couple of times in the last few weeks I've thought it was getting better, but then comes back after just small amounts of exercise. I went on a dog walk yesterday and couldn't stand on it this morning, and have been hobbling around for most of the day!  Yet last week I had no pain for several days.  I haven't run since May really, which is very depressing as I'd just done my first marathon at the end of April!!!

Can anyone else advise exactly what exercise can and can't be done with this type of problem?  Gentleman Gene - how does static stretching make it worse, and in that case, what should be done instead?  The sports therapist said 'anything that isn't weight bearing' is ok and included cycling in this.  However, the GP reckoned that cycling might exacerbate the achilles problems.   I'm lifting weights but that's mostly upper and mid-body and like Brenda, I'm really struggling to keep my weight down now that I'm doing so much less aerobic exercise.  I think that by the time I can get back running I'll be too fat to do it anyway

Sorry, that's another long post and I am sure most of the advice for it has already been posted.  However, I'm really glad to find someone in a similar position Brenda!  I'm similar age to you (40).

Regards, Liz

Bugger, just started a thread on Plantar Fastitis. I have orthotics in both shoes mainly due to my right leg being shorter than my left. I have to be very careful about shoes and trainers and how far they wear before replacing them, I didn't head my own advice nad have been suffering for the last 5 weeks. I was running in Brooks Summons but have switched to asics Gel Nimbus 14, have found these excellent and deep enough for the orthotics and I don't get heel lift as I do with some othe brands and cheaper shoes.

Hi Brenda,

It seems as though you unfortunately have a miriad of problems, so lets go back to the very beginning.

Why were you given the orthoses in the first place, as it may possibly have been the case that you didn't need them. 

"About to scare alot of people" - Everyone pronates, it's part of normal function, if you don't do it, you cannot walk (Pronation is a tri-planar motion that occurs at your subtalar joint and allows for the forward motion of your body - the oppostie to this is supination).  It's whether it's occuring at it's functional limit and therefore overloading structures which are not intended for this amount of stress. This is when a problem then occurs.

Have you seen a podiatrist? You mention the NHS, what have they advised? (I work both for the NHS and privately - hence the question).

Kind regards

Ablefeet

I agree with AF. Too many people are led to believe pronation is some sort of illness or fault. I briefly fell into the trap of orthotics and damaged the ligaments in one of my ankles for the simple reason that the orthotic blocked the natural motion of my foot.

Brenda

I have PF but not as bad as yours.  I have found that when it is at its worse, wearing this http://www.return2fitness.co.uk/foot_care/plantar_fasciitis_splint/plantar-fasciitis-splint  helps to reduce soreness.  I also stretch my plantar fascia, and if I forget, it gets worse.  I stretch it by bending the toes back so that the pf stands out.  I then add to the stretch by pushing my thumb/few fingers into the pf.  Stretches need to last at least 2 mins (not the count of 20-30 that most people suggest - this is not enough time for a stretch to take place).  I  hold for at least 5 mins, sometimes 10. After a couple of days the soreness eases.

You should also check your hamstrings.  I've been studying some anatomy recently it seems that the pf, achilles, calf and hamstrings are all part of one fascial web and that tight hams can cause pf.  I've started to do this myself but too early to report.

A good massage therapist might help, but these need to be trained to a high standard (not your local f.e. college course)  you can find one here http://www.theisrm.com/directory.php

A friend of mine had severe achilles pain due to heel spurs. I don't know if he had PF as well, this was a few years ago now. He had operations to remove the heel spurs - which involved severing the achilles to reach and remove the spur. He had them done one at a time and was in plaster on crutches for weeks and off running until about 9 months after the second op. He got a lot of exercises, physio and massage and after slowly returning to running, was back doing marathons at his pre-op speed reasonably quickly. He was 55+ at the time. He had private health insurance through his work so this probably isn't an option for most people, just thought I'd mention it in case you wanted to ask your GP/specialist about the possibility of spur removal.