Plantar Fasciitis Help?

[TripleB]

My wife has been dealing with plantar fasciitis since August of last year and can't find any relief.

She's tried ice, dry needling, rest, stretches, acupuncture, pain meds, anti-inflammatories, cortisone injections, physical therapy, rolling feet over ice, 'band' to wear on arches, wearing Oofos flip-flops instead of walking barefoot, night sock to wear from 7pm until bed time. Nothing has helped.

Any recommendations as to what to try next?

Thank you!

TripleB

 

[SteveI]

There has been tons of threads on here and everyone seems to have a different story and cure. I had it once in my entire sporting life, it was really painful and I would not wish it on anyone.

Here is what worked for me. Before getting out of bed.. before my bad foot hit the floor I made sure I stretched the fascia very slowly and used a heating gel on that foot. I was told I was not healing because the fascia was tearing again each day when I hit the floor. I did that for about 3-4 weeks.. and I did not try to play tennis until I was completely pain free for a few months. It helped that the outdoor season had just ended.

I never had PF until I moved to a NB tennis shoe. I am told the flex point for your tennis shoe is also very important. I had play played NIKE forever.. then I got an outstanding deal on a NB shoe ... and boom PF. I gave the shoes away to a NB player and he loved them and never had an issue.

I hope that helps BBB..
good luck!

 

[sherpa]

If you learn how to strap your foot correctly, the tape should stop your arch collapsing and allow it to heal. I tore mine halfway through and the taping was the only relief I got, you can also buy 'braces'.

 

[Fintft]

A good physio can reccomend effective stretches.

 

[bananavanman]

My wife has been dealing with plantar fasciitis since August of last year and can't find any relief.

She's tried ice, dry needling, rest, stretches, acupuncture, pain meds, anti-inflammatories, cortisone injections, physical therapy, rolling feet over ice, 'band' to wear on arches, wearing Oofos flip-flops instead of walking barefoot, night sock to wear from 7pm until bed time. Nothing has helped.

Any recommendations as to what to try next?

Thank you!

TripleB

has she tried PRP? I got it in January. health insurance doesn't cover it, but it was only $500. the downside is you have to stay off it 6 - 8 weeks and no antiinflammatories before and after. PRP + tons of stretching and I'm back playing 5x a week.

Platelet-rich plasma as a treatment for plantar fasciitis: A meta-analysis of randomized controlled trials

Recently, platelet-rich plasma (PRP) has been used as an alternative therapy for plantar fasciitis (PF) to reduce heel pain and improve functional restoration. We evaluated the current evidence concerning the efficacy and safety of PRP as a treatment ...

www.ncbi.nlm.nih.gov

Platelet Rich Plasma PRP injections for Plantar Fasciitis

Platelet Rich Plasma injections have proven very useful in the treatment of Plantar fasciitis. Plantar Fasciitis and heel spur injections under the ultrasound guidance increase the accuracy of procedure. Learn all about when and how they should be used.

www.fasciitis.com

 

[mfoolb]

Absolutely don't walk barefoot or use flip-flops. Some kind of elevation in the heel part of the foot will help a faster recovery. I'm kind of surprised that has not been the first and most important suggestion.

 

[Move]

My personal experience : PF is a sympton in which your body (the chain : back-> pelvis -> glutes -> hamstrings -> knee -> shins -> calves -> archilles - foot) tells you that there is a weak point. Start strengthening and stretching the whole chain. Might take months even years before this whole chain is back to where it should be. Playing lots of tennis is a great litmus test for this. I had some immediate relief from PF by doing day to day foot strengthening excercises ( elastic band interior / exterior moves, picking up a cloth with your bare toes, rolling a ball under your feet, walking on your toes and heels -- there are plenty of good YT vids)
Hope she recovers quick, its a nasty injury

 

[Steve Williams]

Move makes some good points about strengthening and it should be everyday. Wide-enough shoes are also important. When I was in a painful period I bought a pair of Hoka Gaviota running shoes and wore them all the time. They were pretty comfortable and I think made a difference. I made a note from week to week of how far I could walk in them without pain. I increased the distance bit by bit. Seeing improvements was good for morale.

When your wife feels a bit better and feels the urge to try tennis again, have a slow transition back in terms of time per session, intensity and number of sessions per week. Don't overdo it too soon.

I found this book very useful: https://www.amazon.co.uk/dp/B0CHL3RPQT?psc=1&ref=ppx_yo2ov_dt_b_product_details

I live in the UK. It might not be available in the USA.

Good luck to your wife. It took me about 6 months to recover but I still think I need to keep up the strengthening and stretching exercises.

 

[ByeByePoly]

There has been tons of threads on here and everyone seems to have a different story and cure. I had it once in my entire sporting life, it was really painful and I would not wish it on anyone.

Here is what worked for me. Before getting out of bed.. before my bad foot hit the floor I made sure I stretched the fascia very slowly and used a heating gel on that foot. I was told I was not healing because the fascia was tearing again each day when I hit the floor. I did that for about 3-4 weeks.. and I did not try to play tennis until I was completely pain free for a few months. It helped that the outdoor season had just ended.

I never had PF until I moved to a NB tennis shoe. I am told the flex point for your tennis shoe is also very important. I had play played NIKE forever.. then I got an outstanding deal on a NB shoe ... and boom PF. I gave to shoes away to a NB player and he loved them and never had an issue.

I hope that helps BBB..
good luck!

Yeah … I remember rolling arches over tennis ball in the morning to avoid the retearing. Now that I’m getting PF warning signs and I generally wake up with tight calves, it occurs to me massaging calves before those first steps might be a good idea. You know you are falling apart when the massage gun is on the bedside table.

@TripleB … hope your wife’s pf gets better. I hear more about pf problems from the pickleballers than any other injury. I continue to think it’s related to tight calves.

 

[jimmy8]

Try surgery.

try a MRI. there's probably something wrong besides plantar fascia problems. It's all connected.

 

[jimmy8]

You also need custom orthotics to prevent reoccurrence after surgery.

 

[SteveI]

Yeah … I remember rolling arches over tennis ball in the morning to avoid the retearing. Now that I’m getting PF warning signs and I generally wake up with tight calves, it occurs to me massaging calves before those first steps might be a good idea. You know you are falling apart when the massage gun is on the bedside table.

@TripleB … hope your wife’s pf gets better. I hear more about pf problems from the pickleballers than any other injury. I continue to think it’s related to tight calves.

Thanks for reminding my old brain. I forgot a key part of my recovery. I had a pal build me a wooden calf stretch board. I spent hours on that thing to help me with my tight calves. You see these things in the PT clinics all over the place. Mine lives right next to my desk and I use it daily if one for a few minutes a day.. 3 x a day.

You have to stop the re-tearing or you will never heal. I know not playing PB or tennis drives folks crazy.. but rest is also so key! Good luck!

PB.. BTW is "The fastest growing source of sports injuries of America" In the latest AARP the mag. Page 7 there is a great article on PB injury and prevention.

PB injuries accounted for up to $600,000,000 in medical cost last year. Yes... $600 million. Have a great time on the courts but be careful not to fall. Lots of hip and wrist fractures.

 

[Move]

Thanks for reminding my old brain. I forgot a key part of my recovery. I had a pal build me a wooden calf stretch board. I spent hours on that thing to help me with my tight calves. You see these things in the PT clinics all over the place. Mine lives right next to my desk and I use it daily if one for a few minutes a day.. 3 x a day.

You have to stop the re-tearing or you will never heal. I know not playing PB or tennis drives folks crazy.. but rest is also so key! Good luck!

PB.. BTW is "The fastest growing source of sports injuries of America" In the latest AARP the mag. Page 7 there is a great article on PB injury and prevention.

PB injuries accounted for up to $600,000,000 in medical cost last year. Yes... $600 million. Have a great time on the courts but be careful not to fall. Lots of hip and wrist fractures.

Agree to be careful, but not moving (hence my profile name ) is way worse in the longer term

 

[ByeByePoly]

Thanks for reminding my old brain. I forgot a key part of my recovery. I had a pal build me a wooden calf stretch board. I spent hours on that thing to help me with my tight calves. You see these things in the PT clinics all over the place. Mine lives right next to my desk and I use it daily if one for a few minutes a day.. 3 x a day.

You have to stop the re-tearing or you will never heal. I know not playing PB or tennis drives folks crazy.. but rest is also so key! Good luck!

PB.. BTW is "The fastest growing source of sports injuries of America" In the latest AARP the mag. Page 7 there is a great article on PB injury and prevention.

PB injuries accounted for up to $600,000,000 in medical cost last year. Yes... $600 million. Have a great time on the courts but be careful not to fall. Lots of hip and wrist fractures.

I have had little luck with static stretches (but still do them). I have immediate relief (Calves, Achilles) with massage gun on calves. I’m well aware that it’s a load exceeding capacity problem (playing too much), but hard to add a weekly “leg day” when you play 3 times a week … sometimes 4. If I stick to always having a day off between … I have been ok. I suspect playing pickleball 6-10 hours a week is a form of “leg days”.

I had a new ache/pain after Monday pickleball. Not a single pain during 2 1/2 hours of play … no pain for hours after being home. Got up from couch and pain right below left ankle was bad enough to make me limp. WTF. I figured it was going to be bad enough to miss pickleball for days. Iced it, took a Celebrex … limped to bed … not happy. Woke up next morning and nothing … not even a little soreness. Just played 2 hours …again nothing. Weird. I played Dr Google, and looks like what they call Peroneal tendinopathy … I am tired of all the anatomy pain lessons.

 

[SteveI]

Agree to be careful, but not moving (hence my profile name ) is way worse in the longer term

Totally agree. I love to hike and bike also. Nothing against PB... does does not work with my current knee and lower back disc issues. I also hate seeing folks get hurt when they could have just done a bit of off court prep.

 

[kl2963]

Check out Andy Bryant. He is a podiatrist and has a very interesting view on plantar. According to Andy not all plantar fasciitis diagnose is plantar fasciitis. Recent studies reviewed there is a blood artery that is being pinched and which is "killing tissues and nerves" which causes pain similar to plantar fasciitis.

Andy Bryant on Instagram: "These are brilliant images of a toddlers foot captured by Finnish physiotherapist @askella.fi On the left, the foot is at rest. It shows how straight our big toe should be and how the widest part of the foot is at the tips

754 likes, 23 comments - andybryant_podiatrist on February 28, 2024: "These are brilliant images of a toddlers foot captured by Finnish physiotherapist @askella.fi On..."

www.instagram.com

 

[TripleB]

Try surgery.

try a MRI. there's probably something wrong besides plantar fascia problems. It's all connected.

What's crazy is that after everything she has tried, insurance won't pay for an MRI!

TripleB

 

[jimmy8]

What's crazy is that after everything she has tried, insurance won't pay for an MRI!

TripleB

Pay out of pocket, your health is worth it. Shop around and find a place that is good and cheap. After you pay, submit it to insurance and fight with them, they will probably have to pay it if the doctor finds something new.

 

[jimmy8]

I told people my heel hurts, they said it's plantar fasciitis. I bought arch support. Later my heel hurt more. Doctor did xray and said I have bone spurs around where the Achilles inserts into the heel bone. And I have heel bursitis. I need surgery to take out the bone spurs. But the doctor needs to detach and reattach the Achilles so as not to knick the Achilles while shaving off the bone spurs. It's all connected.

 

[hitthefence38]

I tried superfeet which seemed to help me but I think everybody's feet is different so while this helps me it might not help with your wife.

 

[ByeByePoly]

I tried superfeet which seemed to help me but I think everybody's feet is different so while this helps me it might not help with your wife.

Yes …I already knew matching shoes and/or insole replacements to your feet can be a frustrating experience. Now add shoe selection for in the house. I decided for now I would avoid most walking in socks or barefoot in the house. I only plan on doing this as long as I have pf arch twinges. I have walked on my hardwood floors and tile in socks for 15 years with zero issues. My guess is that is good strengthening when there is no inflammation/injury. Just a guess … you see conflicting opinion from podiatrist websites. Anyway … for now it’s shoes indoors. I have Sketcher relaxed memory foam loafers that feel great. You would think perfect indoor pf recovery shoes. Turns out my feet seemed to give off pf arch warning twinges more with them on than just wearing socks. Weird. So I tried something else. I have had great luck with the off brand Fitville pickleball shoe (first time in years I didn’t need to replace insole), so I ordered their hands free slip ons. Got lucky … now are my Fitville slippers … they complete me.

I’m pretty sure all of it is just masking the real problem …constant tight calves. Static stretching seems to do very little for me … but short walks with mutts after pickleball seems to help. Massage gun instant relief of Achilles and arches. Maybe I have to be the guy that carries around the massage gun like some carry their oxygen tank. Can someone do damage with 10 five minute daily massage gun calf sessions?

Edit: to clarify … I use massage gun on calves, not on Achilles or arches.

 

[Move]

Yes …I already knew matching shoes and/or insole replacements to your feet can be a frustrating experience. Now add shoe selection for in the house. I decided for now I would avoid most walking in socks or barefoot in the house. I only plan on doing this as long as I have pf arch twinges. I have walked on my hardwood floors and tile in socks for 15 years with zero issues. My guess is that is good strengthening when there is no inflammation/injury. Just a guess … you see conflicting opinion from podiatrist websites. Anyway … for now it’s shoes indoors. I have Sketcher relaxed memory foam loafers that feel great. You would think perfect indoor pf recovery shoes. Turns out my feet seemed to give off pf arch warning twinges more with them on than just wearing socks. Weird. So I tried something else. I have had great luck with the off brand Fitville pickleball shoe (first time in years I didn’t need to replace insole), so I ordered their hands free slip ons. Got lucky … now are my Fitville slippers … they complete me.

I’m pretty sure all of it is just masking the real problem …constant tight calves. Static stretching seems to do very little for me … but short walks with mutts after pickleball seems to help. Massage gun instant relief of Achilles and arches. Maybe I have to be the guy that carries around the massage gun like some carry their oxygen tank. Can someone do damage with 10 five minute daily massage gun calf sessions?

Masking the problem, that well-phrashed indeed. The human body is a chain of bones, nerves, tissue and muscles. Weakness pops up somewhere eventually. Create a habit of pre-injury moving, strengthening, stretching all the parts of this beautiful chain. Not starting when "the damage is done". I know this is hard, it takes a lot of discipline but your body will thank you.

 

[ByeByePoly]

Masking the problem, that well-phrashed indeed. The human body is a chain of bones, tissue and muscles. Weakness pops up somewhere eventually. Create a habit of pre-injury moving, strengthening, stretching all the parts of this beautiful chain. Not starting when "the damage is done". I know this is hard, it takes a lot of discipline but your body will thank you.

beautiful chain at 25 … rusted chain at 66

 

[Move]

beautiful chain at 25 … rusted chain at 66

Rusty chains can be maintained ... and repaired to some extent. I'm 61 now but in better shape than 15 years ago. Starting with tennis revealed i had a lot of catching-up-maintenance to do.

 

[ByeByePoly]

Rusty chains can be maintained ... and repaired to some extent. I'm 61 now but in better shape than 15 years ago. Starting with tennis revealed i had a lot of catching-up-maintenance to do.

I retired from 45ish years of tennis with good knees, which is surprising given all hardcourt and significant hours of singles. I didn’t have gaps in tennis, so never bad out of shape. I have always played tennis enough times a week, and now pickleball 3 times a week where I have zero interest in adding a “gym” day. Anything I add to weekly routine has to be simple and done from home. I had started doing body weight squats, and for a while wall sits/squats. I should start back with them. I am down to my mid-twenties singles fighting weight, and aerobic wise feel in really good shape. For me … the only need is calves down (I guess throw in keeping knees healthy) … fight the tight. My calves have obviously become stronger/larger over last 14 months from just playing pickleball, and I keep thinking I will reach a point where they quit protesting 6-10 hours/week work. Not so far … whiny baaaastards.