how is everyone, post eswt?
This is a thread posted in category: ESWT . . View All Heel Pain CategoriesPosted by Lori S. on 11/22/04 at 00:39
How long before you felt very little pain? I still stretch, and use heat, my doc says 12 weeks for anti-inflamatories, ice. I still have that pain in my ankle- just the right one now tho, its pain like having shin splints but in my ankle.
Tina, how are you doing? Did anyone ever have pain in their ankles? Do you still have swelling? lol...... guess im trying to see if im normal, tho I realize this is all about individual people, it doesnt hurt to compare notes. Anyways, I am hoping for a better tomorrow,,,, for everyone ....
best wishes,
Lorinda
Posted by Tina H on 11/22/04 at 08:19
As far as the swelling, that seems to be almost gone, unless I'm on my feet all day. My ankle still seems stiff. I'm too scared to have another treatment of ESWT at this point. It will be intresting to see if the autologous platelet injections work in larger scale trials. I think I will wait for that. Hope you will be doing better soon. So far for me the most improvement occurred between week 12 - 16. Tina
Posted by Dr. Z on 11/22/04 at 09:26
Try using the plantar fascia stretch that we have been talking about. It really helps but you need to keep with it for at least six weeks. Good for morning pain
Posted by Tiger1 on 11/22/04 at 13:42
Posted by vince on 11/22/04 at 19:22
Posted by Tina H on 11/22/04 at 20:20
Posted by Tina H on 11/22/04 at 20:23
I have carpel tunnel in that hand and I don't like to overextend my wrist more than I have to. Thank you, Tina
Posted by Dr. Z on 11/22/04 at 20:35
Posted by Lori S. on 11/22/04 at 23:49
Around the 4 to 5 week period I was in alot more pain. My doctor told me there could be a calm before the storm, and there was. Heres what I did,
1. Stayed off my feet as much as possible, including keeping my feet up on the couch level, not on the floor when I was sitting.
2. heat, hot soaks, heating pad, which ever felt better, seems moist heat worked better for me , but it just depended on the day.
3. I was taking pain meds - loritab 7.5/500, no anti-inflamatories or ice per my doc for 12 weeks
4. I found that sleeping with a pillow under my feet helped a great deal at night
5. massage, massaging my feet helped a lot too, I massage my feet several times a day
6.I use the fascia stretch Dr.Z posted awhile ago, it really did realieve alot of pain during that period, do other stretches per your docs orders, but dont overdo them, when my feet were really bad at that point, I took my stretching very easy.
I have had some sort of setback, but today is a better day. I think you may be experiencing the storm part of post eswt. Mine lasted about 2 weeks, then I felt alot better, I am still improved over what I was like before eswt, and theres still time to get better, keep your chin up and take care of your feet, baby them.
Hope something here helps,
Lorinda
Posted by Lori S. on 11/22/04 at 23:54
I saw my doc today, alot of my current pain is due to another tendon, we are dealing with that now. I was told no anti-inflamatories for 12 weeks after eswt. I still feel I have improved greatly since eswt, and would do it again. I couldnt walk before, I was to the point of considering a wheelchair. I guess we just keep hoping for more improvement. I do hope you start feeling better. Like Dr.Z said, try the stretch, it really seems to help me alot, I just read and reread how it was explained and tried it until I felt I was doing what helped me feel better.
I actually have had a couple pain-free days about 10 days ago, it was wonderful. Hope you keep improving, and keep in touch!
Lorinda
Posted by Julie on 11/23/04 at 03:00
Here is another exercise that you may find helpful. It has been described several times on the board by Dr Z, and has been found in a randomized trial to be an effective non-weight-bearing exercise for plantar fasciitis. We are including it here so that it has a permanent place on the website.
The exercise should be done first thing in the morning, before taking the first step, in order to reduce first step pain. It should also be done two more times during the day.
I will describe the exercise for the right foot. If it's your left foot that is painful, just reverse the instructions.
Sit upright on the edge of your bed (but see Note below *)
Cross your right foot over your left leg, and rest the ankle on the left thigh just above the knee.
Using your right hand, place your fingers across the base of your toes, and gently pull them towards your shin until you feel a stretch through the arch. If you find this painful, do it more gently.
Hold the stretch for ten seconds, and repeat it ten times, three times a day.
While holding the stretch, use the heel of your left hand to gently massage the sole of the foot from the middle of the arch towards the ball of the foot. (This massaging action is Dr Z's addition to the exercise described in the research article. We both feel it enhances the stretch. If you find it at all painful, do it more gently.)
* Note: sitting on the edge of the bed can be a strain on the lower back, especially if the bed is low and/or soft. It is really better to sit on a straight-backed chair. If your hips sink below the level of your knees when you sit on the bed, it will almost certainly be bad for your back - so sit on a chair. Place the chair close to your bed to that you can do the exercise before you take your first steps.
.
Posted by Tina H on 11/23/04 at 06:38
Posted by Julie on 11/23/04 at 06:58
Tina
I think it sounds like a useful stretching exercise, and I hope it will help you. But don't forget the importance of strengthening the entire foot musculature. The yoga foot exercises contribute to that overall strengthening, as of course do the foot trainer exercises.
I'm glad that the study from which the exercise comes has confirmed that there is a better way of stretching than the weight-bearing calf-and
-achilles stretching exercise against a wall that has been prescribed for pf for so long. (This is my particular bee-in-the-bonnet, as I have always believed that this exercise makes many if not most people with PF worse, and have been de-recommending it ever since I came to heelspurs.) But I do think that stretching, though important, can be over-emphasised. Strengthening is equally important.
.
Posted by Tina H on 11/23/04 at 08:59
Posted by Buck T. on 11/23/04 at 15:54
Sincerely, Buck T.
Posted by Julie on 11/23/04 at 16:19
Hi Buck
Lots, I should think. The article that Dr Rompe told us about the other day is the first sign I have seen that podiatrists are beginning to realise that weight-bearing stretching is not helpful. I think the message will take a long, long time to filter down to the troops. But eventually, perhaps, it will.
Meanwhile, I have been pursuing my one-person campaign against the wall stretch and the hanging-off-the-stair stretch that caused Tina (and many others) so much grief. When I finally hang up my Birkenstocks one of the things I will be pleased about is that I succeeded here at heelspurs in steering people away from them.
I'm glad you are doing well, Buck. Take care,
.
Posted by Tina H on 11/23/04 at 17:57
Posted by Scott R on 11/23/04 at 18:38
The researchers kept the methodology simple and the reporting was clear and complete, but I would like to see follow up research by doctors who expect calf-muscle stretching to be better (since this group expected the plantar fascia stretch to be better).
Here are my objections to the research:
1) Those who had been helped by calf muscle stretching may have been automatically excluded from the results because they did not list prior calf stretching as an exclusion criteria. If patients had been cured by calf muscle stretching prior to the start of the study, then that group of patients who are helped by calf muscle stretching were not taken into account. It could be a heavily biased study.
2) The studied required that all patients be very sensitive to pressure on the heel. This means they did not study plantar fasciitis, but they studied a subset of patients with plantar fasciitis. I do not think "sensitive to the touch" is a required symptom of PF or "chronic heel pain" as stated in the title of the study.
3) Inserts were used which may have raised the heels. This would have made stretching the calf muscles irrelevant because a raised heel makes up for and masks the need for calf muscle stretching, but the pain would return if the insert use was discontinued.
4) Wall stretching was used which is probably the least effective method of calf-muscle stretching.
5) They expected plantar stretching to be more beneficial.
6) It's hard to show statistical significance from two populations of only 40 people.
7) The plantar fascia stretch appears to be before the pain that was reported with the first few steps in the morning. I wonder if the calf muscle stretch also had the benefit of being applied before the estimation of morning pain.
8) They talk about stretching the plantar fascia and achilles tendon. Neither of these tissues have a significant ability to stretch except over the course of years. Muscles are the primary tissues that stretch.
Posted by Julie on 11/24/04 at 02:07
Scott
Thanks for posting these points, Scott. But I hope your reservation about the research doesn't mean that you aren't going to give Dr Z's plantar fascia stretch a permanent home on the board (I see you haven't posted it yet at the end of the yoga foot exercise post)? Although shortened calf muscles play a contributory part in so many cases of PF, strong (i.e. weight-bearing) calf muscle stretching is not necessary or appropriate for everyone, and several people have already found the exercise described by Dr Z and in the article helpful. I was asked to write clear instructions for it, and have done that - now it needs to be put somewhere where people can find it, and I thought the end of the yoga post, to which there is a long-established link, was a good place for it.
My view is that stretching, though important, is over-emphasised as a treatment for pf. Strengthening (of the entire foot musculature) is equally important, but is almost never suggested. The Foot Trainer, and the yoga exercises, especially the toe curling/stretching one, which are strengthening exercises, are the exception. However, the new PF stretch, which was first introduced by Dr Z, has been found helpful by people here, and I do think it should be given a permanent place on the board.
.
Posted by Scott R on 11/24/04 at 09:19
I'm unable to add it to the yoga post. I can make a link to it like yoga, but you have to choose a link phrase.
scott
Posted by Julie on 11/24/04 at 11:18
Could you make it possible for me to revise the yoga post as you did once before? I think it belongs there if at all possible.
If that's not possible, I'll try to think of something. It shouldn't be anything with PF or Plantar Fasciitis or Stretch in the title, as those words appear in practically every post and the boards would become irritatingly sprinkled with links.
.
Posted by Julie on 11/24/04 at 11:21
Could you make it possible for me to revise the yoga post as you did once before? I think it belongs there if at all possible.
If that's not possible, I'll try to think of something. It shouldn't be anything with PF or Plantar Fasciitis or Stretch in the title, as those words appear in practically every post and the boards would become irritatingly sprinkled with links.
.
Posted by Tiger on 11/26/04 at 02:57
Posted by joeW on 12/09/04 at 15:11
Posted by Les S on 2/03/05 at 20:15
Les
