My feet are killing me, I have tried about 8 pairs of boots and every $20-300 insole I can find. Had custom orthotics made, do stretches, I am dying.

What do you recommend?

Cortisone shot to start with. Never walk barefooted on hard surfaces. Wear soft shoes when possible. There is a boot you can wear at night which stretches. Roll your arches every day for several minutes with a frozen water bottle.

Trust me, I have had it several times. The shot has always provided me instant relief.

By the way, my orthopedic surgeon wife agrees.

I had a pair of Cabelas Meindl Perfect Hunters that I bought for a Scotland Stag Hunt that Gave me Plantar Facitis. They killed my feet!!!

It took me Six Months to get rid of it.

Here is what I did:
1)Stop wearing the boots that caused it
2)Do the frozen water bottle thing at night
3)Stretch before bed every night (google will tell you how to stretch)
4)Ibuprophen when the pain is really bad
5)Be patient.

I feel for you it is really painful!

Can't recommend stretching enough had a bout of it this summer.

Look on the net you well find several stretches recommended.

Do them faithfully morning and evening.

I've been down this road too. Stretching helps a lot. 4-5 years ago, at the recommendation of a friend, what I did was buy this boot and wore it at night. Less than two weeks later I won't say I was pain free but I could walk and work all day. I'm still a bit tender of some mornings but compared to back then I'm essentially cured. Now I wear it maybe once or twice a year if I have a very long day on my feet. Laugh if you want...shake your head, say it won't work but for a 20 dollar bill don't knock it til you try it. That boot and a $30.00 pair of insoles and I'm good to go, even stumbling through the creeks in my wading boots.

http://www.amazon.com/Plantar-...plantar+facitis+boot

I have so far spent $400 on different "night" boots, none have worked.

I have gone through every pair of work and hunting boots I own trying to find a shoe that works. I have ok luck with the Brooks Beast, as long as I don't spend too much time on my feet. Walking on dirt doesn't seem to bother me, an hour on concrete and I want to suck start a Glock.

Thanks to all the well wishers, I am going to try and get a referall to a orthopedic surgeon for cortizone shots before thanksgiving. I stretch all the time. I have a feeling I missed the boat and might be past the point where stretching helps. I strech them out all the time. Not much benefit.

Oh my BWW. You have my sympathy. Do you have heel spurs also? I do, along with arthritis in my toe joints. I don't know that the pain is anything like childbirth but by the same token I don't want to know. PF is bad enough. I walked with a cane for 3 months when PF was really bothering me and as you indicated, concrete was a killer. It still is but not like back then.

I expect there are other options than what the podiatrist I visited explained to me. She was talking about surgery and if I recall correctly, they cut the plantar tendon(?) to relieve the pain. I didn't like the sound of that so tried the boot. I don't recall that any kind of shots were mentioned. Evidently I was blessed because the boot worked for me.

quote:

Originally posted by larryshores:
Cortisone shot to start with immediately. Never walk barefooted on hard surfaces or use "thin soled" boat shoes.. Wear soft shoes when possible. There is a boot you can wear at night which stretches. Roll your arches every day for several minutes with a frozen water bottle.

Trust me, I have had it several times. The shot has always provided me instant and continued relief.

Me too. Without a shot it will linger on annoyingly.

Almost as bad as having a Morton's neuroma- that is horrible pain.

I just order the boot above. Been suffering with it in my left foot for 2 months hoping it would go away. I think next week I will go for a shot. Who can give the shot? Primary Care Dr?

I got it pretty bad a couple of years ago and haven't been 100% since. I started wearing Salomon Quest GTX boots and they've been great for me. I've worn them on everything from quail hunts to mountain elk and mule deer hunts and they've been fantastic.

My PA is an orthopedic guy, I am a retired Navy guy and I live near a base so instead of referring me out in town the PA did it.

I personally wouldn't let just anyone do it, they try and localize the stuff. Ideally you'd want someone who was good and had done it alot. I was in and out in 20 minutes, and then felt like someone drove a nail in my foot the rest of the weekend. Monday I was 40% better, today I am 70% better. Even if I am never 100% I am still really happy with the result.

I threw about 10 pairs of boots and shoes in the trash, not enough thickness.

I'll try the solomans.

quote:

Originally posted by Woodrow S:
I just order the boot above. Been suffering with it in my left foot for 2 months hoping it would go away. I think next week I will go for a shot. Who can give the shot? Primary Care Dr?

FYI whenever you get a tendon (tennis elbow, etc) or in this case the plantar fascia injected, you want the injection to hurt- that says they're in the right spot, unlike a joint injection or an epidural steroid injection, where they are injecting a potential space and you won't feel pain.

Anyone with experience can do it- I had a podiatrist inject both my heels, an orthopod inject my neuroma and an FP inject my elbow. I wouldn't fuck around and seek out a podiatrist.

Good luck.

quote:

Originally posted by FMC:
FYI whenever you get a tendon (tennis elbow, etc) or in this case the plantar fascia injected, you want the injection to hurt- that says they're in the right spot, unlike a joint injection or an epidural steroid injection, where they are injecting a potential space and you won't feel pain.

Anyone with experience can do it- I had a podiatrist inject both my heels, an orthopod inject my neuroma and an FP inject my elbow. I wouldn't fuck around and seek out a podiatrist.

Good luck.

Or an orthopedic foot surgeon.

For years I ran every day. At one point I developed a bad case of plantar facitis in my left foot. Hurt from the time my foot hit the floor in the morning until I went to bed. Made running unbearable.

I got a pair of plastic orthotics from a store in Houston called The Good Feet Store. I have used them continuously since then. I use them all day every day. I run with them. And best of all I have never had plantar facitis again.

Had that thing couple of years ago for over a year. Grunted thru it. Hiked thru it. Worked thru it ( construction).
Finally got better. Got Kennetrex boots this year and I Feel like King.
What a difference they make on my hunting/hiking endeavors
It's a bitch to get old

a very late reply, but you may still be suffering.

any 'itis is due to inflammation, so try to limit the amount of inflammation in your body for a bit. cut out all grains and legumes, eat only meat, vegetables, some fruit and nuts. no alcohol, water only. try to get a good ratio of omega 3 fats to omega 6 fats. try to eat only grass fed red meat, and eat lots of fish, and take fish oil. if you need higher carb diet, eat sweet potatoes. try to get as much inflammation out of your body as possible.

i battled this crap for over a year and had basically given up on all the insoles, custom orthotics, etc... what healed me completely...i wore nothing but flip flops for 2 weeks. problem gone, never to return. i have no idea why...maybe the way i gripped my toes, no idea, but it worked.

now i stay barefoot at home, and only wear minimus style footwear. minimus shoes by merrel, and i wear minimus boots by Lems shoes. something with no heel rise, and very little arch support. i prefer boots with no ankle support. i'd rather be as close to barefoot as possible, so my own muscles have to do the work as nature intended. hard flat surfaces kinda suck though, nature did not intend those.

The shots cured mine...also the boot you sleep in works real well but takes longer to get results..a friend of mine made me a wooden shoe that you rock in about 10 minutes a day and it works well...I think someone makes that exercise boot??

NO boot will cure the problem, just aggravate it. You cure it best you can then wear a good boot.

This is what helped me.

1. A golf ball to roll foot on, if it hurts real bad your doing it right.
2. A strausberg sock to sleep in at night (this was my real cure).
3. Superfeet insoles in most all my shoes.
4. After pain had mostly subsided i started a regime of foot strengthening, which is the real problem.

Good luck.

I got it pretty bad about 10 years ago before a big elk hunt in Colorado. Since then I have a stretching routine that I do with my feet every day for about 5 minutes before i get out of bed. I have never had to battle it again. Stretching the foot arch is the key. Not the boot.

Since I have started this a year ago my feet are a wider EE instead of D and a size longer 13 instead of 14.

Brooks Beast shoes help a lot to keep you off your feet during the day.

Walking is fine, but standing kills me.

I walk 3 miles a day, this seems to have made me better able to cope.

Superfeet are great, I had orange, and now that my feet are wide and longer I am on the green fattie ones.

I am going to go paleo, why the hell not you still get to eat meat.

quote:

Originally posted by Big Wonderful Wyoming:
I have so far spent $400 on different "night" boots, none have worked.

I have gone through every pair of work and hunting boots I own trying to find a shoe that works. I have ok luck with the Brooks Beast, as long as I don't spend too much time on my feet. Walking on dirt doesn't seem to bother me, an hour on concrete and I want to suck start a Glock.

Thanks to all the well wishers, I am going to try and get a referall to a orthopedic surgeon for cortizone shots before thanksgiving. I stretch all the time. I have a feeling I missed the boat and might be past the point where stretching helps. I strech them out all the time. Not much benefit.

The stretching and TIME works.. I have had it twice myself - both times took nearly a year to completely heal and go away..

Like yourself, I wear the best shoes and boots, have done custom made boots, etc.. never seemed to matter for me, the pain was just there... and then one day.. poof!! I realized it was gone..

Stretching has worked a bit, I don't use the night boots anymore.

I have multiple surgeons tell me not to get cut on, and several have said that injections aren't a good idea either.

I ordered a pair of Hoka boots. I'll post a review on how they go, in a couple months.

I am on my 5th pair of Brook Beast running shoes. I don't think I could function without them. They are like walking on silicone implants.

Check out the Soleus and Gsstrocnemius muscles on each calf. These are the muscles that attach to the "heel cord". Many times they are very tight and increase forces on the plantar fascia.

This happens when the heel leaves the ground prematurely due to shortening of these muscles. The plantar fascia is repeatedly overloaded and becomes inflamed.

You should be able to find some good examples of stretches on the net. Hope it helps to add this to your routine.

lc

I am a orthopaedic foot and ankle surgeon.

First and foremost plantar fasciitis is a misnomer as the condition is primarily not a "itis" but a "osis" ie plantar fasciois !
It is primarily a degenerative condition with chronic failure of the plantar fascia under load.

The condition is typically attributed to a cycle of failure and attempted repair without evidence of primary inflammation as cause of symptoms !

And here lies the problem in management.

I do not give or advise on the use of cortisone in the heel for 3 reasons.

Cortisone is a strong anti inflammatory and we actually require local inflammation to heal the damaged fascia and its origin on the calcaneus.

Secondly if the cortisone leaks into the fat compartments of the heel pad it causes fat pad atrophy which is irreversible and has the potential of a untreatable situation.

The 3rd reason is mucoid degeneration of the fascia can occur if cortisone is abused and this too is very very difficult to treat. I have operated on patients who had multiple injections and their fascia has turned to a soft mass of atrophied tendon.

The standard treatment regimen consists of achilles stretches, plantar fascia stretches , unloading of the fascia with hard moulded insoles with hind foot motion control.

( these are not off the shelf orthotics but custom made soles based on foot moulds or computer generated impressions )

Dorsiflexion night splints help. I acute cases I have no problem casting a patient to assure healing followed by rehab. It's a tough remedy but but worth it !

weight loss is imperative !

Im somewhat sceptical of achilles and plantar fascia stretches in older people because by that age our fascia and tendons are often very fibrous and in some instances also have undergone fibro cartilaginous metaplasia which do not stretch, so aggressive stretching can actually make it worse in these cases

The trick in all of this is patience.... it takes months ( up to 24 months) to heal.
87 % of patients will heal by 18 months.... if they do not heal we offer surgery and of those we operate another 78% will recover...... there is therefore about 13% of the operated group that do not heal.

ESWL or extracorporeal shock wave therapy is of value. it helps by altering pain conduction in nerves in the heel ( very popular in Germany)

Prolotherapy is snake oil ! this is injection of saline.

There is currently research into injection using stem cells and platelets or platelet derived growth factors. These are showing promise.
Some biologic treatments have been discontinued because of cancer causing potential

No matter, hike through it and drink lots of beer boys

Hiking through it ! nope don't think so, this pesky affliction stops the toughest of the tough dead in their tracks !
Ive seen guys in the military tough it out only to be sidelined for many many months with this.

I have been suffering with this problem for four months in my left foot.

Taping with quality 1 1/2" wide cloth tape and quality spray adhesive has helped. It effectively takes the load off the fascia. I also am sleeping with a splint.

I have recovered sufficiently to start riding my bike again and look forward to the exercise.

I did take a cortisone shot. I also changed shoes to a better fitting lace up shoe, threw away the crocs, and do not walk barefooted. My foot was x-rayed and nothing required surgery, just a strain, but it has damn sure been painful.

Damn Mike, I have had it but never that bad.

It does suck.

ALF, any success with ultrasound guided tenotomy? One of the IR's I work for was talking about it a few months ago but I never looked into it further.

lc

lc

ALF

You note that the tissue disruption is the result of chronic failure under load. What do you see as common denominators of activity that lead to this failure? What symptoms are present prior to the chronic failure? What can be done to prevent this issue of failure occurring?

Is the issue one of a degenerative condition leading to chronic failure of the plantar fascia under load or a chronic failure of the plantar fascia under load leading to a degenerative condition?


lc

Duplicate
Post

The topic is far to complex to cover in a mere paragraph.

To the point is that the term "tendonitis" or "fasciitis" is "old" and actually a misnomer because it is not a true reflection of what we are dealing with here. And more importantly it speaks to the misuse of cortisone in the treatment of this condition. ( some would argue abuse of use because the effects cortisone actually is counter productive)

What we do know is that there is degeneration leading to failure and a subsequent attempt at repair by the body, though the repair is imperfect in that normal type one collagen is replaced with type 3 collagen which has inferior tensile strength.

We also know that conditions like tennis elbow, rotator cuff disease, achilles tendinosis, plantar facsiosis and patella tendinosis quadriceps tendinosis all share the same pathology.

The causes are numerous but in the case of plantar fasciosis aging and postural abnormalities of the foot and lower limb are common. There is some debate as to whether the term chronic repetitive overuse syndrome can be applied to the foot as the foot by definition is designed to be used in a repetitive manner.
( this term or entity investigated by students of the foot in the setting of work related injuries and Workman's compensation claims)

What is exiting is that the medical fraternity is entering a new era in treatment. The shift is to biology and biological manipulation to effect healing. I predict that with time we will be utilizing biological agents to cure conditions like this...... perhaps as surgeons many of our procedures will fall away and will replaced by use of a simple injection or ingestion of a pill.

In the mean time , lose weight ! very very important! correct postural abnormalities wherever possible using orthotics and well designed shoe wear, rest or unload injured tissue so that healing can occur whilst maintaining fitness.

Stay away from me and my knife for as long as possible cause I have a licence and training to do a shit load of damage !

I have the capability of fucking up a foot for life and if anyone offers you a quick fix with a needle loaded with a healthy dose of cortisone and local think long and hard, because if that shit leaks into the fat pad causing atrophy you are in for a world of hurt that is very difficult if not impossible to remedy !

If you have the pain worse in morning on getting up out of bed for the first fifty steps or after sitting prolonged and those first steps are miserable often times this is caused from a low back issue that causes the pain. I have seen so many cases of this in my office in thirty six years of practice that have resolved with Chiropracitc care to the low back. If you haven't tried this conservative approach give it a try.

I have a mixed work schedule, and spend about half my day in the office and half in the field inspecting buildings.

I am generally on concrete, hard tile, or if I am lucky hardwood floors for the majority of the day.

I've had good success not wearing dress shoes, and don't plan to ever wear anything like that again. The Brooks Beast is my go to shoe for every day wear and I use them about 3-4 months before throwing them away. I also wear Keen hiking boots, and have a similar rotation on throwing them away. I spend a lot on shoes.

I have given up on finding an insole that is as good as the one that comes with the Beast. They are pure heaven.

The hard part is at home we don't have much carpet, we have a ton of tile, and the rest is hardwood.

Hardwood floors don't seem to kill me as bad, and I will occasionally walk to the bathroom in the middle of the night on them. But most of the time I suit up with croc flip flips.

Speaking of Croc's they also need to be swapped out ever 2 or 3 months. The rubber they use breaks down quickly.

I have tried several other types of flip flop as house shoes and am not happy with any of them.

Cortizone shots do not work for me beyond a couple of days.

Exercize is hard to get in my current situation. In California I was walking to work 2 miles a day. Here in Germany I have to drive about 20 miles to get to work.

Be careful about advice you get to soldier on and work through it on hard floors. It is all bad, the best thing I have found is to keep your feet well protected.

Any shoes that are not heavily padded will cause you problems.

If you are young, you might be able to do something like this. If you are older than 35 think twice about any advice you get.

One weird aspect is that my feet have grown almost a size and half in the past 3 years.

Had it for a few months this year and got tired of working through the pain of the first few minutes until things loosened up. Bad idea, by the way.

Bought a pair of Nike sandals - big, open-toed sandals with a strap over the top of the foot. Wear them at home whenever possible, and the PF went away in about a week. An easy enough fix and fair preventative for at least some of us "seasoned" hunters.

Before you take that first step out of bed in the morning (OUCH)!!!!!
Stretch your toes back toward your chest like trying to relieve a calf charlie horse. Do it for 3-4 minutes or until you feel it loosens up.
I have had this issue like many others on this thread and this is what I found works best.
We all know what that first step in the morning can be like……………….

EZ