The Plantar Fasciitis Trials – Part 3 – The Podiatrist


podiatrySo.. Picking up where I left off on part 2 – Off to see the podiatrist.

First, lets look at my thoughts/views/experiences regarding podiatrists.  I had never been to one (that covers experiences.)

I love research, so I had googled everything I possibly could in regards to  Plantar Fasciitis and (when I first got them) Vibram Five Fingers.  This had led me  to several Podiatry forums.  I read everything I possibly could on both topics – after all, these were the foot experts right?   Before I looked into Plantar Fasciitis and had been researching VFFs, I noticed a really common theme.  Podiatrists hated them.  This wasn’t a huge surprise, after all Christopher McDougall had said the same thing in articles and in his book.  It was amazing to me the outright vehemence that the Podiatrists posted about them. The more common viewpoint seemed to be that any form of “minimalist” shoe was simply a horrible injury waiting to happen, whether you did “too much too soon” or not.  In fact, the whole idea of “too much too soon” as a problem was ridiculed.

The common premise seemed to be that only in the smallest percentage of people, were our feet mechanically sound enough to walk barefoot for small distances, let alone run in bare feet.  I saw the idea presented that our foot hadn’t evolved to support us running.  I saw it proposed that they were fine for short distances, rarely, on grassy fields only but never on pavement or for distances over a mile or so.

$400 a pair for the orthotics.  They fitted me for them even before I saw the Doctor!

$400 a pair for the orthotics. They fitted me for them even before I saw the Doctor!

Much more rarely, I saw the idea that our feet weren’t developed enough, because we had put them in the sorts of shoes we had.  This last one made the most sense, and not just because it supported the “Born to Run” theory.  When someone has had their leg in a cast, we don’t suggest that they spend the rest of their life in a wheel chair, or with their leg casted up and using crutches.  The very idea is asinine and ridiculous to us.  Obviously, if the leg is broken or there is soft tissue damage,  you let it heal.  Once it is healed you do a series of exercises and physical therapy to get your leg working properly again. Yet EVERY SINGLE PERSON that I have ever met, talked to or heard about that has gone to a Podiatrist has been told they should wear orthotics ($400) and that they should  plan on wearing them the rest of their lives.  Many runners that I read about online – went to a podiatrist and were told that due to their feet they shouldn’t be running at all.

Needless to say, I was a bit concerned about finding a podiatrist, and what they would say.  I was fortunate in that my Tang Soo Do teacher was able to direct me to one of her Black belts that was a podiatrist.  Apparently this doctor had also spent a long time as a runner!  This sounded like he had potential.   I figured I would wear my Five Fingers to the appointment for a couple of reasons. First off, they were the least painful shoes to walk in.  Secondly, Might as well hear his opinion of them right off – and see what he had to say.

I was sitting up right, he then pushed on my foot with his right hand to see how far it would bend.

I was sitting up right, he then pushed on my foot with his right hand to see how far it would bend.

The receptionist looked at my feet and informed me that he was going to tell me to not wear those, they are bad for my feet.  Well, it is what I had expected.  Then she brought me to the machine to fit me for orthotics.  (Before I saw or talked to anyone about how my feet felt.)  When he came in, he was a bit more circumspect about it. He let me know that everyone he had seen come in with those, had come in with an injury. (I did resist asking him how many people came to see him that DIDN’T have a foot injury since he was a foot doctor.  He worked me in to his schedule quickly, and I thought snarkiness was a horrible way to return his kindness.)  He suggested that they should only be worn rarely, and when running short distances on grass, but that they could be a great tool (under those circumstances) to help He had me remove my socks/shoes and then started checking out my feet (yes I washed them before going.)  The most informative was when he had me sit up right with my legs at a 90 degree angle to my body. Then he pushed on my feet to see my flexibility by checking the flexion of my feet.  He informed me that was the root of my problem.  Your standard person would have about 15 degrees in motion – I had five.

KONICA MINOLTA DIGITAL CAMERAHe gave me the standard series of exercises that you see by googling online.  (Pick up things with your toesPull a towel to you. )  He also gave me the standard stretches (stand with the front of your foot on the stair, and lower yourself down to let the bottom stretch, as well as one to do in the morning by holding my heel and pushing on my toes/ball of my foot).

He gave me a list of motion control shoes that would prevent my foot from flexing while I ran. He suggested that I switch to running only in those from now on.  I asked him how long I should expect to use the motion control shoes, his response was “As long as you run.”  He verified with the assistant that I had been fitted for orthotics, and told me I should always wear them.  He then had the nurse make an arch-strap for me to wear for the next week or so.

He then gave me a Cortisone shot in my foot. In hind sight, I really wish he hadn’t.  In addition to the unpleasantness of having a needle designed for a horse put into my foot, it didn’t really help.  See the immediate numbness and relief? THAT Was incredible.  OMG, I understood Nirvana in that pain-free time.  It felt like Jesus himself had come down from heaven and healed the infirm – starting with me.  I was ready to kiss the doctor.  Unfortunately, 20 minutes after I walked out of his office, the pain returned.  Now the pain was not in my heel, but all through my arch (where it has remained to this day.)  By the end of the day, the pain was actually worse than when I walked into his office.

splintI looked at his handout after I left, and it said that night splints (which was also suggested by a physical therapist on my facebook page) helped 20% of Plantar Fasciitis sufferers.  Well, I had an HRA (Health Care Reimbursement Account) through work, so I ordered one of those as well off of Amazon.

Now, I think I have made my mistrust of podiatry fairly clear in this post.  But understand, my foot HURT. I couldn’t run and I wanted too.  So even though I thought the idea of motion-control shoes and orthotics for the rest of my life was not my best move. I was certainly willing to try ANYTHING that would let me walk with less (I couldn’t hope for “no”) pain, and might let me start running again.  So off I went to a local sports store that was recommended on the hand out from the doctor.

The guy at Al & Sherry’s sport shop was awesome.  There is no other way to put it.  He immediately understood my frustration with the 12 mm heal rise of the “motion control” shoes.  He showed me the firm mid-sole that the motion control shoes had, and we checked almost every other shoe that was there to see what its midsole

The Shoe I didn't get.

The Shoe I didn’t get.  Aren’t they BEAUTIFUL?

was like.  We did find one that I LOVED the colors of, but that 12 mm rise was still an incredible jump from my current “ZERO” drop.  I did understand that a slight rise could help relieve some of the tension on my Plantar Fascia.   After looking at the shoes there, and doing more research online – I ended up going with the Saucony Kinvara 2. It has a 4 mm rise, and with the addition of the orthotics – would prevent that midfoot bending (not that they were all that flexible there to begin with.)

I will still wear this when running if VFFs sometimes.

I will still wear this when running if VFFs sometimes.

While waiting the 4 weeks for my orthotics, at the Doctor’s suggestion – I bought a Dr. Scholls one to get me through.  That combined with the arch strap (I bought some as the one got funky pretty quickly) really helped.

So to summarize, here were the elements I was planning on using in my “Cure:”

  1. Cortisone Shot. (Bad Move.)
  2. Stretch my Calf and Foot (using standard calf stretch with wall, and stair stretch)
  3. Footlog – the Doctor loved this.
  4. The Stick – Because it is awesome.
  5. Archstrap – immediate relief and support of the Plantar Fascia
  6. Orthotics – because he is a podiatrist. And I was willing to try it.
  7. Different shoes – grumble.
  8. Foot Exercises

I was happy now that there was a goal. I wasn’t happy with the idea that I was facing something that was going to take anywhere from 6-8 months or a year or more to totally heal, but it was good to have a plan.

Next up – the finale (I hope), and my final thoughts on why Podiatrists give all patients Orthotics (and it’s actually a good reason if you ask me)

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About

I run, because I am a runner. Having realized that I have always "been a runner" - even when I went years with out running, I am learning how it has integrated itself in all aspects of my life. When I started running in highschool, my perspective on life changed. Funny that I didn't realize how much it had affected it until just recently.

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Posted in Plantar Faciitis, recovery, running, running injury
8 comments on “The Plantar Fasciitis Trials – Part 3 – The Podiatrist
  1. Halfathoner says:

    Mine has taken 6 months to heal, and I had to use orthotics (althogh I didn’t change running shoes). So far your doctor is on track…

    • Robinson says:

      Certainly, he gave me the standard response to Plantar Fasciitis. HE said (in some cases word for word) exactly what the Inter-webs lead me to believe he would say!

  2. Oh my Robinson, I am so sorry to hear all this. WOW, and I had always heard good things about podiatrists. But, LOL, the one and only one I have ever met was an avid runner and cyclist. In fact, he had all kinds of running/cycling pictures all over his office. And he was really good in that he helped my friend in a big way.

    • Robinson says:

      Luckily I knew what I was walking into – and heard pretty much what I thought I would. The Orthotics and the arch-strap helped keep my Plantar Fascia supported while the majority of the issues subsided. As I’ll mention in part 4 (I really have to be nearing the end of this..) I still use them occasionally – on the occasions it bothers me more.

      The idea that orthotics is the end-all/be-all answer – is the prevalent one in Podaitry it seems. It just doesn’t make sense to me as a permanent solution. Its like telling a doctor that “it hurts when i do this” – with a response of “then don’t do this”

      I think I have my long-term permanent solution, but it will take a while to fully implement. I suspect that is why Orthotics are often the permanent answer. Can you imagine most people taking up Yoga just to cure their P.F.?

      But I have to repeat – the Orthotics and the Arch Strap really helped the pain die down to the point that I only feel a sharp tightness now. I can run again, walk as long as I want, etc.. So the Podiatrist didn’t steer me wrong. I think he just didn’t go far enough. Who knows, if I hadn’t moved and had gone to my repeat visits every 6 months maybe he would have.

  3. Peter Bird says:

    I know a number of podiatrists who wear Vibrams and there is a Podiatrist on the Vibram medical board, so its a bit unfair to characterize podiatrists as hating Vibrams. They do make a lot of negative comments about them as they are creating so many injuries and creating so much more work for them.

    You also might want to read this Podiatrists rant on plantar fasciitis:
    http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=83788

    • Robinson says:

      I will agree a blanket characterization is unfair, and I do apologize for that. I also agree that there are those good podiatrists out there that make their comments out of concern and hope in preventing injuries in others. I agree that this is an important thing to say, thank you for bringing it up and to the attention of my readers.

      That Doctor in the podiatry link is amazing. I would loved to have ended up with one like him, or found a post like that back when my PF hit. His non-snarky response to the PF sufferer is fantastic, explains things and lays out plan choices that make sense while giving the poor sufferer choices about where he would like to end up.

      It also makes me feel good about how I have tackled handling mine!

      Thank you for commenting!

    • Robinson says:

      I sent an email to the Gentleman that wrote the rant. I am hoping he will let me repost scenario #2 here – that information should be in more places, so more people can find it!

  4. […] at the end of Part 3, I had a plan on how to deal with the Plantar Fasciitis which […]

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The Once and Future Runner
Once and Future Runner

2013 Was an amazing year, for me, So I am really looking forward to 2014!

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