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Plantar fasciitis

 Poster: A snowHead
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I sustained a running injury in may this year which has been diagnosed as Plantar fasciitis which is an umbrella term for inflamation of the heel/arch of the foot. i am probably in a privileged position that in my immediate family i have 3 physios and a chiropractor so treatment etc is all taken care of. So far this has prevented me running since may and each time i try and do some aerobic exercise it flares up again.

my query is not how to treat it but has anyone skied with this injury and how has it limited you and is there anything specific that you have been able to do to help with skiing. We have a week booked in tignes for january and are currently planning 2 weeks in colorado for feb/march so i want to make sure i have done all i can and anything that ill hep when skiing and make sure i can ski as planned.
thanks
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I haven't skied with it, but am currently suffering from it! I am doing foot massage with a golf ball and general calf stretching Any other advice from your team of physios?
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I had/have it - doesn't really interfere with my skiing, because if you have your own boots with a bespoke footbed then the weight is properly spread. Having had lots of problems a few years ago, I wouldn't (IMHO) rely on physios (and certainly not chiropractors) to solve it. I tried all the roller/golf ball/ ice packs, and TBH they didn't really do a lot. I ended up going to a consultant orthopaedic surgeon, had MRI, and she sent me to have some very expensive inserts made for my shoes. After that the foot got significantly better, and only really flares up when I'm too lazy/forget to put my inserts in e.g when I play a round of golf.
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noggy, so a podiatrist for a custom footbed then?
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MogulMonkey,

Possibly a foot orthotic but also address causes, one common one is spending a long time on your feet in hard soled shoes.

Physio to address tight calves and tissue treatments along the line of rolling with ball and stretches of the foot.

Injections a very limited role as the effect short lived.

Shock wave therapy can be helpful.

Jonathan Bell
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I'd get a custom footbed for your ski boots, and a trip to an orthotic centre for some inserts for your everyday shoes.
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I have footbeds in all my shoes and running shoes and has made a huge difference. It used to be agony getting up in the morning. Foot beds really helped.
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MogulMonkey, and never ever walk around in your bare feet. Put some supportive footwear next to the bed and put them on as soon as you get out. Hubby sorted his with some of the shelf silicon heel cups that he put in all of his footwear. At one point he was unable to walk for a few days during one really bad spell. What really cured it though was the total rest from exercise of any sort he was forced into after a more serious injury.
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Hells Bells, Laughing Laughing I love that - breaking your neck as the ultimate cure for plantar faschitis Toofy Grin There's a bright side to everything wink
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genepi, sorted out another couple of niggling injuries too, shame it left him with permanent neck ache though wink can't win 'em all.
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Thanks for the info Jonathan Bell, very helpful.
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genepi, Toofy Grin

have been told to go on crutch's for a week for total rest..to me i might as well cut my foot off rather than opt to walk on one leg - probably have to invest in a moo ski Laughing

have a podiatrist appt set up so will see what happens.

my orginal question was more geared towards anyone that has this and been able to ski on the injury as well.. because at the moment i can sort of get through a 5k run but next day is an issue so just hope i am not liited to ski every alternate day.
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I have skied a week pain free whith plantar fasciitis about 4 years ago. Had own boots and custom fit insoles and was only time that was pain free. Custom footbeds to get proper arch support was big help. Had arch supports in every day footware but ski boots and custom insoles was only time pain free until it finally cleared up after about 6 months. Heel stretches off stairs helped as well.
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MogulMonkey,
Spent January and February resting from all exercise to heal PF. Went skiing in mid-March when I was still getting niggles from it. Subsequent lack of fitness meant I did no long hard days but I can say I had no problems with PF at all which was a happy surprise. Do not have custom footbeds in my boots but what from ade0005, says, it would make sense that they would help even more. PF niggles returned once holiday over but eventually disappeared.
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I have had 3 days of pain free walking and used the bike last night with no reaction when i got up this morning.
The chiropractor who lives in america(only been able to see him over the last 10 days) and specialises in applied kinesiology identified 4 problems which we have tried to fix. a smaller part of a muscle at the back of the knee was not 'firing' to stimulation as it should be, an area between the tibia and fibia was also not firing and a chemical imbalance of fatty acids and magesium.
The muscle at the back of the knee responded to deep tissue massage. The tib fib issue was resolved by a 1" band of tape around the calf for 48 hours( this was positioned very specifically as 1/2 inch either side had no effect on the problem). The chemical imbalance has been treated using omega 3 purified fish oil and magnesium citrate.
applied kinesiology is a topic that is easy to be sceptical of but having seen it used succesfully on myself and others within my family i can only say good things about it. almost every other type of noninvasive treatment has been tried and has not been able to resolve this case of PF for the last 4 months.
hopefully i will remain pain free through the rest of the week and will continue to use the bike and try a run over the weekend. Smile
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Orthotics are the only thing that keeps my other half's PF at bay - we have a crisis if he forgets a pair when we go away. Now we have found that off the shelf ones are good for normal shoes but personalised needed for running. Original ones made by podiatrist, so he knows what they should feel like. Custom fitted ski footbeds are fine for skiing.
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I've had it a few times. Cease running and long fast walks, start cycling. Footbeds in shoes all the time. It should with luck rectify itself. Mine always has. As to skiing this was the perfect activity, as has been said above, a moulded footbed ensures pretty much no pain.
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twoodwar wrote:
I've had it a few times. Cease running and long fast walks, start cycling. Footbeds in shoes all the time. It should with luck rectify itself. Mine always has. As to skiing this was the perfect activity, as has been said above, a moulded footbed ensures pretty much no pain.


+1

It's a notoriously hard one to solve.

I had a bad 3 months earlier in the year. Tried abstaining from excersise,bought new insoles for work and play and it's gradually improved to the point where I can run and play footy again Very Happy

Long journeys in the car with the right foot on the accelerator seem to aggravate it.

Skiing will be no problem, although I'm off to Rivington Alpine for a nice new pair of ski boots next week:)
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@MogulMonkey,
I had a very bad bout of PF a year ago and was referred to a podiatrist. She gave me a fab 3/4 insole to wear in my daily shoes called a 'slimflex simple' insole. It has been an amazing help. Being a dog walker I also was told to change my footwear regularly to ensure I have the correct shock absorbency. I was given exercises to do and a course of ultrasound. Touch wood, if I feel it reappearing it usually means I'm due a new pair of walking shoes so I get some, stick in my insoles and had no further trouble. I've just also had my ski boots checked and was advised to get a Sidas footbed which supports me very similarly to the slimflex one. Hope this helps Smile
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I had bother with this after a double leg and ankle break and after the cast came off i was given orthotics to wear to assist with raising my foot arch again. I wore them for about three years and the problem subsided. 8 years later and i was suffering similiar pain after football and squash matches. I decided to see a private sports podiatrist as thought NHS would take ages even though i still self referred myself. I saw the private guy who advised i needed custom made orthotics at quite a considerable cost. I also got my NHS appointment through within four weeks so decided to see them as well. I got a full bio mechanical survey done and was told i did not need any orthotics and that my problems were all related to poor stretching and tight calves and hamstrings and ankle joints. I now stretch as much as i can and the problem is gone again.

Just be aware that there are some out there who will make you orthotics when you don't need them and i don't for a minute class all sports podiatrists like this. this is just my own personal experience
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Try a night splint in addition to the other stretches/ golf ball stuff. I'm suffering with PF at the moment and it was awful first thing in the morning - I couldn't really walk at all for the first couple of hours each day. The night splint is an ungainly looking, but simple, contraction that basically stops you pointing your toes down when you relax in bed with the resultant shortening of the achilles ; which then "sets" short in that position and causes agony in the heel / foot when you get up until it all stretches out again...eventually.

It's a lightweight contraption with three velcro straps ( there's loads of different makes, but they all do the same thing really e.g. http://www.ebay.co.uk/itm/like/200874534506?limghlpsr=true&hlpv=2&ops=true&viphx=1&hlpht=true&lpid=108&chn=ps&device=c&adtype=pla&crdt=0&ff3=1&ff11=ICEP3.0.0-L&ff12=67&ff13=80&ff14=108) that basically keeps your toes / foot pointing up while you sleep and you can gradually increase the angle / stretch of the achilles over time.

I poohed poohed the idea initially, but as the condition was getting worse so I was eventually condescended to try it and... it was amazing - got straight out of bed the next day walking normally for the first time in several months. It isn't the sexiest looking thing, but it really does make a massive difference. For less than £20 it's worth a shot.

I also now have a foam orthotic thing in my casual shoes and that also makes a difference - I normally wander around in bare feet at home, but when I remember to make sure that I wear these they really help. Only problem is that my work shoes are hardsoled and I cant get the orthotics into them. Not as good as the splint thingy though.
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Only just seen this and thought I'd chip in. I suffered from this - I work on a building site and am on my feet all day with a lot of heavy lifting. I was in agony at the start of the day and found these insole: http://www.drfoot.co.uk/acatalog/copy_of_copy_of_copy_of_copy_of_Dr_Foot_Pro_Insoles__3_4_length_.html I've been completely pain free after wearing these in all my shoes and boots. Hope it helps
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Quote:

I got a full bio mechanical survey done and was told i did not need any orthotics and that my problems were all related to poor stretching and tight calves and hamstrings and ankle joints. I now stretch as much as i can and the problem is gone again.


My experience also, including during ski season. Stretch, roll, stretch as often and as deep and disciplined as possible. Wake with a stretch. Stretch before going to bed. Stretch during the day. It can go in 4-8 weeks.

Orthotics give relief but not a fix.
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I'd get a second opinion. i was diagnosed with plantar fasciitis a few years ago and after no improvement had an MRI scan. It had fractured my sesamoid bone so all the exercises I had been doing where actually preventing my foot from healing.
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Was a long term sufferer, Had been to Chiro, podiatrist, NHS steroid injections , etc. Insoles and massage helped, but it was the 1 mile walk to work each day with laptop that just kept it flaring up. Some days I could barely hobble

Then My chiro suggested I tried acupuncture. I was totally skeptical, being a pretty sciency person, but Chiro arranged a session for free via a mate of his. Well, had the session, Pain instantly went and 20 yeas later its never came back in any shape or form, never even went for a second session. For all I know the planter is still there and its just the nerve that's now dead so I cant feel it, but I don't care. It worked for me. Pain free
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@madmole how much would acupuncture cost normally? Im suffering from bad plantar fasciitis at the moment and im willing to try anything at the moment.
Im thinking about buying some orthotics for my skii boots.. some people say orthotics are just a placebo and dont actually do anything. I also dont see how custom insoles would help as surely they don't actually flex and are to rigid and would just get in the way half the time. probably going to hedge by bets and buy a cheap pair first might get some from here http://www.edunonline.com/product/edunonline-sport-orthotic-insoles/ and see how that pair does me. Though I guess insoles might help me if there is something wrong with my feet but would just improving my skiing technique be miles better?
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@bigsnow, if you buy a "cheap" pair of orthotic inserts like the ones you have linked to you WILL BE DISAPPOINTED they will offer very little if any support for your feet

there are 5 things which will help relieve plantar fasciitis but you need to do them all or the treatment plan does not work...people seem to think that if you chuck in a cheap insole it will go away WRONG

the cause of the condition is normally related to excessive pronation of the foot (a great reason for an orthotic insert) and or tight calf muscles, each night when you sleep the foot gets into a position where the PF starts to repair itself, then you stand up in the morning and tear it again, you walk around and it starts to feel ok then it aches after a while, so you sit and rest, the PF starts to repair again then you stand and it tears again...all this tear then repair being repeated builds up scar tissue which increases the healing time...you MUST break this tear repair cycle but that is just the start
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CEM
"there are 5 things which will help relieve plantar fasciitis but you need to do them all or the treatment plan does not work...people seem to think that if you chuck in a cheap insole it will go away WRONG" [quote]

Would you mind briefly sharing these 5 things? I'm keen to ensure that I'm following all 5 things as one consultant told me "it's a case of pain management" now due to it's severity but I refuse to give in!

As a long time sufferer of PF in both feet and having seen several consultants, numerous doctors and physiotherapist and podiatrist over the years l'm desperately following a physio programme to avoid if possible a calf release operation that's been offered.


Many thanks Very Happy
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If you are still getting pain and swelling I would ask for an xray.

I was diagnosed with PF but it turned out to be a fractured sesamoid bone. Once it was diagnosed and treated (immobilised with a boot thing) it healed fairly quickly and I was running again. I now ensure that all my shoes have good Sorbothane inserts to help with cushioning.

No problems since....
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MogulMonkey wrote:
I sustained a running injury in may this year which has been diagnosed as Plantar fasciitis which is an umbrella term for inflamation of the heel/arch of the foot. i am probably in a privileged position that in my immediate family i have 3 physios and a chiropractor so treatment etc is all taken care of. So far this has prevented me running since may and each time i try and do some aerobic exercise it flares up again.

my query is not how to treat it but has anyone skied with this injury and how has it limited you and is there anything specific that you have been able to do to help with skiing. We have a week booked in tignes for january and are currently planning 2 weeks in colorado for feb/march so i want to make sure i have done all i can and anything that ill hep when skiing and make sure i can ski as planned.
thanks


Can be slow but should respond to:

Physio/stretches
Attention to footwear and possibly orthotics
Possibly shockwave treatment
try to avoid injections but sometimes tried

Jonathan Bell
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http://prostretch.com/

Brilliant pieces of kit and CEM sells them.
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I suffer from plantar fasciitis and I am generally fine when skiing.

I will be honest, after a particularly long day of skiing, I do sometimes start to get the pain in my heel and arch that P.F is associated with. But normally so long as I make a point of undoing my boots at lunch time and taking a decent break, I can avoid that.

Again I will recommend having custom footbeds. I am also going to see CEM next week to try and make my boots a bit better so hopefully I can get rid of the above scenario completely. The custom footbeds already do a very good job to be fair.

One thing I find important is having a nice soft set of shoes to step into afterwards, with nice absorptive insoles. Walking around on the bare floor in just socks is the worst thing I can do. Personally I, and most of the other P.F sufferers that I know, choose Merrell shoes and I would highly recommend them. They do a trainer called the "Chameleon Wrap Slam" which I believe has been a huge help in getting me through the last few years; along with supportive orthotics (NHS provided) inside.
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If you go down the arch support path make sure you dont get insoels that over support your feet as I find these can do more damage than good. These I find are the best off the shelf plantar fasciitis insoles I have tried
http://edunonline.com/product/runners-plantar-fasciitis-insoles/
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All in the insoles the local physio near me in Invenress assured me. Can do most things with the right setup
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i also suffer from pf, and have done for about 15 years, as i am a postman and walk 10 miles everyday the cost of custom footbeds can get expensive, the only problem i have when skiing is that the heel pain transfers up in to my knees, so i cant ski very far without stopping, and generally by concentrating on skiing and looking at the scenery your mind is on other things anyway. in my case the footbeds you can buy off the shelf at boots do work, i have extremely flat feet, and anything that helps to lift my arches really helps.
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compostcorner wrote:
the only problem i have when skiing is that the heel pain transfers up in to my knees

Are you sure you don't have a problem with your ski-boots / footbed there?
I kind of have the reverse problem. I suffer from PF, particularly in my left foot which is flatter and pronates. I also suffer knee pain in the same knee. Except when I'm skiing, when I'm in boots with a custom footbed. Last year I got orthotics fitted for my shoes which has significantly improved both the pf and the knee - in fact the knee pain tends to come back when I work from home and don't wear the shoes/ orthotics.
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The reason it hurts after running but not skiing is that in the former you rip the newish scar tissue that has begun to form while starting to heal (same process overnight hence morning pain, discomfort etc) while in the latter you don't since the foot is much more static.
That said your might still be bugged by foot cramps as feet muscles and Achilles' tendon might well be unrelaxed. It's as if they go onto high alert. At least that's what happened to me (it still does to some extent but at least it's PF free), I also religiously iced my foot for 15 mins at the end of the ski day just in case.
Basically different things seem to work for different people. For example the injection was very good for me but not others. But there is overwhelming evidence for the success of footbed ( preferably customised) and stretching (including the overnight splint - surprisingly effective I found).
Whatever you do go skiing!!!! You will survive! Little Angel
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mikeelsa wrote:

Just be aware that there are some out there who will make you orthotics when you don't need them and i don't for a minute class all sports podiatrists like this. this is just my own personal experience


+1!! Went to a well known private podiatrist in Manchester with heel pain. Failed to diagnose PF, made me expensive orthotics of different heights as apparently I've got one leg longer than the other. Can't wear them and hasn't solved the problem, but have been working with a chiro I know and some golf ball rolling and calf stretching has made a big difference. Have just ordered some orthotics too so fingers crossed I can get it sorted soon - driving me mad!
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