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Gastroc Release Surgery for PF plus New and Unusual Foot Pain

I have been suffering with PF for the last 8 months. I stopped running in October hoping that it would resolve if I stopped running on it. I have tried pretty much everything possible with little relief. Ice, stretching, orthotics, night splint, etc. What seems to aggravate it  the most is being on my feet 10-12 hours a day at work as an O.R. nurse....even more aggravating than running on it. One of the sports medicine orthopedic surgeons I work with took a look at me this week and said that my fascia covering my gastrocs was very rigid and that the stretching that I have been doing is pointless and never going to help...he said my only hope is a gastroc release surgery. Has anybody had this done and if so, did it work? How long is the recovery? I am signed up for IM CDA which is only 5 1/2 months away....I'm getting a little discouraged!

To make matters worse I have develped a new foot pain on the outer side of my ankle/heel at the junction of the ankle and heel pad about 1 1/2 inches below and slighly posterior to the lateral malleolus. The pain radiates to the heel and is "burning" to "sharp" in quality...much worse than the PF ever was!  BTW, I am middle-aged (51) if that has any bearing on advice! Thanks!

Comments

  •  Vicki, give me your email address, I climb with a surgeon who I think has done it, I can forward your info to him and maybe he can have some insight.  He is climbing this week in VT so you might not hear from him for a while.  Also, I might be able to find the name of a surgeon in Wisconsin I believe who has done a ton of them and consulted with my guy with phone conversations and videos of the surgery.  I think.... I'm not in the medical field at all so I could be wrong, but someone will tell me soon enough!!!!!!  My email is cohibaforbes@gmail.com

    Dan

  • Hi Vicki,

    I am sorry you have been in pain for so long.

    In reading your history and treatments done so far, I see nothing about any massage, muscle work having been done to your calves/feet/legs? Is that true?

    Before EVER considering surgury, I recommend you try muscle work. Leigh will chime in here soon and her web site ATA has video's, advice on how to do this. From day one muscle work to the calves would have been how I would have treated you along with all the other things you were doing( rest, ice, splint etc)

    Carrie
  •  @Carrie: couldn't agree more, I've had 2 surgeries (joint related) and I'll never be right again.  I wish I had stated the same caution, do not go under the knife unless totally necessary, I just wanted to put you in touch with people that can hopefully shed some light on the subject for you, not to give you surgery, and hopefully good surgeons realize this.  but they know who to contact for tests.  My buddy went to Buffalo State to have some kind of MRI done after he had worked out on the treadmill to track his circulation in his lower leg so that they could diagnose it, pretty cool stuff.  But, as Carrie stated, surgery is always a last, last resort.  thanks for pointed that out!!

  • yup, going to agree with the others. Surgery is a last resort for this kind of stuff. image

    There needs to be a whole lot of work before that because something is most definitely not working in the foot/ankle area to cause that many problems in the gastroc/soleus/musculature. If even standing at work/walking is problematic, there is also probably something out of wack with shoes etc. Long story short- so many different things can cause uber tightness and pain and that will move and worsen as it the injury goes, either down into the foot itself or up into the knee and hip.

    Time to get the actual treatment process started - soft tissue work, joint mobilization, etc etc. This isn't the fun stuff, but the recovery is going to be much shorter than going under the knife and being back to square one in 6 months when the underlying problem rears it's head again.

    Who have you seen so far??
  • Besides the surgeon I work with who gave me his opinion to have surgery, I have seen my chiro who did ART on my feet and calves in October. I had to quit after 2 sessions due to income loss for over a month from a wrist injury. I am back at work now and catching up financially. ART is definitely at the top of my list. Upon doing some research for services in my area (Golden, CO), I found a performance lab in Boulder that does trigger point dry needling. It is performed by a PT. Has anyone had it and/or have an opinion about it? I am interested in trying that as well as ART. I'll get a gait analysis while I am at it. Other therapies I have been doing are self-massage with the TP Massage roller and self-trigger point therapy with a knobble. I also just purchased the book "Why You Really Hurt: It All Starts in the Foot ." After doing the tests in the book, I discovered that I have a Morton's foot so I am trying a small pad under each 1st metatarsal to balance my feet...only 3 days with the pads so only time will tell if they will be of any benefit. Thanks so much!
  • are you using the TP roller for the calf or the big one.

    The calf one was like a miracle for me. I'd had PF for months and months and months. Started with that thing and in 2 weeks it was almost completely gone.
  •  Vicki- another one for not going under knife yet! I am also on my feet for 12hrs in OR as CRNA. been battling Post tib tendonitis, was in a boot x5 weeks, then PT. Now I am getting a combo of Graston technique and ART. Graston, while not fun at all, has made a huge difference!!!!! also been getting massages and rolling. ice bottle massage. See if you can find a chiro that does ART and Graston.

    Yesterday, I pretty much made it through the day without the arch pain I was getting at work. I felt something more like a tightness/slight niggle yesterday, but not the discomfort i was having. I have had about 6-7 treatments so far? My ROM is much better, more springy.

    It doesn't help the the floors in the OR are so HARD! I wear Danskos.

    I did have a fascia release for plantar fascitis in 1991, that was before all the ART and Graston and other soft tissue modalities known available today. I wish I didn't do it now on hindsight. It changes the whole dynamic of my foot and stride. 

    Going to see chiro in little bit, will see if he knows Graston folks in Colorado.


  • Vicki -
    1. the PF:
    SURGERY is a last choice, and I'm a surgeon....
    listen to those people. they are WICKED SMART.
    ice bottle massage can do miracles, especially after every run (it will decrease the inflammation as well) - the problem is probably from the gastroc though

    2. Morton's: don't be shy to get a steroid injection in there. the pad is a 50/50

    did I mention those people are wicked smart - listen to them ;-)

    keep us posted
  • Hello all,
    jusst wanted to chime in as well...I have been batteling PF for around 6-8 monts and actually tore some ligaments around nov...couldnt take care of it due to work but now that holidays are over im in a boot for 6-8 weeks ...now weight for this period of time...training thru the issues was my problem and after 4 injectios during this period the liggys gave said screw you so now im out of business till mid feb..outseason put on hold and chomping at the bit...gotta be doing something
    any suggestions..maybe swimming
    thanks
    James
  • James& Vicki- try some pool running ! There is some info in the wiki on a pool running training program.

    James when my foot was in acute phase for post tib, I was unable to push off wall, so I would be careful with that.

    http://members.endurancenation.us/R...ol+running

  • Thank you so much everybody! I spent many hours looking at every inch of Leigh's website over the weekend and have started some of the trigger point stuff....I have so many painful knots in my legs, there aren't enough hours in the day to treat all of them! I've already been doing the foam roller for some time, but I saw plenty of new things to try. I'll start pool running as well. The waterproof case I ordered for my iPod should get here today...perhaps I can endure it if I have music! I have an appt on friday to see a chiro who does Graston Technique and ART. I can't wait to get started with him! I'll let you know how it goes!
  • Vicki,
    Being a massage therapist who went to school out there (boulder), I think you should ask around and find a Massage therapist and start from square one. Find someone who can help you not only through the massage but through feedback as to how your musculature is changing with all the self treatment you are doing. The hospital side of me (registered respiratory therapist) says it is hard to know what is working when you are throwing so many therapies at the problem at one time. Keep it simple, and find someone who can do a good "old fashion" deep tissue/sports massage.
    Good luck!!!
    Ebe
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