Injection for Plantar Faciitis - I'm About To Do It
As if recovering from a broken 5th metatarsal (June) isn't enough. Been VERY carefully/slowy ramping my running time over the last 6 weeks or so. Higher frequency and lower duration. Been riding a bike though like a man on fire. Somewhere along the line I started getting arch and heel pain. I sort of expected this in the injured/fractured foot but not in BOTH feet and not for longer than a couple of weeks. Been doing EVERYTHING under the sun. Stretching several X per day, strengthening, balancing, ice, massage, TP therapy, Leigh Boyle PT stuff. You name it.
I've heard a lot of good things about getting "the shot" and I'm seriously considering it. I've heard that although it's a needle and breaking the skin and all that the risks are very minimal and the potential for success is very high.
Who has experience with injections for PF?
Comments
Socks. Night splints.
Then might consider a shot; and even in your case not 100% sure I'd do it so close to the stress fx.
Can also reduce fat pad around heel but I understand your frustration. I had PF from Boston 2010 until this August. Did everything you have done and more. Then got a shot and ZERO improvement so I got ESWT which helped briefly and then later another shot of Cortisone from another entry angle and again NADA! Crap! Just lived in pain until I finally got a REALLY DEEP
massage from a S&M Brunhilda type which helped. Got a second DEEP massage and it basically resolved. Did IMC marathon in light trainers and no problems!
So basically, injection is not a magic bullet and has side effects. I got no improvement after two injections but many others see a big difference. Keep us posted as to your decision and progress. Good luck. It is a major PIA I know.
I'm going to hold off on the shot. Been doing a bit of experimentation for past two days with NOT wearing my custom orthotics. Noticing significant decrease in heel pain symptoms.
I still wear my night splint even w/ PF better due to paranoia! Good luck Jim!
http://www.heel-that-pain.com/
That quick huh?
There was just an article on LAVA for this, altho for achilles tendonitis:
lavamagazine.com/features/platelet-...z1dgw35xrP
Jim,
Last year I had what became a very bad case of Plantar Fasciitis.
Here are all of the different things I tried that didn't work for me:
After market orthodics (Super Feet)
Custom Orthodics
Lots of massage work on foot and calves
1 cortisone shot
Night Splint
Multiple foot rollers
stretching
Yoga
Frozen Water bottle
icing
Rolling my foot on a golf ball
An Advil routine
I am probably missing some things, but in short I spent about $2,500 on all of these things and none of them worked, but I kept looking for a solution.
I went to see a guy who practices "The Graston Technique". I am not sure if you have ever heard of "The Graston Technique" if you haven't I would encourage you to go Google it and do a little research.
Here is what I learned and know about The Graston Technique from the guy I saw. Plantar Fasciitis is generally a symptom of another problem, while my PF was inflamed, for me it was due to having weak Abductor & Adductor muscles in my legs. Over time the other muscles were overcompensating for my muscle weakness and this was leading to problems in my calves and all the way down to my Plantar Fascia. I am sure this sounds a little weird and I am not a Doc so bear with me ,I am doing my best to explain it as I understand it.
So what happens over time is that scar tissue forms in the plantar fascia and the calves. As it has been explained to me, muscle fibers lay on top of each other almost like sheets of paper. When scar tissue gets in there it acts like cement and the muscle fibers can not move/stretch like you need them to when you run, this is what is causing the pain to occur.
So here is the big difference between The Graston Technique and a lot of other treatments. With The Graston Technique you will go see someone (most likely a chiropractor or PT) who will use the graston tools on you. What they do is they will put a lubricant on your foot and calves and use these metal tools (which look like dull butter knives) to go in and massage/break up the scar tissue. I will tell you the treatment is not super pleasant, but nothing you can't handle. They will pinpoint the problem areas and use those tools to dig and break up the scar tissue on specific problem areas. The idea is to break up the scar tissue and then your muscle fibers can move freely as you need them to when you run. Then your pain will go away. For long term success you need to figure out where you have muscle inefficeincees (sp?) and fix those or else over time the problem could come back.
I went in for treatment once or twice a week and didn't realy do much running, but in 4 weeks I was about 85-90% healed. The guy I saw said I was one of the top 5 worst cases he had seen, the sooner or earlier you get to someone the less work/down time it will require to fix. Since this has just happened, I would bet overall it is not that bad and your down time could be a lot less than mine was, maybe a little as two weeks.
As it was explained to me the reason this tends to work better than all of the items above that I tried is because a lot of the items that "stretch" the Plantar area really do nothing to get rid of the "scar tissue" so it just sticks around and over time it goes down some, but then people have flair ups again. They start running again and haven't fixed their muscle weaknesses. The other reason is these metal tools in the hands of someone who knows what they are doing can really find and target the problems areas and work them to break down the scar tissue. Much like a good massage therapist knows how to work the kinks out of your muscles better than say having your wife work on you. While this doesn't always feel great while they are working on you, they spend their time really working the problem areas to get you fixed. Where as someone who is just rolling their foot on a golf ball can't target the exact area as well and it a lot of cases that person is not also having their calves worked on.
Graston is a pretty aggressive treatment and will most likely leave redness or bruises on you after treatment. I would say one thing you should do is give yourself 4-5 days before you go back for another treatment. Don't go in for a treatment and then go back for another if you are still sore from the 1st treatment, more is not better. Letting the area recover after it has been worked on is the best thing you can do.
I will also say I went to see a chiropractor who really does not practice traditional chiropractic medicine, in short he doesn't crack backs. He works with a lot of endurance athletes and runners, so he knew what he was doing.
On The Graston Website you can find approved providers in your area, if you go this route I would suggest you ask what kind of patients they work on, you will be looking for someone who works on a lot of runners or triathletes.
Since seeing my guy, I have never needed to wear orthodics and I am 100% back to normal.
I apologize for this being really long, but wanted to try and explain everything the best I could with as much possible detail.
If you have any questions please feel free to ask and if I don't know I will ask the guy I saw who helped me. I hope this helps you with either treating the problem at home with something like using a Golf Ball & then a rolling pin on your calves or finding a Graston provider in your area.
I hope this helps!
Thanks for the info on Graston. This is the first real explanation I have heard on the technique. My insurance will cover these sessions so I'm heading to a Graston provider next week for a consult.
Look for someone who works on runners or endurance athletes.
The session will not feel great and you will probably be sore the next day, but you will soon start to feel much better.
Interesting, all I can say is that it worked for me. Before going to a Graston I tried everything I listed above and none of it was working.
I am not a Chiro and have no agenda, it was just a therapy that worked and I was amazed how quickly I saw results.
Just trying to help others out.
@Jason, thx for the info. Anecdotally I've heard good things about Graston.
Jim,
Just curious if you ever saw anyone about your foot or what you have been doing to treat your PF?
Jason - I decided to give the stretching and calf raises/strengthening more time. And I believe it's paying off (fingers crossed). I'm feeling better than I was 2-3 weeks ago. And I've actually been slowly increasing my run time as well. I also have found that rotating footwear during the day has helped - staying in any one shoe for a long period of time seems to really bother my heels. I still have bad days, like in the evenings, where it hurts but like I said, I'm figuring out how to manage it.
Thanks for checking in!
I am glad I didn't get the shot. My symptoms have been improving very slowly (knock on wood) and I have been able to increase intensity and volume as well. Although my podiatrist mandates wearing my custom orthotics all day long, I have thrown that advice out and just wear them running (like I always have before). THAT seems to be the #1 fix for me. Also, I tossed a pair of shoes that no matter what I did at the end of the day they hurt my heels.
Knocking on wood...a lot.
@Jim, glad to hear this. I had two injections and didn't get one iota of relief from either. Night splint, stretching and DEEP massage helped the most. Keep up the good work.
Amazed at how much effort is involved in keeping things flexible and the muscles and tendons moving.
thanks for Jim Moss for starting the thread and all the folks who have chimmed in along the way.
EN Rocks
That's great to have BOTH available. My ART doc has an abnormally strong masseuse in his office whose elbows and balled fist functions as a steel Graston tool! She cured my PF when two injections and ESWT did not.