Last updated March 15, 2008

Sore feet?


Philadelphia "foot notes"

Email us your Foot Note and we'll get it onto the site within 2-3 days.


w/ permission from www.heelspurs.com

Anyone out there have any experience to share on the subject of plantar fasciitis or foot pain in general?

For those unfamiliar with the term, plantar fasciitis means the bottom of your foot hurts, usually in the heel and/or arch areas. Quite often it is a default diagnosis when all tests are negative (e.g. for bone spurs, hairline fractures, tumors). A popular site for information on plantar fasciitis is heelspurs.com).

A lot of people have this. It is a particularly frustrating condition since, unlike with a bone spur (where the spur is removed) or a fracture (where the fracture is splinted and heals), with plantar fasciitis there is no tried and true course of treatment, there are no observable symptoms, and there is no timetable for recovery.

Anyhow, we hate to lose dancers, even temporarily, so you are invited to submit your experience with foot pain in the form to the left. The submissions will be posted below, most recent first. Maybe some piece of info might be helpful to someone.


Submissions from Readers (immediately below)
Click Here for Michael Riley's Notes, further below.

Submissions from Readers
( Most Recent First -- you may want to read from the bottom up, since
references in the later ones are often to something in the earlier ones)

Yes, A shoe thing: "I agree with Jenn's comment [Editor: Remember, these are arranged most recent first]about MBT shoes (they make sandals too). Although expensive ($250), the contour of the bottom of the shoe takes the pressure off the plantar ligament/tendon and lets you walk without intense pain. And while at rest (on the Metro, standing on the job, etc.), you stretch the calves constantly because of the unique shape of the shoe, and a stronger calf helps strengthen the plantar ligament as well. I also agree with comments on the site regarding sprained ankle histories contributing to PF; I've torn ligaments in my ankle playing basketball, and I believe the PF developed because the foot ligament takes more of the load/tension because of the weak ankle ligaments. I also believe well-cushioned running shoes and orthotics actually weaken the foot and contribute to PF. I recommend strengthening the foot (slowly) with Fell-type (not much of a heel cushion) running shoes and even running "barefoot" in the new Five Finger Vibram shoes that simulate bare-footed running."

Charlie M

Marathoner with PF "The first time I got PF was after I ran my first 12 miler (I was training for my first marathon). I was out of commission for 3 weeks and desperate for solutions...cortisone injection first-so painful I cried. Then I bought expensive arch supports and orthotics, not that helpful but still better than nothing. Completed 2 marathons and many 10Ks since but my PF are more constant now, never completely goes away. More pain in the arch than the heel most of the time except when I wake up in the morning, then I gotta stretch the heel and arch out. I'm considering one of those soundwave therapies, any opinions on that? And how expensive do these procedures run as my HMO insurance will definitely not cover it."

Annie

What has helped: "I still have plantar fasciitis but have found the following items a big help.

1. Pain relief is best obtained using the techniques from The Trigger Point Therapy Workbook by Clair Davies. www.triggerpointbook.com/plantarf.htm. Some people get rid of pf using these techniques. It is an excellent must have book for pf and any other aches and pains. It will save you money on physio etc visits.

2. Strengthen your feet and shins using the Foot Trainer www.foottrainer.com/index.html

Hope this helps."

Roslyn

I had plantar fasciitis release surgery 8 weeks ago and have more pain now than before the surgery. The pain nevers goes away and shoots up my leg and into my toes. I wish I would never have had the surgery.

CATHI

cwhim@sbcglobal.net

[Editor's note: In reading the submissions below, you will find a preponderance of bad results from the surgery. Though we do not have any statistics or pretend to know the success rate for plantar fasciitis surgery, keep in mind that most people reading this website are not doing so because their feet feel fine, or that their surgery was a success. So what you read may not be representative of surgeries in general; or maybe it is, we don't know.]

A shoe thing: "I have suffered from plantar fasciitis for over a year. I have found a shoe called the MBT trainer. I cried when I put them on. The shoe takes the pressure off the tendon. So the tendon can heal. It is amazing. I bought mine at Foot Solutions store. I urge anyone with pf to try them on. They are expensive and worth every cent!! I pray that this advice helps someone.Good luck."

Jennhasty846@msn.com

Hi, I am only 19 and have had Plantar Faciitis for 5 years now, and lets just say, IT SUCKS TO FEEL OLD AT THIS AGE, a lot of people do not understand what is going on. the only thing that I can find to do without having surgery, is wearing night splints to streatch the tendon, and if I over do it durring the day, using crutches. i have to use crutches about three days a week, and have had about 7 heel spurs in the past five years, but really the only thing to do, is to not walk. if one has a case as severe as mine, exercising doesn't help, ( danced for three years) really taking good care of your feet is the best plan.

TARA
ta19ra87@yahoo.com

I have been suffering from this for almost 2 months now. My job requires me to be on my feet for up to 14 hours with no breaks. I have never had a problem until I fell and develped a secondary sprain in one of my ankles. Even though this was awhile ago, I think my feet have felt the pain. Until this site I could not pinpoint my problem, that i actually was suffering from pf. I do have one question for fellow sufferers is:

Have you ever woke up in the morning and could barely walk on your feet until a few minutes later after bloodflow got to them? Does heat help more than ice?

Thanks!
Missy
misskitty3681@yahoo.com

[Editor: "Pinpoint" we feel is a bit strong; We wouldn't think you could pinpoint your problem from reading submissions to this site from non-medical folks. We're touchy on that point.]

Have any of the readers had "Needle Debridement", a type of minimally invasive surgery (Percutaneous Needle Therapy) for plantar fasciitis? If so, did you experience improvement in your pain?

http://www.medscape.com/viewarticle/445806

Howard
quadratic@juno.com

I had plantar fasciitis about 10 years ago but it went away. It has returned and won't go away. I have it in both feet. I ice,stretch and have weekly cortisone injections. I have had to give up my aerobics and walking. My flip flops are the most comfortable. I even got permission to wear them from the doctor I work for. Am I doomed to being unfit and in pain when walking and standing. I keep telling myself this will go away. All responses appreciated.

maped1@sbcglobal.net

Poor Surgery Result 2: "I had the Plantar fasciitis Release 6 months ago. It was one of the bigest mistakes of my life. Now I walk with a limp, can't wear anything but tennis shoes and probably always have a look of pain on my face. Had a MRI last week but it did not find anything. The doctor says "oh well, too bad"."

Bonnie
Email

[Editor's note: Remember when reading that the submissions appear in reverse chronological order, the most recent on top. There are four other entries below from persons who had the release surgery]

Anodyne: "When I was treating for something else, my podiatrist from Temple Univ. Foot and Ankle Institute, James McGuire, mentioned Anodyne treatments for plantar fasciitis. I Googled it and it's some kind of infrared light thing. The Dr. said something like "I took the machine home with me, didn't expect much, but it solved the problem I was having." Now I'm interested!!!! He said that it was growing more popular and that the Temple U. Foot and Ankle Institute would have to buy more of the machines to accommodate the demand for it. I believe the guy is totally reliable. Worth watching."

Poor Surgery Result: "I had plantar fasciitis for over 15 years. Would stop walking/exercising when it was bad, wore orthodics, had cortisone shots, etc. None of the podiatrists I saw mentioned PT or stretching. Finally in Sept. 2005 I had surgery on both feet. The surgery was a breeze compared to the pain I was having. The good news is that the heel pain is gone. The bad news is the pain has moved behind the toes on the front foot pad. It is worse that ever and I cannot be on my feet for more than 30 minutes without being in pain. I am now in PT and doing stretching exercises 2x/day. So far, no improvement. To those with pf I say get it treated within the first few months. I waited too long (over a year) before starting treatment and did not do follow up appts. when things did not improve...I just stopped walking, hiking, dancing and running. Now I regret it."

Tried everything, Facing Surgery: "I have had plantar fasciitis now for a little over a year. I have tried everything. Physical Therapy, Stretchs, ultrasound, ice, massage, orthodics, and two cortisone shots. I have found no relief at all. My doctor said there is only one other suggestion and that is surgery. He said he only does it as a last resort, but, he would do it for me since nothing else has helped. I am so scared of surgery, but, i feel so depressed. I have run out of options. If anyone has had surgery, I would love to hear from you. I even am wearing a boot at night from my doctor, but, that doesn't work either. I would appreciate any suggestions. Thank you so much and for the informative website."

Cindy at lilsis2mel@yahoo.com

Re-Visiting "Patience, Patience": "I think there is a world of wisdom in Kathy T.'s submission below under the heading "Patience, Patience": "Don't give up. It can take lots of visits to different people before you find someone who is right for you." This certainly was the case with my toe problem (not plantar fasciitis). Six or so podiatrists, one physiatrist, one orthopaedic surgeon. And finally one day, a podiatrist had the idea to change the mechanics of my walk via an insert in my shoes, and that was the beginning of steady improvement and a return to normal activities."

Shock Wave?! "I have had plantar fasciitis for over a year, had therapy, 2 coritizone shots, and most recently Shock Wave Therapy. The Shock Wave was more painful than childbirth and I would not do it again. It has been 7 weeks and I am still in as much pain as before. The dr. said not to give up hope but honestly I am ready for the surgery at this point."

Anna

Morton's Neuroma: "Any advice for someone with Morton's neuroma who's had the decompression surgery, still has pain, but doesn't want the nerve removed?"

my email idancenow@comcast.net

"Yet a 3rd has plantar fasciitis surgery - [Editor: See the two submissions below this one as well.] I have had plantar fasciitis release surgery. It was not as bad as I thought it would be. I went through some physical therapy afterwards, but now, I am better than ever. I have no more pain, and am not experiencing any negative affects from it. I am glad I did have the surgery. I went forever with pain. I hope this helps some to feel more at ease about the surgery. I am on my feet at work (I am an industrial maintenance electrician) at least 12 hours daily. I do not suffer anymore."

Kandy
opet@commspeed.net

Someone else had the Surgery! - [Editor: See also the submission immediately below this one for another report.] "I had plantar fasciitis surgery on Sept 16 and immediately felt better. Previous to surgery both feet had hurt but the right was the worst. I had the surgery on my right. I felt great in both feet for about 5 1/2 weeks after surgery, but after that began to have pain again. I feel now that I am at the same spot as before the surgery, both feet are painful again. I've tried stretches, icing, heat, everything I've read. I don't know where to go from here. I'd love any suggestions."
Crystal

mom2myqtz@msn.com

Someone had the Surgery! - [Editor: after 2 years, this is the first communication from someone who had plantar fasciotomy surgery] "I have suffered with pf for 9 years. I was a waitress during the whole time. I continued to waitress even when I became pregnant and couldn't take any medication. I believe this really caused significant damage. I quit waitressing when I was 8 months along and could hardly walk anymore. Two years later I had a plantar fasciotomy in my right foot. The healing process was slower than I expected with a lot of pain, but not more pain than pre surgery. It has been 9 months since then and I feel much better, I will get some i-roc shoes when I and afford them. I want you to know that the surgery did help. Thank you for the web site and my prayers go out to every one with foot pain."

Anita in Denver

Anyone have Surgery? - "I have had Plantar fasciitis for 13 years. This site has been wonderful in helping me feel like I'm not alone. I got some great advice - Thank you for your stories. Has anyone had surgery for it? Nothing is working for me and I've gotten really depressed. I don't want to have surgery but if someone has any stories (good or bad) I'd love to hear them. I'm at a point where I can't work and need to take some time off to get better. I've learned that I definately need to stretch and loose some more weight before I deceide to have surgery. Thanks Everyone!!!" [Editor: No, noone has ever written into this site who had surgery for plantar fasciitis. If there's anyone out there, let us hear from you.]

Skip the Cortisone - "Got this from Pat Croce's show on WIP years ago. I had had 2 courses of cortisone treatments, and was about to embark on a third try when a caller to Pat's show described symptoms similar to mine. Pat recommended NO MORE CORTISONE. This got my attention. Instead, he recommended that the patient stretch the calf muscles by standing 12" to 18" from a wall, with the balls of the feet resting on a 1" book. Place hands on wall. SLOWLY lean forward. If you feel pain in your calf muscles, slow it down even more, and move closer to the wall. Do this for 20-30 reps, several times a day. Ice the area afterward. Continue daily, moving further away from the wall as the tightness and pain in the calves diminish. Continue for the rest of your life. Seriously. Don't exercise without first doing this stretching exercise. I had suffered for years from this condition, and have been pain free since doing the stretching before exercising. If it doesn't work, then you probably need more serious medical attention. But it worked for me."

Birkenstock shoe question "Two different podiatrists gave me conflicting answers about Birkenstock shoes for plantar fasciitis. One said they are good to wear because of the arch support and the other said that the heel is the opposite of what is needed. Anyone know who is right?"

Lin at lryokelson@wideopenwest.com

Receding Symptoms - "I wrote before (below) about my big toe arthritis (which is doing great with a wafer-thin inflexible insert) -- but now I'm writing because I have made the rounds on another issue, hammer toes. My fifty-something year-old toes are starting to claw. I saw three podiatrists and an orthopaedic surgeon. My second toe in particular hurt a lot. The podiatrists were quite helpful and they talked about surgery with a high chance of success. But as with the big toe arthritis, I got lucky again. I discovered from playing with the offending toe that it was less painful if I bent it straight. I experimented with taping the toe straight for about 4 weeks. It worked beyond all expectations. With the tape I was normal and without pain. And even better, now I don't tape it and it does not hurt. The important point that I would like to share in all this is that with both my big toe arthritis and the hammer toe my symptoms not only stopped advancing, but also receded once an adjustment was made."

"I've had fasciitis and nobody diagnosed it as that. The doctors couldn't find anything wrong and dismissed it to age, 65. The fasciitis has subsided with stretching exercises,(I used to be a dancer) from my own process of elimination. The problem now has moved to the balls of my feet and are quite painful. Had the MRI's and exams, doctors couldn't find anything wrong???? It still is very painful, and I am at a loss to know where to turn next for relief. Any suggestions? Thanks" Carol
Dixie611@aol.com

Four Way Regimen - "The thing that worked the best for my plantar fasciitis was a combination of therapeutic massage on the foot/heel and calf muscles, chiropractic adjustment on the foot, acupuncture on the foot and calf stretching exercises. Additionally I wear cork orthotics most of the time. I find that all of these therapies have to be done on an ongoing basis."

Multiple Diagnosis Blues - "I had a Morton's Neuroma removed 8 months ago. Two months after surgery I moved to another place. I had just bought Merrell sandals and walking fast in the airport hurt my feet. One day later, my 2 feet began to hurt every where. The heel, the whole bottom of the foot including ball of the foot, joints toes. I cried so, so badly every day because the pain was almost intolerable. The doctor said it was a minor simpathetic disorder and it was going to take very long to go away. However the physical therapist says my fascia was also hurt. Though I'm feeling much better than 6 months ago, I'm confused. The pain is now at the bottom of the arch but more towards the ball of the foot and less on the heel. It also hurts along the internal side of the feet. The foot that I had the surgery hurts more. Please help me."

Lili at babsyvelarde@yahoo.com.mx

Stretches the Key - "Hey - Had plantar fasciitis about 10 years ago. Misery for about a year. I went to a doctor and insisted on a referral to a physical therapy clinic in town that I knew made great orthotics. I knew that my abnormal gait pattern was contributing- I supinate greatly on heelstrike. Went to PT, Had ultrasound and had on orthotic made, bought the type of shoes they recommended for my feet and did all of the stretching mentioned here. I keep up with all of these and have been painfree since then. If I start to have problems I know I have slacked up on the exercises."

Acupuncture Enthusiast - "Go Acupuncture! I'm excited to shine some light upon on a recent study describing the impressive effectiveness of acupuncture on plantar fasciitis. Search Acupunturetoday under foot pain."

Nidia De Bourg
thedebourgs@yahoo.com

"Along with foot pain relief, an acupuncturist will treat holistically any other problems. Typically, there are other symptoms common with foot pain that indicate a kidney dysfunction. Such as low back pain, night sweats, ringing of the ears,and rosy cheeks indicating internal heat. If you'd like some more information, Go to Acupuncture.com. You can search for a practioner. Better yet, try looking for an acupuncture school with a deep discount student clinic, with the same benefits."

Frustratin' - "I have had what seems to be plantar fasciitis for one year. I have had 3 cortisone injections, have ineffectual orthotics, taken Vioxx,rubbed, exercised and intermittently iced my aching foot,and slept with a friggin' boot, all with NO relief. The thing that feels the best is my cold tile floor. I have high arches and have gone back to running out of frustration because this is what seems to have saved me from bouts of depression. Thanks for listening."

Kim
kimsta56@comcast.net

A "Lifer" at 22? - "14 years of pain now. I've had plantar fasciitis since I was 8 years old. I used to walk on my toes everywhere I went and tell my Mom how bad my heels hurt. My Mom just thought it was because I was in ballet class; she was wrong. I've seen 11 doctors over the years. They can't seem to understand my problem. I have few pf symptoms and since I'm young, not active due to severe foot pain, and very small, I don't fit the typical profile. The orthopaedic surgeons I saw immediately wanted to do surgery. DO NOT HAVE SURGERY!! Just read the latest research available on pf and you will quickly learn that most people never recover from the surgery. (You can find many journal articles about pf on PubMed's website.) I finally saw a podiatrist at the Mayo Clinic. As soon as I started walking he knew exactly what my problem was. I have pronation and valgus rotation such that everytime I step my arch collapses. He casted my feet and fit me with graphite orthotics. I've had them for 1.5 years. I'm all better right? Wrong. Though my pain has greatly decreased, I still have pain when I walk for long distances. I've been told I will never have pain free steps, but I can decrease the pain by wearing good shoes and my orthotics. Due to the trouble I've had with my feet, I've come to value the engineering of the human body. I owe it all to my feet that today I am studying bioengineering and will soon start med school to become an orthopaedic surgeon. Don't worry, I will not be performing any plantar fasciotomies! We are working hard to find a way to stop the pain for people that suffer with this disease. One day soon foot pain will be taking a hike from our lives."

Ultrasound - "This is my third year in a row, same time of year, same foot, with plantar fasciitis. As a triathlete, I hate to miss training but this time, I am trying to rid myself of all pain. I am now running in the water and using ice, warm water, and massage treatments. I am also seeing my chiropractor 3x per week for ultrasound. Its been 2 weeks of treatment so far and its healing much faster than last year when I didn't use the ultrasound."

Didn't Jump For Surgery - "I have big toe arthritis ("moderate to severe degenerative changes to the fifth metatarsal phalangeal joints"). My big toes do not bend the required 65 degrees required for normal functioning, but bend only about 30 degrees. It hurts. By the time I dragged myself to the doctor's office, I could barely walk. A podiatrist gave me wafer-thin inserts for my shoes (I think the brand name is carbonplast) and like magic I could walk and dance again in a very short time. But here is the point. At the beginning, within two weeks I went to 3 podiatrists and a rehabilitative MD and each of them saw this 50-something guy who could barely walk and each of them discussed only surgical alternatives. They should not have! By being a coward (surgery!) I saved myself an operation. With the inserts, my feet have improved to the point where I walk and dance normally."

Super Shoe - "I have discovered a shoe that eliminates the need for the orthotics and actually help my feet. The site is www.i-roc.com"

Deb
djsc@quixnet.net

Capzasin - "Hello. Though my problem is not plantar fasciitis but is with the toes, I asked my podiatrist which topical ointment or cream he would recommend for pain relief and he said that capsaicin, a cream having extracts from hot peppers, is the best of the lot. One packaging of it is as "Capzasin". A problem with the product is that if you cover the area of application (with a sock for instance), it burns like hell. So I don't know how one is supposed to apply it 3 times per day as recommended. The instructions say that "a transient burning sensation may occur upon application". A more informative instruction would have been "If you use this product and wear any clothing over the area of application, it will burn like crazy and you may feel compelled to remove your clothing to obtain relief". With that caveat, it gives noticable relief from pain, and I am definitely glad it was recommended to me."

Given Little Advice - "I have recently been diagnosed with having plantar fasciitis, but have been given very little advice in what I should do (other than keep returning for expensive cortisone injections). Thanks indeed for the excercise tips, which I will start to use, and let you know how I get on in a couple of months. Good luck to you.

Pete Best"
England
peter.best@energis.com

Wanted: Comfortable Shoe - "If this is too "off-topic", please feel free to delete, otherwise --- can anyone recommend a source, either in the Philadelphia area, on-line, catalog, etc. for a comfortable dance shoe (suitable for swing, lindy, etc.)for a female with a short (5.5) wide foot? I'm doing more and more dancing. It's a boon to my body, a salve to my soul, and a boost to my energy level; every part of me is ecstatic with the exception of my poor sore tootsies!! Any suggestions would be much appreciated. "

Dancer Girl,
Pat T.
Parish@ix.netcom.com

Get a Dog for the Dogs - "I'm sure you've already heard this, but I'll just share what worked for me after a painful year of plantar fasciitis. Three things together: 1) A podiatrist gave me achilles heel stretches to do right BEFORE and after getting out of bed in the morning and occasionally throughout the day. They only take about 30 seconds to a minute. 2) A man at a shoe store in my town (Carlisle, PA) made orthotics for me. I wear them 100% of my waking hours. 3) When I was somewhat better, I got a dog and that forced me to walk at least a mile every day. Eventually (after many months), my feet were strong and pain free, (and I discovered swing dancing. Happy feet!)

However, even now, if I skip the stretching or try wearing sandals (no orthotics) or bare feet, I can feel hints of the plantar fasciitis pain warning me.

Laura Taylor"
ltaydmcc@aol.com


USA Today Article - "There is an article in the 9/19/02 USA Today newspaper on a controversial sound wave treatment for plantar fasciitis. According to the article, the treatments, $2000 to $3000 apiece, are for advanced cases of pf only, and there are studies which reach opposite conclusions on the effectiveness of the treatments. "

De-feet - "Here's not a recovery theme, but more a preventative one. When I was early-forties, I went on a health kick and joined a gym. The gym had a device that allowed you to slip your foot under a pad which was connected to a pulley with weights. It was kind of a nautilus machine for the foot. The idea was to raise the foot using the heel as a fulcrum, against the resistance of the weight. In retrospect, this was a terrible idea. My feet were never the same. I developed severe heel pain which was diagnosed as plantar fasciitis, thus beginning an odyssey similar to the ones described below. I want to add that I pretty much got over it in time."


Lose Weight - "I had plantar fasciitis a year and a half ago- left foot first, then after that healed, the right one hurt. I used gel heel pads in all my shoes, a night splint for a while, ibuprofen for when I couldn't stand it, and lots and lots of ice. It took about 6 months to completely recover. I never did do the stretching exercises recommended to me, but the ice and heel pads felt good and seemed to work. I also undertook to lose excess weight- about 20 pounds- in conjunction with the treatment, and that probably has more to do with my recovery, and no re-occurrence. If you are overweight, please consider lightening up. If not, heel cups and comfortable supportive shoes should help."

Chiropractic - "A really skilled and sensitive chiropractor can re-align your spinal cord, pelvic and sacral bones so that your feet are also in alignment and you are not putting pressure on them in an unnatural and unhelpful way simply by walking, etc. I wish you all good luck and have really appreciated the advice on this site."

Julia

Exercise, Exercise - "I have been suffering with plantar fasciitis for about a year now. Long story, but I had a large tumor removed from my foot about 9 months ago and because of problems involving a long recuperation and the further changes the surgery has caused in my gait, I keep aggravating the plantar fascia injury. Cortisone shots and Advil give temporary relief, but the exercises that you posted seem to work great in immediately giving relief for the pain. Although it comes back, I think the exercises overall work best. I would like to know why my doctor did not mention them !!"

CAW

Patience, Patience - "My sympathies to anyone with plantar fasciitis. I am a 50 yr old dancer who has danced pretty much my whole life, including teaching with my husband. He HAD pf and was 'cured' by using drugstore heel cups. For under $10 you might be cured too. These have helped other dancers in pain and is mentioned for pf in several articles and books I found.

My foot pain woes are different, but the problem and process of finding care that really helps sounds similar. My pointers to any dancer with foot pain:

Remember, if you could trade in your hurting feet for a new pair, you'd get a pair much dumber than your well-trained smart old feet.

Best wishes and thanks for the references and other sources.

Kathy T.

p.s.Don't give up. It can take lots of visits to different people before you find someone who is right for you."

Quick Results - "Does the pamphlet say "some improvement after two months of treatment"? I took it upon myself to try the 4 exercises for 4 times per day for 3 days now. Last night my feet hurt noticably less when dancing, and less after dancing. What a deal! 7 years ago a doctor prescribed exercises for my plantar fasciitis but I do not remember doing the exercises so often. Nor do I remember them having much effect. I did not stick with the program at that time. 2 of the exercises were the same as 2 of yours (#1 and #3). Another was to stand with feet flat on the floor and, while keeping feet flat, squat down. Very cool. Thank you."

Sturdier Shoes - "This is not about myself but someone I know who dances all the time, I mean really all the time. He developed serious heel pain and was trying different things. He said his biggest improvement came from replacing $60 ballroom shoes with a sturdier $120 shoe, and also using inserts. After that he said his feet hurt very little. HTH."

Another Foot Site - "Check out www.hapad.com. This website offers a wide assortment of inserts and pads to allieviate painful foot problems. They even have a section dedicated to heel pain. I have metatarsal problems and was given their pads by an orthopedic surgeon who works with athletes. Dr. Eremus out of Bryn Mawr diagnosed me in seconds. The relief was amazing. Anyway, check out the site. It's good for a reference. You can search by ailment. Unfortunately the online ordering never seems to work. If you see something that looks like it may help, just call them. Good Luck and hope you are back on happy feet soon."

Kathleen S

Well Heeled - "Just wanted to add my two cents... Since I teach fitness and dance classes all day long, it shouldn't have surprised me that I was recently diagnosed with heel spurs, plantar fasciitis and degenerative arthritis in my forefeet. As others have said, alleve has helped, gel insoles have helped, and podiatrists have helped BUT my chiropractor has really helped the most...

She's shown me exactly where the muscle weaknesses are that I have to correct in order to keep from getting worse, exercises I can do, physical manipulations that I can do myself either with fingers or a golf ball, etc...

ANYWAY, if you haven't tried a chiropractor, it's an idea... I live in Conshohocken, if you live nearby, I could refer you to mine, otherwise chose one with experience in sports related injuries and not just back pain!!! All this being said, I'm still not dancing as much as I might like and I've (for the most part) given up my 3-4" heels :-("

Denel
upbeat@ix.netcom.com

Psychosomatic - "I never had foot pain, but I did have physical symptoms that no doctor could explain, and after 5 years of tons of doctors and tests and mis-diagnoses and wrong medications, what finally helped me was hypnotherapy. in my particular case, it was a psychosomatic disorder... emotional issues expressed as physical symptoms (like Woody Allen's blindness in Hollywood Ending, just out)... the hypnosis sessions allowed me to understand what was causing the issue, and train my mind (and body) to not be controlled by it..."

Can't Stop Dancin' - "I had heel pain which I put up with until it got so intense I had to stop everything. Orthotics, which several of my friends told me was their answer, did not help, they even hurt my feet more. However, soft inserts (cushions) which I bought at the Acme helped the most - more than ibuprofin, stretching, cortisone shots, heat or ice. What the previous person said about comfortable shoes strikes me as related. It may be very important what we walk on or in. After a time I was back on my feet dancing. I think I would not have been out so long if I had not danced while hurt but that is a tricky call since something hurts usually all of the time, and who can stop."

Shoe Size - " A friend of mine, who is the daughter of a podiatrist, suggested that I change shoes when I complained of foot pain recently. It reminded me of the advice a podiatrist actually gave me a few years ago. He traced an outline of my foot on a piece of paper and then placed one of my dance shoes on the outline. Actually, it fit INSIDE the outline. His point was clear: my shoes were too small for my feet. I was suffering from both foot pain and vanity.
So, very recently, when my feet were hurting from just walking, I heeded my friend's advice and changed into a comfy pair of old and very cushioned running shoes for a few days, and almost immediately I had no soreness. I think the shoes (more cushioned or less, wider or narrower) that we wear really do affect our feet. The choice often becomes comfort or beauty, because I don't think anyone has yet designed a pair of comfortable shoes that look good. I don't know if this is true for men's shoes, but it seems to be the case for women's.

The adrenaline-rich experience of dancing usually obscured foot pain for me until after the milonga. (Walking to the car was sometimes tricky, however.) Once home, I often used ice. It always worked as a short-term remedy. "

Tape and Inserts - "It sucks, for sure. I've had trouble off and on with plantar fasciitis, and I think I have it mostly under control, but it's touchy. I favor the physical therapy-type treatments: strengthening by means of tensing the foot while weighted, stretching the calf, stretching the bottom of the foot by kneeling and gradually weighting the turned up toes or by stretching it with yor hands (see Anderson's stretching book, of course). My podiatrist taught me to tape my feet for dancing and I do if I think I'm going to be on them for a long time in heels. It is incredibly comfortable, but it doesn't do anything for one's elegant appearance of course. You can find instructions on taping for PF in books on sports medicine or on the web. It might be worth doing for a while to protect your feet while doing whatever makes them hurt most.

I screamed at my podiatrist until I got inserts for my shoes, and I really think that was the turning point, because they help my feet fulltime (as opposed to the taping). I also believe that dehydration (or just being vaguely underwatered) makes my feet more likely to be inflamed and to hurt. I can't convince a doctor of it though. On the other hand, water is healthy and cheap - worth trying."

Heel of a Thing - "I had plantar fasciitis about 6 years ago. It put a stop to most of what I did. Like yourself, I tried everything but nothing seemed to make a noticeable difference (ice, heat, stretching exercises, cortisone shots). I saw 6 doctors. I would say podiatrist Gary Gordon in Glenside was the one that impressed me most. In about 1 year, I was 80% better, but I could not (and still cannot) run, etc. I can dance just fine though and am grateful for that. If I run or try to play tennis, my heels hurt. Otherwise, I'm fine. "

This website started in response to Michael Riley's absence from the dance scene due to severe plantar fasciitis in 2002. Tragically, Michael died in October, 2002. Prior to his death, Michael made various detailed and useful submissions to this site which appear below.

[ June 12, 2002,Editor: Michael himself checks in. What follows in this box is an email from Michael, a brief interview, and successive emails. Submissions from readers are above.]
June 12, 2002
The key to curing plantar fasciitis, for me at least and apparently for most people, seems to be stretching. All the other techniques, ice, ibuprofen, tape, etc. help heal the injury, but do nothing to prevent re-injury.

The web site heelspurs.com has a wealth of information, but it neglects the most important fact of all: Stretching cures and prevents reoccurrence. You have to do it, and you have to do it right.

A doctor that I saw at Rothman institute said in effect: If I do the stretching program he gave me, I can be cured for life. If I don't, I could get reoccurrences, or, as was happening to me, I could get steadily worse.

After reading extensively, talking to other doctors, and studying some of the more level-headed books on health and fitness, it's become obvious to me that this is true.

Before I found this out, my strategy for preventing re-injury was to avoid any activity. You can see how this would cause further shortening of the muscles, and fascia, and how this would make things even worse. Once I started the stretching program, I ran into another problem. I had never done any stretching before, and didn't know how to do it. I had no idea how much to stretch. I didn't know how much was too much and how much was not enough. It was a real battle finding out the answer to this question.

Correct stretching comes from "feel" and from experience. "Feel" is difficult to explain because it is subjective, and experience was no help to me because I hadn't had any. I turns out that I had been way too cautious. I've since learned that it's almost impossible to tear the plantar fascia while stretching, and that some minor soreness is a natural result of stretching. The Physical training program at the Rothman Institute has been a big help to me, and I now think I'm starting to get the hang of it.

-- Michael Riley

June 19: A brief follow-up interview:

SMR: Michael, your previous correspondence sounds promising. You referred to your regimen as a physical training program, is it the same as physical therapy?

MR: I meant physical therapy. My mistake.

SMR: Is it directed solely (no pun intended) to the treatment of feet?

MR: My stretching program is specifically for plantar fasciitis.

SMR: Rothman Institute is at Jefferson University Hospital, correct?

MR: Correct. 925 Chestnut Street.

SMR: Do they have a division solely for the treatment of feet, or is it their general orthopaedic division that you saw?

MR: I saw Dr. Steven Raiken. As I remember it, he's not the foot specialist. He's an orthopedist. I think there is a orthopedic foot specialist at Rothman, but he was busy. Dr. Raiken cost me $210 for what seemed like about 15 minutes. You have to pay up front and submit your own insurance claim. However, if this works, it was worth $1,000,000.

SMR: You have seen a number of doctors. Didn't any of them clue you into the importance of stretching exercises?

MR: Previous doctors may have mentioned it, but they didn't really say it in a way that sunk in. Raiken really made it clear. He said that if I didn't do the exercises I could easily have this problem forever, and if I did the exercises I could be cured forever.

SMR: How long of a time frame are we talking about?

MR: That info is in the handout I got from Rothman, and it says this:

"Patients who follow the stretching program will experience some improvement after two months of treatment. Typically over 90% of patients will have relief of symptoms after six months of treatment."

Since results are not quick, you really have to be convinced that the treatment will work before you start or you won't finish.

SMR: Are you taking direction from any other source right now?

MR: I'm also seeing a Dr. Mallory Eisenman who is a podiatrist. She has much more time to explain and to answer questions. At first it seemed that the two doctors conflicted on some important points, but with some effort at communication, the conflicts were resolved and they both now seem to be in agreement.

SMR: Anyone that has read this far is waiting for an answer to this next question. What are those stretching exercises you are doing, can you explain them?

MR: Sure, here are the Rothman's exercises:

1. Gastroc Stretch. I see runners do this all the time. Stand facing a wall with your hands on the wall. Extend the foot to be stretched behind you, leg straight. Keeping the heel on the floor and the foot turned slightly inward, gently lean into wall until a stretch is felt in the upper calf. Hold 10 seconds. -Repeat 2 times. Do at least 4 sessions per day.

2. Soleus stretch. It's the same as the Gastroc stretch but with knees somewhat bent. You should feel it in the lower calf.

3. Stand on a raised step or on the stairs facing the higher floor. Move one foot back and rest the ball of the foot on the step. Allow heel to drop until a stretch is felt through the arch of the foot. Hold 10 seconds. Relax. -Repeat 2 times. Do at least 4 sessions per day.

4. Sit in a chair with a cold soda can placed under the arch of the foot. Roll the foot back and forth over the object. Gradually increase your pressure on the object as tolerated. Continue for one minute. -Repeat 4 times a day.

SMR: I know you had x-rays to rule out bone spurs. Did you have any other tests?

MR: Yes I had an open MRI of my foot done and it showed no tearing of the fascia.

SMR: Just want to remind before ending that neither Michael nor I are doctors, and we were talking specifically about Michael's condition which may or may not be the same thing as someone else's. And all of the above may or may not be right for every problem, so see your doctor. Anyway, thank you, Michael. And good luck.

MR: Thank you.

June 22, 2002
An email from MR:

I'm feeling better, and I'm even more convinced than before that stretching is the cure for me. Yesterday, I walked to the corner store for no reason at all. Just felt like taking a walk. A week ago, I had to get up my courage just to walk across the room.

When I went to Physical therapy, the trainer did make two changes to the original stretching program that Dr. Raiken gave me. The first three stretches are now to be done 20-30 seconds instead of 10 seconds. And the set of four stretches is to be done at least five times a day instead of at least four times a day. I don't know if this is better for everyone, or just better for me, or better for someone who has already done a week of the program. The trainer did say that you can't stretch too long or too often. Of course you can stretch too far, but I've found that if I gradually apply pressure to slowly deepen the stretch, the worst that happens is I'll get a little more sore than usual and may have to postpone my next stretch an hour or so.

The trainer also said to apply heat before stretching and ice afterwards. He said the ice was more important, but I've read that heat is also important. For ice I use heavy duty rubber gloves filled with one part rubbing alcohol to three parts water and keep them in the freezer. I seal the ends with rubber bands. Don't heat or ice for more than 15 minutes, and don't fall asleep.

I'm glad you put in the disclaimer about seeing a doctor.

Doctors are expensive, and it's hard to find one that works for you, but It's really worth the time and the money. Also, a doctor or a trainer can measure how far you can dorsiflex your foot (bend at the ankle to bring the ball toward your head). 15 degrees more than a right angle is about average, mine was only five degrees when I started.

Michael

June 24, 2002

I went to see yet another doctor today, Dr. Stanley Jacobs, a physiatrist. He's the head foot guy at Jeff rehab. Because he's so popular, my first appointment with him was set for more than a month after I'd initially made it, which was several weeks after I'd already been following the advice of the other two doctors.

He basically confirmed what the other two doctors said. In fact, he hands out the same info sheet on stretches as Dr. Raiken. The only thing he added was to say that it was important when doing stretches #1 and #2, to either keep the foot being stretched facing straight ahead or slightly inward. Don't let it face outward.

Michael