Anyone with plantar fasciitis?

[trevagandalf]

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So, I started having plantar fasciitis in December last year during my OB/GYN rotation as a MS3. I ignored it thinking that my feet were just tired. Then it got worse during winter break and since then I have been diagnosed of having chronic plantar fasciitis.

Now, I am in my surgery rotation and I was able finish my first month of rotation since because it was trauma/EGS and there was lots of time of downtime in between surgeries. However, now I am in Surg Onc where the surgeries are sometimes 8-10 hours. I have written many times to the faculty and they are aware of the situtation and after a lot of trying to switch to a different specialty, trying to get doctor's notes recommending me that I sit down. And after all the drama, they believe that they are already extremely accomodating letting me ice my foot a few times per surgery.

Yeah, except that it does not help, icing for 30 minutes 3X during a 10 hour surgery still means that I am standing in the hard concrete floor 8 and a half hours in the day. It has been getting worse and now I am in the 2nd week of the rotation pushing through pain and thinking that I will not be able to make it. Every step I take feels like I have pins stabbing into my foot and there is a constant dull aching pain that has gotten progressively worse. They say that they want students that are enthusiastic, interested and asking good questions. Except every time i know there is a surgery I am extremely afraid and traumatized. During surgery all I can think about is how to put pressure off my heels and get through the surgery, get through another day. I have cried every single night and I don't believe I can go on like this anymore. The constant pain is killing me and now I can barely finish clinic.

I don't think my plantar fasciitis is going to get better during a surgery rotation since the standing really hurts my foot. I have already pushed back surgery for 2 months, deferred family for next year and have done everything to make my plantar fasciitis better. I have shot corticosteroids, done night sprints, good shoes, stretched, celebrex and nothing helps.

Right now, I just want to get through this rotation and be a pathologist, but I just can't go on like this anymore. I don't know what to do. Has anyone else been in a similar situation? Does anyone have any advice? I just have 2 weeks left to finish surgery but i can't imagine scrubbing in to another surgery anymore. Thanks.

 

[trevagandalf]

Now, looking at how student doctor network is organized, I realized I posted in the wrong section. So will anyone with plantar fasciitis please look at my post on the allopathic thread? I am at the end of my rope and I really wish someone will have a brilliant idea that will make all my problems go away. Thanks.

http://forums.studentdoctor.net/showthread.php?t=720993

 

[Obnoxious Dad]

Get yourself to a podiatrist. I had plantar's in January 2002 and saw a podiatrist. Five months later I took a golfing vacation to Ireland. You can't take a cart on most Irish golf courses.

The podiatrist will tape your feet to support them and you will get almost instant pain relief.

Have the podiatrist look at your shoes. You might need to get a pair of professionally fitted orthopedic shoes. The idea is to get enough support under your arches.

I feel your pain.

 

[phantomx87]

I completely understand where you're coming from... I had plantar fasciitis for almost a full year in 2008. I was working 24hr shifts in the ED and never got to sit down. The condition only got worse after I underwent bilateral fasciotomies (long story... chronic exertional compartment syndrom FTW!). Oddly enough, the only thing that helped me was running! It hurt like you wouldn't believe (well, I'm sure you'd believe me), but after a few weeks of constant stretching and eating ibuprofen like tic-tacs, the pain was gone.

Now the problem is in my right foot! It's worse than before, and I am pretty sure that it's my Dansko's that cause the problem. I am with cardiac surgery now (80hr wks and in the OR almost exclusively).

I know your pain!

 

[AyCaramba]

I don't have anything exceedingly helpful to add, but when I had plantar fasciitis a couple years ago, I rolled my bare feet over a relatively large (gatorade) plastic bottle whenever I was sitting down at home. The bottle was bumpy and did a really good job of massaging my feet and stretching them out.

 

[atstudent]

I don't have anything exceedingly helpful to add, but when I had plantar fasciitis a couple years ago, I rolled my bare feet over a relatively large (gatorade) plastic bottle whenever I was sitting down at home. The bottle was bumpy and did a really good job of massaging my feet and stretching them out.

We use this A LOT in the athletic training room with our athletes who have plantar fasciitis. In fact, I was going to suggest just that. Also, for a little while, we had a Gatorade bottle kept in the freezer. This made it solid to help keep its form when rolling, but also for the cold too. A nice cold ice massage for the feet...

 

[p30doc]

I've had it a few times, not as severe as your case OP but stretches really helped it feel better/resolve. I've worked a few jobs with long days on my feet (12-14 hr shifts). I found new balance tennis shoes were the best for me.

 

[HanginInThere]

We use this A LOT in the athletic training room with our athletes who have plantar fasciitis. In fact, I was going to suggest just that. Also, for a little while, we had a Gatorade bottle kept in the freezer. This made it solid to help keep its form when rolling, but also for the cold too. A nice cold ice massage for the feet...

And I was about to suggest this. I gave myself a mild case of plantar fasciitis last summer (overtrained running in bad shoes) and rolling my feet on a frozen gatorade bottle felt great. Also, you mention good shoes but not orthotics - the podiatrist will tell you what you need to do, but until you have a chance to get an appointment you might want to stop by a running store and get a set of good orthotics if you don't already have them.

 

[team doc]

Unfortunately no quick fix for you.

Our sports med docs here really focus on heal cord stretches. One of them used to have bad plantar fasciitis and it didn't get better until he got disciplined with his stretches. Just takes a couple minutes twice a day. Best way is to let your heels slowly drop off a step.
We also like to encourage strengthening by doing toe raises with both feet, lifting one foot off the ground and slowly coming back down with the other foot.

Heel cups can also decrease some of the tension on your plantar fascia by increasing the angle of your ankle while standing. Just a couple extra degrees can bring you some relief.

If you continue to have problems many patients are having some success with refractory cases treated with platelet rich plasma injections.

Here are a couple articles that you might like if you haven't seen them -
http://www.aafp.org/afp/2001/0201/p467.html
http://www.aafp.org/afp/2005/1201/p2237.html

 

[Kahlan]

Get yourself to a podiatrist. I had plantar's in January 2002 and saw a podiatrist. Five months later I took a golfing vacation to Ireland. You can't take a cart on most Irish golf courses.

The podiatrist will tape your feet to support them and you will get almost instant pain relief.

Have the podiatrist look at your shoes. You might need to get a pair of professionally fitted orthopedic shoes. The idea is to get enough support under your arches.

I feel your pain.

I second this. The entire point of a podiatrist is that they specialize in feet (and sometimes above, depending on the state). The simple fact is that a podiatrist is better trained to deal with your problem, especially if it has been resistant to your prescribed treatments.

 

[AbbyNormal]

I have it but it is a minor problem now since I started doing foot exercises and wearing Ariat shoes. I have several varieties of Ariats and my favorites are the terrain hiking/riding shoes, very comfortable and good support.

 

[SirGecko]

Get yourself to a podiatrist. I had plantar's in January 2002 and saw a podiatrist. Five months later I took a golfing vacation to Ireland. You can't take a cart on most Irish golf courses.

The podiatrist will tape your feet to support them and you will get almost instant pain relief.

Have the podiatrist look at your shoes. You might need to get a pair of professionally fitted orthopedic shoes. The idea is to get enough support under your arches.

I feel your pain.

Professionally made orthopedic inserts for the win! If you get properly fitted inserts they kick so much ass. (none of this off the rack stuff, actually fitted) They are kind of expensive though.

 

[SLUser11]

So, I started having plantar fasciitis in December last year during my OB/GYN rotation as a MS3. I ignored it thinking that my feet were just tired. Then it got worse during winter break and since then I have been diagnosed of having chronic plantar fasciitis.

First of all, I've had plantar fasciitis and I know that it can be very painful. My personal success came from a combination of stretching, daily taping, and good shoes. It never came to this, but several orthopaedics I know recommend the boots at night as well.

However, I think that most people on your surgery rotation will pin you as a drama queen, whether it's fair or not. Since they're on their feet so often, a large percentage of surgeons have dealt with fasciitis of varying intensity over the years, and have worked through the pain. They probably have a hard time understanding why you can't do the same.

Unfortunately, you've probably been labeled as a complainer, and they're unlikely to do much more to accomodate you. I can't believe they'd even allow you to scrub out three times during a case to ice your feet. You have to understand how rare it is for someone with this condition to be completely debilitated and unable to stand up for any period of time.

You've been lumped in with people who treat their fibromyalgia like a terminal diagnosis, or have a history of severe hypoglycemia. It may not be fair, but I wouldn't push the issue much farther, or it will likely affect your grade.


I've attached a pic of the taping method that worked best for me. Good luck.

 

[runner87]

A podiatrist can make a rubber mold of your foot that will insert into your shoes, which is supposed to help relieve the pain while standing and walking.

Also, some people find the triggerpoint system to be effective: http://www.trisports.com/trigger-point-plantar-fasciitis-kit.html, which essentially massages the calf muscles that cause plantar fascitis.

 

[girlsporty]

A podiatrist can make a rubber mold of your foot that will insert into your shoes, which is supposed to help relieve the pain while standing and walking.

Also, some people find the triggerpoint system to be effective: http://www.trisports.com/trigger-point-plantar-fasciitis-kit.html, which essentially massages the calf muscles that cause plantar fascitis.

I had plantar fasciitis for a few months while doing a lot of mileage years ago. It was not nearly as bad as yours, but stubborn and persistent. I used ice massage, heel cups in my running sneakers, LOTS of stretching and leg massage. The heel cups were from the drugstore. Nothing fancy. I hear taping helps some people a lot. Can you wear sneakers in surgery in your hospital? Does the ice even help? Actually, are you SURE it's PF if nothing is helping?

I was on surg onc, and when my feet hurt (just hurt, not PF) I would take one out and rub my heel on the back of my dansko. Switch feet, repeat. No one noticed... or cared if they did. Try not to be obvious. The other thing I did was wear diabetic support knee-high stockings. Laugh all you want, but BOY do my feet (and back) feel better! Some people steal TEDs but I prefer the stylish-ly black ones. 😛

Have you tried acupuncture? And do you try all these things one at a time or serially?

I"m sorry you're in so much pain. I'm surprised they let you scrub out and then back in, to be honest. Good luck!

 

[MattD]

I'm throwing my hat into the ring for seeing a podiatrist or sports doc as well. Trying to push through it probably isn't going to be too helpful. Training and a proper orthotic should make a world of difference.

I've never had PF, but I did develop a pretty nasty achilles tendonosis this year. The thing that finally worked for me was buying a pair of cowboy boots with a decent heel. The change in foot mechanics relieved the stress and helped with the pain tremendously.

I also agree that even if your attendings were super-DUPER sympathetic about your problem (they likely aren't), they probably still don't want to be hearing about it every day. Further complaints aren't going to help you. However, I don't know how your rotation works, but have you tried arranging to spend more time in clinic? If you're not wanting to do surgery for a career, it's not horribly important to be getting tons of 'enthusiastic' face time in the OR with attendings, and clinic may be easier on your feet. Just a thought.

I hope things work out for you!

 

[SurgGal128]

I was a surgical tech before med school, and it's so tough on your feet! I can totally relate, I got few breaks when I worked nights and weekends and it is killer after 12 hours of standing all day on hard concrete.... even if you don't have plantars fasciitis!

Some of the nurses I worked with had plantars fasciitis, and they all had different tricks. I've heard the gatorade trick before, also a tennis ball seems to stretch the arch well to give you some relief. It's a great investment to get custom made inserts, although they are expensive. It will be worth it to save your feet and prevent surgery!

Another word of advice... they teach OMT techniques for this at some DO schools, so if you can find yourself a DO friend who knows some techniques, you can have them practice on you 🙂

 

[hopeful84]

Make an appointment to see a doc. In the meantime,

1. Massage like the others said: tennis ball, golf ball, frozen water bottle, whatever
2. Stretch. Try dropping the heel of your foot of a stair.
3. Corticosteroids. No, I am not a doc but they REALLY help some people.
4. Insoles. Whatever works for PF. I like soft plastizote with Hapad inserts but then my feet have different issues.
5. Get thee to a drug store. Buy a night splint as they are relatively cheap and helped my roommate (as did corticosteroid injections).
6. NSAID?

 

[IRxOCPharm]

Hey sorry to hear about this! I'm a runner and had this recently. Aside from all the other great suggestions (which I second adhering to) I'll also add getting either a night splint or at least a stassburg sock (see link below). For me, the issue was caused by a combination of running intervals, yoga, and swimming. No idea where it stemmed from exactly because it came out of no where.

Unfortunately the only thing that finally worked was taking an entire week off from all sports, along with strapping my foot (Ace bandage with a foam support under my heal), sleeping with the strassburg sock, taking advil/tylenol several times a day, bumping up some really good foods like turmeric, salmon, walnuts, aloe vera juice, lemon water (to help reduce inflammation) and icing it when ever I could. It definitely helped because I was able to run again within a week, but could still feel it slightly. I too am on my feet a lot during the day (not as much as you) so to fully heal it took a few months. It does seem like there is a lot you have control over such as taking aspirin, icing, sleeping with a night splint, strapping your foot during the day, etc. So it may be the combination of all these things that finally helps. Everyone is different. Some can have PF for a month, six months, a year, two weeks, just keep doing what your doing!

 

[Depakote]

Now, looking at how student doctor network is organized, I realized I posted in the wrong section. So will anyone with plantar fasciitis please look at my post on the allopathic thread? I am at the end of my rope and I really wish someone will have a brilliant idea that will make all my problems go away. Thanks.

http://forums.studentdoctor.net/showthread.php?t=720993

merged identical threads.

 

[34140]

oh man, i got planter fasciitis after my IM rotation with 5-6 hours of standing rounds. nothing helps but massaging it and rest. i hope itll go away eventually.

good luck to you!