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Thursday, April 29, 2010

Heel Pain: Reader's Speak Out


This is going to be a reader (are you guys out there?) based post on various topics. But I want the focus to be POSITIVE NEWS. Emphasize what has worked for you. Do not emphasize what has not worked for you on this site. If you can relate in 1 to 6 sentences at most what was HELPFUL in your treatment, you will help hopefully 100’s who read the post (eventually!!). I will comment occasionally and will initially try to have my own patients generate a lively conversation. I am very sure that we all will learn a lot from those who post comments. With most injuries, it takes 2 to 5 treatment avenues (for example, icing, stretching, inserts, physical therapy, etc.) to completely get better and prevent reoccurrences. STAY POSITIVE for the reader. With all the negativity in the news and on the web, and when a patient is dealing with pain, they need a POSITIVE HEALING message. Pain is negative, let your comments be positive. POSITIVE NEWS brings HOPE and hope allows for HEALING. Please be a part of the HEALING PROCESS. I will place this paragraph at the top of each of these Reader Speak Outs.


Question for the Reader(s): If you have had pain in the bottom of your heel, what 1 treatment do you think was helpful/most helpful? If you have more than 1 you would like to discuss, please do a separate post.

6 comments:

  1. What worked for me - after trying many, many things I found on heelspurs.com (a great site). I finally "won the battle" with over the counter arch supports -- hard ones with a real "lump" in the arch (I used phase 4, I saw them on TV, but I think many over the counter ones will work as long as they take the pain off of the heel and move your weight to your arch - this takes the pain off of the heal a lot. And massaging as described in the book "The 5 Minute Plantar Fasciitis Soultion".

    Read the book - I'll bet it will work for you - all the research is there in writing.

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  2. Mike, Thank you very much for posting the comment on plantar fasciitis. You definitely hit the nail on the head with your comment that the arch support has to transfer weight into the arch strong enough that the heel feels suspended. This is crucial. I have ordered the book 5 Minute Plantar Fasciitis Solution and will have a post probably 1 month from now on its thoughts. I also read with great interest some of heelspurs.com info. This is a great service for people, but I didn't agree with everything they said. It is a great source to continue helping people fine-tune their own individual treatments for plantar fasciitis. I will be referring to heelspurs.com in future posts. Mike, thank you for starting this discussion and staying positive. When I graduated doctors felt they were very successful treating plantar fasciitis/heel spur syndrome if 50% of those patients avoided surgery. Now, with all we know, less than 1% need surgery in our sports medicine center, but I am sure it is more in the other locations. Let's continue to get the word out that this potentially crippling injury can be cured.
    Another reason plantar fasciitis does not get better for all of you that are suffering and trying to do the right things, is that you have the wrong diagnosis. So many patients come in with a diagnosis of plantar fasciitis only to have a plantar bursitis, calcaneal stress fracture, plantar tendon strain, nerve pain. This is why seeing a specialist, and asking questions about differential diagnoses, is very important in stubborn cases. Thank you Mike. Dr Rich Blake

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  3. I am currently seeing Dr. Blake for a heel stress fracture. I'm at a point in my recovery where some light, easy running is appropriate. Post-run icing (ice bath followed by rolling the heel over a frozen water bottle) has been very helpful in controlling the body's post-run inflamation response. And the sooner that I do the icing after the run, the better!

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  4. MatD made a great point about post-exercise icing the sooner the better. Normally, within 2 hours of the exercise is ideal to ice, but you can still get a benefit as long as you ice before going to bed. This type of post-activity icing may go on for months, so you have to develop a good routine. Golden Rule of Foot: Ice for 2 weeks longer than you think you need to ice.
    MatD presented with heel pain which turned out not to be plantar fasciitis, but a calcaneal stress fracture (diagnosis made by MRI). Heel pain is normally considered to be plantar fasciitis by everyone, but those cases that are not responding should be worked up deeply to see if they are something else. Dr Blake

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  5. HI Dr. Blake, I think your blog is outstanding and so supportive! It's incredible that you can do so much! I was hoping you could answer a question I have about a steriod shot for heel spurs. Should a Dr. Ever place a steriod shot in the middle of the back of the heel?

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    Replies
    1. Thank you for your posting. In the back of the heel of course is the achilles tendon. I try to avoid any tendon with cortisone. Some are experimenting with ultrasound guided injections to place the cortisone only in the bursae, and probably using short acting cortisone, and 2 weeks protection in a removable boot, but I am still skiddish about that. I know with chronic pain, unresponsive to PT, with a positive bursae on MRI we are all tempted to give a shot, but I have still seen the achilles tear which starts another year of rehab. Hope this helps some. Rich

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.