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Saturday, April 16, 2016

Generalized Heel Pain: Email Advice

Hi Dr. Blake!
I noticed that one of your hobbies is hiking. I feel like you might have some good advice to get me through a field season. I was recently diagnosed with PF and Haglunds Heel and my heel is on crooked.  I hike 10ish off trail miles a day for work. Several of those miles are in streams on river rock, jumping off of log jams, etc. And all of these miles are done in waders and wading boots.
I have insoles, my right foot is taped (I haven't had my left foot examined yet), cortizone injection 3 weeks ago and I am a frequent user of Ibuprofen. I'm not completely weight bearing yet. 
Do you have any stretches that I can perform out in nature? I watched your stretching video, but I don't have any walls around me. I've been doing the stretch you say is a no no. But, I do it one leg at a time. I hang my heel off the river bank or a log. I do try to find a good boulder to try to stretch on, but it's difficult to get a balanced stretch.
I usually, but not always will have time in the work truck between sites where I use a tennis ball over my foot~ is there any stretches I can do in the truck?
OH, and is backpacking possible?  
Thanks so much for this service you do with your blog,

Dr Blake's response: Shannon, first of all, tell me what hurts (ie bottom of heel, arch, back of heel, achilles, calf), and when it hurts (getting out of bed in morning, putting boots on, walking at work, evening hours, sleeping), and what makes what better or worse. Rich
Thanks for your speedy response!
Since having the cortisone shot in my heel, that spot is pain free. The shot is in the heel (center left (my left)).   But, everything around it feels pain.  The back of the heel gets painful. My Achilles is often sore. I don't feel the morning pain since the shot, and I do stretches before getting on my feet. I do get stiff after I get home and sit a while. When I'm working I have been feeling pain about one mile in. No pain at night since the cortizone shot.  I had to stand on my feet in one spot for 5-6 hours the other day...pretty painful by about the 2nd hour. I notice that I walk on my toes more often and that can't be good for my back.
Ice and heat help.
I'd love to soak it in Epsom salts but my foot is taped.
Ibuprophen ( We call it I-be-broken in our household) helps. I recently took a 4 day break from it and my heel and ankle were sore.
I've been massaging my calf muscle and foot and that helps keep my calf from tensing up.
I hope this is helpful.
Thank you!

Dr Blake's response:
Hey Shannon, switch to support the foot taping so you can get it wet and do Epsom salts, may make a difference. Go to www.supportthefoot.com. Get the regular size. Just seems like the inflammation is out of control. Could you wear an Anklizer boot on in the field 4 hours a day to rest it better? I would love an MRI to see if you have a bone bruise/stress fracture!! At least, making the right diagnosis can help with PT recommendations on what to safely do. Hope this helps some. Rich

Thank you!! I just ordered the Support the Foot tape. I've actually had a big change this week with my foot. I tried the hard plastic insoles and they've helped dramatically! I was dreading hard plastic, but it really did the trick. I did about 9-10 miles each day last week and I'm able to bare weight. I'm so excited! I think I will be able to go backpacking and hiking (outside of work) this Summer. 
thanks for your advice and thanks for doing your blog~ I've learned a lot.

Have a great weekend!

Dr Blake's Response: Great News. Glad getting the right support helped. The support the foot tape will be good for flareups or long hiking for added protection. 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.