Dr Blake's comment: There are 3 phases of rehabilitation: Immobilization (which you are in and were trying to do for yourself), Re-Strengthening, and then Return To Activity (typically why you are preparing orthotics to allow function but still resting and supporting the arch). So, you are out of Phase in your treatment. You need to be immobilized with tape, removable boot, crutches if need be to create the 0-2 pain level environment of healing. It is all about timing, and at the relatively early times of treatment, doctors usually get this right. You not so.
Dr Blake's comment: So, an MRI to know if you have a plantar fascia tear would be nice. Please order support the foot tape online. Since you have definitely found taping helpful, I would not be without taping for the next 3 months. Hopefully the orthotic devices are coming in now, so they will help. But you also should be spending some time in a boot. Associated with Immobilization is Anti-inflammatory. I am not a big believer in drugs, especially without a definitive diagnosis, so I would rather you lay your foot on a reusable ice pack for 10 minutes 3 times a day to constantly cool your foot off.
Dr Blake's comment: Creating a pain free environment often requires time off work and feet are the most needy since you have to stand on your foot. If injection therapy is being used, it can take 3 injections to get full relief waiting one month between injections to make sure of the results of each. I personally would rather start with physical therapy. Ultrasound typically shows thickening of the fascia when there is some tearing (micro or macro scopic). This means that there is some degeneration of the fascia, or weakness, and putting cortisone into the tissue is risky. Do this the least possible. There is no excuse for his rudeness, I am sorry.
Dr Blake's comment: Sounds like you are moving in the right direction, just a bumpy road. I would not stop taping until you are back to work for 2-3 months and doing well. The taping has worked for you since day one. As long as the orthotics seem to transfer weight off the painful spot, you are good in that area. If you are worried about foot strength, see my you tube videos on foot and ankle strengthening. Go to YouTube and type drblakeshealingsole foot and ankle strengthening and they will pop right up. If every evening you do 2 or 3 exercises, you will be fine. Just do not push through pain. I should recommend the work Z-coils more often.
Dr Blake's comment: You do not go back to work the first day you feel better, but if you have had 2 weeks of consistent relief, then back to work you go. That does not mean you tolerate pain however, so if you can not modify your job, and you can not keep the pain between 0-2, you have to go off work for another month. This is what we tell all our injured workers. You have to go back to work to test it, but it may not succeed. There is no guarantee that if you rest for the next 2 months, that it will be any better. What you have tried is going back to work, but having physical therapy twice a week during the first month you go back. That, along with your icing 3 times a day, taping, orthotics, Z-coils, some body shifting, and 800 mg ibuprofen 3 times a day for 5 days on, 2 days off can all help you. Good luck my friend. Rich
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