The Plantar Fasciitis Trials - Part 3 - The Podiatrist

So.. Picking up where I left off on part 2 - Off to see the podiatrist.

First, lets look at my thoughts/views/experiences regarding podiatrists.  I had never been to one (that covers experiences.)

I love research, so I had googled everything I possibly could in regards to  Plantar Fasciitis and (when I first got them) Vibram Five Fingers.  This had led me  to several Podiatry forums.  I read everything I possibly could on both topics - after all, these were the foot experts right?   Before I looked into Plantar Fasciitis and had been researching VFFs, I noticed a really common theme.  Podiatrists hated them.  This wasn't a huge surprise, after all Christopher McDougall had said the same thing in articles and in his book.  It was amazing to me the outright vehemence that the Podiatrists posted about them. The more common viewpoint seemed to be that any form of "minimalist" shoe was simply a horrible injury waiting to happen, whether you did "too much too soon" or not.  In fact, the whole idea of "too much too soon" as a problem was ridiculed.

The common premise seemed to be that only in the smallest percentage of people, were our feet mechanically sound enough to walk barefoot for small distances, let alone run in bare feet.  I saw the idea presented that our foot hadn't evolved to support us running.  I saw it proposed that they were fine for short distances, rarely, on grassy fields only but never on pavement or for distances over a mile or so.

[caption id="attachment_2234" align="alignleft" width="275"] $400 a pair for the orthotics. They fitted me for them even before I saw the Doctor![/caption]

Much more rarely, I saw the idea that our feet weren't developed enough, because we had put them in the sorts of shoes we had.  This last one made the most sense, and not just because it supported the "Born to Run" theory.  When someone has had their leg in a cast, we don't suggest that they spend the rest of their life in a wheel chair, or with their leg casted up and using crutches.  The very idea is asinine and ridiculous to us.  Obviously, if the leg is broken or there is soft tissue damage,  you let it heal.  Once it is healed you do a series of exercises and physical therapy to get your leg working properly again. Yet EVERY SINGLE PERSON that I have ever met, talked to or heard about that has gone to a Podiatrist has been told they should wear orthotics ($400) and that they should  plan on wearing them the rest of their lives.  Many runners that I read about online - went to a podiatrist and were told that due to their feet they shouldn't be running at all.

Needless to say, I was a bit concerned about finding a podiatrist, and what they would say.  I was fortunate in that my Tang Soo Do teacher was able to direct me to one of her Black belts that was a podiatrist.  Apparently this doctor had also spent a long time as a runner!  This sounded like he had potential.   I figured I would wear my Five Fingers to the appointment for a couple of reasons. First off, they were the least painful shoes to walk in.  Secondly, Might as well hear his opinion of them right off - and see what he had to say.

[caption id="attachment_2232" align="alignright" width="250"] I was sitting up right, he then pushed on my foot with his right hand to see how far it would bend.[/caption]

The receptionist looked at my feet and informed me that he was going to tell me to not wear those, they are bad for my feet.  Well, it is what I had expected.  Then she brought me to the machine to fit me for orthotics.  (Before I saw or talked to anyone about how my feet felt.)  When he came in, he was a bit more circumspect about it. He let me know that everyone he had seen come in with those, had come in with an injury. (I did resist asking him how many people came to see him that DIDN'T have a foot injury since he was a foot doctor.  He worked me in to his schedule quickly, and I thought snarkiness was a horrible way to return his kindness.)  He suggested that they should only be worn rarely, and when running short distances on grass, but that they could be a great tool (under those circumstances) to help He had me remove my socks/shoes and then started checking out my feet (yes I washed them before going.)  The most informative was when he had me sit up right with my legs at a 90 degree angle to my body. Then he pushed on my feet to see my flexibility by checking the flexion of my feet.  He informed me that was the root of my problem.  Your standard person would have about 15 degrees in motion - I had five.

He gave me the standard series of exercises that you see by googling online.  (Pick up things with your toes.  Pull a towel to you. )  He also gave me the standard stretches (stand with the front of your foot on the stair, and lower yourself down to let the bottom stretch, as well as one to do in the morning by holding my heel and pushing on my toes/ball of my foot).

He gave me a list of motion control shoes that would prevent my foot from flexing while I ran. He suggested that I switch to running only in those from now on.  I asked him how long I should expect to use the motion control shoes, his response was "As long as you run."  He verified with the assistant that I had been fitted for orthotics, and told me I should always wear them.  He then had the nurse make an arch-strap for me to wear for the next week or so.

He then gave me a Cortisone shot in my foot. In hind sight, I really wish he hadn't.  In addition to the unpleasantness of having a needle designed for a horse put into my foot, it didn't really help.  See the immediate numbness and relief? THAT Was incredible.  OMG, I understood Nirvana in that pain-free time.  It felt like Jesus himself had come down from heaven and healed the infirm - starting with me.  I was ready to kiss the doctor.  Unfortunately, 20 minutes after I walked out of his office, the pain returned.  Now the pain was not in my heel, but all through my arch (where it has remained to this day.)  By the end of the day, the pain was actually worse than when I walked into his office.

I looked at his handout after I left, and it said that night splints (which was also suggested by a physical therapist on my facebook page) helped 20% of Plantar Fasciitis sufferers.  Well, I had an HRA (Health Care Reimbursement Account) through work, so I ordered one of those as well off of Amazon.

Now, I think I have made my mistrust of podiatry fairly clear in this post.  But understand, my foot HURT. I couldn't run and I wanted too.  So even though I thought the idea of motion-control shoes and orthotics for the rest of my life was not my best move. I was certainly willing to try ANYTHING that would let me walk with less (I couldn't hope for "no") pain, and might let me start running again.  So off I went to a local sports store that was recommended on the hand out from the doctor.

The guy at Al & Sherry's sport shop was awesome.  There is no other way to put it.  He immediately understood my frustration with the 12 mm heal rise of the "motion control" shoes.  He showed me the firm mid-sole that the motion control shoes had, and we checked almost every other shoe that was there to see what its midsole

[caption id="attachment_1529" align="alignleft" width="150"] The Shoe I didn't get.  Aren't they BEAUTIFUL?[/caption]

was like.  We did find one that I LOVED the colors of, but that 12 mm rise was still an incredible jump from my current "ZERO" drop.  I did understand that a slight rise could help relieve some of the tension on my Plantar Fascia.   After looking at the shoes there, and doing more research online - I ended up going with the Saucony Kinvara 2. It has a 4 mm rise, and with the addition of the orthotics - would prevent that midfoot bending (not that they were all that flexible there to begin with.)

[caption id="attachment_2239" align="alignright" width="113"] I will still wear this when running if VFFs sometimes.[/caption]

While waiting the 4 weeks for my orthotics, at the Doctor's suggestion - I bought a Dr. Scholls one to get me through.  That combined with the arch strap (I bought some as the one got funky pretty quickly) really helped.

So to summarize, here were the elements I was planning on using in my "Cure:"

1. Cortisone Shot. (Bad Move.)


2. Stretch my Calf and Foot (using standard calf stretch with wall, and stair stretch)


3. Footlog - the Doctor loved this.


4. The Stick - Because it is awesome.


5. Archstrap - immediate relief and support of the Plantar Fascia


6. Orthotics - because he is a podiatrist. And I was willing to try it.


7. Different shoes - grumble.


8. Foot Exercises

I was happy now that there was a goal. I wasn't happy with the idea that I was facing something that was going to take anywhere from 6-8 months or a year or more to totally heal, but it was good to have a plan.

Next up - the finale (I hope), and my final thoughts on why Podiatrists give all patients Orthotics (and it's actually a good reason if you ask me)