Plantar Fasciitis/Achilles Tendonitis

intheclouds

Any tips for dealing with the pain?

Im under physio care and the underlying problem is an obvious one (weak glutes, tight calves, 3 previous knee surgeries on one knee resulting in a LOT of imbalance) so am trying to get that sorted (while simultaneously rehabbing the most recent knee surgery!).

The problem is that it has become a constant chronic issue - I literally cannot walk 2 steps without it flaring up. There is no let up from the pain at all.

Calf stretches help - for about 15 minutes. Deep tissue massages helps a bit too but again, only temporarily. When it started (about 2 years ago) it was something that would flare up after a run or would flare up for a few weeks at a time and it only hurt immediately after exercise and first thing in the morning. It was mild then too. Now its constant and much more painful. So much so that I am in tears with the pain sometimes.

I havent gotten back to running since my most recent knee surgery - and was hoping to be there by now but the foot pain is preventing it (its on the opposite foot to the operated knee).

I just need some tips for managing the pain. Im not looking for medical advice.

strelok

do you have a lacrosse ball? rolling my feet on one of them (or a golf ball) throughout the day helped me when I had the ol PF.

foam rolling my calves and glutes helped too, although as you said with the stretching, it wasn't exactly long term stuff.

rustynutz

I suffered terribly with this for about a year, what eventually cured it was custom made orthodics, not cheap at 400 euro but gave me my life back! I found rolling my arch on a small bottle of frozen water gave me some relief, good luck on your road to recovery

intheclouds

Thanks for the tips.

Tbh I don't get a huge amount of relief from rolling the foot on anything, it's all referred pain, I get more relief from stretching my glutes, hamstrings and calves. Sometimes after a long series of calf stretches it literally feels like someone has taken a clamp off my heel.

I've been wearing a small arch support that helps a bit during the day. I'll try the ice bottle rolling on the arch anyway. I do get some relief from icing my Achilles' tendon, but again, short lived.

I'd like to avoid the orthotics route seeing as weakness/imbalance from my previous knee surgeries are most likely the root cause, I'd rather try to address that. I'm aware that I walk badly, so need to resolve that.

Is there any relief from particular types of footwear? My feet seem to swell a little over the course of the day so I've been wearing quite loose trainers.

alltacht

Out of interest, can you elaborate more on your awareness of 'walking badly'?

intheclouds

alltacht wrote: »

Out of interest, can you elaborate more on your awareness of 'walking badly'?

Well Ive had 3 knee surgeries on one knee. The first one changed my biomechanics (never should have been done) - they sawed off the tibial tubercle and moved it a cm or so medially so that the patellar tendon insert was tightened up - the objective was to tighten up the joint to prevent further dislocation. This means that if I stand up straight, my right foot is no longer parallel to my left foot and points out - or if I stand with my feet together, my right knee points in and my leg looks twisted. Obviously when you change someones biomechanics like that, you get knock on effects elsewhere. There were further years of knee problems and at least a 3 year period where I couldnt weight bear at all on that leg while a consultant refused to operate (turned out to just be torn meniscus that had jammed the joint).

For me the main knock on has been imbalance throughout. Weaker knee and hip on one side, overtightened glutes and quads on the other side. A loss in the ability to "dip a toe in the swimming pool" on one leg and unconscious compensation for decades.

If I were to describe how I walk badly - when I was a young teenager (before any knee surgery) I could "swagger" - think a cowboy from an old western - knees bent outwards, using the bum to propel yourself along. Now I couldnt possibly swagger - its more like I use my legs as two poles and try to mince along causing the least amount of pain - ok, thats an extreme description, but you get what I mean? Ive a hard time transferring force through the operated knee - still. I dont stride with any confidence at all.

So Im very lopsided and Ive a host of compensation issues all over the place as a result.

alltacht

Well its good that you have an awareness of what you're not doing. I suppose the biggest things that are missing are rotational movements and flex/extend movements in the joints when you walk. Can't imagine your pelvis is too happy with your leg setup. So you're surviving mainly in one plane of motion. It seems like you've had a lot of work done, and got relief. But your body is setup this way to keep you safe and upright (even if its causing you a ****load of pain), so you're just gonna leave the clinic and walk back into your pain.
I know that in your situation its more extreme, but some people hurt their ankle and don't bear weight on it for a few weeks, the brain adapts and throws out that movement. The ankle heals, but the brain's not bothered with it anymore, it compensated without and the body forgets that ankles movement and who knows maybe in 5 years now their back is hurting them from not being able to load up your movements in a balanced way with both feet. Show them how to access movement on all planes of motion throughout the gait cycle using that ankle again, brain sees its safe to go back there and it can be a positive result for them.
I suppose what I'm saying is, working on the relationship from your foot to your head might give you some pain relief. I'm not sure if I can recommend people on here but a treatment protocol I'd explore would be the Anatomy in Motion approach. Karen Lacey would come to mind. Ronnie Warde in the west too.
It would just be cool to see if your body could re-access some of the movements you are missing that allow your joints to stack up and experience different movements, in a practical sense, using each phase of gait and what the body should be doing to help you walk more like your swaggering teenage self.
As for running, isn't that old saying that you must walk before you can run :P

intheclouds

alltacht wrote: »

I know that in your situation its more extreme, but some people hurt their ankle and don't bear weight on it for a few weeks, the brain adapts and throws out that movement. The ankle heals, but the brain's not bothered with it anymore, it compensated without and the body forgets that ankles movement and who knows maybe in 5 years now their back is hurting them from not being able to load up your movements in a balanced way with both feet. Show them how to access movement on all planes of motion throughout the gait cycle using that ankle again, brain sees its safe to go back there and it can be a positive result for them.
I suppose what I'm saying is, working on the relationship from your foot to your head might give you some pain relief.

yes in bold above is in a nutshell what has happened me over literally hundreds of dislocations and 3 different surgeries. Even when I have managed to access the movement on all planes again afterwards (which I did do after the original surgery), further injury robbed me of some ability over time again so I ended up with reduced usage slowly.....without even noticing!

Thats where Im at now - working on the relationship from head to foot. I think the most recent knee surgery was really just the straw that broke the camels back tbh. I had been maintaining a relatively pain free and comfortable walking lifestyle for a few years running 3 times a week on a treadmill (no concrete for these joints!) but when the knee troubles kicked in again I had months of inactivity (well, knee inactivity) and slumped into old bad habits, followed by surgery which Im still in recovery from (it was only 3 months ago) - so Im just more bockety than usual!

But the foot thing has been there on and off for a couple of years now so although I may have been keeping a lid on it - it was waiting to strike hard!