From: andrewh@rosemount.com (Andrew Holtum)
Subject: Re: Plantar Facitis (?sp)
Organization: Rosemount, Inc.
Date: Mon, 25 Jan 1993 14:29:56 GMT

In article <1993Jan21.124050.11168@ncrcae.ColumbiaSC.NCR.COM> dougg@churchill.ColumbiaSC.NCR.COM (Doug.Gilliam) writes:

>Thank you very much.  Please post your opinions since there seems to
>be a good bit of interest in the subject.

>Doug Gilliam


I developed PF last May after starting running the previous November.
Prior to that, I been primarily a racing cyclist for about 10 years.
I ran lots in high school and part of college, but never had any major
physical problems (a tribute to the resiliency of youth?- I am 35
years old). The problems started when I hit about 40-50 miles per week. 
Anyway, my left inside heel developed classic symptoms:  soreness in the
morning gradually going away after walking around.  Eventually, it started
to hurt during runs to the point of me having to limit my running to 
alternate days and low mileage.  I self-diagnosed my problem using Galloway's
Book on Running and tried icing my foot.  I tried stationary biking.
I tried aerobic step workouts; anything!  I found that doing these sorts
of things allowed me to have a few decent low-pain runs, but the problem
wouldn't go away.

There was one race- a triathlon relay in June- where I had to run 5 miles
for a team.  I had committed myself to this event early in the year and
knew how hard it was to find replacements so I didn't want to let them down.
I basically trained low, quality mileage in order to survive the race (I
ran a 29:57 :-)).

By July, I decided to visit my doctor who directed me to a podiatrist.
He confirmed the diagnosis of PF and  proceded to tape my foot with some
non-stretch surgical tape and some special cement to hold it all tight.
I was to run with this arrangement for 5 days and report any changes at
my follow-up appointment.  The idea was to see if orthotics would help.

The pain diminished greatly during those 5 days, so when I returned I 
decided to get fitted for orthotics.  There really wasn't any other
alternative except for cortisone injections.  The doctor didn't advise
this.  I also could have tried "passive" treatment (rest, rest, rest)
but I didn't want to lose that much fitness and the doctor said that there
was a good chance that the pain would return.  BTW, I forgot to mention
that the reason for the PF was over-pronation in one foot. Although not
excessive, it was enough to cause problems.  They also correct both feet
in a case like this to avoid leg-length problems caused by a single
orthotic.

Happily, the orthotics worked.  It took about a week or two for the pain
to stop, but I haven't had PF problems since late July.  I don't wear them
in my street shoes, it seems that using them while running seems to be
enough.  Even more happily, the orthotics were 80% covered under my medical
insurance (they cost about $140). In my case, I would have gladly the full
price knowing that they worked so well.  I still occasionally have a twinge
of pain in the morning (kind of a "stiffness" kind of pain) as a reminder
that my problem is "managed" and not "cured".  But no pain during runs!

One interesting sideline:  My podiatrist said that if the problem got so
bad that the muscle/tendon actually ruptured from the stress, once healed,
the problem would probably not come back but would probably require 
orthotics anyway to control the foot which would have lost stability from
the muscle damage.  He was not advocating this as a solution, however!
He also said that if he developed a way to non-surgically ease the stress
on the muscles involved in PF by dissolving them say by an injection, he'd 
probably be rich (richer?!) since he has seen so many cases in his career.

Andrew Holtum
andrewh@rosemount.com
Rosemount Inc.
Chanhassen, MN