Podiatrist v. Orthopedist?

[bearcatfan]

I have had plantar fasciitis for several years now. It is now a little worse despite the stretching, etc. I have seen a sports medicine orthopedist about it, and have custom inserts for my shoes. My treatment has been very conservative thus far, and I do all the usual suggestions for it.

Oh yeah, I have chronic tendonitis, too.

It all seems worse lately. When I sit down, and then get up after even 10 minutes, I hobble like an old lady to the point that even my kids notice. It is definitely PF - bottom of the heel and all that.

Any thoughts on seeing a podiatrist for something like this? Has anyone seen both and can compare what they will/can do? The thought of shots gives me the willies, and I've heard different stories about how successful that is, but I'm willing to at least see if perhaps a podiatrist would be more helpful. I am also open to switching practices (since there are things about this one I don't like) but I wonder if another sports med person would be any different.

[Pat58]

Just pulling up a chair to this conversation.

[moviegrl1737]

Is your tendonitis also in the feet or elsewhere? A podiatrist is generally going to do all the things your sports med doc has done already (inserts, exercises). PF usually comes down to rest and PT. Which is never what anyone wants to hear.

[raeven]

When I had my terrible time with PF, I finally went to my family doctor, who then referred me to a podiatrist. I'm not sure what they may or may not do differently than an orthopedist, but that is where they sent me. He took an x-ray of my foot, gave me a prescription for a stronger anti-inflammatory thank you can get otc, gave me a sheet of stretches to do, recommended some inserts for my shoes. I also bought a pair of birkenstocks that I could easily wear and slip in and out of all day around the house. They were the #1 key to healing the PF for me. Annoying as it was to have to wear them every step...it allowed my foot to heal up very quickly. I was told to come back 30 or 60 days later (forget which), but by the time I returned my foot was all better!

About a year or so later my other foot started acting up with it. I found these at my cvs and again, I wore it 24/7 on my foot, and the pain went away immediately and never progressed.

http://www.futuro-usa.com/3M/en_US/F...4529207&rt=rud

I hope you find relief soon one way or another. Hugs!

[athompson10]

When I developed PF, I went to a podiatrist who did much of what your orthopedist did (orthotics and stretches). You might not get any new treatment ideas but it's always good to have another perspective, especially since your problem isn't going away.

I also opted for cortisone shots in both heels because I could not walk at all without disabling pain. The first shot lasted about two weeks, until my followup appointment; the second lasted, well, almost forever. I get warnings now when my PF is coming on - a distant bruised feeling in my heels - and I've been able to ward off any severe recurrences by changing up my shoes and doing my stretches. This has also been a lifesaver when I get that warning feeling, as my PF seems to be worse in the morning after a night of bedcovers pressing down on my feet:

Night foot splint http://www.drugstore.com/futuro-plan...size/qxp185647

I hope you recover soon. PF pain is nasty.

[JackieB]

My brother is a podiatrist, and I've seen a podiatrist in Minneapolis who is rather famous. For me, the usual treatment didn't work...icing, stretching, exercises.

I think that PF originates from imbalances in the foot and all the accomodations your body does to try to right itself. I have an ankle that has issues from my gymnast days. I had really good luck seeing a massage therapist who believes PF extends up into the calf and further. Lots of myofacial release was the ticket for me.

I like to do Jill Miller's "On Demand Pain Relief" foot section. She has one that you do with her balls (or Pinky balls) with one hand on the wall that really targets the foot and fascia. I can do it once and feel much better. I just bought her "Treat While You Train" kit during Mary's sale and need to peruse it; I'm sure there is foot stuff there, too.

[luvcritters]

Have you ruled out bone spurs? I went to 2 podiatrists. The first one told me I didn't want orthotics because they're messy. I ditched him real fast.

This is an expensive remedy but it works on my PF. And other places. We bought it for our dog but I use it most. 1 minute once or twice a day and relief is within hours or the next day.

http://www.amazon.com/TENDLITE%C2%AE...ords=tendlight

My chiropractor told me 2 or 3 laser pointers taped together, from an office supply store, will do the same thing.

[wishiwasinhawaii]

Originally Posted by JackieB

My brother is a podiatrist, and I've seen a podiatrist in Minneapolis who is rather famous. For me, the usual treatment didn't work...icing, stretching, exercises.

I think that PF originates from imbalances in the foot and all the accomodations your body does to try to right itself. I have an ankle that has issues from my gymnast days. I had really good luck seeing a massage therapist who believes PF extends up into the calf and further. Lots of myofacial release was the ticket for me.

Completely agree with what Jackie B said--it has a lot to do with muscles further up the leg and releasing the tension helps with PF. I've had PF and another condition called PTTD which is somewhat similar to PF but affects a different tendon, although both insert to muscles in the leg, which made me think the problem in my case was being caused by tight leg muscles. What I've been doing is foam rolling and that has gotten rid of PF and PTTD, which is a condition that is hard to treat. The rolling has to be done in a certain way for it to be effective. Of course, I'm not a doctor and I don't know if what worked for me would work for anyone else, but I would take Jackie B's suggestion and see a massage therapist since you've had PF for a while. He/she should be able to release the muscles in your leg, but it may take some time. He/she should also be able to show you some foam rolling techniques.

As for doctors, I've always seen a podiatrist for these conditions, not an orthopedist. I wear orthotics but the podiatrist told me I can start experimenting walking without them so we'll see how that goes. Good luck and let us know how you make out.

[yogapam]

I have struggled with PF too and it can take a long time to resolve. From my experience patience and perseverance are key! I did see a podiatrist and she prescribed orthotics which I still wear if I am walking any distance. I also wear Vionic/Orthaheel sandals in the summer and slippers in the house. She did give me a cortisone shot into my heel and although it did help in the long run, it was very painful and my foot was quite sore for several days after. I don't think I would do it again.

I try to stretch & exercise my bare feet a lot - CS, yoga, and other barefoot workouts like Ellen Barrett are helpful. I have used these balance pods in bare feet, rock my feet back & forth to get into the fascia and they feel so good: http://www.amazon.com/j-fit-Balance-...t+balance+pods There is a dvd called Stiletto Recovery and it has some helpful exercises.
I have also used a night splint similar to the one Linda mentioned above, and found it very helpful. It just takes time and I would absolutely avoid any medium to high impact exercise.

[JackieB]

I wanted to add that like Pam, I have found being barefoot and exercising barefoot has helped. CS, Ellen, V-Core. I don't wear shoes in the house and no longer use any orthotics in my shoes. I do take care with my shoe purchases...I wear expensive shoes...Danskos, Naots, top of the line Nike shoes when I walk.

PF is awful...you have to get up on those feet every day. I hope you find some solutions. I opted to not do any cortisone injections as I had heard that the pain and recovery was, um, intense.