Plantar Fasciitis
 

Anyone out there have experience with plantar fasciitis? My husband has PD and began feeling pain in his left heel (the more involved side) after running a few months ago. He is trying orthotics, stretching, ice, and massage. The plantarflexed (pointing down) position of the foot at night is worsened by PD which tends to cause tightness in the calf muscle. Has anyone used a night splint to keep the toes and ankle flexed? Any other suggestions that you have tried?
Thanks.
Dylpup

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Hi, you may also want to post your question on the Parkinson's Caregiver forum, a forum specifically for caregivers of PWP. There are some patients on there as well, it's a great forum for caregiving issues. I know there must be someone on there that has dealt with this very issue who can help you and your husband. Here's the link:

http://www.myparkinsons.org/cgi-bin/forum/forum_show.pl

I have lots of experience with pf but not pd. There are alot of treatments
for pf and Ive tried them all. ONe thing that helped was to freeze some
water in a 16 oz water bottle ...put it on the floor and roll the foot
over the ice....it was able to stretch alot better and stretching does
help....this was advice from my pt.:) I hope he feels better soon...its
no walk in the park even if you could.

pm me with more questions if you have any...id be happy to help:)

I had PF a few years ago; the only thing that helped was staying off of it for an extended period of time. I was not trying to do this; it happened in the summer when I visited a friend with pool for a vacation. I mostly was in the pool or out on the side with my feet up for about 10 days. No weight on my foot.

It went away and has never returned (healed?).

It is extremely painful - good luck to the two of you!

Hi Dylpup, I hope that this information helps. Plantar fasciitis is caused by the stretching of a tight band of fibrous tissue attached to the bottom of the calcaneus (heel bone), and just behind the toes. Visualize a bow (Bow and arrow) The bow string is similar to the plantar fascia. When extra weight or stress is placed on the fascia it stretches and starts to microtear away from the heel bone. It is the precurser to a heel spur. Walking barefoot puts the most pressure on the fascia at the heel and should be avoided.
It usually comes on insidiously rather than an acute contusion or injury. The inferior aspect of he heel begins to hurt after a vacation, moving, carrying heavy objects, or increasing an exercise program. Being over weight does not help. The classic pain is most acute when one stands up from a chair or car, or getting out of bed. There is less pain once you have walked short distances. One tends to limp on their toes making the calf muscle even tighter. If one has Parkinson related dystonia it compounds the problem.
Treatment:
Wear supportive shoes at all times when walking. Use a clog with a slight heel lift instead of a slipper. Purchase over the counter arch supports (From a hiking or sporting goods store). Custom orthotics from a podiatrist or orthopedist may be necessary. The key is not to let the fasciia or bow string stretch so it can begin to heal itself at the bone.

Stretching the calf and hamstring muscles multiple times daily helps. We use plantar fascia night splints in resistant cases

Cortisone/local anesthesia injections into the heel reduce the pain dramaticly but wear off in one to two weeks. The positives out weigh the negatives and are beneficial for most patients.

Physical therapy can be helpful but expensive. Use Ice rather than heat.

Strapping or taping the arch of the foot helps.

NSAID meds are little benefit. We take enough medication anyway.

A cast or cam walking boot may be used in extreme cases.

Surgery is rarely necessary (1-2%) When conservative therapy is unsucessful,
a soft tissue procedure called a plantar fasciotomy is performed. We rarely remove calcaneal heel spurs anymore.

Make an appointment with a podiatrist or orthopedist. Over 90% of plantar fasciitis patients can be pain free.

There are a few more treatments available,but the above list will cure plantar fasciitis in most patients.

Good Luck, Gary (Podiatrist)

Thanks
 

Sorry I've been away. Thanks for all the useful input. I would think this might be a common problem with PD.
Dylpup