Foot Problems Clinic

[Heeler]

I used to be a runner (two or three miles every other day was common) until I started getting a pain in my right knee (it was diagnosed as a flattened cartilege...nothing that I could do, except take pain killers...which I do not.) This caused me to severly reduce my lower body excersise regimen. (OK, all-around reduction, really.) But my knee doesn't bother me now.

Over a year ago I twisted my left ankle and although it was uncomfortable for less than a day, it appeared to have healed well and almost all discomfort went away quickly. No more than three weeks later I sprained it again, but so severely this time that I felt (heard?!?) a loud pop. I instantanly broke out in a sweat and was in extreme pain for many days later. I had to use crutches for about a week.) The ankle pain still persists (although nowhere as severe.) A couple of months ago, my family doctor agreed that it appears to be some sort of remnant tearing, or something to that effect. At that time I had x-rays and an MIR, but neither apparently showed any broken bones. In the last five weeks, I've also been experiencing very severe heel (plantar fasciitis) pain. Again, this was confirmed by our doctor who suggested stretching and pain relievers.

Over the years I have worn arch-supporting inserts, and I have again been wearing some more aggresive arch supports. These seem to help a bit overall, but the heel pain persists, especially when I first get up every morning or after I've been sitting for a few minutes. I stretch numerous times throughout the day and still avoid painkillers. My ankle and heel both cause me to limp and I feel this is throwing out of whack my other foot and leg!

Please: What do you recommend? What sort of specialist should I see?

Thanks!

[Woottons]

Hi

I tried copying a leaflet about plantar fasciitis that I wrote, this was unsuccessful. This has a specific exercise, which I find very effective, the main point is you have to hold the stretch for 60 seconds. It sounds as if you have not seen a Podiatrist regarding your insoles, if you buy them from a shop, you do not know what you are buying, so I would recommend seeing a Podiatrist who specialises in Biomechanics. You will also find some other tips in the leaflet that will help. I would always try conservative treatment first ie, orthtics and stretches, before considering acupucture or a steroid injection.

If you send me your email address I will send you the leaflet, as the forum would not allow me to copy it.
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I practise at this private clinic
http://www.thefootandanklepractice.com/

[Heeler]

Hi Ms Wootton!
Sorry for my delay in acknowledging your response. Please be assured I appreciate your comments!! Re. the insoles, these were custom made by podiatrists. In fact, I did go see a specialist this last summer and purchased a new set to make certain the support was correct and adequate. After consultation, I agreed to have the podiatrist inject into a specific point in my heel a nerve killer. The heel pain went way almost immediately and I remained pain-free for almost three months without having to get a second or third shot (I understand that is not uncommon.)

However, even before the three months went by without the very significant heel pain ever returning, my ankle still was giving me problems with a different pain location. (The pain in the heel had overridden the ankle pain so much so I wasn’t even noticing it!) Now, about five months in, I am not seeing any further improvement: My inner ankle hurts most of the time and is still causing me to limp. The heel pain is also present, although much less specific than before. (I guess the dead nerve (or bundle?) is not transmitting information, but surrounding tissues, including other nerves, still are.)

I stretch regularly; I allow my foot to hang over the edge of my mattress while sleeping; I've tried wearing a soft night splint (but it actually caused more pain) all of these to no avail.

This has driven me to request a referral to another specialist, an orthopedic/sports medicine specialist. I just got a comprehensive MRI of my ankle (fascinating pictures, although I have no idea what I’m looking for!!) and I’m now waiting on the reviewing physician's results.

Thank you!

[Woottons]

Thanks for getting back to me. Yes MRI's are difficult to understand unless you know what you are looking for. You may have posterior tibial dysfuncton, the MRI will show up any swelling or inflammation of the tendon.

Good luck, and I hope you are pain free soon.

Sam
_________________
I practise at this private clinic
http://www.thefootandanklepractice.com/