Getting Plantar Fasciitis

I have officially become a statistic. It’s not that I haven’t already become one, but this one is pretty hard to take. Several weeks ago I wrote about plantar fasciitis (heel pain) in my blog. I had arisen one morning with the tiniest tingle in my heel and of course I immediately thought: the scourge of plantar fasciitis. So I wrote about it. I started stretching a little more every morning but within a week, I had become one of the Four F’s who statistically are much more likely to suffer from plantar fasciitis than any one else. The Four F’s are also the same unfortunate group who, as medical students and resident’s we referred to with derision when we discussed those most likely to suffer from gall bladder disease. Who are the Four F’s. No it’s not a rock group comprised of stupid people. It’s a Fat Fertile Female over Forty. And what is it about the F word that makes it so easy for some to say with an ugly scowl on your face and thereby say it with disdain. And this group of individuals who, in my experience are some of the most lovely people I treat, are some of the most mistreated. But we’ll talk about that another day. For today, we’re talking about ME, ME, ME and my stupid foot and what I’m going to do about it. Then you can try it too, because there are bunches of you out there suffering from this disorder and frankly it’s just not right.

So sure, if you’re suffering from overweight (and we’re now saying it like that so doctors and insurance companies will know this is a disorder and not just some bad habit, like biting your nails) then it could make sense that there would be increased pressure on the bottom of your foot and that could cause plantar fasciitis in and of itself. But why female? There must be some hormonal component and we know this is likely to be true and it’s so in other conditions involving soft tissues, like ACL tears. But there are plenty of men out there suffering from overweight who really should be getting plantar fasciitis, but they’re not. And why over forty? Okay, so you’ve been stomping around on your feet longer than a twenty year old. That should seem obvious. So what. There are a lot of twenty year olds who weight twice what I’ve weighed in my 53 years. Why don’t they have it? And then, why fertile? What does having babies have to do with anything like this? Or gall bladder disease for that matter? Suffice it to say, it’s just a fact. There are plenty of explanations out there for why we old overweight obese omni-nurturers (I like that onomatopoeia better) are suffering.

So here’s what I’m going to do. I’m going to try to get rid of this problem without taking a single pill. Can’t promise I can do it, but I’ve done it before with two other repetitive strain disorders and have won. No pills, no injections, no surgery! Okay, now there’s one caveat, and that is, you can’t treat a femur fracture or cancer this way. We’re just talking about plantar fasciitis today.
I’m going to stretch, stretch and stretch some more. Before I get out of bed in the morning I’m going to stretch my ankle, foot and toes back, like as if you were going to stretch your Achilles tendon, but more so. Then I’m going to massage the arch of my foot and my heel. I’m going to do this every time before I get out of bed…EVERY TIME, without fail. Well, if the house is on fire or someone is breaking in through my window, guess I’ll jump out of bed and suffer for a bit.

I’m not going to go barefoot, unless I’m in bed or in the shower. I’m going to have a variety of shoes and slippers sitting around so I can always have the bottom of my feet supported and padded.

If I’ve been sitting for a while, I’m going to stretch before standing up and while I’m sitting, I’m going to put my foot further under my chair and stretch my Achilles tendon and the bottom of my foot passively so when I stand up, the plantar fascia is already stretched out.
These things are eventually going to become habit and even though I’m currently only having symptoms on my left foot, I know I’m susceptible to having it on the right, so I’ll do the same on that side. And even when I no longer have symptoms (which could take 6-12 months…no lie…and I’ll expect that and not be surprised when my pain is not gone in 3 days) I’ll still continue to stretch.

In about a week or two, if my symptoms aren’t gradually improving I’ll start using a night splint. That is a well padded splint you can wear at night to keep the plantar fascia stretched out. At night we sleep with our feet pointed down so the plantar fascia gets tight and even though we now know that this disorder has something to do with the Four F’s, once we’ve got it, the nightly contracture of the plantar fascia keeps reinjuring it, like Prometheus and the eagle.

And last but certainly not least; I’m going to drink more water, eat more fruits and veggies, try to eat as much organic whole foods as I can and keep losing more weight. BTW, I’m only 3 of the four F’s now. Which is the one we have control over? Yeah, you got it. My BMI is now 24 and I am officially “healthy.” But I have to pay for past transgressions. Keep following my blog so you can get more updates on how I’m doing.

December 3, 2007

I'm just going to go ahead and enter today now because I'm driving to Abilene for a book signing later on and I won't be back home until tomorrow. Yes, I know I'm going to have to learn how to do this on a laptop from a remote sight. But not today.

Let's talk about feet. Women's feet specifically. Remember I flew out of bed a couple of minutes ago. Try not to do that. If your house is on fire or there's someone in your room who you think might be trying to kill you then haul ass and worry about your feet later.

In all other circumstances, if you're older than 40, try to make getting out of bed a ritual of tender loving care, because more than likely there's something wrong with the bottom of your feet. I don't know why but for some reason the bottom of women's feet are especially sensitive. The plantar fascia is a structure that starts at the base of our heels and stretches like a bow string across the bottom of the foot. When we sleep the bow string shortens because our foot is relaxed and pointed down. Trust me, no once sleeps with their feet pointed straight up. Guys, if you ever look over and see your wife with her feet pointing straight up, then either she's stretching her foot or she's dead. Give her a foot massage or start CPR, which ever seems most appropriate and which ever she will allow you to do. If she's alive and you tilt her head back and start blowing down her throat she'll probably bite your lips off and then you'll know she has plantar fascitis. You'll have made the diagnosis. You don't even need to go to medical school.
When you sleep with your foot pointed down and it stays pointed down all night, the plantar fascia contracts. When you get up, put your foot down and stand up, you force the plantar fascia to stretch out acutely. This sometimes will tear the fascia, sending a searing pain across the botttom of the foot. Keep doing it and that eventually leads to plantar fascitis. If I see a hundred patients with plantar fascitis in my office, 99 of them are women over the age of forty. Why? Who knows? There must be some hormonal factor or something.

So when I turned 40, the next morning when I got out of bed like I was 39, there was a searing pain across the bottom of my foot. Of course I knew exactly what it was and from that day forward, except for last night, I always stretch my feet before I get out of bed. Just stretch your toes and feet upward, like you were stretching your Achillies tendon. Of course I told my husband I would be doing that from now on so he wouldn't try to do CPR on me and you would be wise to let your husbands know that too.

And those of you gals who are already 40 and have not experienced the pain...well you must have young feet for your age...