I'm still wondering about a specific surgery....

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Permalink Reply by Kay Warren on October 26, 2009 at 9:35pm

"excessive motion of the ankle" causes PF.... and they want to put in an implant.... ummmm..... I looked this up,
http://graphicsdept.com/hyprocure/hyprocure.htm

I don't trust the site. They're using "scare language" and taking some half truths and spinning them out in a way that makes me nervous. I would not be eager to let a doc try this on me. But I have a few questions for you.

Let's get a few things straight. I'm not a doctor. I do medical massage and have for 25 years. I spent 5 of it working for an orthopedic surgeon. You mention that your feet are flat. You are female. Do you have bunions? Do you have children? How many? I know that seems like a weird set of questions, but here's why. In months 6-9 of pregnancy, your body dumps relaxin into the body. It softens up the ligaments so you can give birth. Well, it doesn't just affect your pelvis. It affects the entire body, including the feet. The ligaments don't re-tighten later. The more children you have, the more pronounced the effect is. Some people have naturally loose ligaments, they also tend to develop bunions. If your feet are flat due to a natural level of ligamentous laxity, then your doctor's explanation is plausible. But, I've also seen very loose flat feet with very tight ankles. See, the ankles are a sort of load dispersal system. If they are too tight, then the plantar fascial tendon is being overstretched and torn. The answer for that is to get the ENTIRE ankle moving properly, which will reduce the strain on the tendon. The next thing I'd consider if your ligaments are seriously lax is prolotherapy. Prolotherapy is an injection of a dextrose (sugar) solution into a particular ligament to snug it up a bit. The shot is MUCH less painful than cortisone, an is typically done as a series of three sets of microinjections over a period of several weeks in order to control the amount that the ligament tightens. Putting in an implant when ligaments are seriously compromised without tightening the ligaments doesn't make sense to me. Now, I don't know that your doctor wouldn't tighten surrounding ligaments while putting in the implant, but I'm trying to give you as much info as I can from limited information. It is VERY rare for the tibia to actually fall into and "off the inside" of the talus. So the next real set of questions is, how much ankle movement do you have? How far can you point? How far can the foot come back up toward the knee without help? How far can you move it to the inside? And the outside?

Basically if this is done, with every step you take the distal end of the tibia is going to be coming down on a metal screw. Bone isn't really that hard. If the doc isn't good with placement, I could see lots of problems with destruction of cartilage, spur formation, gradual hairline cracks of bone, and other issues. If osteoporosis runs in your family, these risks increase. In short, you couldn't pay me enough to have this done.

What kind of surgery did you have? What are your previous injuries? Can you see a different podiatrist? A lot of the extent of what I'm asking can only be determined by examination, you need a really good doc who actually understands re-hab. Most of them don't. There is a very specific type of stretching that re-programs muscles, it should be par of your daily routine if you have PF.

Surgery is serious stuff, and that goes triple for foot surgery. Anything you do to the feet has repercussions through the rest of the body. I'm not talking about "reflexology" here, I'm talking about the mechanics of the kinetic chain, moving all the way up into your hips and low back. Hit my website, www.kaywarren.org read up on PF, and I'll do my best to answer your questions. Ask me for the guide to healing plantar fasciitis without surgery. It's free, and I promise I'll never spam you or give out your info.

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Permalink Reply by Lois McGuire on October 27, 2009 at 9:14am

Kay Warren said:

"excessive motion of the ankle" causes PF.... and they want to put in an implant.... ummmm..... I looked this up,
http://graphicsdept.com/hyprocure/hyprocure.htm

I don't trust the site. They're using "scare language" and taking some half truths and spinning them out in a way that makes me nervous. I would not be eager to let a doc try this on me. But I have a few questions for you.

Let's get a few things straight. I'm not a doctor. I do medical massage and have for 25 years. I spent 5 of it working for an orthopedic surgeon. You mention that your feet are flat. You are female. Do you have bunions? Do you have children? How many? I know that seems like a weird set of questions, but here's why. In months 6-9 of pregnancy, your body dumps relaxin into the body. It softens up the ligaments so you can give birth. Well, it doesn't just affect your pelvis. It affects the entire body, including the feet. The ligaments don't re-tighten later. The more children you have, the more pronounced the effect is. Some people have naturally loose ligaments, they also tend to develop bunions. If your feet are flat due to a natural level of ligamentous laxity, then your doctor's explanation is plausible. But, I've also seen very loose flat feet with very tight ankles. See, the ankles are a sort of load dispersal system. If they are too tight, then the plantar fascial tendon is being overstretched and torn. The answer for that is to get the ENTIRE ankle moving properly, which will reduce the strain on the tendon. The next thing I'd consider if your ligaments are seriously lax is prolotherapy. Prolotherapy is an injection of a dextrose (sugar) solution into a particular ligament to snug it up a bit. The shot is MUCH less painful than cortisone, an is typically done as a series of three sets of microinjections over a period of several weeks in order to control the amount that the ligament tightens. Putting in an implant when ligaments are seriously compromised without tightening the ligaments doesn't make sense to me. Now, I don't know that your doctor wouldn't tighten surrounding ligaments while putting in the implant, but I'm trying to give you as much info as I can from limited information. It is VERY rare for the tibia to actually fall into and "off the inside" of the talus. So the next real set of questions is, how much ankle movement do you have? How far can you point? How far can the foot come back up toward the knee without help? How far can you move it to the inside? And the outside?

Basically if this is done, with every step you take the distal end of the tibia is going to be coming down on a metal screw. Bone isn't really that hard. If the doc isn't good with placement, I could see lots of problems with destruction of cartilage, spur formation, gradual hairline cracks of bone, and other issues. If osteoporosis runs in your family, these risks increase. In short, you couldn't pay me enough to have this done.

What kind of surgery did you have? What are your previous injuries? Can you see a different podiatrist? A lot of the extent of what I'm asking can only be determined by examination, you need a really good doc who actually understands re-hab. Most of them don't. There is a very specific type of stretching that re-programs muscles, it should be par of your daily routine if you have PF.

Surgery is serious stuff, and that goes triple for foot surgery. Anything you do to the feet has repercussions through the rest of the body. I'm not talking about "reflexology" here, I'm talking about the mechanics of the kinetic chain, moving all the way up into your hips and low back. Hit my website, www.kaywarren.org read up on PF, and I'll do my best to answer your questions. Ask me for the guide to healing plantar fasciitis without surgery. It's free, and I promise I'll never spam you or give out your info.

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Permalink Reply by Lois McGuire on October 27, 2009 at 9:34am

Kay, Thanks for the reply. I think you can tell by my discussion that I'm getting desperate. The pain is constant and the only relief is to stay off my feet...period.

To answer your questions, I have two children, 40 and 38. No bunions and no bone spurs.
I think this Dr is very credible. He is the third one I've seen. He comes with good recommendations. His exam included xrays and ultra sound. The surgery I had was on the PF. Not the same Dr as I have now. I do know that he said the tendon was so inflamed that when he touched it with the instrument it exploded (not his words but you get the drift).
My ankles are very loose according to the Dr with lots of movement from side to side. I don't believe I ever injured my foot. I've always had flat feet and back in those days Drs weren't part of my families vocabulary!!
The pain in my foot gets worse as the day goes on..not just when I get out of bed. My shoe get tighter and tighter as the foot swells. The pain will radiate into the inside of the foot below the ankle bone. That actually is a sharper pain that when I step on it.
I guess I'm looking for a quick fix as this has been going on for so long.
I will visit your site. Can I get the guide you mentioned off of your site?

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Permalink Reply by Kay Warren on October 29, 2009 at 6:37am

Yes, you can get the guide from my site. From what you're saying, I would try prolotherapy first. Google "prolotherapy" and your state, and ses if there's a doc anywhere near you, and get their opinion. There aren't a lot of docs that do it, but it works really well.

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