Posted by: runsinthefamily | July 24, 2010

Doctor visit

Thursday afternoon I went back to the podiatrist to see what he could do for my PF.  This is the same podiatrist I went to early on, who adjusted my orthotic slightly, and told me to come back if it kept getting worse.  I really procrastinated on calling for another appointment, because I was worried he would want to give me a cortisone shot, and after a bad experience in college with one, I really didn’t want to go through that again!  ( it did help, but it hurt like heck).

This podiatrist, Dr. Beekman, is also rather unusual in that he is interested in not just podiatry, but also talks about trigger points, referred pain, and is always trying to explain about how there is a layer of fascia all throughout your body that “connects everything”.  I had only heard little bits of this before, and I’m still not sure how to explain what he was telling me about.  The closest idea I have read to explain what he means is Myofascial release, and I have found a blog where a runner posted about it here.  Interestingly enough, she also talks about trigger points in another post, which Dr. Beekman told me a lot about on Thursday.  Her post on trigger points is here.

The way Dr. Beekman explained myofascial release ( I am assuming that is what he was telling me about) is that the fascia, is a thin web-like layer that stretches throughout the whole body – covering muscles, tendons, organs, and if you have damage or injury in one part of your body, by manipulating the fascia in other parts of your body you can release the muscle that is causing the pain.  ( this is my understanding of what he explained – it may not be totally accurate, but it gives you an idea).  He also found trigger points in my arch, and actually used a needle with Novocaine in it to try to release the trigger point!  It was completely bizarre, but it worked ( I did ask him if this was like acupuncture, but he said not exactly).  When the needle hit the trigger point, it felt like an electric shock – as he kept it there for maybe 20 seconds ( it seemed longer, but I don’t think it was) the pain of the needle on the trigger point diminished, and when he stopped and told me to put my shoes on and see how it felt, you could have knocked me over with a feather when I realized the major pain I was feeling in my arch ( from the hill run a few weeks ago ) was gone.

However, I have, as he said, “layers and layers” of pain, muscle imbalances, and other issues along with the PF.  I was in his office for almost 2 hours, as he kept solving one part of the pain, have me run, only to realize one part of the pain was gone, but another part remained.  So he would find another trigger point, (although he only used the needle on the one on the side of my arch) rub it to release it, have me run, adjust the orthotic slightly, have me run again, and so on for almost two hours!

We ended up with most of the pain gone, still some remaining, but hopeful that as my foot gets used to the orthotic adjustments that will go away also.  I may have to go back in a week or two – but I also have an ART appointment this week, and I am going to see if Dr. Zak can release the trigger points that Dr. Beekman found again.  I was worried my muscles would tighten up again, and they are a bit, but not as much as before.  When I got out of bed this morning I massaged the plantar fascia as I do every morning, but when I stepped down I had no pain at all!  So definitely a big improvement there.  I think on that hill run, I must have been holding my foot in a different way to subconsciously avoid the plantar fascia pain, and ended up screwing all the other muscles up.  So as long as I come back carefully, I think I will be okay.

I did try running this morning, and while I didn’t time myself or wear my Garmin, I think I ran about 2.5  miles.  It wasn’t perfect, but I realized that I have to keep working on relaxing my foot, because it felt a bit of pain and wanted to tighten up again.  When I got home I found a trigger point in my calf, which really helped my foot feel better as I massaged it.  Looking on the internet later, I found this awesome website, www.triggerpointbook.com with some information on trigger points for plantar fasciitis and achilles tendonitis, and saw the trigger point in the tibialis posterior muscle is the one I was massaging!  I’m sending for the book, to see what else might help.

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Responses

  1. I am glad the Doctor was able to help relieve some of your pain. I hope you continue to heal quickly. I have a habit of favoring things when I have pain as well. In fact, I favored my calf so much last year I ended up hurting it more in the end (landing on crutches for a week and off running for 2 solid weeks).

    • Yikes – yes, I’m hoping it will all start going away – it is still feeling weird to walk, so I’m going to keep on with the cross training and just try running every other day, and build slowly.

  2. Trigger points and myofascial problems can be a real pain. Circulation is always compromised where there is a trigger point and therefore, without manipulation it is hard to heal. Thanks for sharing your experience.

  3. Thanks Ken – I’ve been massaging my foot and my calf since Thursday, and it seems to be helping – but slowly.


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