The Foot Surgeon Recommended ...

NOT surgery. Not yet. Imagine! He has more things to suggest before we try surgery on the plantar fasciitis. I don’t think he was very impressed with the other podiatrist’s recommendation of two months of "hammock therapy." And neither was I - it didn’t work and it seems I wasted two months. He was also not impressed with the custom orthotics that the podiatrist had made for me, with a rather hard heel plate; he prefers a softer one, so I will be getting ANOTHER pair of custom orthotics. Interesting factoid: I got in to see the orthopedic surgeon in ONE DAY, but the appointment for the orthotics takes at least a week, no exceptions, “Ron” is very busy. Is there a message there?

Whether there is or not, I really like this doctor. He is a board-certified podiatrist and podiatric surgeon. He is young (compared to me) but not TOO young, he didn’t recommend surgery as the first option even with my history, he is a very competitive runner and triathlete, and he was VERY informative. So much information that I wish I’d taped it. Happily, Sunshine went with me, so we can compare notes. I had an appointment with the other podiatrist too, and I just cancelled it.

This guy is my new foot doc. His name is Troy A. Vargas, D.P.M., at St. Croix Orthopaedics, centered in Stillwater, Minnesota. Here are some of the things I heard him say (not to be confused with whatever he ACTUALLY may have said):

• Plantar fasciitis can be cured without surgery 90% - 95% of the time.
• It appears more in aging people, so may be somewhat of a degenerative problem.
• The surgery is simple and quick - just a few minutes to remove the center (usually) of the fascia where it attaches to the bone, and put in a few stitches. The only surgical issue is getting through the layer of fat which forms the heel pad. The body ultimately replaces the removed portion of fascia with scar tissue.
• There is a potential complication of nerve pain CAUSED by the surgery, which is very hard to treat and is the primary reason why doctors are slow to treat plantar fasciitis with surgery. It can make the pain worse. As far as he knows this complication has never appeared after one of his surgeries.
• Running on grass trails is much better than running on pavement. Go to the park. I will!
• A second steroid shot is not out of the question (I’ve had one already).
• Night splints are good - keep it up.
• Stretches are very important - several times per day, both the Achilles’ tendon and the hamstrings; that’s all connected.
• He suggested all sorts of cross-training: Biking, pool running, swimming, elliptical, and more. Of course.
• I didn’t ask about hot and cold treatments, and he didn’t offer anything.
• There is another therapy (I missed what it was exactly) that he might want to try before doing surgery.
• He knows that PF is impacting my lifestyle, and that is an important consideration.
• There is a theory that some cases of PF may become chronic, without inflammation, and if so the correct medical term would be plantar fasciosis instead of plantar fasciitis.
• In an aside, not discussing PF in particular, he did mention that sometimes an injury will rupture and then the pain will actually go away. I think he was implying that’s what may happen in some cases with PF.

Specific, immediate instructions for me:

• OK to run on grass, be guided by the pain. Yay!
• Avoid hills.
• Go immediately to the Brace Place (do not pass GO) and get new orthotics by Ron. Wear them all the time, including running.
• Continue with the Strassburg Sock night splint.
• Stretch the Achilles, calves, and hamstrings several times per day.
• Come back in three weeks for a steroid shot (one week before my next marathon).

I’ll keep posting. I really would like to stop writing about plantar fasciitis pretty soon, but today I feel hopeful and cheerful. Despite the pain at the end, the Moose Mountain Marathon was a delight, and now I have a doctor in whom I feel some confidence. This day is a masterpiece!