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Monday, October 13, 2014

Prolotherapy for Plantar Fasciitis- does it work???

As most of you already know I have been working out with Innovative Fitness Kits for over a year now as one of their sponsored athletes. (and I LOVE IT!) One of the things I do for them is write a monthly blog for their newsletter. Most recently I blogged about my experience with Plantar Fasciitis this year, and more specifically on whether or not Prolotherapy was an effective treatment. So I thought I would share it on my own blog for ya'll to read:)


Plantar Fasciitis- Just Go Away Already! Does Prolotherapy Help?

Plantar Fasciitis is one of the most frustrating injuries I've ever endured. In fact it isn't “one of”, it is by far the most frustrating of them all. If you've ever dealt this this injury you know what I'm talking about. It can stick with you for months and sometimes years. This is because there is no tried and true way of getting rid of it. There are certain forms of rehab that work for some, and for others are completely ineffective. I'm gonna talk about everything I've tried so far, including my most recent treatment- Prolotherpy, and give you my 2 cents on its helpfulness in healing my heel.

PF (plantar fasciitis) is one of the most common and painful injuries runners encounter. For those of you that don't know what PF is, here is a quick definition from Wikipedia- “Plantar fasciitis (also known as plantar fasciopathy or jogger's heel) is a common painful disorder affecting the heel and underside of the foot. It is a disorder of the insertion site of ligament on the bone and is characterized by scarring, inflammation, or structural breakdown of the foot's plantar fascia. “. In my own words- PF is a nasty angry devil bitch in your heel. It starts off as a “soreness” in your heel. Maybe you wore the wrong shoes out for a run? No, you wish it was as simple as that. It's an annoying (often excruciating) pain on the inside of your heel (sometimes feels like your entire foot hurts....) that is with you each and every step. For a lot of people the pain is the worst in the morning and it gets better as the day goes on. Not for me- mine just hurt all the time, walking or running. Ok so that pain in your heel is getting worse and you go to your physio and he gives you the devastating news that you have PF. Here are some of the things he or she will tell you to do in hopes of getting rid of it.... all of which I have tried and will tell you about.

  1. Wear some sort of night splint or Strassberg sock. They are designed to keep tension on the tissue (plantar fascia) so it heals in a stretched position at night. Yeah, that did nothing for me except annoy me while I was sleeping. But many people have found success with this simple method
  2. Strengthening exercises and rolling your foot out with a ball. After 6 months of this, I still have PF, so not sure how helpful they have been....
  3. New shoes or orthotics....tried about 8 pairs of shoes and 3 pairs of orthotics..... nothing seemed to make a difference for me.
  4. Icing and ibuprofen. Icing helped relieve the soreness/pain after a run, but it would quickly return the next day when I ran. Advil just helps with the pain...doesn't actually help it go away.
  5. Get your foot adjusted. I saw a chiropractor, he adjusted my foot/heel. This did not help, it only hurt while he was doing it.
  6. Take time off. Completely unload your Plantar Fascia. Limited walking and definitely no running or other weight bearing activities. I took 6 full weeks off of running and work. When I first started running again (very limited amounts at first), the pain was definitely diminished. But within a month of being back into my full time training, the pain was almost unbearable again.
  7. Shock wave therapy- I have not tried this myself, but know a few people who have. There conclusion is that it helps initially- for a few days...but the pain then returns. And the treatment itself is quite painful.

So this brings me to the last method of treatment that I tried- Prolotherapy. After 3.5 months of dealing with this terrible injury and trying so many things that just weren't working, I was feeling frustrated and hopeless. My sports med doctor presented me with a few more “advanced” options. By advanced I mean last resort kinda stuff. She was hoping one of the more simple methods would have worked by now, but since they were not helping we had to try something new....

  1. Platelet-Rich Plasma (PRP) Therapy- “It utilizes platelets from your own blood to rebuild a damaged tendon or cartilage. It has been successful in not only relieving pain, but also in jump starting the healing process. Your blood is drawn and placed in a centrifuge for 15 minutes to separate out the platelets. The platelet-rich plasma is then injected into the damaged portion of the tendon or cartilage with the guidance of an ultrasound machine.” (www.emoryhealthcare.org).
  2. Corticosteroid Injection- “Cortisone is a hormone that is naturally produced by your body's adrenal gland as a response to stress. Cortisone injections contain a synthetic version of this substance and are given as a shot directly into the injured plantar fascia ligament, or into the side of the heel. Cortisone is a powerful anti-inflammatory substance. In the case of Plantar Fasciitis, bringing down the inflammation surrounding the plantar fascia ligament can then lead to relief of pain” (www.heelthatpain.com)
  3. Prolotherapy- is a regenerative injection therapy. It involves injecting an otherwise non-pharmacological and non-active irritant solution into the body for the purpose of strengthening weakened connective tissue and alleviating musculoskeletal pain. Thanks Wikipedia for that definition.

So I was presented with these three options, knowing that they would all require 2 things that scared me- 1. more time off of running and 2. needles into my heel. We decided that Cortisone injections would be my last resort, as the possible side effects were the worst of the 3. So it was between the PRP therapy and the Prolotherapy. We decided on the Prolotherapy treatment, as it was a bit less invasive.

The following week I had my first appointment with Dr Bovard who would be giving me the Prolotherapy. I would be getting the injections once every week for 6 weeks. During this 6 weeks I was still allowed to run, but very limited. No longer then 45-50 mins, 5 times a week and only if the pain level in my heel was less then 4 out of 10. I was very happy I was still allowed to run at all.

I knew that the injections were going to hurt. Even though there was a numbing drug put in with the prolo solution, the first 20 seconds were pretty painful. The entire procedure is less then a minute, so really its not so bad. For the first few hours my heel felt good...cause it was numb! But then the next 24 hours it was very sore and tender. My heel was more inflamed then before....but this was the point- now my PF will start healing faster. That's kinda how prolotherapy is supposed to work...I think....hahaha I can't explain all the science behind it, so please goggle it if you really want to know exactly how it works.

So every Monday for 6 weeks I went in and got the injection. It has been almost 7 weeks since my last injection. Each week my heel was supposed to get better, and by the 6 weeks after my last injection, my heel should be much better. Well not sure that this is what has happened. I knew that Prolotherapy wasn't a miracle cure and that I wouldn't be 100% pain free. But I was hoping for close to that....Each week after the last injection I began to increase my mileage and the intensity of some of my runs- as long as the pain wasn't getting worse. Some days I felt almost nothing when I ran- it was amazing. I really felt like I was making progress, and that I was gonna kick this PF once and for all! But then there would be days where my heel was angry and painful again. In the last few weeks, progress has come to a standstill, and the pain remains on a daily basis. It is not bad like it was in the spring or summer, its manageable....but none the less there is still pain.

So did the Prolotherapy work? I definitely think it helped, but not to the extent I had hoped for. I am running pain reduced, but not pain free, which is obviously where I want to be. People who have had PF tell me that one day I will wake up and it will just be gone. It is hard to imagine just waking up one morning and having no pain in my heel. Just the thought of this happening brings a smile to my face. While I wait for this miracle to happen, I will continue to do my exercises, ice my heel, get regular massage and physio, and pool run on days when my heel is extra sore. As long as it's not getting worse....I feel like I'm making progress. And if things start getting bad again- well then I still have 2 treatments to try- PRP therapy or Corticosteroid injections..... Let's hope we don't have to try either of these....


For those of you that don't like needles....don't watch this.  Here's a video of Prolotherapy.  It's hard for me to watch, and think that I had that done to me!  Yikes. ouchy.

23 comments:

  1. Of all the points in the foot, it just HAD to be the one that meets the ground! It's good you got some pretty promising results from prolotherapy, however temporary they may have been. Careful with the corticosteroid injections though, as these are known to have adverse side-effects such as plantar fascia rupture, or it may cause your plantar fat pad to atrophy.

    Agnes Lawson @ MedWell Spine, OsteoArthritis & Neuropathy Center

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  2. I can definitely relate. I've been dealing with what I think is PF for a few years now. It's to the point where I can't do the exercise I like (high impact cardio and weight training). I've been using a dorsal split at night and it helps to the extent that it doesn't hurt so bad to walk in the morning. But beyond that, I don't think it's done much.

    I finally made an appointment to see a podiatrist just to confirm whether or not it's PF.

    Thinking about getting a Plantar Fasciitis Sleeve from Feetures!

    I'll be happy to share any successes here! I'll also add your blog to my RSS feed! :)

    GOOD LUCK!!

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  3. I experienced PF for close to 2 years. It was the most painful experience one can have. I went to a podiatrist. I did the cortisone shots, had it casted for almost 2 months and then again off and on over the time. I also wore the useless night brace. I call it my $2000 bionic foot! Then in July 2012, I broke my other ankle. After about two months of not knowing what was going on, the PF disappeared. Just like that. so the joke I make now is I know the "cure" to PF. Break your other ankle! Obviously I do not recommend this, as I am now on a waiting list to have the surgery to fix the ankle, it is humourous to think of how I "cured" my PF!!

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  4. I did have prolotherapy for different issues and they were successful. I was told by my sports med doc that prolotherapy does not always work on PF and would not recommend it.

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  5. Now a day every person is busy his own work they can,t take proper exercise for their healthy life.But buying a best foot massager machine every person can doing exercise in own home when he feel take exercise.

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  6. I have been dealing with PF for about 6 months now , I recently bought myself a 170 $ pair of New Balance shoes for work.. I am a keyholder at our local Dollar Tree spending quite a big of time on my feet .. I took up running 2 years ago , but fell away from it .. Never had an issue WHEN I was running .. only since I stopped .. hmm hubby pointed out I didn't have these problems when I was running,, I roll the frozen water bottle under it .. soak in Epson salts.. Not sure I want to try the needles EEK.. should see within a few days if these shoes are going to help lessen the pain by the end of the day. I wake up feeling good ; just by the end of the day I have a hard time walking .. would LOVE to take up running again ..

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  7. I am so glad to say thanks you...Your post gives me lots of important information about the Prolotherapy...

    prp therapy Los Angeles

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  8. Whether working or exercising, we all spend an enormous amount of time on our feet. According to a recent study, three out of four people experience a serious foot problem at least once in their lifetime. We treat in Foot pain, Foot problems, Plantar Fasciitis, Plantar fasciitis treatment, Achilles heel, Bunion, Foot conditions and Heel Pain.

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  9. Hi!

    I know this is a dated article, but I came here after reading your Wait! What Just Happened blog entry on your new website. (Great article by the way, and I'm sure those days were frustrating for you, but like you said, this is just this year and you have lots of time left! And you're such an amazing, inspirational runner. You have plenty of time to conquer anything!)

    So, my question is whether the PF is completely gone now? Did you wake up one day and it was gone as others had suggested? Considering how you just did on the Eastside 10k, it sure looks like it.
    I'm hoping it's gone!

    Sad to hear that even elites like you can get these debilitating injuries.

    I've had this going on for the last couple of months and I think it is finally getting manageable.

    Keep up the great work on all fronts - running and kitties! And being a great Canadian.

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  10. Thank you for your great post. I've learnt some important things from your blog. I'll bookmark your blog for future visit. keep posting good contents please. Thanks again.

    pure cambogia slim

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  11. I had this problem for the longest time when I was training for my half marathon. I found that while the solutions that you listed in your post gave some temporary relief, the only real fix to the problem was to take a break from running for a while. Otherwise, I would just keep aggravating the injury.

    Alberto Lawrence @ Institute Of Sport

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  12. Thanks for the post hope it will work for me. Now a days its being tough for me to deal with my plantar fasciitis. Read more My blog

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  13. Hey, very nice site. I came across this on Google, and I am stoked that I did. I will definitely be coming back here more often. Wish I could add to the conversation and bring a bit more to the table, but am just taking in as much info as I can at the moment. Thanks for sharing.
    PF Night Splint

    Keep Posting:)

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  14. Thanks for the great information.....f you suffer from heel pain it can stop you dead in your tracks. Pain in the heel can be due to many different factors; however the main culprit is usually Plantar Fasciitis.
    plantar fasciitis shoes

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  15. one of the best knowledgeable information. If anyone have hell pain what type shoes for plantar fasciitis you recommend?

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  16. A great read, another product that helps me walk is https://www.soulinsole.com, fits in any shoe and helps reduce pain, give it a try if you want :) i recommend it

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  17. A podiatrist is the specialized doctor for feet care. I personally recommend Shazia Malik (www.malikpodiatry.com) in the Montreal region, but whoever you choose, just don't hesitate, they can really help.

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  18. I think I will need to try harder to accomplish my dream. I think it is not easy
    plantar fasciitis

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  20. Great, thanks for sharing this amazing information. I have read this blog,its really a useful post about Plantar Fasciitis.

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  21. This comment has been removed by the author.

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  22. I was a runner and suffered from excruciating PF for a year and a half in my right foot. It felt like my foot was ALWAYS on fire or like someone was driving hot pokers into it. The pain even started to creep up the sides of my ankles and lower calf. Nothing helped to alleviate it and I tried them all. I had an MRI scan and the Radiologist said it was one of the worst cases of PF he's ever seen.
    The only thing that worked for me was the dry needling technique and a cortisone injection. This was performed under ultrasound guidance by a Radiologist trained in musculo-skeletal diagnostic imaging and procedures. He numbed my foot first with Lidocaine and I only felt that initial needle for maybe 5 seconds and then didn't feel any of the dry needling or cortisone shot after that.
    The dry needling technique is when he continuously poked at the plantar and surrounding tendons in my foot for about 3-5 mins with a dry sterile needle. What this does is it re-sets your body's anti-inflammatory response and focuses on healing up the "damage" that the dry needling did. The cortisone shot was injected after the dry needling to also help with the healing process.
    My results?...I was cured! I haven't felt the pain in my foot since and that was 7 months ago. I feel like crying with relief every time I realize that hateful foot pain is gone!!
    In keeping with healing this injury I totally gave up running because I was damned if I were going to go back to that agonizing PF pain again. I did try to start running again about 2 and 1/2 months after the procedure but I ended up with sciatica, knee pain and some initial pain in my foot again. I loved running but the injuries it gave me weren't worth staying at it for me. Instead, I took up hiking and walking a lot with my dog and going to the gym for strength training. My goal is to stay active and injury free and to enjoy my activities without the pain from injury so I have found other methods to keep strong and fit.
    I hope my story helps you and and it at least gives you another alternative to curing your pain when all other techniques fail.
    :)

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