Dexamethasone, or yet another PF sob story.

First, a little history: I developed PF in my right foot in fall 2002. After trying to run through it for about a month and a half, I finally took some time off. December 8th 2002 was the last time I had a real run-- I still remember it. I took a month off of running, tried coming back real easy, and the pain was back.

This process repeated itself about 5 more times over the next year. In the past 13 months I haven't run more than 5 miles in a day or 20 in a week. I've taken up to 2 months with no running at all and the pain has never gone away completely . I got prescription orthotics about 7 months ago, and they haven't helped. Neither has icing nightly, arch exercises (like towel scrunching), rolling a golf ball, using a foot massager, stretching my calves 8 times a day, using a PF night splint, or taking lots of ibuprofen.

So last week I finally went back to the podiatrist to ask about getting a steroid antiinflammatory injection. I figured "I've tried everything else for the past year, this probably won't hurt." He gave me an injection of 4mg Dexamethasone right where the PF attaches, coming in sideways from the inside of my heel. It also had some lidocaine in it for short-term pain relief. I took it real easy for the rest of the day, trying to walk as little as possible.

The next day my heel felt sore, but in a different way than usual. I gave the foot a full day of rest, then started nightly therapy again, consisting of foot massager, towel scrunches, stretching, ice, a big dose of ibuprofen, and then a PF splint while sleeping.

It's been 5 days since the injection, and I think my heel hurts more now than it ever has during any point since the PF developed. And unlike before when the pain was worst for the first 10 minutes after waking up, now it hurts all the time. It feels bruised, like someone smacked my heel with a 2x4 in a Turkish prison ( have you ever seen the movie Midnight Express?).

All I can say is, wtf?

Has anyone else had this experience with Dexamethasone? Can anyone recommend anything I haven't already tried?

I have had PF twice. Once I had it for months and it went away. It came back after calf cramps and I've had it again for months. Right now it's as good as it's been since it started.

One thing I can say is leave it alone. If you are running on it, squishing it on a golf ball, stretching it etc. it will probably be irritated and fight you. Contrast baths are the best thing I've found. I switch mine every 10 minutes. Cold should be about 55-60 degrees (not 32) and hot about the same as a hot bath, around 95 or so I think. Do that as much as possible. Also ibuprofen is good if you can take it. I take two with each meal. Give it a couple weeks without running and see if it improves.

If you are not satisfied with the progress, then I would consider surgery or a cast without surgery. I would probably go with a cast without surgery. Every time you step on it tears again, so you need to stay off of it as much as possible. Wear shoes with good arch support all the time, Birkenstock sandals are good. Put them on when you step out of bed. Wear running shoes if possible. If you must wear dress shoes get some good insoles/arch supports or wear your orthotics. It CAN get better, but it won't until you can put it out of your mind.

Yours sounds really bad so I wouldn't run on it, but usually you can if you can stand the pain. Just watch the speedwork. There were a couple times when I was sure mine would tear while doing 400's, but it never did. Running in the pool is probably a good idea to keep fitness and flexibility and the water massage.

Good luck!

Dexamethasone, or yet another PF sob story.

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