MRI shows low-grade partial tear of PF, two podiatrists tell me "that's just what plantar fasciitis is."
So this flare of my PF has been going on for a year in my left foot, although I've had a certain degree of PF pain for a few years in both feet. I've gone through rest, compression sleeves on my foot, stretching. Then a cortisone shot and physical therapy. The cortisone shot wore off about halfway through my PT sessions and the pain was just as bad as before, despite increased strength and flexibility.
Somewhere along the way I also got custom orthotics and changed from Hokas to more minimal but supportive shoes, some zero drop others not.
None of this seemed to be fixing it, so I got an MRI in mid-May. Findings:
- Moderate plantar fasciitis with superimposed low-grade partial tear at the central cord origin.
- Os trigonum noted with small marrow edema and cystic change across the synchondrosis. Findings may be seen in the clinical setting of posterior ankle impingement.
- Small subtalar joint effusion.
- mild retrocalcaneal bursitis.
I was alarmed at the mention of the tear, but couldn't get the podiatrist to call me back or move up my appointment that was still three weeks out. Finally the office called back to relay the information to not do any jumping, running, or "explosive movement" - no problem there, I hadn't done any of that for a year.
When I finally had the appointment, the podiatrist said that chronic PF always had some amount of tearing (I get that, but I assumed those "microtears" were not the same thing as what was noted on the MRI report). I was put in a cam boot for four weeks with little instruction besides don't walk too much, and he suggested prolotherapy injections while I was in the boot.
I'm not keen on the idea of prolotherapy because it seems like the last thing I need is more inflammation in my foot after all this time. He also offered PRP injections or shockwave therapy, but it's almost like he's giving me a menu of various experimental treatments not covered by insurance and I can basically throw a dart and pick one.
I went to another podiatrist for a second opinion a week ago and she said the same thing about the tear not being anything beyond standard long-standing PF. Her office doesn't offer shockwave or PFP injections but said either of those were decent bets. But all she could offer, if the walking boot didn't help enough, would be to have me wear it for another month while I was completely non-weightbearing, or surgery.
I'm just so frustrated. Trying to actually get this healed seems impossible. I don't know if I overdid it with my stretching and exercises during physical therapy, but I suspect I may have. After the first week in the boot, I decided to really try to rest it and I'm trying to get under 1000 steps per day. It's really tough but I'm not sure what else I can do at this point.
From what I read here, what works for one person doesn't necessarily work for another, but if anyone has any advice, I'd be grateful. I don't mind paying out of pocket for therapies that will work, but I'm tired of chasing after ineffective treatments.