PLEASE HELP!Torn Flexor digitorum brevis muscle & plantar fasciitis

[melissa851]

I was diagnosed with plantar fasciitis, when, after a run in May 2008, I began experiencing foot pain, it was very sore, I could barely walk and was using crutches for the 1st couple of weeks, after 9 months of treatment, it was less painful but I was still unable to do very much or even walk very far without a lot of pain. I finally got an MRI and was diagnosed with a torn Flexor digitorum brevis muscle & plantar fasciitis, I then wore a walking cast (floating cast) for 3.5 months. I just got another MRI & there is STILL a "small tear". (this is 14 months after the injury) plantar fasciitis is now gone.

My foot is feeling better now, it doesn't hurt CONSTANTLY anymore, but still gets very sore very easily, and gets very swollen at times, still no running, roller-blading, hiking, biking, going to the gym, or even gong for a walk.

I also got custom orthotics, & have seen my family doctor 2 physio therapists, a podiatrist & a sports therapist. (I've rec'd acupuncture, ultrasound therapy, shockwave therapy, muscle stripping, laser therapy)

Also had a cortisone injection in October 2008, my foot got very sore and swollen after this.

I never walk bare feet, not even in the shower! No high heels either.

I am also taking fish oil & MSM, icing every night, and rubbing my foot on a tennis ball as I was told these may help.

I am now getting Shock Wave treatments, this seems to be helping somewhat.

Does anyone have ANY ADVICE?????? PLEASE HELP!

[Heidi]

Hi

It sounds like you have tried everything!

All I can say, is that if the tear isn't healing properly, there must be a reason for it. Any muscular tear, given a chance (i.e. with rest and treatment like you've had) should heal in this time frame.

Obviously with the feet, it is difficult to fully rest them without sitting down constantly for weeks on end. What I suspect is happening, is that it heals (at least partially) and then any slight increase in activity, breaks down the delicate new fibres.

Have you done any form of strengthening for the muscles of the foot? If not, what I would suggest is to continue with your treatment as you have been, rest as much as possible (i.e. don't do anything you don't have to....even revert back to the boot if you can). Then add in some strengthening exercises (proving they are comfortable to do). This will get the muscles used to activity slowly. Gentle contractions whilst a muscle is healing helps the new fibres to align properly making them stronger. Then very gradually increase the amount of activity you are doing. But I think this needs to be a very gradual process.

Sorry I can't be much help!

[melissa851]

Okay, thanks Heidi.

Is there any specific exercises you can suggest, other then picking up a towel with my toes?

Do you know if this is a rare injury? I am unable to find much online.

What about a plaster cast for a few weeks? Or even surgery? Are these options?

It has now been 15 months since the injury. I'm getting desparate!

Melissa

[Heidi]

Hi melissa

I think it is quite a rare injury. Or at least a poorly documented one! I can't seem to find much either!

In terms of exercise - yes the old 'picking the towel up with the toes' is always quite a good one. Also try using a pencil.
Try sitting with the front of the foot on a pair of bathroom scales and heel on the floor. Apply pressure down through the foot. Use the scales to measure your improvement.
Try stretching it by gently pulling the toes back. Don't do this too hard, especially to start with!
Practice pushing down one toe at a time when the foot is flat on the floor.
You can also use a resistance band to resist toe extension and flexion.

I'm afraid I don't know about surgery. Is it possible for you to get an appointment with a foot specialist?