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plantar fascitis diagnosis and funny bone

by chris

I have been diagnosed with plantar fascitis,being treated for it (night splint, ice , taping, shoe inserts etc) I noticed recently that when I touch the top of my left foot (the one with PF only) and move my hand up on top of the foot, I get this electric feeling right there. I dont feel it any other time at all. My doc did not do xrays or anything of the sort. I am a runner. Just wondering if I coudl be having something else than plantar. My other sxs (have improved with ice, night splint and massage mostly)are the following: pain under foot, pain behind heel, usually in am but also when just sitting there quietly. My feet are high arch. Could it be another problem than PF?


RESPONSE
Hi Chris,
The funny bone sensation you are getting on top of your foot has nothing to do with your plantar fasciitis other than the fact you are a runner with a cavus or high arched foot.
When you either rub your finger along the top of your foot or even tap your finger at the highest point in the arch you are probably experiencing either a shooting sensation or tingling sensation.
For most people this sensation will travel all the way down the foot going in between the first and second toe.
What is actually happening here is that you have a neuritis or inflammation of one of the sensory nerves that passes down along the top of the foot, just under the skin. It is one of the nerves that gives you sensation on top of your foot and has nothing to do with motor function (muscle function) of the foot.
Because you have a high arched foot, although this is not limited to this type of foot structure, your laced shoes have pushed the skin (and nerve) into the top portion of your foot and since you have a high arch the top of the foot bones are more prominent and thus more pressure is created.
What happens here is the nerve than becomes irritated or inflamed as it gets stuck between your shoe and corresponding bone.
When running your foot swells a little bit and the tighter you lace your shoe, the combination creates greater pressure.
This is a fairly common problem. Keep in mind if your doctor gave you orthotics, this could actually exacerbate the problem and you should bring it to his/her attention.
What you can do on your own is 1. do not lace your shoes as tight and 2. buy a Dr. Scholls round, non-medicated pad (the largest size they sell; they are generally orange like in color). Then find the exact point where the nerve seems to be irritated, place the "hole" of the pad over that spot and then lace your shoes. This will help protect the spot from further irritation.
Sometimes a cortisone injection can be very helpful. In severe cases surgery is sometimes performed to free the nerve from any surrounding scar tissue which may be present, but this procedure is one you would like to avoid if possible because of low success rate. Most cases can be adequately treated with conservative care. Discuss this problem with your doctor.

Marc Mitnick DPM
DISCLAIMER

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