twisted ankle/plantar fasciitis

by Bettyann
(Fort Lauderdale, Florida)

Me twisting my right ankle seemed to have had a domino effect which is quite confusing to me. Six months ago I simply twisted my r ankle trying to avoid a wheel barrow in my walkway but I had heavy packages in my hands as well. No big deal at the time, no swelling or bruising either. A couple days later, my r ankle started to bother me and I was limping by the end of the day from work, not bad, just annoying! Still, I thought it will go away because I have done this in the past. Four weeks later, its still there. Six weeks later its starts to swell a little and went to get x-rays and nothing is broken or fractured. The doctor told me to get an ankle brace from the drug store and later he gave me an actipatch to wear at night. Nothing was helping and it was getting worse. The swelling was worse and went into the foot and toes. The left foot started up the same way. The first doctor seemed like I was bothering him and his final advice was to stay off my feet. I never went back to him. I was kind of lost at this point and continued to work because I had to. I started getting heel pain, sharp excruciating pain that started to move around my r foot and ankle, pain in the morning was like walking on broken glass but subsided then returned three hours later with a vengeance! I went to the ER and they said I was fine and to stay off my feet. Am I crazy? I decided to go to an orthopedic doctor who consulted with a podiatrist. One says the pain could be coming from the lower back and the DPM says it could be CRPS. They both did say PF could be a possibility but nothing was working,like the ice,anti-inflammatory med,rest and pt. I had gotten x-rays three times during all of this and had to get a MRI which showed the edema, sinus tarsi syndrome and partial tears. Things had gotten better but I still had a lot of pain and did not walk correctly. I did get one cortisone shot and I felt like a million bucks for a couple of days but both doctors agreed it would be too dangerous for any more shots. Why? They gave a below-the-knee boot to wear for three/four weeks. So yet I go to another podiatrist and he said I have classic PF and I get my third cortisone shot this week from him. He said this within 5-10 minutes of seeing him. He also taped my r foot. Once the pain goes away in the r foot then I should have no pain in the left--so there is no need to inject thel Is he right? I am 45yrs/110lbs. Any input would be great. Thank you, BH


Hi Bettyann,
You have supplied me with a lot of information but unfortunately you are not clear on some points.
What I gather is you have some "tears" noted on the mri, but I am not sure where they are located; is it a tear in the ankle or plantarfascial ligament?
Since you have a history of trauma, (twisting of ankle) I am not so sure your problem is coming from your back and therefore think it is located strictly in the foot/ankle.
You have had cortisone shots which have given you short term relief, but you do not mention where the injection was given.
In any event, if the mri mentions a "tear" then one of the best ways to approach this would be through immobilization with the use of some sort of cast in effort to allow the area to heal.
You also mention one of the doctors suggested CRPS as a possibility. This can happen particularly in women you have been walking with a guarded gait for a period of time. Ask your current doctor about this possibility and if he or she suggests that CRPS might be a possibility then you need to see a neurologist or pain management specialist, because most doctors are not properly trained to treat this condition and it left untreated can be a devastating medical problem. Read my section on CRPS.
Marc Mitnick DPM