Pressing my heel into the cool, hardwood floor of the hallway, I wait for the lightning bolt. It is a ritual of the wounded. Every morning, for 108 days, I have performed this tentative dance, anticipating the sharp, white-hot jaggedness of plantar fasciitis. But this morning, there is nothing. The silence in my foot is as profound as the silence of my phone, which I just discovered has been on mute for three hours. I missed 18 calls. People are screaming into the void of my voicemail while I am standing here, marveling at a chemical miracle that I know, deep in my marrow, is a lie.
That first week after a cortisone injection is a hallucinogen. You feel like a god of the sidewalk. You walk to the grocery store just because you can. You take the stairs. You forget that for the last 8 months, your life was measured in the distance between chairs. We call it a success because the pain is gone, but we are confusing the absence of a signal with the resolution of the crisis. It’s like turning off the smoke alarm while the kitchen is still smoldering. You haven’t put out the fire; you’ve just made it easier to ignore until the roof falls in.
1. The Illusion of Victory
Camille T.-M. understands this better than most. She is a piano tuner, a woman whose entire existence is predicated on the precision of 0.08 hertz. When she walks into a room with an old upright, she isn’t just looking at the keys; she’s listening for the structural fatigue of the wood and the tension of the wire. She came to me after her third injection in a year. She was desperate. A piano tuner who cannot stand to use the sustain pedal is a tuner out of work. She had been offered the ‘quick fix’ by a generalist who saw a swollen heel and reached for the needle.
For 48 days after each shot, Camille felt like she could hike the Alps. By day 58, the dull ache returned. By day 88, she was limping again, the pain vibrating through her leg like a dissonant chord.
The Nature of the ‘Truce’
We talked about the nature of the ‘truce.’ Cortisone is a powerful diplomat. It enters the localized theater of war in your heel and demands an immediate ceasefire. It shuts down the inflammatory response with an iron fist. The swelling recedes, the heat dissipates, and the nerves stop screaming.
But the diplomat doesn’t stick around to rebuild the infrastructure. The diplomatic mission doesn’t address the fact that Camille’s calves are as tight as a high-E string, or that her footwear provides about as much support as a piece of damp cardboard. The truce is temporary, and when the diplomat leaves the room, the internal factions start fighting again, often with more violence than before.
The Cost of Arrogance
I spent four days walking 1208 steps an hour on cobblestones, feeling absolutely nothing. I thought I was cured. I was arrogant. What I was actually doing was shredding my plantar fascia because I couldn’t feel the warning signs. I was redlining an engine with a broken cooling system because someone had taped over the temperature gauge. When I got back to London, I couldn’t walk for a month. The ‘victory’ of Rome cost me 188 days of recovery.
The Body as a Kinetic Chain
This is the problem with the symptom-suppression model of modern medicine. It treats the human body like a collection of isolated parts rather than a kinetic chain. Your heel doesn’t hurt because it’s ‘bad.’ It hurts because it is being asked to do a job it wasn’t designed for, or because it’s compensating for a failure elsewhere.
(When standing at the wrong angle)
Maybe your hips are weak. Maybe your big toe doesn’t have enough extension. Maybe, like Camille, you spend 8 hours a day standing at an angle that puts 208 percent more load on your medial tubercle than it can handle.
[The needle is a mask, not a map.]
The Permanent Trade-Off
When we look at the long-term data, the story of cortisone gets even more complicated. There is evidence that repeated injections can actually weaken the structural integrity of the fascia. It can lead to fat pad atrophy-literally thinning the natural cushioning on the bottom of your foot. You’re trading a temporary inflammatory problem for a permanent structural one. It’s a bad bargain, yet we keep making it because the alternative-rehab, strengthening, mechanical correction-takes time. And in a world where I miss 18 calls because I dared to put my phone on silent, time is the one thing no one wants to spend.
I eventually directed Camille toward a different path. We stopped looking at the needle and started looking at the way she interacted with the earth. We looked at her gait, her orthotics, and the way she balanced her weight while reaching for those high notes on a grand piano.
She needed a team that looked at the long game, the kind of expertise you find at
Solihull Podiatry Clinic, where the goal isn’t just to stop the pain for a month, but to ensure you’re still walking without a limp in a decade. They understand that a heel is part of a person, not just a billing code.
Real Healing is Loud
We have to stop being seduced by the ‘click’ of the pain turning off. Real healing is loud and messy and slow. It involves eccentric loading exercises that make your arches ache in a different way. It involves 58 days of stretching when you’d rather be sitting on the sofa. It involves the humility to admit that your body is telling you something important, and that silencing it is an act of aggression, not care.
Ugly Footwear
(The initial resistance)
Real Freedom
(The lasting result)
She had to relearn how to stand. She had to invest in footwear that she initially thought was ‘ugly’ but eventually realized was ‘freedom.’
The Mute Button on Health
We often treat our bodies like high-performance machines that we can simply ‘service’ and return to the road. But machines don’t feel; they just fail. Humans feel so that we don’t fail. The pain of plantar fasciitis is a sophisticated communication system. It’s a request for change. When we answer that request with a steroid, we are effectively hanging up the phone. We are putting the body on mute.
🔇
And as I learned this morning with my 18 missed calls, eventually, people stop calling, and the problems just get bigger while you’re not looking.
The Real Peace
I watched Camille tuner a piano last week. She didn’t have the phantom limp. She wasn’t shifting her weight every 8 seconds to avoid the ‘hot’ spot on her heel. She was balanced. She was grounded.
Time to Structural Harmony
1008 Hours
It had taken her nearly 1008 hours of dedicated physical therapy and mechanical adjustment to get there, but it was a real peace, not a temporary ceasefire. She hadn’t just silenced the pain; she had addressed the dissonance in her own structure.
Negotiate a Lasting Peace
If you are currently in that blissful, post-injection week, I am happy for your relief. Truly. But don’t let the silence fool you. Use this window of comfort not to go for a ten-mile run, but to do the boring, tedious work of fixing your mechanics. Use the truce to negotiate a lasting peace. Because the diplomat will eventually leave, and when he does, you want to make sure there’s nothing left to fight about. The needle can give you a moment of quiet, but only the work can give you the song.
Honesty Carries You Forward
The World Rushes Back In
I finally unmuted my phone. The world rushed back in with a series of digital chirps and vibrations. 38 new emails. 18 missed calls. The chaos of being alive. I stood up, feeling the stretch in my calves, the solid connection of my midfoot to the ground, and the slight, healthy tension of a body that is finally being listened to.
It wasn’t perfect, but it was honest. And in a world of quick fixes and masked symptoms, honesty is the only thing that actually carries you forward.
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