The Scribbler

9 March 2012

What I’ve learned about plantar fasciitis

What is plantar fasciitis?

The plantar fascia is a thick band of tissue (like a ligament) that stretches from your heel to your toes. It supports the arch of your foot and acts as a shock-absorber when you walk or run. Plantar fasciitis is inflammation of this band of tissue.

It’s most likely caused by repeated small injuries over time, so if you do a lot of walking, running or spending time on your feet. It’s sometimes called ‘policeman’s heel’ as officers walking the beat were said to be commonly affected and the pain is usually felt on the underside of the foot near the heel.

Typical symptoms include pain which is worse first thing in the morning or after a period of rest. It often eases off as you move around, but can be triggered again by a long walk, run or just being on your feet.

My experience
I first felt a bruised sensation in the heel of one foot after training and running which didn’t go away after a couple of days. It was more noticeable first thing in a morning.

I hadn’t been pounding out lots of miles or running much more than I usually did. But I had been running with a club and doing hill sprints and short sprints – both of which would naturally force me more onto my toes. I am a bit of a speed demon and enjoyed the sensation of the sprint sessions, but they may well have contributed to my injury. Or it may just have gradually built up over time.

It’s a pretty common and frustrating injury among runners, so I quickly found plenty of sympathetic and useful advice.

Advice:

  • Don’t keep running on it
    Pretty obvious really. An injury caused by impact is unlikely to improve if you keep pounding the pavements or trails. The problem is that it can seem to come and go.In my case, it never hurt enough to really make me wince. And it very rarely hurt when I was running. So I would rest for a few days and try a run again, find that it hurt afterwards, rest again and repeat.
  • Rest it
    The words runners hate to hear. Resting is what you do after a long run, ahead of your next run. Resting feels like wasting time when you could be training.The problem with the plantar fascia is that it’s slow healing and because of where it is, you’re unlikely to be able to fully rest it. It took me a long time to realise that even a short lunchtime walk could upset it.Some gentle movement, exercise and stretching can help loosen up the plantar fascia and encourage it to heal.
  • Get some advice and treatment
    There are simple things you can do to help treat plantar fasciitis at home. Icing the area intensely can help reduce the inflammation and ease the pain. But it’s a case of getting an ice pack on for 20 minutes at a time 3 or 4 times a day, not just 5 minutes with a pack of frozen peas.Other home-made treatments include rolling your foot over a bottle of iced water, or giving yourself a foot massage with a golf ball to really get into the sore spots and break down any patches of stiffness.One useful exercise for stretching the plantar fascia was to put a towel on the floor and try and pick it up with my toes. I’d often do this one standing at the sink brushing my teeth in a morning. 
  • Cross train
    You can keep your fitness up with non-impact exercise like cycling and swimming. I learned to enjoy the cardio effect of an indoor row bike row session instead of a run. Just watch out for those exercise classes where you might be jumping or hopping and putting impact on that foot.

What I learned:
I did all of the above, but also made the mistake of trying to keep running at the kind of pace and intensity I had been used to after a few days’ rest.

But I realised that a cycle of run, hurt, rest… run, hurt, rest was ultimately fruitless and eventually I went to seek advice from a sports physio. That really marked the start of me better understanding and beginning to treat it. He looked at the way I stood and walked, did some manipulation on my foot and generally prodded around until it really hurt.

In my case, it’s linked into the fact that I pronate (in simple terms, my knees pull inwards a little). I already wear orthotics, special insoles that help position my feet to correct this. But that same instability meant that I was putting added pressure on my plantar fascia.

I’ve had several weeks of treatment and been given lots of exercises to do to either loosen up the plantar fascia or strengthen the muscles in my calves and foot to try and get them pulling in the right direction. Because of the tightness in my plantar, my calf muscles also became very stiff and tight and I had to have some deep sports massage to loosen them up too.

The key for me has been to persist and to be patient. So I keep doing the exercises and stretches, even when there’s no pain. I keep a golf ball in my desk drawer and try to roll my foot over it once a day at least.

Losing the simple freedom and adrenaline buzz of even a short run, did affect my mood and made me more likely to reach for the comfort food. And self massaging your foot or calves with a foam roller, golf ball or iced bottle hurts. Sometimes you really don’t want to do it. But afterwards it does feel better.

I’ve also had to ease back into running again. My physio wrote out a plan to help me return to running and it was just like starting over with a 5 minute walk and a 1 minute run. Unfortunately, my speed demon tendencies had me trying to run that minute at my fastest pace and by the end of the session, I’d really aggravated my plantar again.

So I learned to slow down, run easy. And to take note of the drills I’d do in the running breaks, knee lifts and heel kicks, fast feet and lateral shuffles – designed to switch on the running muscles, especially the glutes and to encourage me to pick up my feet quickly.

I’m not sure if I’ve managed to change the way I run in only a few weeks. But I’m more conscious of trying to land lightly and pick up my feet, but avoid pushing off my toes.

It is getting better. But it is a frustrating injury that can seem fine one minute day and then be back again the next. I’m very much hoping that I’ll be back to running regularly and building up time on my feet again soon.

Sources of information:

http://www.patient.co.uk/health/Plantar-Fasciitis.htm
http://www.sportsinjuryclinic.net/sport-injuries/foot-heel-pain/plantar-fasciitis
http://en.wikipedia.org/wiki/Plantar_fasciitis

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8 Comments »

  1. I’ve not long recovered after 20 weeks of pain with pf – running was nigh on impossible in the first couple of months, but I bought a Strasbourg Sock and it really helped. Now back to running, but I’m really unfit :/

    Like

    Comment by Vicki Thompson (@ladywhippet) — 9 March 2012 @ 19:13 | Reply

  2. Very informative article. This is the most common problem I see in my practice. Here are some sources for more information.

    http:\\www.thetampapodiatrist.com

    fixfootpain.com

    Tampaheelpainrelief.wordpress.com

    Like

    Comment by Dr. Marc Katz — 11 March 2012 @ 15:07 | Reply

  3. […] haven’t  felt that I’ve been running very much as I’ve dealt with my plantar fasciitis trouble, but I’ve realised that getting back to running has pretty much dominated my head […]

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    Pingback by Further adventures in cycling « The Scribbler — 19 April 2012 @ 18:24 | Reply

  4. […] and not really doing enough about it. By the time I saw a physio and started properly managing my plantar fasciitis, running had to take a back seat and I returned to walk/run to get my feet and calves fit and […]

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    Pingback by 2012 – a review of my training and racing year « The Scribbler — 30 December 2012 @ 19:26 | Reply

  5. […] injury like I was at this time last year. Fingers and everything else crossed, but it looks like my plantar fasciitis and other bio-mechanical niggles are behaving (please don’t let that be the curse of […]

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    Pingback by Trainer tart | The Scribbler — 27 February 2013 @ 20:22 | Reply

  6. I was diagnosed with PF back in 2009 and I ignored it for several months, which made the condition of my left foot worst. In 2011, I’ve decided to have stem cell treatment. Actually, that was the second time that I had stem cell treatment with Dr Grossman (an orthopedic surgeon from Stem MD)… the first time was for my patellar tendonitis… both of them went successful… The treatment for my PF took 5 weeks (2 sessions per week Wednesday and Saturday). 3 weeks after I had my last therapy session, I started to feel the beneficial effect of stem cell and on the 5th month, I was able to have a “normal” run. I know that it took me awhile to recover, but it is better to wait for something that you know you will get positive results than to depend on fast-acting painkillers, which effects could only last for hours…. I hope you will be able to find the appropriate solution for you PF too, so you can get back to running… I know how runners feel if they can’t get a good run for days… frustrating!

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    Comment by Michael Garrett — 21 July 2013 @ 16:30 | Reply

  7. Reading this resembles very much what i am currently experiencing the frustration of not being able to run is simply depressing i have not ran for 3 mths and cannot wait but i do know that if i were to run i could cause more damage and longer recovery i am waiting for the day when i will be able to run again

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    Comment by sasi — 9 March 2015 @ 22:35 | Reply

  8. Diets high in fat and protein are usually effective for people in losing weight.
    Flat feet have various degrees of arch degradation when the
    body’s weight is on them. My mother and my grandmother are very
    calm people who seem to handle stress very well.

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    Comment by Rheumatoid Arthritis — 9 November 2015 @ 16:53 | Reply


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