Plantar Flasciitis - tips?

Mike_Honcho

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Aug 21, 2007
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Oh what fun!!!!!!!


Anyone been through it? Have any tips?

I have been reading a lot, rolling my feet on a 2" wooden dowel (that feels nice - not), stretching and trying to wear shoes with support. I can not sleep with a boot on.


I *NEED* to get back to running for the sake of my sanity.


TIA
 
After running 17 marathons in 17 years with no problems, I went out running (more like slow jogging) New Years Day in a pair of L.L.Bean boots with rubber bottom/leather tops and a raised heel. It was one of those beautiful winter days and I ran about 7 miles. Toward the end of the run I started having sharp pains in both feet. The next morning I got out of bed and actually fell over. The pain and symptomss continued for several weeks and got worse. A couple of different physicians and some conventional treatment options made little difference. I still tried to run now and then but even walking was painful.

Finally out of desperation, I took a friends suggestion and tried a really good Platies teacher. We worked pretty aggressively and after 10 sessions (three per week) I began to feel better. After 20 sessions the pain and the plantar fasciitis was gone and hasn't returned. The wooden roller and stretching and massage helped but the Platies teacher was the one who made the difference for me.

Also I use Superfeet brand (green) insoles in all my footwear now(recommended by the Platies teacher) which really helped as well. Ran 13 miles on Saturday with no problem. Vitamin M (Motrin) is your friend. Heat is not and made mine feel better at first and then more painful the next day. Good luck with this. Keep us Posted.
 
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I know you mentioned the boot...and this is similar, the Strasbourg Sock. It works. Gotta do the stretches and rolling n the dowel and such, it all works together but people swear by that sock for getting them back on the road.
 
Okay, had this several times in my life and treated it for the last 20 yrs as a PA in the ER. Go to Ideal Feet and get their basic arch support. It takes a week to adjust to them, increasing wearing time by one hour each day. It will feel like walking on a golf ball at first. It cured my fasciitis within 14 days. It stretches the fascia and as long as you continue using it you won't be symptomatic . And they become very comfortable and supportive. Or spend 10 dollars and tape 2 rolls of dimes to your arch!! Just kidding about the dimes.
 
I to have had it. Not fun. Developed it from funning on indoor short tracks. All i could do was stretch as soon as I got out of bed and several times a day. And take a anti-inflammatory to help with the inflammation.
 
I have dealt with this most of life. Last year it got so bad I would almost have to crawl out of the bed in the morning then any time I sat down through out the day and got back up I looked like I was 90 years old for the first five minutes.
Almost a year ago I had some type surgery that they punched little holes all over my heal (not sure what it was called), That didn't really seam to help much. I then went and got fitted for orthotics (foot levelers) and as someone else mentioned at first they sucked, "like walking on golfballs". However after using then for a couple months I can say they feel much better. Some days I have little to no pain at all.
I have also lost 42 pounds since the first of the year so I cant really say what was the most contributing factor.
 
I used to get PF to the extent that I could barely stand up the morning after an easy 5-miler. Then I started barefoot running. That was almost three years ago, and much to the chagrin of medical professionals, family, and marathon snobs, I now run more (25ish miles a week when I'm not feeling lazy) and faster (10 trail miles just under 90 minutes) with no pain whatsoever. The transitional phase was tough,and there is a substantial chance of hurting yourself pretty badly if you don't take it slow at first, but it was 100% worth it in my opinion. I rarely run barefoot now, but have transitioned to five fingers and now to merrell trail gloves. I get a lot of flak from friends about how my hippie-ass is stupid for ignoring all the modern technology blah blah blah. I don't care what anyone thinks or says about the method, it worked for me, I lost a good amount of weight and kept it off, and I have more energy than I ever remember having before I started running. So the hell with them. As usual, YMMV and all that...
 
I had PF very badly from working on concrete in a aircraft maintenance facility. The thicker that stuff is the worse it is for you and this so happen to be an old AFB. Well my wife bitched at me to wear flip flops. I had never worn them at all. Well I went out and got a Pair of Rainbows and started wearing them any time I could away from work. I be damn if the PF went away. That was three years ago. Needless to say I had to hear the I told you so shit for a while. I guess that would be as close to going barefoot every where as you can get.
 
Quite commonly it's related to posterior tibialis weakness not stabilizing the mid foot. Find a very experienced physical therapist with advanced Ed. Not someone just out of grad school. If they have the professional designation FAAOMPT it's a good start.
Even then its a rough waiting game. Though the post tib may be the cause you have to get the inflammation on the plantar fascia under control.
 
The most basic cure for PF is stretching of the plantar fascia multiple times daily. It can have a success rate of 95%. Most other treatment is hooey and has no significant evidence for efficacy outside of testimonials, "I did that ( pick a treatment) and it worked"

Barefoot running must be approached with care..it is not for everyone..it can cause other problems which are being seen much more often...metatarsalgia, calf pain, stress fracturesof the calcaneus and metatarsals...etc.. Good luck
 
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As someone else stated Heat does not help but Ice does. Like others I stand on hard concrete all day. If I think it will be a rough morning, the night before I will ice both feet and in the morning no pain to very mild pain. And yes I have had it bad enough to have to crawl in the morning before.
 
Sorry to hear you have it, I had PF for about 14 months. It definitely sucks. I tried almost everything (pretty much everything short of surgery). Mine is finally gone, and I'm back to running.

For what it's worth, here's my observations / experiences.

- it doesn't just go away on it's own, and you can't just gut your way through this injury. This is hard to hear for someone who likes to run...but the running has to stop until the pain is totally gone for a week or two...and then you start back SLOWLY. Ignoring this just makes you have a prolonged time away from running.
- icing and NSAIDs are good to reduce inflammation. I liked using mini water bottles, put them in the freezer and use them to roll your foot over. I did this 4-6 times a day (I have a mini-fridge in the office, so I could do it at work pretty easily)
- golf ball under the foot makes for a good foot massage and helps break up the scar tissue. Hurts at first, but eventually you can work your way up to actually standing and putting a fair amount of weight on it as you work it back and forth.
- tight calves, lower back, thighs all can stress the facia and you should stretch these areas out. Rollers work well, and are also considered torture devices in most 1st world nations.
- Boots and Stausburg socks helped to keep it stretched over night and reduce pain in the morning, but didn't fix things for me on their own. They also suck to sleep in. I wore mine after the kids went down when watching TV and as many nights as I could stand.
- choice in footwear makes a big difference, get professionally fitted (and not at foot locker or Dick's sporting goods). Cheap shoes (not just running shoes, but everyday shoes) were a big part of the problem for me.
- Insoles are key. I tried the green superfeet insoles and they didn't work for me. Tried other over the counter ones, they didn't work either. I had to go with custom fitted orthodics.

What finally solved the issue for me was to suck it up and pay for a specialist to mold my feet. They were expensive, and I got ones that would would stand up to a lot of abuse...actually they are made of kevlar. After three weeks of wearing them (every day my feet felt better and better) I was confident enough to start trying to run again. Started at only a mile to a mile and a half every other day for about two weeks, and I'm back up to about 25 miles a week again after three months. Like I said, start back SLOW.

I also bought a mountain bike and biked for cardio when my feet were bad. Being sedentary sucks, and it helped keep me from going nuts if I couldn't run.
 
Quite commonly it's related to posterior tibialis weakness not stabilizing the mid foot. Find a very experienced physical therapist with advanced Ed. Not someone just out of grad school. If they have the professional designation FAAOMPT it's a good start.
Even then its a rough waiting game. Though the post tib may be the cause you have to get the inflammation on the plantar fascia under control.


Bam!!! Winner.

The pain is VERY localized to the insertion point between the calcaneus and the talus.

I have been reading a lot about both and I can see why they are associated / treated similarly. Sadly it really does sound like it will not 'just go away' and it is going to require that I stop running for a while.

I am not a small person, I run on the balls of my feet only, I like hills, and I was bumping my training in hopes of running a 1/2 marathon in 8 weeks - bad combo. Back to the bike I guess.


Thank you all.
 
Almost 3 weeks now, lots of ice the first 10 days or so, now I am not icing nor am I consistent w/ Motrin (I tend not to take anything for any reason), lots of stretching, lots of rolling my feet on a dowell, always wear either Birkenstocks or Super Feet Greens (the Birks are the best), and generally trying to stay seated through out the day.

i have not run in this time nor done karate, I have ridden a bike @ 8 times for no more than an 90 minutes. It definitely inflames it, but nothing like running. I am trying to limp along with infrequent rides of 60 minutes max. The pain is much better but it is certainly there. I am hoping that in another 3 weeks this will be markedly better and I can try running again and get back to karate.
 
On occasion, there may be another problem either masquerading as recalcitrant plantar fasciitis or occurring simultaneously with the plantar fascial issue. That problem would be tarsal tunnel syndrome. The tarsal tunnel is just that - a tunnel in tissue thru which a nerve goes. If the tunnel is too tight the nerve gets pinched and pain ensues. In cases where the pain of apparent plantar fasciitis does not resolve in a reasonable amount of time, I have my patients undergo a nerve conduction study to rule out the nerve issue. Amazing how many times we see either both problems at the same time. Injections can be added to the armamentarium of treatment options and at times surgery will provide the desired relief. Posterior tibialis tendon dysfunction can contribute to the evolution of the problem as well as a tight gastrocnemius. PT is oftentimes very useful if these mechanical aspects are involved. In my sports med clinic, I give my patients about 3 weeks to get better conservatively before escalating my evaluation and treatment. More than a couple of months is too long!!
 
I had it in my left foot. It's mainly because of a weakened arch. The more arch support you put, the weaker you get. It may relieve the pain, but you will never recover from it because you need to strengthen it. Started wearing "barefoot" New Balance and Merrell running shoes, and it went away. I use them all the time for any type of exercise. Walking on loose sand barefoot helps a lot too. I walk around at home barefoot as much as possible.



Ex Umbris Venimus
 
I had chronic PF for about 2 years before I finally couldn't take it any more and seen a specialist. For therapy I rolled my foot on a frozen water bottle and sat on a chair and wrapped a Towell around my toes and pulled hard to stretch my foot out. I also tried some new insoles the doctor recommended not sure what brand but their purple. He also recommended I wear crocs in the house.
Now I very rarely get PF.
 
Loosing weight and perscription inserts helped me. Also when I get a flare-up I roll the bottom of my foot back and forth on a frozen small gatorade bottle. Sucks you have this its a frustrating problem.
 
It's a real PITA for sure. To stretch it out, face a wall about 3ft out from it. Lean into wall keeping feet flat on floor. Do this first thing in the morning and several times a day. Take NSAIDs for the inflammation and roll bottom of foot over frozen water bottle. It will take time to heal. Good luck
 
I had PF so bad I could barely walk for a week. It took two weeks of rest, ice, and stretching to be able to return to any kind of moderate activity, and a month to really get back to training.

Ironically, I went from Brooks Beasts (big heel-toe drop, lots of motion control), to Brooks PureCadences (very minimal stability control), and I haven't had problems since. We were regularly doing 7 miles, and the issue never returned.
 
My pt told me to stretch nightly, and also massage the whole heel area to break up the scar tissue. It was painful for a few weeks of massaging every night, but started to get better and then finally went away. She also told me to take Naproxen daily for a couple of weeks (if your stomach can handle naproxen, my brother can't take it at all).

I was actually barefoot running and also running with the merrell barefoot shoes before I got pf. If you plan to do this, get ready for a couple of weeks of break-in pain. You will be sore for a few days until you get used to it. Barefoot running helped my posture and I had some back pain that went away also.
If you don't want to barefoot, find out what type of runner you are and get the appropriate shoes. It will help. When I played basketball I was more of a ball striker (forefoot runner), but once I started running more, I found out I was more of a heel striker (except when sprinting/doing intervals or bursts). New Balance, brooks, and a bunch of other companies make specific shoes geared toward the type of runner.

and, another vote for superfeet green insoles. they seemed to help during recovery and I still use them.
 
If you're getting desperate then look into "dry needling." Hurts like hell, but it has worked for me (so far).

Stretching properly, golf ball (massage), and ice are important; but heat is needed to stimulate blood flow in tissue (fascia) that does not usually get good blood flow.

Good luck.
 
another vote for the Superfeet.... I hated the damn things when I first put them in my shoes and had to wear them a couple hours at a time for several days and slowly increase it until you make it all day. They will help

JW