I'm not a big cortisone fan...always seems to make things worse in the end.

I had PF really bad several years ago and tried everything on the Internet. What worked for me in the end was shockwave therapy through a chiro office. Same as what they use to pulverize kidney stones.

As you can imagine, it's not cheap but ended up working for me. I think I paid around $250/session for 5 sessions. Has not flared up in four years.

does that hurt like Hell? ;)

I've heard the electric therapy can help significantly

I had plantar fasciitis about ten years ago and I tried just about everything, with the exception of the shockwave therapy. I had two cortisone shots about three-six months apart, extremely painful to have done and I wouldn't say that there was a ton of pain relief. In hindsight, I wish that I hadn't had the shots.

What worked best for me was the night splint which I wore for a while...also had custom-made orthodics that I used for a year or so.

I haven't had any issues since...I have been using over the counter orthodics (Powerstep) for about eight years now which work really well. I have pretty high arches, so I need something and the custom orthodics were too heavy and stiff. Good luck.

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Jamie

I suffered from PF for nearly 2 years. Cortisone shots would only provide me with about 5 weeks of relief, then it would come roaring back. So if you go that route, I would try to wait until closer to your race.

When it flared up so badly I could hardly walk in Aug 2014, I took 2 weeks off, and a combination of EPAT (shockwave) and ART got me to the IMFL starting line in relatively good shape. I then took 2 full months off from running after IMFL. While I could feel a bit of tightness in that foot during 2015, I ran pain free this year, which included IMLou.

Do you run in support shoes? Do you wear arch support inserts in all your shoes? Sleep in the boot? I still do all of these things, for preventative measures.

Good luck.

I've been sleeping the strassburg sock for as long as it will allow and wear hoka cliftons. I have 2 pair that I rotate and have been using hokas for awhile

Had the shot- felt awesome the next day. Did an Oly about 4 weeks later, did great. Started feeling little 'pings' again. Did another Oly (now about 7 weeks after shot) and 5 miles into the run with 1 mile left I felt/heard a pop and hobbled to the finish line and straight to the med tent for ice. Next day foot was swollen and bruised- had torn the PF and was out for the next 6 months. Wouldn't recommend the shot.

Absolutely! The first time was horrible. I equate it to stepping on a sharp stone in the grass barefoot-surprising, shocking and painful. After the first dozen zaps, you numb up a bit...but still hurts haha.

The day after the second treatment I felt results and almost craved the pain of the shockwave therapy. A bit perverse I guess.

It really worked for me, I'm glad I stayed with it because in the end it was worth it. I can actually get out of bed and walk instead of crawling to the bathroom.

Don't take this the wrong way, but the above quote is a pretty telling statement. With regard to your question about the shot, there really is no way to know if it will be helpful or not without just getting it done. The range of results from cortisone injections range from "Why the eff did I do that, now it's worse," to "Wow, that seems to have done the trick." To be honest, I have found that neither of those are the norm, just the extreme ends of the range. Most folks that i have dealt with that have had injections see some short term relief, but nobody can predict how long that relief will be.

If you do choose to have it done, I would strongly advise you to follow the mantra of laying low for several days immediately following the injection. Also, consider it a one and done or possibly two and done treatment. Multiple treatments can actually degrade tissue ... that's no bueno.

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Dan Hollingsworth

Nobody grows old by merely living a number of years. People grow old only by deserting their ideals. Years may wrinkle the skin, but to give up interest wrinkles the soul." - Douglas MacArthur

interesting timing I just got my first shot this morning.

I started to get PF in early March. Trained through it this summer and did IMWI. Took it easy for a few weeks and when I started back up there it was so decided to deal with it. I have had 3 appts with Ortho. First 2 we didn't do shot as she was afraid if I continued to run on it it would tear. I did all the program you describe for 2 months. I would say it is 80% better. If I run more than 30-40 minutes it flairs. 20-30 I'm good.

We agreed this morning to starting cortisone as 1) it is getting better and 2) I plan frequency and volume via short runs for the next few months. Don't plan anything over 30-40 min per day.

I would wait till after race for the shot. My symtoms were the same (ie. limp for first 10 minutes of day then fine). I would be concerned about masking that and doing real damage by pushing. If you can't train on it you probably have the answer about whether you should race on it.

If the shot doesn't help, I don't plan on getting another. I plan on continuing my treatments and resting from running. If I can walk the race in January so be it. I'm hoping this will help with a little inflammation.

I don't plan on attempting to run either this week. Only swimming and cycling later in the week. Maybe elliptical next week. I'm going to see what the doc says first

Question: is your pain at the bottom of the heel or on the side or back of the heel?

The reason I ask is that I'm trying to diagnose my own foot pain. I had a partial tear of my left PF two years ago. Had the cortizone shot; it didn't help much. For me, icing, stretching, and massaged worked best. Ended up doing two IMs later that year along with several OLY and Sprints. It was sore most of the time but I could still get around 20-30 mpw in.

This spring I did a trail run and I really aggravated it again (could hardly walk on it). I took a a week off of running, it heeled, and I was still able to run a marathon 3 weeks later.

I trained most of the summer mostly pain free and I too did IMLOU this year. I started building my mileage in November and on Thanksgiving morning I ran 13. I could feel it getting sore during the run and after the run I could hardly walk. It seems to be improving slowly. What I don't understand is that the pain I have now is not on the bottom of the heel but rather on the outside of the heel. I'm not sure if this if PF, achillies tendonitis, or what? That is why I asked where your pain was.

I was thinking about making an appointment with the podiatrist this week but I'm trying RICE first.

I really wanted to up my run mileage this winter but my left foot seems to be a limiter. I would take a cortizone shot in a second if I knew it would fix the issue.

Would love to read more success stories on this thread!

I came down with Plantar Fasciitis this summer. I got a cortisone shot in late August or early September. I also bought new running shoes with more pronation control. My foot was getting better until last week when I was running in our local turkey 5k. I guess I pushed it to hard because it started hurting as soon as I finished. I think I might have torn the PF. My symptoms are the complete opposite of what they were. The pain in my foot gets worse as the day goes on and the more I use it the worse it gets. I have an appointment with a podiatrist tomorrow morning. I'll let you know how it goes.

This is a complete N=1 story, but probably worth sharing.

Had PF two years ago....sharp heel pain came on suddenly at the end of a run. In the space of less than a mile, it went from a "niggle" to forcing me to stop running. Woke up in the AM, got out of bed and dropped like I had been shot, the pain was so bad.

Went to podiatrist that day and had a cortisone shot. While it helped somewhat, it was not enough to let me resume running (that took months). But I think he also nicked a nerve with the shot......even after the PF had disappeared, I had pain and discomfort at the injection site (interior side of my heel). In hindsight, I wish I hadn't gotten the shot.

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definitely not. Just a band-aid. If you have already done the training and you are going for a world championship maybe, but otherwise no. Not worth it.

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Take it or leave, but this is what worked for me - walking on sharp gravel barefoot. 5-10 minutes a day for 3 weeks and PF was gone. And its free. Hurts like hell of course but it builds character :-) Found out about this in ChiRunning book.

Definitely try using a night splint. That might help stop you from aggravating it each and every morning. Maybe you've recovered from some of it, but PF is very difficult to 'completely get rid of'. You'll probably always have to be aware of it, and wear the night splint if you feel symptoms. Some night splints are very uncomfortable but I found one that's pretty easy to find online or drugstores called 'Futuro plantar fasciitis sleep support'. It's much more comfortable than the socks (it's not as extreme I think) and I find I can wear it all night.

I did the shockwave therapy and had mixed results (two different PF occurrences - once it helped, once it didn't). I got it for $50/session in CA.

Good luck. PF is a pain!

PF is not something that you can just train through. It's the type of injury that will linger and only get worse if you don't temporarily change your training lifestyle. I had it for 5 years before I quit all court sports. Only then did I get rid of it. You need to ask yourself if that upcoming event is worth it. Is it worth a possible 2 or 3 year setback? Or maybe even a permanent injury? Only you can answer that. My advice is to shut it down now. Take the trip if you have to and volunteer at the event. Shut it down and give it time to heal. Follow the advice of your doctor and get healed. Otherwise, you might be on here in a couple of years asking the same advise.

Show me the data on cortisone shots for PF. I doubt they're out there. I find the most frustrating thing about PF is all the anecdotes swirling around in this data vacuum. Here's a blog post that covers the one study that looked at high-loading strength training as a treatment (heel raises, but not just focusing on the eccentric phase -- it includes eccentric, concentric, and isometric contraction phases). Sample size = 48, half assigned to regular PF stretching; half to high-loading strength training.

http://www.running-physio.com/pf-new-research/

Bottom line: better foot function (i.e., less pain) after 3 months in the latter compared to former group. No sig diffs btwn groups at 6 and 12 months, though...

As a bitter sufferer of PF I want to point out that both groups were still experiencing pain at 6 and 12 months. Makes sense as the average duration is 2 years. I just finished an 18-month bout (but trained and raced through it). Still, I'm so fricking over it. Foot pain is not fun.

First, I wish to thank everyone in this post...I have learned a lot. And have a couple of questions.

I have many of the symptoms of mild PF. (stiffness in the morning, and pain during first km of running, nothing past that.) I had it checked with ultrasound and there was no evidence of thickening...so if it is PF...it is a very mild case. My goal is to prevent it from getting worse.

1) Night splint has been hugely helpful in relieving morning walking pain and the initial pain I experience during running. 50% of the time I run now, there is no pain. 3 cheers for relative simple and non-invasive therapy! I run approximately 80km per week, have not changed my training load in terms of distance, but have been speeding up and doing a little more hill related work with no increase in pain. I run in Asics Tartherzeal 3 shoes and have never had issues. During my last IM in October, my leg achilles area did swell to the point where my shoes rubbed the skin raw on the achilles...this had never happened before with these, or any other in fact, shoes. The inflammation has since dissipated and the shoes do not rub on my achilles. (Warning sign I'm sure....) Should I consider a different pair of shoes? If so, what kind of shoe should I be considering? I really do not understand shoes. :(

2) This is where I hope others can give me more information. My PT (who is completing his PHD in sports related PT) believes that the primary cause of the injury is over use of my left leg due to having broke my right tibia almost 2 years ago. 3 screws were inserted and removed 10 months after the break. I was working on right leg strengthening, but the differences are obvious just by looking at the muscles on both my legs and through various strength tests done by my PT. Thus, he says, the key is activating the muscles in my right leg and getting them stronger to take the load of the left PF and foot. Intuitively this makes sense for PT, and better body balance is good regardless. He has me doing many jumping exercises and stretches, as well as working on muscle activation in therapy sessions and teaching me exercises to fire and coordinate my underused muscles in my right leg.

My question, however, is should I be doing more to stretch/relax my left calf? Is sports massage effective of this or just wasted money?

Darren - you're running 80 km/wk, doing *more* speedwork and hills, and you're wondering if **massaging your calf** will keep your problem from getting worse?

hello. Is Darren home.

Shockwave therapy worked for me.

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Formely stef32

Regarding the Achilles rubbing, wear a little longer sock. That way you have something between the shoe and the skin.

I have been suffering with plantar fasciitis and a heel spur for about 9 months now. It started on probably the only day in March in Cleveland when the weather was good enough to run outside (I had been running on the treadmill most of the winter) with my brand new running shoes - different brand than I had used the previous 5 years. Immediately had heel pain and ignored it for a few months to go into a situation of limping after a long run for the rest of the day and having some degree of pain all other days with every step.

Tried to get ready for IMLou but dropped out (partially because of this) in September, since then I have not run except for one attempt in October that was very painful. I have seen a chiropractor every week for electro muscle stimulation, ultrasound, deep tissue and rapid release. It has gotten better but it hasn't fully healed yet. What has made a big impact however is wearing soft shoes during the day and putting the Spenco inserts in them. Because my achilles seems to feel weak I have been doing eccentric heel drops as well which seem to help the whole joint get stronger. Now going for custom shoe inserts which are on order at the moment in hopes of being able to run soon.

I'm signed up for the LA Marathon... with no running fitness at all and coming from injury it is rather unlikely I will make it. Next up will be IM Oceanside. I'm really trying to invest the time in recovery now in hopes of having a strong tri season... fingers crossed. Chiro (who treats a lot of runners) does not recommend a cortisone shot as it doesn't address the problem.