About 10 weeks before Kona some years ago, my achilles flared enough that I had to stop running.
I aquajogged and did eccentric exercises for a few weeks until I was able to run. I managed to Q for Boston at Kona.
I think that I read that Tom Evans (or whoever) aquajogged for weeks before winning IM Canada to rest his achilles.
Not PF, but still an overuse injury.
Wearing an orthotic when you're up and about might help rest it.
PF stretches have been reported to help.
I'm not a big fan of steroid injections, but I'm NOT an orthopod, sportsmed or podiatrist, either.

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Dick

Take everything I say with a grain of salt. I know nothing.

Don't get shots. Don't don't don't. You will treat the pain but not the underlying injury. Too many shots and you weaken the PF and when it tears it ain't fun. My podiatrist is pretty sure that's what happened with Payton Manning. Too many shot just to get him through a game and it tore.


I just finished my 3rd shockwave treatment for PF that has been plaguing me for over 6 months. Extremely painful but it's beautiful because when the machine turns off the pain stops. I get a bit sore for a day but NOTHING like the actual PF I've been dealing with. I held off for a long time because I wasn't sure of the efficacy but I'm impressed with how much better it feels already.

Mine has cost me $550 for 3 treatments and that should do it.

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Jen

"In order to keep a true perspective on one's importance, everyone should have a dog that worships him and a cat that will ignore him." - Dereke Bruce

I'm with you. Cortisone is catabolic. It can help, especially in season (like for TS), but it is risky and this is just a hobby for us, nothing that we NEED to do to earn our living.

The new research treating plantar fasciopathy like tendinopathy is very promising. Finding out the loading is obviously hard, especially since there is no consensus in how to load any other tendinopathy.

However, we do know that when tendinopathy flares up, its usually a reactive tendinopathy and then we know what to do: reduce load, maybe change loading patterns, until it settles, then build load slowly to cause adaptation.

I just got/had a little case of peroneal tendinopathy. Reduced running volume by 50%, only ran in the shoes that caused minimum discomfort, did some high load through strenght work (sitting calf raises). Almost completely gone by now, just took a few weeks. That has been the case for my last achilles tendinopathy as well: I can catch them early enough never to be too bothered by them. Plantar fasciopathy seems much harder though, maybe because its not completely like a tendon in its structure (litterature calls it aponeurosis and fascia interchangebly it seems? Dno about histology.) and maybe because it is not attached to muscle in one end and thus harder to get the loading to 'hit' where we want.

I've added a picture explaining the continuum of tendinopathy. The original article from Jill Cook is easy to find and a good, fast read.

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Endurance coach | Physiotherapist (primary care) | Bikefitter | Swede

Hello Hatsack...I'm home when I'm not out swimming riding and running! ;)

Like I said...I have consulted two doctors about this, I have had a diagnostic ultrasound which indicated no physical signs of PF, and I have been working with an experienced PT whom I trust. So I've been doing more than massaging my calf or ignoring it!The PF-like symptoms have been a slow creep; my doctor has explicitly told me she is comfortable with me continuing to run. (She is normally very conservative on this; she is a sports/rehab doctor)

The run leg at Kona was the first time my shoes gave me any bother in terms of rubbing my achilles. Did a 70.3 3 weeks after Kona and had bloody shoes after. (1st in AG, so worth it! ;)) (NO PF type pain at all during/after both events, just odd that my achilles seemed swollen enough to rub the back of my shoe when it normally does not..no shoe or sock changes) Like I said in my initial post, 2 years ago broke right tibia. Last March I switched from Gaerne to Specialized S-works shoes and experienced some discomfort in my left calf. Adjusted the cleats and all seemed well again.

I'm willing to endure pain to achieve my goals, and I understand PF is NOT something you can work through, so that's why I'm in this thread looking for answers!I think the helpful advice I'm looking for is someone who is familiar with Asics shoe lineup. I'm running on Asics Tartherzeal 3 and have been super happy with them for training and racing. Does Asics offer a very similar shoe with greater arch support that I could alternate into my training routine? I used to rotate through different styles of shoes...until I found tartherzeal 3 and loved them that much. Would rotating my shoes be helpful to keep this from progressing?

Again, a huge thanks to everyone contributing to this thread.

A rehab exercise which shows some promise....

http://well.blogs.nytimes.com/...heel-pain-treatment/

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Chicago Cubs - 2016 WORLD SERIES Champions!!!!

"If ever the time should come, when vain and aspiring men shall possess the highest seats in government, our country will stand in need of its experienced patriots to prevent its ruin." - Samuel Adams

In my office I start with icing on the water bottle, stretching and the Strassborg sock. I strongly recommend properly supportive shoes all day, every day. For most people this means a rigid sole, flexible only at the ball of the foot. I can't stress enough the importance of this.
The hypermobile foot will often require an orthotic. For many, it's about control of the foot, not shock absorption. Physical therapy, specifically deep heating modalities, are helpful.
I provide patients with a link to a core training workout, or send them to the gym for this. Training the gluteus medius will lessen the propensity to intoe when fatigued. This intoeing results in increased pronation as the foot seeks to return to a straightened position, therefore causing more stress to the fascia. You can see this intoeing in many runners late in races.

For lengthy cases I'll recommend a course of anti-inflammatory Meds. I will also use cortisone, but make the point that the other treatments are mandatory.
There are two main types of cortisone: mid and high potency. The mid-potency leaves the body in 1-2 days. The high potency sticks around in the form of crystals. I will use a course of 4-6 injections of the mid potency steroid for most difficult cases, and restrict the use of the high potency for those in severe pain (unable to walk).

There are those who tend to over stretch, so for those I recommend cutting back.
That link is a good one, I routinely recommend eccentric calf exercises. After all, that is how the gastroc-soleus muscles function: eccentrically.
I use shock wave therapy for difficult cases, and tell patients that results may take 6-8 weeks. This is also helpful.

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Dr Jay
http://www.Tri-Pod.net