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Chronic Plantar Fasciitis
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I have problems with my right foot and it's chronic at this point. It crops up every couple of months and slows me down for a long time. I've tried increasing volume at a snail's pace and reducing (and even eliminating) any sort of speed work, but I clearly have a larger issue. What stretches/exercises/spells/etc. do you guys/gals use to thwart this pain in the ass condition? Every time I start making progress and getting fast it comes around to ruin my day.
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Re: Chronic Plantar Fasciitis [jhammond] [ In reply to ]
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Golf ball. And my hard core massage therapist inflicting pain. Anything else is too soft for me to make progress.

FYI, there’s at least one longer thread somewhere on here with other treatment ideas.
Last edited by: DFW_Tri: Jun 23, 20 4:13
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Re: Chronic Plantar Fasciitis [jhammond] [ In reply to ]
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Mines not chronic, but it comes up a few times a year. I like rolling it out on a frozen water bottle a few times a day.

Strava
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Re: Chronic Plantar Fasciitis [jhammond] [ In reply to ]
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Foot log roller from roadrunner sports. Kept it under my desk at work for a couple of years and got rid of the PF thankfully.

------------------------------
The first time man split the atom was when the atom tried to hold Jens Voigt's wheel, but cracked.
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Re: Chronic Plantar Fasciitis [jhammond] [ In reply to ]
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I use a lacrosse ball when it starts yelling at me, but that's only to treat symptoms.

What's actually helped (to the point that it hasn't bothered in months) is three-fold (and most came from the other thread that was mentioned above):

- Tape foot every run with KT Tape (search that other thread for how).
- Wear PF sock always, even when not running.
- Toe raises, lots of 'em! I'd do them often throughout the day, but now I do them while brushing my teeth, typically 65-90 at a time.

Some other things that have also probably helped:
- I found shoes that fit my feet better with great arch support (I have really high arches): Altra Paradigms and Solomon... somethings... for running. New shoes for the office, as well (Merrill hikers).
- I ran more often and really developed a large base before adding any speed work. As in, running every day for 30 minutes or more. And even now, speed is occasional, a couple of times per week at most, and only after a really good warm-up.

Keep in mind, this is what has worked *for me,* and it does not mean it would for you: seems that PF is different for everyone.

And it took six months before anything started to really get better. But keep trying things - you'll find something eventually!

Good luck!
- Jeff
Last edited by: jkstevens: Jun 23, 20 4:35
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Re: Chronic Plantar Fasciitis [jkstevens] [ In reply to ]
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jkstevens wrote:
What's actually helped (to the point that it hasn't bothered in months) is three-fold (and most came from the other thread that was mentioned above):

Someone must have deleted their post because I don't see anything linked above. Can you provide the link please? I would really appreciate it!
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Re: Chronic Plantar Fasciitis [jkstevens] [ In reply to ]
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jkstevens wrote:
What's actually helped (to the point that it hasn't bothered in months) is three-fold (and most came from the other thread that was mentioned above):

Someone must have deleted their post because I don't see anything linked above. Can you provide the link please? I would really appreciate it!
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Re: Chronic Plantar Fasciitis [jhammond] [ In reply to ]
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Try Graston therapy with a wrench...sounds weird but I swear it got rid of mine.
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Re: Chronic Plantar Fasciitis [jhammond] [ In reply to ]
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Everyone's comments so far have been treating the symptom and not finding root cause. For me, I can treat the symptoms (calf stretches, lacrosse ball, art, graston, etc) and while it helps, it never truly goes away. You need to find why your plantar and calf are getting inflamed. In my experience, it has mostly been because my quad or anterior chain is not activating. My posterior chain is doing all the work which puts a ton of load on glute all the way down to my calf and into my plantar. Your calf and plantar can only do so much work. Once I get my anterior chain firing correctly, I can feel a big difference.

blog
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Re: Chronic Plantar Fasciitis [jhammond] [ In reply to ]
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It wasn't linked, just mentioned.

Search it out, should be fairly obvious, it's pretty long.

Sorry, just don't have the time this morning to look.
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Re: Chronic Plantar Fasciitis [stevej] [ In reply to ]
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stevej wrote:
Everyone's comments so far have been treating the symptom and not finding root cause. For me, I can treat the symptoms (calf stretches, lacrosse ball, art, graston, etc) and while it helps, it never truly goes away. You need to find why your plantar and calf are getting inflamed. In my experience, it has mostly been because my quad or anterior chain is not activating. My posterior chain is doing all the work which puts a ton of load on glute all the way down to my calf and into my plantar. Your calf and plantar can only do so much work. Once I get my anterior chain firing correctly, I can feel a big difference.


This is good advice, I have had some issues with PF over the years and my sports therapist always says that Calf and PF issues are always the result of something else. Once we find and treat the real cause Calf and PF will clear up.
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Re: Chronic Plantar Fasciitis [jhammond] [ In reply to ]
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Aside from just chopping the damn thing off, I really don't have much to add. I'm going on 3 years of PF and have been the podiatrist (who works with local athletes), physical therapist, massage, you name it. I've done it, bought it, tried it.

I will say that some of the best advice I've had so far is that sometimes it just needs to calm down and NOT be worked by a wrench or a ball or stretching, etc. If working it out isn't working out, then calming it down (20-30 day minimum for me), a boatload of Advil/anti-inflammatory drugs, followed by slow and comfortable stretching for 2 weeks (don't over-do stretching or aggravating anything), and then massive support while slowly increasing walking volume (tape, insoles, special socks, etc), and then keeping it worked out (wrench, ball, ice massage) has allowed me to actually reintroduce running. I'm on try #3 of this, except this time I'm not messing around. I'm 4 months into this try (previous tries were rushed).

There might actually be a light at the end of the tunnel for me. Time will tell, but after 3 years of being halted by PF, I'm actually functional. I can only run 3 miles at a time right now (compared to 25K trail running that I used to do regularly). So, I have a long road ahead of be. And I feel like I could invite PF back into my life in the snap of the fingers, but right now I'm able to keep it calm.

PF is a bitch. So sorry that you are affected by this. It sucks. Good luck to you...

Hillary Trout
San Luis Obispo, CA

Your trip is short. Make the most of it.
https://www.slogoing.net/
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Re: Chronic Plantar Fasciitis [jhammond] [ In reply to ]
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I had constant issues with PF for several years throughout the 80s and 90s, and in 2001 I had by far the worst episode, which lasted 3 years. It was bad enough that I had to spend at least 20-30 minutes stretching in bed when I woke up in the morning, just to be able to get out of bed. I tried everything but nothing helped, and was starting to seriously consider surgery.

It occurred to me that once my feet had been "stretched forward", the pain was minimized or gone, until they were allowed to relax by sitting or sleeping when it would come back with a vengeance. At this time, a co-worker told me about the Strassburg Sock. I started sleeping in those, and after a few weeks could get out of bed with little or no pain. I also started wearing shoes with zero drop (Vans Old Skools) and after a few months it had completely cleared up. I've found since then that if I wear shoes with more than 4mm drop, I start feeling twinges of it coming back, so I have completely quit wearing shoes with any kind of raised heel. I've now gone 16 years without a flareup...

"I'm thinking of a number between 1 and 10, and I don't know why!"
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Re: Chronic Plantar Fasciitis [jhammond] [ In reply to ]
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I had it bad for 18 months a few years back and kicked it completely by:
1) Taking 10 weeks off from running
2) ART
3) EPAT
4) Wore the boot when sleeping (took some getting used to)
5) Stopped going barefoot, was always in shoes with support or Oofos

Started back very slowly with PF socks during all runs. I've been PF free for 5 years now, during which time I've done IMs, marathons, speed work, etc.

Good luck, it's a PITA.
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Re: Chronic Plantar Fasciitis [mbwallis] [ In reply to ]
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mbwallis wrote:
I had it bad for 18 months a few years back and kicked it completely by:
1) Taking 10 weeks off from running
2) ART
3) EPAT
4) Wore the boot when sleeping (took some getting used to)
5) Stopped going barefoot, was always in shoes with support or Oofos

Started back very slowly with PF socks during all runs. I've been PF free for 5 years now, during which time I've done IMs, marathons, speed work, etc.

Good luck, it's a PITA.


What is ART and EPAT? Also, what kind of boot were you wearing?
Last edited by: jhammond: Jun 26, 20 9:56
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Re: Chronic Plantar Fasciitis [jhammond] [ In reply to ]
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ART = Active Release Technique, a type of massage therapy.
EPAT = Extracorporeal Pulse Activation Technology, basically a shockware therapy administered by a podiatrist to trigger your body to heal itself.

I did these at the same time so I cannot really say which one was more effective. But I know others who have been greatly benefited by ART.

The boot was given to me by my podiatrist. They are designed to stretch your plantar while you sleep. While mine wasn't exactly like this one, you can get the idea:
https://www.braceability.com/...etching-night-splint
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Re: Chronic Plantar Fasciitis [jhammond] [ In reply to ]
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My experience with PF has been varied. I've had clients with PF, I've personally had long and short bouts, but each recovery there is an recurring theme:

1a. There is a general core imbalance in strength and/or flexibility wise (overuse/underuse, over/under stretching in one area; many people I've worked with on this sit a lot for work)

1b. These imbalances can be higher up the leg than you think, i.e. your glutes, hip flexors, low back, abs, quads, hamstrings, and not your lower legs or feet.

2. In my experience rolling and stretching the area itself, although feels good (and is addicting), is only marginal in contributing to actual recovery, not solving the actual problem, and might make it worse if it becomes compulsive and then excessive.

3. It's not uncommon to have a generally spontaneous and quick recovery even with chronic cases. I have seen this a few times, but never in clients who focused on stretching and rolling the feet only. Not saying recovery wont happen, but I've had better luck overall with focus more on general leg and core strength and flexibility and less focus on the foot/calf only rolling and stretching.

Some exercises that might help to start. Go easy, body weight or very light weight,, 10-15 reps, few sets, and build as tolerated:

Ease off or stop activities that piss it off.

Morning stretch: before stepping out of bed, flex toes up hardish with full knee extension, point gently, repeat several times. You can do this mild to moderately throughout the day as well, before standing from sitting, while standing, etc. Avoid compulsive usage though.
Lunge, straight back leg, toe forward, tighten glute, stretches hip flexor area. Reach arm up and away from back leg for additional stretch. Can be done in place then walking lunge as comfort allows.
Lunge floor stretch, knee planted, lunging forward with chest up hip back, more hip flexor stretch.
Leg cross stretch. One leg crossed with ankle on opposite knee, pressing down on the upper bent knee away from the body to stretch hip flexor, piriformis, glutes.
Double and/or single leg Romanian Dead Lifts, slight bent knee.
Straight leg Duck walks, toes up. Vary the toes pointing in, out, forward.
Double leg toe press and then to single leg eccentric heel drops (Depends on pressure tolerance on the forefoot.) On a step, use the both feet to press up, remove one leg from step, single leg heel drop down, add second foot back for repeat press up.
Toe curls using a towel. Scrunch up and then lengthen a towel with your feet. You can also use marbles to grab with toes and put in a cup.
Leg extension toes up, on chair. On a machine is good too if you have access.
Leg curl with full extension (knees locked) at the finish , toes up (machine if you have access)

Everyone's situation is different, but hope this helps.

Best of luck

Matt Leu, M.S. Kinesiology
San Pedro Fit Works, Los Angeles, CA
Endurance Athlete and Coach
Consistency/time=results
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Re: Chronic Plantar Fasciitis [jhammond] [ In reply to ]
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Missing from all the replies above is the correlation between a loss of dorsiflexion range of motion and the presence of plantar fasciitis pain. Think of it this way- the ligamentous insertion point at your calcaneus is overstressed. This is why it hurts when you forcefully stretch it, ex standing up first in AM. Repeated stretching of a soft tissue structure that hurts will only serve to hurt it more and delay or abort the healing process. With a loss of dorsiflexion, people frequently can't get the normal 20 degrees with their knee bent. This implies that there is a limitation with the ankle joint. Soft tissue stretching of the gastroc and soleus complex is appropriate and needed to decrease the load repeatedly borne by the plantar fascia. However, mobilization of the ankle to a full 20 degrees of dorsiflexion is needed as well. If one ignores this joint, chronic plantar fasciitis will likely result. So if you don't have pain, then it comes on, that is your cue to perform exercises that abolish your pain and return the joint to full range of motion. Typically one might progress to improve dorsiflexion in a non-weightbearing position to full unilateral weight bearing. This can be a nagging injury if not treated fully and just managed while exercising at your previous levels- don't overload an already overloaded structure.
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Re: Chronic Plantar Fasciitis [AndrewL] [ In reply to ]
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AndrewL wrote:
Missing from all the replies above is the correlation between a loss of dorsiflexion range of motion and the presence of plantar fasciitis pain. Think of it this way- the ligamentous insertion point at your calcaneus is overstressed. This is why it hurts when you forcefully stretch it, ex standing up first in AM. Repeated stretching of a soft tissue structure that hurts will only serve to hurt it more and delay or abort the healing process. With a loss of dorsiflexion, people frequently can't get the normal 20 degrees with their knee bent. This implies that there is a limitation with the ankle joint. Soft tissue stretching of the gastroc and soleus complex is appropriate and needed to decrease the load repeatedly borne by the plantar fascia. However, mobilization of the ankle to a full 20 degrees of dorsiflexion is needed as well. If one ignores this joint, chronic plantar fasciitis will likely result. So if you don't have pain, then it comes on, that is your cue to perform exercises that abolish your pain and return the joint to full range of motion. Typically one might progress to improve dorsiflexion in a non-weightbearing position to full unilateral weight bearing. This can be a nagging injury if not treated fully and just managed while exercising at your previous levels- don't overload an already overloaded structure.

You're clearly much smarter than I am and my eyes glazed over a bit reading this. What kind of exercises would I perform in order to gain this range of motion back?
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Re: Chronic Plantar Fasciitis [jhammond] [ In reply to ]
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Not smarter, just different. You could start with sitting in a chair with a towel wrapped around your forefoot and heel on the ground. Use the towel to pull your forefoot up so stretching your ankle into Dorsiflexion. Try it multiple times and mutiple times per day. See what happens. If you get worse, then stop. If you see improvement then try more. Over time Progress to standing on affected leg and pushing your knee forward over your toes as far as can go. These are joint stretches so don’t hold more than a second or two. Dont force it and Don’t rush it either. The longer you’ve had this and the more irritated it is then the longer it will take to resolve. Don’t make it worse though.
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Re: Chronic Plantar Fasciitis [jhammond] [ In reply to ]
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I cured mine about 5+ years ago following advice I read on thread somewhere here. Find painful spots in calf and massage. Then strengthen calf doing single leg negative toe raises. Was back running in about a week.

I try to do the negative toe raises every other day. When I neglect to do this for a while, I'm reminded when PF starts to come back.

________
It doesn't really matter what Phil is saying, the music of his voice is the appropriate soundtrack for a bicycle race. HTupolev
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