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Plantar Faciitis - my Notes on runner's heel pain
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"Abstract"
Excess tension on the underside of the foot prohibits correct function required for forefoot running. The condition distorts the foot structure, pulling the foot apart internally downward, causing impingement at top of foot and a failure point at the heel area connection.
Remedy:
Specific lengthening of the underside tissues so as to allow them to operate and align correctly with the foot body as the toes dorsiflex. Restore normal ROM allowing the toes to flex without causing excess tension under the foot. Re-balance and strengthen foot.

Backstory:
At the PT last week she diagnosed PF in my left heel. She tested my calf ROM and my left had more flex than my right (which I knew). She was obviously looking for a tight calf. She taped my foot, applied ultrasound, lent me some foot mini-wobble boards, etc and said no running or walking (swim bike only) & come back in three weeks.

I have one good foot, one bad foot. I am pretty sure I know the causal factors, but what is the mechanical difference between my feet? That I found out.

1. I clamped my right foot with this massage tool I made a while back . Flexed my toes all the way back, and felt some "good" pressure. I clamped my left foot, pulled my toes back and I hit the roof! Classic tissue in distress. Went to work using my jig to loosen things up. A good hour working on it. The key here is under no-load, the top of the foot must be supported when you pressure in the bottom. Big difference.

2. I always kneel using my right knee down, right foot flexed. This weekend I tried the opposite while changing out some snow tires = almost impossible!. My left foot toes would not bend enough to allow me to drop down on that leg. I kept working at that and was able to execute, uncomfortably mind you.

3. I made a small foam EVA bar to put sideways inside my shoe. Hurt like heck initially, but that's good news. Used it all day long, including a few hours cycling. Cycling was curious because the bar engaged my arch more heavily than I expected during climbs or when pushing it. Repeated heavy and static loading of the foot is the reason for dysfunction.

4. My heel pain is gone, but I am certainly not expecting the tissue back @ the heel to be healed enough to run.

At least until tomorrow :)

Training Tweets: https://twitter.com/Jagersport_com
FM Sports: http://www.jagersport.com/
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Re: Plantar Faciitis - my Notes on runner's heel pain [SharkFM] [ In reply to ]
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I have been fighting this for a year. My left heal is killing me. I think my issue was small bike shoes pushing my toes together along with wrong running shoes. I am working on spreading my toes often throughout the day. I roll a small studded ball under my foot while spreading my toes as wide as I can and when I feel the joints crack (usually one, two if I am real lucky) I get relief. I am interested in your fix. Possibly a picture of the piece you made?

Gwen Jorgensen has a video on Facebook where she explains her foot workouts to keep them strong.
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Re: Plantar Faciitis - my Notes on runner's heel pain [timr] [ In reply to ]
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I tried a lot of things, and was visiting the grandparents when I came across the HoMedics Shiatsu Select Foot Massager with Heat....in 2 days I felt like I was cured. I know it sounds crazy but the combination of spinning metal balls and heat pushed so much blood to my feet. I got home and ordered the thing, within 2 weeks I was pain free. I had been suffering for about 6 months. Give it a try you can get at Walmart etc and if it doesn’t work for you return it.
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Re: Plantar Faciitis - my Notes on runner's heel pain [EnderWiggan] [ In reply to ]
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I just looked this up. $40.00 sounds like a good price to try it. I am not sure my heal can take any pressure on it from a hard ball but I will do what you suggested and if it doesn't work I will return it. Thanks for posting about this.
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Re: Plantar Faciitis - my Notes on runner's heel pain [SharkFM] [ In reply to ]
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I agree with a lot of this. Mine was caused by cycling shoes too small, which caused me to cramp up the toes, like somebody else said. And then oddly enough, a small amount of running where the toes can be spread out seemed to actually make it better the next day. But the key is no hills because that works the calves too much and tightens things up again. And also tons of arch support while healing, especially while running and biking.

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Re: Plantar Faciitis - my Notes on runner's heel pain [timr] [ In reply to ]
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What’s great is you can put as much pressure as you’d like. Start with just resting your feet on it, and slowly build...

Best money I spent all year. I really hope it works for you.

Ps. I also recommend the night sock, it felt like it was doing nothing for me but it really helped in the long term.

timr wrote:
I just looked this up. $40.00 sounds like a good price to try it. I am not sure my heal can take any pressure on it from a hard ball but I will do what you suggested and if it doesn't work I will return it. Thanks for posting about this.
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Re: Plantar Faciitis - my Notes on runner's heel pain [SharkFM] [ In reply to ]
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Try this treatment. I have had PF for over 12 years. This has worked better for me then surgery, stretching and even orthotics. Best of all you can do it yourself for free. https://www.youtube.com/watch?v=GQhtavGoL6A
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Re: Plantar Faciitis - my Notes on runner's heel pain [timr] [ In reply to ]
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timr wrote:
I just looked this up. $40.00 sounds like a good price to try it. I am not sure my heal can take any pressure on it from a hard ball but I will do what you suggested and if it doesn't work I will return it. Thanks for posting about this.

I think in general everything is a bit too mild. The tissue under the foot is really strong and tough. The bone structure of the foot is supposed to have a nice curve there and ratcheting the linkage that comes off the big toe will pull it down into a weaker position - and in my case I had that pain long before my heel gave it up.

So imo the biggest bang for the FRT buck is to support the top side of the foot and pull the bottom in while flexing the toe back. I was working more to the Mid and front area of the foot. Just grinding. Oddly enough I felt no heel pain doing this. And I thought my heel would be toast the next morning - it was not at all. It felt way better. I had no morning pain today.

The biggest culprit seems to be the big toe and its connective tissue. It's because we really drive off the big toe. At least that is what I did with this leg.

Heat is good, massage is good too. But again the tissues are so strong I doubt there is much profound change going on there.

Training Tweets: https://twitter.com/Jagersport_com
FM Sports: http://www.jagersport.com/
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Re: Plantar Faciitis - my Notes on runner's heel pain [mvswim] [ In reply to ]
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I forgot about this, I used a wrench and some moisturizer and did three times a week for the 3rd and 4th month. It’s painful but I felt like it was working.

mvswim wrote:
Try this treatment. I have had PF for over 12 years. This has worked better for me then surgery, stretching and even orthotics. Best of all you can do it yourself for free. https://www.youtube.com/watch?v=GQhtavGoL6A
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Re: Plantar Faciitis - my Notes on runner's heel pain [mvswim] [ In reply to ]
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I really can't thank you enough. I have tried a lot of stuff including expensive laser therapy. I woke up with no heal pain this morning. Lastnight, 5 minutes into this video I had to grab a wrench and some coconut oil and then finish watching. 3 lumps on my heal, 2 went away after building into hard pressure. The 3rd was tougher and 20 minutes, maybe longer, I got it smooth. I couldn't get the 'speed bump" across my calf though. It's about 3-4 inches up off my heal. I will keep working it. Definitely some smaller bumps here and there on both feet but WOW, THIS WORKED AMAZING. Thank you for posting that video!!
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Re: Plantar Faciitis - my Notes on runner's heel pain [timr] [ In reply to ]
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I'm a real fan of mechanical intervention - methods that disrupt, lengthen, increase circulation by invoking a healing response. I told my running buddy with a bad big toe he needs to have a small car drive over it (just kidding) but you get the idea.

Speaking of which I was out at the track last night 2 weeks ahead of schedule. It was more for discovery.

How much flex do you have in your foot? I really noticed the difference:

Right : Toes flat, almost 90 deg
Left : " ", about 70 deg

Big difference. And that little rope that runs off the big toe. I believe it is correct to run through your big toe line, into the leg. If the foot can't flex properly that line is distorted, the power shifting or rolling towards the outside of the foot.

I've made a noticeable improvement in my left side function, but heck have a lot more to do before I ramp things up again.

Training Tweets: https://twitter.com/Jagersport_com
FM Sports: http://www.jagersport.com/
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Re: Plantar Faciitis - my Notes on runner's heel pain [SharkFM] [ In reply to ]
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Both my feet have equal flexibility in the toes. I can bend them back almost 90 degrees with no pain. I don't know what my issue is but I think I have been over scraping. My left heal is very sore now.
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Re: Plantar Faciitis - my Notes on runner's heel pain [timr] [ In reply to ]
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I have not tried the scraping yet. Might give that a go tonite.

Weather is really nice I couldn't resist. Rode the bike to the track and ran 2km warm up. Then decided to do slow intervals 400M. Well last one was a good pace in my flats.

Well this morning I had the sore heel again :(. It's too early for me that tissue needs more time to heal, despite the slight improvement in foot function.

On scraping. My Achilles I had everything done - ultrasound and scraping. etc. This was over a year. Scraping is a bit like an IMS (needles). It imparts damage to break-up scarring, increasing blood flow and healing response. I guess it worked.

I got the clearance to go (with the Achilles) and it was far from perfect - I had to grind through running on it and it got stronger as did my throttled ankle, as I went along.

Training Tweets: https://twitter.com/Jagersport_com
FM Sports: http://www.jagersport.com/
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Re: Plantar Faciitis - my Notes on runner's heel pain [SharkFM] [ In reply to ]
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Finally going to MD tomorrow for mine. Started last August. Was able run 40-50 mph along with biking and swimming through the discomfort, but really flared up last week. Shut running down for 6 days. Tried this am and hobbled through 3 mi before I said enough is enough.
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Re: Plantar Faciitis - my Notes on runner's heel pain [SharkFM] [ In reply to ]
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Oh man you’re running in flats?! Yikes man I would really suggest going to a high heel drop shoe like 10mm, this will take pressure off your Achilles and fascia. Also no high speed running, puts way more pressure on the fascia. The trick for me was running enough but not so much to re-injure it because then you’re back at ground zero. I caveat all of that with it’s my n1 and lots of reading.

SharkFM wrote:
I have not tried the scraping yet. Might give that a go tonite.

Weather is really nice I couldn't resist. Rode the bike to the track and ran 2km warm up. Then decided to do slow intervals 400M. Well last one was a good pace in my flats.

Well this morning I had the sore heel again :(. It's too early for me that tissue needs more time to heal, despite the slight improvement in foot function.

On scraping. My Achilles I had everything done - ultrasound and scraping. etc. This was over a year. Scraping is a bit like an IMS (needles). It imparts damage to break-up scarring, increasing blood flow and healing response. I guess it worked.

I got the clearance to go (with the Achilles) and it was far from perfect - I had to grind through running on it and it got stronger as did my throttled ankle, as I went along.
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Re: Plantar Faciitis - my Notes on runner's heel pain [SharkFM] [ In reply to ]
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I highly recommend following that video posted above. I still have one small bump in my left heal but I will keep working it. Just grab a clean, non rusty, wrench around 3/4" to 1" size and pull smooth and easy, light pressure, across your Arch and every direction across your heal. See if you feel any bumps and try to work them out. My right foot is as smooth as can be but my left foot, where the pain is, had several heal bumps. Now only one is left and it is only about 5-10% annoying where I was laying in bed stretching my feet and toes before even touching the morning floor and still hobbling out of bed. I think the light pain I feel now may be because I am working into a very deep hard scrape to try and get that last piece broken apart or it's ghost pain because I have dealt with it so long. Either way it's way better and I highly recommend it.

I also switched from zero drop to Hoka Clifton 4 and I believe that is why I have been able to run through it this long.
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Re: Plantar Faciitis - my Notes on runner's heel pain [timr] [ In reply to ]
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I might suggest scraping before sleep and also wearing the sock at night.p BTW the foot massager thing works well on working those bumps.
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Re: Plantar Faciitis - my Notes on runner's heel pain [timr] [ In reply to ]
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The wrench is money! It's certainly the best starting point.

I grabbed 17mm I had in the toolbox here, some skin creme and went to it last night after a gym workout. You can use the round end as well to duplicate the pressure I was getting with my massage pliers.

Just like the kid said I have really grainy feel under there, and was able to target trouble spots.

Inside heel /ankle was sensitive. Apparently blood flow can be shut off due to tension is this area, starving the PF @ the heel. Outside heel was no picnic either.

Going to try it on the calf soon.

Training Tweets: https://twitter.com/Jagersport_com
FM Sports: http://www.jagersport.com/
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Re: Plantar Faciitis - my Notes on runner's heel pain [SharkFM] [ In reply to ]
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Update: As it healed etc. I found the PF was caused more by the outside of my ankle and calf, along the same line as the IT band. So worked pretty hard at that chain and also into the hamstring.

My heel really started to feel like it was loosening off and recovering.

The PT put me on heel drops, which I found I was not doing correctly. She wanted a rapid drop to full range.

I still have some pain but in a good way, and I'm back to running at a good pace again. In fact better than ever as both legs are functioning much closer to symmetrical.

Training Tweets: https://twitter.com/Jagersport_com
FM Sports: http://www.jagersport.com/
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Re: Plantar Faciitis - my Notes on runner's heel pain [mvswim] [ In reply to ]
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mvswim wrote:
Try this treatment. I have had PF for over 12 years. This has worked better for me then surgery, stretching and even orthotics. Best of all you can do it yourself for free. https://www.youtube.com/watch?v=GQhtavGoL6A

Isn't this effectively a DIY version of Graston therapy?
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Re: Plantar Faciitis - my Notes on runner's heel pain [EnderWiggan] [ In reply to ]
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Came across this post and bought one of these as a result for my wife (and me):

https://www.amazon.com/...00?ie=UTF8&psc=1

Gotta say, it's pretty impressive. Not as direct as working with a hard ball or the "melt method" but it sort of forces you to relax and let it do it's thing.
Pretty phenomenal for $40 or so.
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Re: Plantar Faciitis - my Notes on runner's heel pain [sjn] [ In reply to ]
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I guess it is. It works so I use it.
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Re: Plantar Faciitis - my Notes on runner's heel pain [EnderWiggan] [ In reply to ]
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EnderWiggan wrote:
I forgot about this, I used a wrench and some moisturizer and did three times a week for the 3rd and 4th month. It’s painful but I felt like it was working.

mvswim wrote:
Try this treatment. I have had PF for over 12 years. This has worked better for me then surgery, stretching and even orthotics. Best of all you can do it yourself for free. https://www.youtube.com/watch?v=GQhtavGoL6A
This gua sha was a big part of my recovery from PF as well. It helped me get healthy enough to be able to run with orthotics, and the continued treatment gave me a full recovery even though the symptoms were really bad for about a year (30min run = 3 days of limping...)
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Re: Plantar Faciitis - my Notes on runner's heel pain [SharkFM] [ In reply to ]
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Physical therapist here. Your observations are spot on. If there is lack of mobility in the ankle/foot, you're going to compensate elsewhere- in this case your plantar fascia.

There is also good evidence to support that glute max/med strengthening is effective in treating plantar fasciitis. I would incorporate some hip stability/strengthening exercises if you haven't already done so.

Also, ultrasound for treating plantar fasciitis is total BS. There is 0 evidence to support this. Some private practices still use this because insurance companies reimburse it on occasion.
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