I’ve had this heel and achilles problem for 8 months. I’ve now been to a physiotherapist who diagnosed it to be heel spur due to plantar fasciitis. So now I’m getting shockwave therapy of 2500 ‘shots’ to my heel once a week for 3-5 weeks.
This seems to be working.
Problem is what to do to avoid it returning? My physiotherapist seems more interested in discussing triathlon races than what I need to be doing to prevent it form returning. I doubt he is the expert in this field. He has his office nearby, and due to health scheme over here with long waiting lists, I’m not switching to another physiotherapist.
The race season starts in 6 months time. So what should i do to prevent it from returning? Any success stories? Any good videos on youtube, or any recommended websites?
Go see a podiatrist who specializes in runners. Your local running club should be able to point you in the right direction. I had text book case of PF for a while and nothing I did on my own was working. Doc prescribed custom orthotics and it made a huge difference, almost immediately. To look at them you would never thing you could run in them but I won’t run a step without them. They made that big of a difference. No experience with a heal spur though.
I don’t understand your logic. The program is working but you think he’s not good? Assuming he’s given you stretches/exercises for the area you should just incorporate these into regular sessions to prevent repeat. If the exercises become easy then you’ll need more advanced ones, but you may get these from the physio as he sees you responding to the current set.
With regards to my specific experiences:
I had it for most of 2012 and spend the end of 2012 and beginning of 2013 in physio: shock treatments, icing, heating, stretches, strengthening around the area, etc. For this season I managed to train with no PF issues although it came back after my last race of the season. So annoying! Not quite as bad this time, but I put it down to not focusing on injury prevention during my peak training and the lead up to it.
I had good success with the following:
Stretch the foot by putting your toes against a wall, or stretching them with my hands
Lots of exercises for the feet (scrunching a towel with your toes, or performing the same action)
Lots of balancing exercises (e.g. single leg squats on a BOSU ball)
Rolling the bottom of the foot with a wooden ball (varying the size of the ball), followed by rolling on a frozen water bottle, stretch and then heat.
I’m back doing this at least once daily and it’s getting better again. The more love you can give it the better. I try to stretch the calves 3 times daily and sometimes scrunch my feet within my shoes at various points throughout the day. I’m sure there are more scientific advice you can get from people in the know but I’ve accumulated these exercises from physios.
Consider differnt shoes or at least rotating though several different shoes
Don’t assume you need more cushioning in your shoes. Dropping offset and going from a stability to neutral shoes has had no impact in my PF. If anything it’s the opposite since my economy and foot strike is improved. You do im fact learn to run softer/smoother with less heel cushioning.
Run more frequently to achieve the same mpw.
+1 on lots of stretching.
consider adding in some short hill sprints to increase leg strength and improve form.
add in running drills if you don’t do them now. Skipping, strides, hopping.
I’ve treated scores of athletes with chronic PF (better called plantar fasciosis) and agree with the advice given by dado0583. It’s essential to restore tissue flexibility.
You likely have built-up scar tissue that needs to be removed by white blood cells. This requires bruising it back to the inflammatory state (fasciitis).
An old-fashion rolling pin can substitute for a wooden ball. Roll out (crunch) any tissue that “pops” on the bottom of your foot. Do this at 10/10 pain level for 1-2 minutes a day on a regular basis until the pain and popping resolve. No pain, no gain.
What Pedalhead suggested - scar tissue repair via its breakdown during skillful manual therapy that inflames tissue - is one of the key points most PF sufferers do not comprehend. It is a painful secret (pun intended) by virtue of being an extremely painful therapy and by being counterintuitive process (deliberately aggravating pain and discomfort instead of pursuing seemingly quickest path to being pain-free).
Smart PT will not start planning “return to performance” protocol with the patient until it is clear that both PF manifestations (heel pain, etc.) and its underlying reasons (limited flexibility of the posterior chain, bad choices of running and work shoes, etc.) are fixed. Individual physiology, age, lifestyle, PT experience and modalities used, etc. will dictate re-generation process and its duration. Some are lucky to heal in 1-2 months, some end up taking alternative endurance sports for couple years…
My Experience below for what it’s worth … this process has also helped a lot of athletes since.
One thing nobody discussed is ? Find the SOURCE of the PF … all the treatment in the world won’t help it go away for good if you haven’t eliminated the cause. I eliminated the cause, haven;t had a sniff of it since!
How long ago did you have the platelet therapy done? What other kind of therapy did you do in the past? Shots/inserts/PT?
I had cortisone shots about 6mo. ago and changed shoes. Seems to be working for now. My Dr. and I discussed platelet therapy as a next option.
It was my back. I had YEARS of chiro, art, massage, 1 cortisone shot before a pro mountain biker told me to go see a Prolo Doc locally. After 2 platelet treatments, it’s fixed. Proloaustin.
Thanks for all the replies. There’s a lot here to incorporate in my daily routine.
I’m in the middle of the shock wave treatment. Once that’s finished in a few weeks, then I guess I’m on my own.
A question about the frozen bottle and tissue crunching exercises: Is one supposed to do these even though there is no longer any pain in the heel? The reason I’m asking is because the treatment I’m going through seems to be fixing the current problem. What I need are things to do to prevent if from returning.
Yeah, I’m middle aged, 6-7 kilos above ideal ‘Kona weight’, and have done a bit too much uphill running the last couple of years. Guess I’m a textbook case.
I tried just about everything and suffered for almost two years. I finally took someone suggestion and got custom orthodics. It was about $400 but the plantar fasciitis has now been gone for over a year.
Like others here say, it’s worth looking at form to eliminate heel strike. Running injuries seem to vary person-to-person, but the relationship between form and PF is common. My experience is, I had PF in 2011 and immediately did all of the standard stuff (with minimal results). Runners at my local tri store pointed me to shoes that minimize heel strike as both street shoes and running shoes. In part because the shoes made it easy, I changed my stride so I now have a standard strike on the ball of my foot. I’m now at 35 mpw, and a happy guy.
It took me a while to kick my PF, but I find doing heel and toe walking drills (tippy toes and heel walk) has helped me stave it off. Even just while walking around the house barefoot.
I’ve had PF since June or July. It was limiting my running to 1-3x a week depending on how I was feeling. I was going to a sports foot doc for therapy and he was suggesting a few different uncovered procedures to take care of the problem. I decided I didn’t want to go that route and I would just ride it out. About a month ago I went for a run and noticed how badly I strike my heel. I shortened my stride and basically ran on my toes for the next 45 minutes. The pain in my calves from that run was instant, it felt like I had just run a marathon. The next few days as my calves returned to normal I read up on form and stride length and came to the realization I was severely over-striding and with each stride my heel would slam the ground. The past 3 weeks I’ve logged 6 days of running each week following the BarryP base building plan and I feel my PF going away. No ice, no extra stretching, just paying attention to keeping my feet under my body, which naturally reduces the load of stress being put on my heels.
I’ve had this heel and achilles problem for 8 months. I’ve now been to a physiotherapist who diagnosed it to be heel spur due to plantar fasciitis. So now I’m getting shockwave therapy of 2500 ‘shots’ to my heel once a week for 3-5 weeks.
This seems to be working.
Problem is what to do to avoid it returning? My physiotherapist seems more interested in discussing triathlon races than what I need to be doing to prevent it form returning. I doubt he is the expert in this field. He has his office nearby, and due to health scheme over here with long waiting lists, I’m not switching to another physiotherapist.
The race season starts in 6 months time. So what should i do to prevent it from returning? Any success stories? Any good videos on youtube, or any recommended websites?
Just my experience here…I fought PF for 2 years! I stopped running completely for 6 months. It did not get any better at all during that time, so I figured, screw it, I’ll run and see what happens. I started out with 1/2 mile runs and gradually worked my way up to 40 miles per week over 18 months. The pain was not getting worse, so I just kept increasing mileage slowly. Then one day I woke up and the pain was gone completely. It was like somebody flipped a switch. One day pain, the next day gone. Poof… Strange. Has not returned and it has been 6 years. I saw a couple of podiatrists and physical therapists while I was having pain. During that 2 year period I tried orthotics, stretches, night splints, foot taping, massage, shoe heel lifts, you name it. Nothing seemed to work. It just went away one day and never came back.