Let me apologize in advance for posting yet another PF question, but I am starting to lose my mind. I developed this in my left foot 2 years ago, and recently have developed it in my right. I have tried icing, the TM ball, not walking around barefoot, stretching, Advil and the occasional night boot, but I can’t seem to make it go away for any length of time. A few hours after I run, the pain will start, and will last for a few days, only to restart after my next run.
Here’s my question. I am planning on doing IM Brazil, but don’t know if I can tolerate this much longer. Does anyone have a “sure thing” that they have used, or heard others using, that had great results? I am heavier athlete which I know is part of the problem, but I have a hard believing that this is something I just have to live with. This is the first “injury” that has made me consider giving up the sport.
I had PF for 3 years and tried all you have listed - then I had ESWT - (shock wave therapy_ if I had listened to my doc I would have been fine but went back to training too early) - it then came back and so we did a partial release on my PF - this worked and now pain free but take preventative measures every day.
The last step if the release did not work - was to severe the nerve!!!
Not sure if this helps but I understand your frustration having lived there.
A doctor friend of mine recently published his research on plantar fasciitis. Topline results:
98% of his patients recovered within 3 months to normal activity after doing the “stair stretch” on the inflamed foot for 3 minutes (continuously) 3 times a day. Worked for me. Hopefully you aren’t part of the 2%.
Thanks for the replies. I just did my first set of stair stretches…keeping my fingers crossed. The 2 things I want to avoid is surgery and having to give up racing. Also, does anyone know if continuing to run while still with PF causes long term damage? If not, I may just suck up the pain, finish IM Brazil, and retire my running shoes.
Here is a link to a site that has an injury prevention guide for this. Notice a couple of things. In the pictures all exercises and stretches the subjects are all barefoot. Read the last line of the injury prevention guide. It says to run barefoot on the grass for a mile or two.
Use the night boot consistently…I had this recurring problem until I just kept sleeping in the boot after it was gone…I slept in the boot for 6 months and finally don’t have this problem…I’d wear it until IM Brazil if I were you. And keep icing…put your foot in a bucket of icewater for 30 min a night.
It is good to get everyones anecdotal experience (even the reply with the ESWT and plantar fascia release). I treat about 75 patients per week with PF. It is very common. Luckily, it almost always resolves with what you have been doing and have just read. There have been almost 200 studies over the past 40 years showing this. However, in each of these studies, a small subset (about 2-5%) it just does not respond no matter what even after 1-3 years. I hope you are not one.
But, look on the bright side as the odds are on your side! There is NO “sure thing” though. I especially liked the comment by some STer who claimed he “cured” his plantar fasciitis by running barefoot in grass for 30 SECONDS. Cool.
If you have a night splint - wear it. The controversy about not going barefoot: right now, don’t. I’m also an advocate of fixing one’s one mechanics and strengthening the foot/lower leg. I love barefoot running, but during an acute inflammatory stage it is not a very good idea (you will find out pretty quick if you try it). Also, don’t beat yourself up over your weight - yes loose it, but PF is an equal opportunity affliction. I see in in young, old, thin, obese, sedentary and active, high arch and flatfoot. Each person likes to blame what they do (stand on concrete all day, oveweight, worse bad shoes 20 years ago, etc.). What links all these people together is generally some sort of gastrosoleus equinus (tight posterior muscle group(s)) causing the chronic fibrosis (a more correct term). Most true, acute cases of plantar fasciitis (truly just inflamed) from a quick overuse or trauma responds very quickly and is easy to rid oneself of. Chronic cases are another story as you are unfortunately finding out.
I’ve recently licked PF, and while strethcing, strengthening, and all the rest were vital to more recovery, anti-inflamatories were what made it possible.
PF is related to tight calves. Tight calves are related to tight hamstrings. Tight hamstrings are related to weak core muscles. (The muscles along the back of your leg are holding your torso up, doing the work of your abdominals). SO no matter how much I stretched my calves and hamstrings, they went right back to being tight because they were doing work they’re not supposed to do. Only when I focused on strengthening my core and improving my posture was I able to relieve those muscles of the additional work and start to develop their length.
That helped me remove the CAUSE, but it still didn’t remove the PF. Problem is, inflamed tissue tends to re-injure. That’s why cortizone shots work – they reduce the inflamation and give the tissue a chance to heal. But only if you remove the cause.
As I developed my core strength and postural muscles, I started on a regimen of way more ibuprophen than is directed on the bottle. Gradually, as the pain subsided, I reduced the dosage. I kept my pain level constant while reducing the dosage, until I was pain free with no Ibu. Now I’m starting to run again, finally!
Last: New shoes. NOT cushy shoes. Firm shoes will help prevent your heel from “dipping” too low and putting excess strain on your achilles tendon and fascia. Running shoe companies make their shoes nice and cushy because it feels good in the store, but trust me, that’s NOT what you need.
Thanks for all the advice. I guess I just need to be more diligent in the daily grind of taking care of this. I admit that up until now my rehab, although exhaustive in methods, was lacking in consistency.
I like the stretching and the core muscle strengthening. I like the firm shoes.
But despite the use of “itis” - many people think that PF results from micro-trauma/tears is the fascia. The inflammation comes second. Blocking inflammation with NSAIDS (which by the way are very weak anti-inflammatories and you need to take pretty high doses for a while to get even that) may not be beneficial. There is the concern that prostaglandins play a role in soft tissue and bone healing (NSAIDS block prostaglandins…) but I doubt it really matters (but it is an interesting aside). Steroid injections are a great way to fight inflammation but again you aren’t addressing the underlying problem. Then there is the very real risk of rupturing your plantar fascia after steroid injection…Plus high dose NSAIDS carries some risks.
When you talk about the “night boot” have you looked into the Strassburg sock? http://www.thesock.com/ ? It’s pretty effective.
Bottom line, PF is an inflammation problem directly related to YOUR mechanics. Go to a good PT or Sports Med Doctor for a proper evaluation. Individual accounts on this forum may help to compare “Pain stories” but won’t help you. If you want to race Brazil find out what’s causing YOUR pain.
-HWM www.slopesports.com
I am just now recovering from a 1 year bout with PF. It is starting to feel very good. One thing I discovered very recently with a visit to a Physical Therapist for a neck issue is that my calves are VERY weak. I could only do 15 calf raises (one leg at a time) on each side. That shocked me. Maybe it was part of the issue. Anyway, try it and see what you get. My PT says that I should have gotten 27-30 easily. I am working strength now.
The night splint was golden for me. I got quite a bit of relief from it. Also, when I started running again, I taped my foot. Helped quite a bit. I also took ibuprophen (800mg 3Xday) for about 2 weeks to kick start my running.
Now, 9-10 miles is no problem. I have not tried any hard hill runs or track intervals yet. Probably won’t for some time (maybe never). Even with much reduced run volume, my fitness was not too far off. COmes back quickly.
If you’ve been dealing with it for 2 YEARS and have EXHAUSTED conservative treatment and continue to have debilitating problems that may prevent doing an IM…then…surgery (oh my g#d!) “may” be an option…or you can continue to suffer…surgery is not without risk including nerve injury and developing more of a flat arch, but, is an option…get it done by a orthopedic surgeon who specializes in foot and ankle surgery or a podiatrist, either who does alot of these releases…(I hope not too may STers go ballistic for even contemplating surgery!)
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I have posted this before so here it is again - and it works for a lot of people. My unlicensed practice has cured at least 10 people this year while completing marathons.
All of the posts contain sound advice but here are two items not mentioned: 1) PF, if it gets cranked up, can take from a couple to 18 months to heal. It will go away during that period of time even if you do nothing. Mine was around for about a year and I did almost everything mentioned in the posts. That’s the bad news – here comes the good news. 2) There is a way to tape your foot that really helps some people. I ran 2 marathons with my foot taped. Couldn’t get out of bed in the morning without limping but I ran all I wanted. You need a disposable underwrap and 1.5 inch Zonus tape. I really need to post a pic but the basic move is put the underwrap around the middle of your foot to protect the skin and then circle it twice with the Zonus. Then make a horseshoe strap with the tape starting from the tape on the middle of your foot (on the side) around the heel to the other side twice. Then anchor it down by going around the middle of the foot again. You need Zonus b/c it won’t let go when it gets wet. I also taped both feet because the taping is obviously reducing the pronation in your foot to some degree and I decided to stay balanced. That may or may not be smart but its what I did. And, b/c you are messing with your foot strike you need to listen to your body. Finally, tighter is not better. Just get it sort of snug. If that description made no sense I will try again.