March 15, 2009

Help to Heal Plantar Fasciitis

In 2007, I suffered something fierce from bi-lateral plantar fasciitis and didn't run for six months. Because of my experience, I learned a lot of useful information (albeit a little too late at times). I want to share what I discovered, just in case you or someone you know is in a similar situation. (This entry stars my dogs with cameo appearances from my cat, The Wookiee.)

My healing began when I realized my PF wasn't just an overuse injury from running but was cumulative from standing all day & on concrete floors, lack of arch support in my shoes, walking barefoot, tight calf muscles and genetics. While I'd been plagued with PF before, what made this bout different was that it didn't respond to the usual round of ultrasound, message and physical therapy. My new physical therapist used a wooden knobble to break up the scar tissue in my feet. (Ouch, more please.) She also advised that to run with PF would delay my healing and continue to tear my already inflamed & micro-torn fascia. She implored me to STOP RUNNING—immediately! Initially this was really difficult for me to embrace until I understood WHY: I was re-injuring my feet by running. So like a good patient I followed her advice.

Furthermore when I thought I was helping my feet by using a foot roller, I was instead damaging them BECAUSE I applied too much pressure while ice-rolling. This might seem obvious but in case it isn't I'll spell it out: Do NOT stand on the foot rollers/frozen water bottle when messaging your arches. Instead, be seated (like I am in this video) and gently roll your feet across the surface of the roller/bottle.

To combat my PF, I took a "leave-of absence" from running for six months. That's a long time for a runner. Still I considered my life-long love & relationship with running and I looked upon this hiatus as essential to the bigger picture and my healthy running future. As, I am adamantly against cortisone shots and I avoid using anti-inflammatory pills for more than a week, my plan took a longer purposeful duration.
I treated my PF with a cocktail of remedies: time off from sports (that impact the feet), arch support bands, message, ultrasound,  Futuro Night Splints, icing, gentle stretching, and changes in my behavior. Behavior changes included no walking barefoot for more than a few minutes, wearing arch supports (Powerstep Pinnacle) in my shoes and stretching more regularly. All of these things worked and when I feel a twinge of the PF, I begin this cocktail of remedies.

Trail Pixie's "Feet-back" on orthotics & arch supports:
Despite two different podiatrists fitting me for custom-made orthotics (both soft & hard), what's been best for me were the full-length Powerstep Pinnacle orthotics, which I wear daily. From time to time I also wear Arch Sleeves when the PF aches/flares up. Added benefit: doubles as a cat toy.

Trail Pixie's thoughts on the "oh-so sexy" night splints:

I HIGHLY recommend the Futuro Night Splint (or one of similar design). I am modeling my well-loved pair in the photo. Initially I tried the FootSmart Passive Night Splint. It was too hot and interfered with comfortable sleeping. I also developed achy knees from wearing it (!) so I found the shorter, more comfortable and less hot (but still "sexy") AirForm Night Splint. I do NOT recommend the Strassburg Sock and any contraption it resembles because I believe it stretches the wrong area (the toes) versus gently holds the fascia in a passive position preventing it from tightening up overnight.

Trail Pixie endorses all foot rollers pictured here:
Winner: the frozen water bottle! (Go green runner/re-cycler/re-user & the thrifty);
Runner Up: the black & white wheeled wonder. (Hits all the right spots without the chill.);
Sweep: the wooden roller (Textured for that special something.).


Unknown said...

This was so informative...I wear orthotics for a metatarsal fracture..I need new ones though and reading this blog made me realize I can't mess around with my feet...they are so very good to me and I must love them back : ) so I will make an appointment Monday to get new ones : )

What shoes haave worked for you? Salomon have been a staple for me but lately my toes have suffered some pain...thinking of trying something new

Trail Pixie Trespas said...

Hi Trailgrrl! I am glad this posting was helpful. Everybody's feet are different so what works me might not work for you too. For trail running I wear the Vasque Velocity W or B width shoes (W is better) and for the roads I wear the Brooks Adrenaline GTS, always Wide width. I have normal arches but tight fascia bands. It doesn't help that I have "skinny" feet that lack fat pads for cushioning. I seek shoes with some forefront cushioning and arch support. Before buying and while trying shoes, I take out the shoe's factory insert and stand on it; if my foot overlaps it I find the shoe too narrow. I will also bend the shoe and if it is very soft/pliable &/or bends at the arch, I put it back in the box. If the shoe bends slightly at the point where my foot would naturally flex near the forefoot and I can put my one orthotic into the shoe for added arch support, I consider a purchase. Too stiff of a shoes might cause achilles problems. Also I wear my orthos in nearly ever shoe I have, even my slippers.

GJS said...

I had been suffering from PF for a few months from playing tennis too much. Then I got tennis elbow and I stopped playing about 8 weeks ago. My PF was pretty much gone until this week when I decided to start using the treadmill at the gym! I, too, do not use anti-inflammatories or cortisione. Personally, I think they are a crutch and only mask the problem giving the sufferer a false sense of healing. I'll have to try those night splints. I am also trying a supplement called Liga-Tend so I'm hoping this gives me some relief from both of my tendon issues! I have been in PT for 6 weeks for the elbow and I'm not seeing any results except for some muscle tone in my shoulders and upper back!
Were your orthotics from your podiatrist? Do you really feel they are helpful? When I was really having trouble a few months ago I found a taping method that helped soooo much! Also, I like your reminder about not going barefoot. I live in Arizona and I wear sandals daily and go barefoot all day long. I'll have to keep this in mind!

Trail Pixie Trespas said...

GJS, You are wise to take time to heal so you can play again. I have orthotics were from my podiatrist but they didn't work as well, nor feel as supportive, as the PowerStep Pinnacle I use in all of my shoes (except for my great Dansko clogs and Mephisto sandals that have excellent arch support). Where did you find the taping method, I have seen others tape and would live a refresher. Enjoy AZ!

GJS said...

I have a pair of Earth sandals and Dansko's but I've grown to love my Earth shoes more. Go figure! Here's a link to the taping method that I found helpful:

Hope this helps!

Unknown said...

I was just diagnosed with PF two days ago and they gave me a cortisonze shot in my right heel. My left heel feels the tingle too but not as bad. They taped me. Here are two URLs with the tape method and
The shot did not work and today I'm in the removable boot. Tomorrow is the MRI to looks for a fracture. I have no idea what I did or how I got this. I'm not overweight, don't stand a lot, don't play sports, although I have been a tap dancer the past 2 yrs. and do not want to give that up. I didn't realize arch supports were so important. I've been doing the rolling on the ice bottle too. Even tried the muscle stimulator electrode zapping last night from my husband's knee replacement therapy. Seems to me that "stretching would make this PF worse" so how does stretching, doing the exercises, etc. relieve the PF when doing the dancing or sports iritates it? I'm confused the doctor is not helpful rushing me through their process with no answers.

Dan said...

I walked/jogged on pavement two days in a row and my PF flared up again. Time to break out the roller and sexy splint again!

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