The signs and symptoms of plantar fasciitis (plan-tur fashee-EYE-tiss) started out mild for me. About 10 weeks into marathon training, my feet started feeling sore after a run. I could run and walk fine, but a couple of hours after a workout they would feel sore in the arches. With rest they’d improve, but it would come back again after a run. Over a few days, the soreness progressed to a mild burning sensation that got worse the longer I stayed on my feet. Eventually after a week or so, I felt the heel pain most commonly associated with plantar fasciitis (PF). Upon waking in the morning, the inner corner of my heel, just below the ankle, felt sore when I walked. It looked like my chances of running the marathon in another 10 weeks were doomed. Continuing to run through PF can cause the plantar fascia to rupture painfully, requiring the wearing of a boot cast for up to six weeks and in some extreme cases, surgery. The good news is I was able to develop a successful treatment plan and after a couple weeks of cross-training, I was able to get back to running and go on to complete my first marathon in 4:02:39 without any PF pain during or after the race.
Please note that I am not a medical professional. I simply share my experience in the hope that it can help another person bounce back from PF. The other thing I want to make clear is that PF is a tricky injury to treat and it can take some experimentation to figure out what works. What worked for me might not work for you. You need to figure out both what the cause of your PF was (more on that in a minute) and which treatments help you.
For immediate pain relief:
1. Ice. Use an ice pack (frozen peas or corn works well because the packet molds to the foot) with a thin towel to protect the skin, and ice the foot for 15 minutes at a time a few times a day as needed. Just be careful and make sure to warm up the foot again and then do a gentle stretch of the foot (grabbing the toes and gently drawing them back toward you) before walking again. You can also freeze a plastic water bottle in the freezer (leaving room at the top for the ice to expand) and roll your foot on the frozen bottle. That does the double duty of icing and massaging at the same time.
2. Anti-inflammatory medications. There is debate about whether PF involves any inflammation at all (the pain stems from micro-tears in the connective tissue that runs from the heel to the toes) but there’s no doubt that nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen help relieve the pain of PF. Personally I don’t think drugs like Advil treat the PF, they just mask the pain. That’s fine if you’re in a lot of pain but I quickly decided the meds were not necessary.
For further injury prevention:
3. Determine what caused your PF and take steps to mitigate further damage. For some people the key to what caused their PF is clear. It can come on from being overweight or from repetitive strain due to running or other athletic pursuits. Think about what recently changed for you. Have you added something new to your workouts? (For me the culprit was tight calves from running and the introduction of training on the indoor spinning bike. Standing up on the pedals repeatedly stretched and strained the ligament that runs under the foot.) Has it been too long since you bought new athletic shoes?
4. Switch to cross-training. If you want to stay active to lose weight or continue a running training plan without actually running, consider cross-training activities such as cycling, swimming, and aqua-jogging. I found that while spinning on an indoor bike aggravated my feet, I could cycle on my road bike without problems.
To treat the PF:
5. Do stretches for the feet and calves. Before you get out of bed in the morning (and a few other times throughout the day), do a toe stretch by gently pulling back on your toes. Perform a towel stretch by looping a bath towel under the ball of your foot and gently pulling the towel ends back toward you. For the ball stretch, roll a tennis or golf ball under your foot for up to half an hour a day (I know that sounds like a lot but it’s what’s billed as a “magic cure” for PF in Running Doc’s Guide to Healthy Running: How to Fix Injuries, Stay Active, and Run Pain-Free). Most important for the treatment of PF and prevention of it in the first place (in my opinion), are calf stretches. I don’t mean just stretching your calves after you run. This is so important I’m going to say it in bold: You need to do calf stretches several times a day throughout the day. First do the gastroc stretch, which involves leaning into a wall with your arms outstretched and the affected leg straight back behind you with the heel on the floor (the Running Doc says to turn the foot slightly outward). Lean in and feel the stretch in the upper calf. Do that for 20 seconds, then slightly bend the knee of the affected leg to perform the soleus stretch to stretch the lower calf for another 20 seconds. Alternate those stretches several times. One more note on stretches. I saw lots of recommendations for Achilles tendon stretches (standing on the edge of a stair step and lowering the heels, then raising the heels, and repeating). That absolutely aggravated the PF for me. Here’s a video I found on YouTube that demonstrates three appropriate stretches and then explains why that Achilles tendon stretch is inappropriate (he calls it the Negative Heel Stretch):
Gear that helps:
6. Wear a Strassburg sock or other device. The idea behind the Strassburg Sock is that you wear this sock at night while you sleep to stretch the plantar fascia.
Normally while you sleep the plantar fascia contracts and then when you wake up and stand up, the tight plantar fascia lengthens suddenly and that causes pain. I found that wearing the sock prevents that problem, and I do recommend purchasing the sock. It provided immediate relief of the sharp heel pain I had felt in the mornings. For a less expensive option, follow these directions to make your own no-sew plantar fasciitis sock.
7. Use KT Tape Pro. Without a doubt the one thing that allowed me to keep running as I recovered from PF is KT Tape Pro. Please make sure that you buy KT TAPE PRO rather than the older cotton version which does not stay on as long. If I followed the directions to apply the KT Tape Pro properly, it would stay on for 5 or more days (or until I soaked in a bath or went swimming. It stays on during short showers but I found it could not stand a long soak). The pre-cut kinesiology tape strips are expensive and you want to make them last. Many people apply two strips for the PF application (as directed on the package insert) but I went with three as demonstrated in the KT Tape website:
8. Consider orthotic insoles. Many people swear by insoles such as Superfeet Green Premium Insoles or professional orthotics from a podiatrist. Others argue that such insoles are a crutch that does not really fix the problem in the long term. (Personally I think it’s important for a runner like me to be able to get back into running ASAP and then work on the stretches and strengthening exercises and only then consider running in a more minimalist shoe or even barefoot). Because I had success with the Strassburg Sock and the KT Tape Pro, I never bought insoles so I cannot speak to this one way or the other. (Anyone care to comment?)
Another healing and preventative tip:
9. Do strengthening exercises for the plantar fascia ligament. Once you have reduced the pain of PF you can begin doing strengthening exercises. These include drawing the alphabet on the floor with your toes, picking up marbles with your toes, and scrunching up the end of a towel (pulling in the length of the towel toward you with your toes).
I wish you all the best in healing from plantar fasciitis!
What has your experience with plantar fasciitis been? Do you have any tips for recovering from plantar fasciitis?
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