Plantar Fasciitis - Yuk!

I'd heard of it.  I sure couldn't spell it.  Before I got it, I figured anyone who whined about their foot being sore was a wuss... but this injury sidelined me for the better part of 9 months.

It started slowly.  I can't place exactly when my left foot started to hurt.  I had completed a few long runs in a couple of weeks (a 180K, a 50K, a 10K and a 67K) and for a few days before the 67K (STORMY), I started to really notice it.  Since it  really started to bother me in the 67K, I will blame Gary Robbins and Mark Fearman because I was pacing them. 

What is Plantar Fasciitis?

Your plantar fascia is a band of connective fibrous tissue that goes from the heel to the ball of the foot.  In a "normal" foot, it's what forms the arch.  The arch flattens when you put pressure on your foot.  It also flattens if you run on it a lot  (pronation or flat feet.)  Like an elastic band that isn't very stretchy, if you stretch the plantar fascia too far it will fray or snap.  When this fascia gets overused or injured, it gets inflamed and very sore... and it usually takes a long time to heal.

Who gets Plantar Fasciitis?

Plantar fasciitis is apparently the most common injury for people who participate in high impact sports.  Running is certainly such a sport.  So is tennis or hiking.

Why do you get Plantar Fasciitis?

I've found several medical explanations that are usually interrelated:

• running hills
• poor footwear
• flat feet (pronation)
• overuse
  

What are the symptoms of Plantar Fasciitis?

• your foot hurts a lot when you get up in the morning
• pain on the bottom of the foot, usually centered around the heel

Here are some of the things I tried or learned of while trying to fix the problem:

• stop running.  I hate to tell you, but this is what I think worked better than anything to cure this injury.
• stop walking barefoot.  I love walking barefoot, so this was a big challenge.  For almost 8 months I had to wear shoes in the house.  The good news is that I ended up buying a pair of plastic clogs (crocs, holey soles) and they are awesome!
• get new shoes. This to provide cushioning and support for your plantar fascia.  I had to retire my beloved Nike Skylons.  These shoes had served me for 10 years and probably 20,000 km of running.  (I now use them in the garden.)  As a variation on shoes, these ones have a big spring in the heal to dampen the impact.  (My friend Sarah Gallazin swears by them for her PF.) 
• get orthotics or rigid foot beds.  Well, I had orthotics, but the podiatrist I went to said that his, and only his, $700 rigid orthotics would provide relief.  I also went to a podorthist, who did a detailed gait analysis and  proscribed rigid foot bed at $30.  I took 2 and fired the orthotics guy.
• get a night sock or a night splint. I didn't use these, but a friend with the same problem who did said they worked well.  The idea is that they support your arch during the night and thus allow it to heal  quicker.
• cortisone. The second sports medicine specialist I saw insisted I get a shot.  I did.  It hurt like hell.  Then my foot stopped hurting in the morning.  So, it sure worked to stop the pain, but 3 weeks later, my plantar fascia ripped completely off my heel bone when I went for a snowshoe run.  So in my case at least, it would have been better to not mask the pain. 
• stretch. A simple and I believe effective cure.  I put a piece of 2 X 4 under my bedroom window and did heel lifts most mornings.
• physiotherapy and/or massage. Sure feels good, but I can't point to a miracle cure from either of these.
  
• icing.  I found that freezing a water bottle and rolling it under my foot while at my desk helped.
• rolling golf balls.  The idea is to provide deep tissue massage to the plantar fascia by rolling it over a golf ball as you sit at your desk or the breakfast table.  Hurts, but I think it helped

More information:

My buddy Troy Angrignon lent me his book, "Fixing Your Feet" by John Vonhof.  It's a great read with lots of hints and tips for how athletes can avoid and treat foot problems. 

Excellent writeup on plantar fasciitis in the American Family Physician