LooseCrew-JeffO: Plantar Faciitis

LooseCrew-JeffO

Ramblings of an adventurous guy living in Denver and playing in the mountains.
For my trail adventures, visit my Trail Bum blog

Sunday, July 05, 2009

Plantar Faciitis

I have two injuries...
One started with a knot next to my Achilles where the Achilles attaches to the calf. It rubbed the Achilles until the Achilles became inflamed. This started after the Salida Marathon. This is the primary injury that dropped me from the Moab 100, but my heel started hurting during the same race. I thought it was bruising from all the slickrock.
I didn't realize my heel was a legit injury until about a month later. It took a while, but finally it became obvious this was plantar faciitis.

The Achilles injury was more dangerous, but being hobbled by my plantar, the Achilles was not aggravated. What I've done for this is massage, with lots of hard, sustained pressure inwards, and sideways. It might be healed by now, for all I know, but I still massage it just to be sure.

Most of my efforts have been on my plantar, because it is what I feel all the time. It also is the one that doesn't want to get better.

Massage - I was told to massage in a "spreading fashion", using my thumbs to dig in and pull opposite directions.
I was also warned never to massage the sore part of my plantar with a solid object. A tennis ball, towel, or washcloth is what was suggested to me.
I also use my thumbs to massage my calf. That part is very painful because it has to be a deep-tissue massage.

Icing - Never ice and stretch at the same time. Only warm tissues should be stretched. Icing is used only when swelling is a problem. The sole purpose is to stop and reverse swelling.

Insoles - I had stopped using insoles. Big mistake. I accidentally wore the wrong shoes at the Steamboat Springs Marathon and had no insoles!
I haven't had $450 orthotics made for me, and I don't see the use. It won't get me back to where I was. I need to stay off it - not splint it and keep trying. Also, I think most of my problems started from an imbalanced stride. Orthotics won't fix the stride problem. I need to address the problem, not the symptoms.

Stretching - I've been told by one person that only one thing will heel plantar faciitis - stretching. Nearly everyone tells me the cause is a plantar that is so tight it's ripping right off the heel. So I try to stretch everything from heel to the back of the knee.

Analgesics - Ibuprofen, Acetaminophen, aspirin will eat your gut if you live on them.
I take 81mg aspirin, which is supposed to be good for your heart as you get older. One a day.
Acetaminophen doesn't work as well for me as ibuprofen, but I'll take it as an alternative to shift the destruction from my kidneys to my liver.
I only take one or two ibuprofen a day. Usually one. Only with food.
Analgesics can keep down swelling. Swelling is bad for circulation. Good circulation will help you to heal faster. So when swelling is down, I improve healing by using heat and massage.

I bought a Strassburg sock, but it did nothing for me! It even cut off circulation in my toes and made me lose lots of sleep. The directions said that if it was uncomfortable, it was too tight, but I kept backing off the pressure and it never got comfortable, and it didn't seem to be stretching my plantar much. Then a guy at a race told me that he stuck a stiff insole inside his Strassburg sock to make if more effective and much more comfortable.
Then I saw these boots. They all have a solid footbed.
So I bought a stiff insole, and sawed-out a foot-shaped piece of Plexiglas and stuck it in. All of a sudden, my Starssburg sock was comfortable enough to wear all night and my plantar started healing. This was only half a month ago, though, so I'm not out of the woods.
As far as cost goes, I wasted my money on the Strassburg sock. The splints or boots cost less than the stinkin' sock! And they don't need modifications and are WAY more comfortable.

So there you have it. I've done nearly everything to get this healed.

If none of the above works, I can still try cortisone injections or surgery.

Here's the toll on my training.
The Weekly mileage is very erratic. You can see the Bandera 100K, then a couple of restful weeks. Then several weeks in a row where I gradually cranked the mileage. Then a week of rest. Then a couple more moderate-mileage weeks. Then the Moab 100. It's hard to see a pattern after that.

But one glance at the monthly graph shows the pattern.

Nose-dive.

I'm not only no longer a trail-runner - I'm not even a runner. I don't like biking, but I do force myself to bike once or twice a week. That's the only training I get. The few times I let myself run, I can't even run hard, so running isn't training.
I edited my schedule on the right to reflect what's left of my year.

I don't know if this post will help anyone or not. Seems like everyone I meet these days either has, or had, plantar faciitis or an injured Achilles.

4 Comments:

At 9:12 PM, Blogger Meghan said...

JeffO,

We are simultaneously injured!

DON'T DO SURGERY! I've been told that, for PF, surgery should only be considered after 1 year of activity modification [That is, stopping running and switching to cross training or some other sport that didn't cause the injury.] without healing.

I've learned that the first thing you have to do is to get control of inflammation before you can remove scar tissue and re-strengthen the PF and surrounding tissues. PF massage and PF stretching [methods of scar tissue modification], and strength exercises [method of tissue rebuilding] only inflame the tissue more, if you're already inflamed.

To get rid of inflammation:
1. stretch/massage everything but the PF
2. foot ice bath, full immersion 10 min x 3 times a day
3. ibubrofen at prescription strength, 800 mg x 1 or 2 times a day
4. prescription, non-steroidal, oral anti-inflammatories
5. acupuncture [results not proven by the medical community, but has been found helpful by some]
6. preventing the inflammation that results from lengthening the tissue after it's been left shortened for a long time, by wearing the Strassborg sock or another night splint
7. air cast, a boot device that keeps the PF lengthened and doesn't allow any PF contraction while walking
8. steroidal injection

Once you get control of inflammation, then you get yourself into some sort of rehab/physical therapy sessioning with guided stretching, massage, and strengthening.

Send an email if you have other questions. It's a terrible battle, it really is!

I feel for ya!
Meghan

 
At 10:15 PM, Blogger Sunshine Girl said...

I feel you pain JeffO!

It's true. We all know friends who have had the evil PF. But they have lived on and survived and thrived! And you will too!
Eventually everyone gets better, riiiiiight?! It is a tough battle and I empathize huge. In the meantime, watch your diet and try to maintain some kind of semblance of fitness. Find something you can do and DO IT.

Good thoughts your way Jeffo!

Leslie and Keith
Personal Cheerleaders

 
At 9:16 PM, Blogger majhanc said...

I have PF too, and I can't seem to get rid of it. Even when I don't run it hurts, so I would rather run. I have gotten incredibly slow because the pain really starts to set in when I run far. I also can't stand to run on the road because it seems too hard. I am extremely frustrated. I hope you get rid of your PF soon.

 
At 9:19 PM, Blogger majhanc said...

I have PF too, and I am miserable. Running makes me happy, and not being able to run or running super slow makes me crazy!

 

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