Plantar Fasciitis



As requested I will go into a little bit more detail about my battle with plantar fasciitis.  The usual caveat applies here.  If you are having a problem it is always best to check with your physician.  Although I am a physician and occasionally play one on TV, I do not dispense medical advice via this blog.  I am just relaying my personal experience and what worked for me. 

My problem started a little less than a year ago.  If we want to play the blame game, credit goes to my buddy Barry.  I visited him in California and had a session with this ART guy that he recommended.  This fellow picked up on my tight IT band really quick and went to town on it.  He also said my feet were flat and I tended to pronate.  After I told him I was running in Nike Frees he told me I needed more support.  I immediately picked up a pair of Brooks and hit the streets.  I remember thinking, "man these things really put me on the balls of my feet".  My calves were feeling it.  A few weeks later, it was a Sunday, I thought I had stepped on a stone.  I kept looking for a bruise on my heel.  This continued to worsen until I asked my podiatrist friend about it.  Within 5 seconds I had my diagnosis.  Plantar fasciitis.  He gave me a script for some custom orthotics.  I never got them.  I talked to another buddy who actually makes orthotics and he told me it was a waste of time as far as plantar fasciitis was concerned.  He told me all I needed to know that day.  For whatever reason it didn't sink in.  His advice:  "stretch your damn calves".  That was all I needed to do but I wasn't doing it right.  So for the next several months I took a shotgun approach to my fasciitis.  I saw my massage therapist.  He got medieval on my feet and it hurt like hell and it pretty much cured it for about a week or two. Then it was back.  Classic PF, pain was worse in the morning with the first step or just after sitting for a while.  Not good.  I spend most of the day on my feet and the kettlebell sport training and attempts at running weren't helping. GS was out and so was running.  I spent a lot of time doing more strength training and I got more focused on my concept II rower.  One nice thing was I beat my 7 min goal on the 2000m row.  That's one goal knocked down for the year.  I also picked up a Strassburg sock for night time.  This helped quite a bit.  You can check that out here.  It took a little getting used to but I think it helped.
I also got some inserts for my shoes that I liked.  They were $20 per pair, way cheaper than custom orthotics.  Here is the link to the inserts.  I still keep them in my work shoes because they don't bother me and I am used to them.  Did they help?  Probably.  They certainly didn't make things worse. 

What really did the trick for me though was getting serious about the stretching.  I was using a weak approach where I would stretch them for 30 seconds or so and think that was enough.  WRONG!  You have to be serious about this.  Make it a religion.  First you have to do it for a longer period.  3-5 minutes at a time sounds about right.  Plus you have to do it often after gradually working up to the longer stretch.  I like three or more times a day.  I try to space them out, maybe a morning stretch, and early evening stretch or before I train and then again after I train or before bed.  You have to hold the stretch for a long time.  I also got serious about stretching the hamstrings as well.  Very important.  For a while it didn't seem to work but after a couple weeks I was able to get back to running and GS training with no setbacks.  If you want to know why this works look at the picture at the top of the page.  You can see the connection to the achilles tendon and the calf.  This entire myo-fascial system is in continuity and tightness one place will lead to downstream events.  The bottleneck happens to be at the plantar fascia where it attaches to the heel.  That's where the tension is.  If you don't fix this it keeps happening.  You rest the foot at night it starts to heal, you put weight on it in the morning, it tears again.  The cycle of inflammation and repair never ends.  The solution is to "stretch your damn calves".  I probably should also have done a month or so of NSAIDs when this started but I don't like taking medication, go figure. 

So what finally convinced me to get serious about fixing this problem.  I ordered the a video from this website.  It was an instant download and was the best $15 I ever spent.  All you need to know is right there. In addition to that I went back to my nike frees.  A few folks have recommended the vibram five fingers shoes.  I can't bring myself to wear them for they are hideous to look upon.  I am not saying never but definitely not right now.  There has been a lot of talk about barefoot running and recently a book was released entitled Born to Run (not to be confused with the Springsteen song).  It is about a tribe of indians who run and run and run and don't have the type of foot problems we have.  I haven't read it but I plan to.  You can get it here.  There is much speculation that our currently favored running shoes and other shoes for that matter basically act as casts preventing the intrinsic muscles of the feet from doing much of anything.  This in theory can lead to problems and lets face it, foot problems are terribly common.  I have at least 10 friends who are battling PF at present.  I hopefully have put them on the right path though.  We could go on and on discussing shoes, theory, and the like.  Rather than overindulge in such cerebral masturbation keep it simple and "stretch your damn calves".



 

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Comments

  • 2/27/2010 9:40 PM RICHARD wrote:
    10-4 on the stretch-stretch-stretch. PF had me down and out about 18 months back and it was the frequent calf and ham string streches that helped. right now I'm wrestlong with cocyx pain and sciatic nerve stuff. it is the proper frequent stretching that gets this stuff "on the run". I'm just now grtting back to KB cleans and snatches. At 67 I have to be tickled and greatful when i can rehab myself.
    Reply to this
    1. 3/11/2010 11:56 PM Scott Helsley wrote:
      Piriformis syndrome???

      Reply to this
  • 2/27/2010 9:54 PM RICHARD wrote:
    Also here's a neat site http://www.cmcrossroads.com/bradapp/docs/rec/stretching/
    Reply to this
    1. 3/11/2010 11:55 PM Scott Helsley wrote:
      Wow thanks for that Richard.  That there is an excellent resource!  Very comprehensive.

      Thanks,

      Scott

      Reply to this
  • 2/28/2010 1:23 AM Ronnie wrote:
    Funny you should write this today. I have just come to the conclusion I have to get serious with my stretching. I asked my wife to dig into my calf muscles with her elbows this morning and it was almost more than I could bare. And she was using very little pressure. After about 20 minutes of hell, I felt like I had knew legs. This has got to be better for my feet, too. I need to get my legs and lower back to limber up, and the only way to do it is to get on board the stretch train. Great post!
    Reply to this
    1. 3/11/2010 11:54 PM Scott Helsley wrote:
      Yep you got it Ronnie.

      Reply to this
  • 2/28/2010 11:25 PM bill wrote:
    I also get results doing acupuncture and moxibustion. Incidentally not all the needles go into the affected foot but also the calf and foot and even hands and forearms of the other limbs.
    Reply to this
    1. 3/11/2010 11:53 PM Scott Helsley wrote:
      Interesting.  I don't even know if anyone around here does that sort of thing.  I'll have to do a search on acupuncture and PF.

      Thanks,

      Scott

      Reply to this
  • 3/1/2010 9:36 AM Lorraine wrote:
    Hey Sean - I still maintain that 20 min. with Susanna Baxter will make the plantar fascitis a thing of the past. But holy hell is it debilitating when you have it. Makes it seem like that trip from the table to the refrigerator is a journey that isn't really worth it.

    As for the book - I just finished it and I can't recommend it highly enough. Fantastic story with lots of great characters. Fun read and I was wishing that it wouldn't end.
    Reply to this
    1. 3/11/2010 11:51 PM Scott Helsley wrote:
      Lorraine,

      Its Scott ; )  Yeah you are probably right.  Whatever happened to her anyway.  Is she still one with the bells?  I need to get that book but i am afraid if I do I'll find myself at a store buying a pair of vibram five fingers. 

      I wish you would've been at the Ahnold. 

      Sean or whatever my name is.

      Reply to this
  • 3/1/2010 7:03 PM Duane wrote:
    Daily Mail article more or less lifted from the book "Born to Run."

    http://www.dailymail.co.uk/home/moslive/article-1170253/The-painful-truth-trainers-Are-expensive-running-shoes-waste-money.html#

    I read the book a couple weeks ago. Highly recommended.
    Reply to this
  • 3/2/2010 10:23 AM James Boelter wrote:
    Congratulations on getting a handle on the PF. I do some bodywork, and I've had some success in dealing with it in my clients, but if they don't do the follow up work (in other words, "stretch your damned calves"), it comes back in a month or two.

    Good job, great post!
    Reply to this
    1. 3/11/2010 11:48 PM Scott Helsley wrote:
      James:

      I think if I would have done my stretching after I had my MT work on my feet, I would have cured this a lot quicker. 

      Thanks,

      Scott

      Reply to this
  • 3/9/2010 7:15 PM Rooster Shamblin wrote:
    http://roostershamblin.wordpress.com/ would you please spend a few minutes reading my blog about all things chicken. I have been raising more than 50 breeds of chickens 40 years.
    Reply to this
  • 3/11/2010 9:31 AM Katie wrote:
    Scott, great article- hope your pf is healing well. Definintely continue stretching- but it's also important to keep your arch supported to prevent the plantar fascia tissue from overstretching and becoming inflamed(it happens upon weight bearing, when there is no support). Stretching definetely helps too. Have you tried rolling/massaging your foot over a frozen water bottle? That may bring some relief as well. Best of luck with your pf!
    Reply to this
    1. 3/11/2010 11:46 PM Scott Helsley wrote:
      Thanks for the message.  I did try the water bottle trick.  It certainly didn't hurt but the real improvement came with the stretching.  I suspect the combination of that with the stretching would have some big advantages.  Excellent points you brought up.  Thanks for your comments.

      Scott

      Reply to this
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