I've met the devil and his name is plantar fasciitis. PF, for short.
In the past, I've run with PF until he finally left me alone. This year, PF started to remind me that it's never completely gone. PF started to sneak up on me. Towards the end of marathon training, the arch of my left foot would start to twinge. Very familiar with what that means and what's to come, I furiously rolled and stretched. I kept PF at bay for a while.
But even after taking a week off from running post marathon, PF returned with a vengeance. The ironic thing about PF is that you can run with it. Initially, when I start running, my foot hurts, but that ends after about 2-3 minutes into the run. That is because the plantar fascia, the large thick tissue that runs along the arch, stretches out with movement.
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With the exception of that half marathon I ran in November, I've been running pretty conservatively since the Chicago marathon. But PF doesn't care. The pain has continued to worsen, particularly if I don't adhere to my massage and stretching regimen. Because, as you will see in the report card below, that is really about all you can do for PF.
Oh, if I had a dollar for everyone who has recommended that I get a steroid shot in my foot. Everyone knows someone who did this and "was cured". Remember Mr. Loud OM from my yoga class? He's also very convinced that a steroid injection in the foot is the only thing I need. Well, Debbie Downer NP has news for the steroid people:
"The risk of ..plantar fascia rupture... is greatly increased by history of treatment with a corticosteroid injection....Corticosteroid injection into the superficial fat pad can cause fat pad necrosis due to the lack of shock absorption normally provided by the superficial fat pad..." MedscapeWah wah. Um, no thank you. I'll take a pass.
As a medical provider, I like my treatments proven and tested. I turned to the clinical evidence and found exactly what I was looking for, clinical guidelines for the treatment of plantar fasciitis. Clinical guidelines can be found for almost any entity. The guidelines are research based and interventions are graded, much like a report card, so you can make an educated decision about your treatments. The only exception is the grade F, which as opposed to the failing grade we all associate with the letter F, is the expert opinion of the team evaluating all the studies and is a recommended course of action. No matter what the grade given, keep in mind that with every treatment tested, there are always outliers, and low rated interventions will work for some folks. My advice is if you want to play it safe, stick to the tried and true, highly rated interventions.
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-I've been massaging my arch with the Rubz ball. You can use a golf ball as well.
-Wearing my homemade Faux Strassberg Sock at night. Although I will admit to tearing the thing off halfway through the night because the stretching of the fascia can be somewhat painful at times. The longer I wear it though, the better my foot feels in the morning.
-Stretching is done via yoga--I find Downward Dog to be very effective as it not only stretches out the bottom of my feet but also my calves and Achilles tendons.
-I'm not taping my foot (but you can and they like KT tape), but I do wear my Feetures PF compression sleeve religiously.
The physical agents, which were given a D, included electrotherapy (TENS), laser therapy, phonophoresis/NSAID, ultrasound, and shockwave therapy (which was successful for me in the past). Nowhere in this article did I see anything about ice. Icing the foot, rolling on a frozen water bottle...not mentioned. I suppose it's one of those interventions that can't hurt and might help. And I have resorted to an occasional dose of ibuprofen when the pain is unbearable.
Rest as an intervention was given an F, meaning that the team evaluating the evidence likes this recommendation. Makes sense to me. I'm going to follow that advice as well, taking a week or 2 of rest after January 1.
Rest as an intervention was given an F, meaning that the team evaluating the evidence likes this recommendation. Makes sense to me. I'm going to follow that advice as well, taking a week or 2 of rest after January 1.
The other intervention I am going to investigate after the first of the year is ART. Active release technique is manual therapy at its most intense. I'm ready to dig in. I've got big plans in 2016, and I'm not going to let this devil in my foot sideline me.
So you're probably wondering why I'm not taking my break now while I'm having so much pain in my foot. I'm in pursuit of my final goal for 2015. My mileage goal for this year was 1251 miles. A strange number, right? But 1251 miles=2015 kilometers. I'm SO close. With the flare of my PF, I was going to give up on the goal. That was until my friend Sue, at This Mama Runs for Cupcakes, challenged me to finish. She's chasing her 2015 goal of 1000 miles. Also very close. So we're doing this together.
Don't judge. I'm so close. As of today, I have 12 miles to go.
And then some rest and a plan of action to exorcise this devil from my foot.
Have you ever had plantar fasciitis? What treatment modality worked for you? Would you push to get those last 12 miles done?
And then some rest and a plan of action to exorcise this devil from my foot.
Have you ever had plantar fasciitis? What treatment modality worked for you? Would you push to get those last 12 miles done?
