4 Don'ts and Dos for Injured Runners

Disclaimer: This is an updated post from 2017.

Been there, run that. I'm the runner who ran a race on a broken toe. I'm the runner who bought herself a road bike and road tested it wearing the boot. I'm the runner who trained for and ran a marathon while battling plantar fasciitis--with my doctor's approval, of course.

We've all got stories. While researching this post, I found multiple stories of runners "pushing their limits", including a story about a runner who was planning to crutch walk the Boston Marathon. I get it. He's injured and can't run. But come on man! These articles portray the runners who do these things as heroes. I'm thinking that this act of bravery could lead to new injuries, including nerve damage to the upper extremities. Brave or foolish? Not to say that any of us wouldn't consider said act of bravery. It is Boston after all!

I also read a race recap where the runner actually walked a half marathon--wait for it, it was the Disney Wine and Dine Half Marathon--wearing a boot. Foolish? Risky? I've been in a boot and all I can say is wearing it threw off my entire gait. I would imagine there's a huge risk of injury to the unaffected extremity. The author comments in the post that she regretted her decision to boot walk the race. But if you are interested in trying this, she has some suggestions on how to best attempt this. I'd probably stay away.

Even elite runners aren't immune from running while injured. Sarah Crouch ran the 2019 Boston Marathon with a 'stress reaction' in her femur. You know how this ended, right? She hoped to be the top American woman finisher but instead developed a fracture in her femur during the race, finishing in 60th place.  She and her coach received a lot of well-deserved flack for this. However, I think we runners all understand her determination to push through injury.

Common sense tells us that sometimes, as runners, we have to give ourselves a break. But common sense isn't always common when it comes to race day or training decisions. There's no glory in being sidelined. An injured runner may be longing to participate in an event he trained for. Is the price to pay--more time off the road, medical bills, or worse--worth it?

Foot Pain: A Runner's Search for Answers

Disclaimer: This is an update of a post I prepared in 2014. I received a pair of Oesh shoes in exchange for my honest review. 

When you tell people you are a runner, what is the first thing they say to you? Does it have something to do with ruining your knees? If I had a dollar for every time I've heard that running is going to ruin my knees, I could retire and move somewhere warm. Can I put it out in the universe and say emphatically that I've never had issues with my knees?

What I have had problems with are my feet. When you think about it, it makes a lot of sense. Most studies report a force of 3x body weight on the feet during a run. That means for this 125 pound runner, my feet absorb 375 pounds with every foot strike. So it's no wonder that my feet sometimes beg for mercy! Actually, it's amazing that they let me run any sort of distance.

Since we ask so much of our feet, it's important that we take good care of them. That includes proper footwear. I've got some experience here, having had more than my share of issues with my feet over the past couple of years!

Revising My Fitness Goals for the Rest of the Year

Oh 2016, I had such big plans for you! I was going to travel and run all over you. Even though I started off the year with that pesky foot issue, I worked through it and got to the start lines of my 2 bucket listers, the Sarasota Half Marathon in March and the Big Sur Marathon in April. I returned home from California full of hope and ambition! I felt euphoric and fulfilled. I set my sights on a few half marathons for the rest of the year.

Naturally, fate had other plans for me. My son broke his leg and we got a new puppy. I could roll with that, but after a fall on a rock last week, my plantar fasciitis flared badly. It has yet to calm down. As you read this, I'm getting an x-ray and spending the morning with my sports medicine specialist. No matter what the outcome of that visit, it's clear to me that a revision of my goals for the year is in order.

What's a runner to do?

It isn't as if I haven't been in these shoes before. Literally and figuratively. Does it even matter what's wrong with my foot? No matter what the diagnosis, I'm still going to have to take some time off. Again. So I took a look at the goals I set for myself this year and made some alternative goals that will keep me in shape and ready to run once I can hit the road again.

It's a wrap!

It's the end of the year as we know it...

It's time to take down all the holiday decorations and get back to my regularly scheduled life. But first, I've got a few loose ends to tie up here on the blog. The Weekly Wrap, hosted by Tricia and Holly, is the perfect place to do it! You may want to check out what everyone else is posting and while you are there, wish Tricia and Holly good luck on the WDW Marathon, happening next weekend!

So let's get this party started! First things first, a few leftovers from 2015:

I did a data dump with my Garmin and found all kinds of fun statistics. I'm kind of a numbers geek. My Forerunner 10 gave me a surprisingly large amount of interesting (at least to me) data. I've summed it all up in this fun infographic:

This week I received a few reminders of some awesome events I participated in this fall.

My official Chicago Marathon participation certificate arrived:

In case there was any doubt.

I also received some photos from the Underground Polar Express run that I participated in a few weeks ago. A fun day with friends, it was a great event for a good cause. I'll be back. So fun.

Me, Marcia, and Sara

Never one to miss a photog! But check out the shirtless guy behind us. Really? In December? At a Santa run?

This past week, I hit my final goal for 2015, that #RunThisYear goal of 2015 kms/1252 miles that I set for myself one year ago. That is my highest yearly mileage ever, and this was my first year ever that I didn't miss any time on the road for injury. I am thrilled with that, and I need to give credit to my coach Becky, who has worked hard with me to strengthen and balance my glutes, hips, and hamstrings. She also developed a marathon training plan for me which was tough, but effective. Low miles, lots of cross training, and plenty of mental toughness sprinkled in.

As promised, after this run, I hung up my running shoes to devote some time to recovery. Hoping my hiatus will be brief. But I need to get this PF under control. My love/hate relationship with my faux Strassburg sock continues. Got heel lifts? Downward dogs? Compression sleeve? Foot strengthening? Did you even know this was a thing? According to this article, it is THE thing for PF.

So yes, I'm doing those heel lifts. What else can I do?

The first thing I did was treat my feet to a pedicure on New Year's Eve. Afterwards, I slipped on my new Oofos sandals, which I won from Kim at Kooky Runner. I think I'm in love. Let's just say these flip flops are my new favorite thing! Have you tried them yet?

It's all about the pretty toes...and the super comfy shoes!

I also went to see Becky for my weekly workout--she had me doing more cleans, front squats, and deadlifts. Since she's a corrective exercise specialist as well as an endurance coach, I asked her for any advice she could give me that I wasn't yet doing for my foot. She talked with me about doing some arch rolling on the lacrosse ball as soon as I get up in the morning, before I even stand up.

Since Becky was on board with my plan to take some time off running, I was able to leave the CrossFit box with a bike trainer to use for the winter. Can you say win?

Thanks to YouTube, I rode for an hour on Saturday through the Italian countryside and on Sunday, I rode along the beach and up a mountain. I'll be sharing more about indoor bike training in a separate post, but let's just say it is a worthy successor to the treadmill. Equally as boring and tough. I wore my heart rate monitor to make sure I was getting a decent workout, and I stayed in "the zone". Oooh, the pain! The sweat! My husband had to turn on the ceiling fan. I chugged my Nuun hydration throughout.

Completely non-running related but worth a mention: I went to see the movie Sisters with my sister Lisa. We had heard that the movie had received mixed reviews. But it's Tina Fey and Amy Pohler! We both thought it was hilarious. In fact, we laughed so hard we cried. If you liked Bridesmaids, you'll like this one. There are so many one-liners that I can't remember them all.

We decided that we need to up our dance game. Not that we ever had one...

What did you do this week? Ready to go back to reality? Seen any good movies (besides Star Wars?)

Running with the devil

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.

source

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..." Medscape

Wah 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.

source

Here's what I've been employing to try to control the pain of PF: (some links may be affiliate links)
-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.

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?

I'm linking up with Holly and Tricia for their Weekly Wrap! What are you up to?