I’ve been quiet on the blog side of things recently, and I can’t say that it’s because I’ve been out running and enjoying the scenic lowcountry views around here. As some of you may remember, I took a hiatus from running for most of 2015 due to a nagging pain in the foot- the dreaded Plantar Fasciitis. In 2016 I finally recovered and enjoyed a year of fun runs and marathon training. However, in late December, I began to notice some soreness developing in my left foot when I would wake up. Not wanting to believe something was wrong, I chose to pretend it was nothing and continued on- I had a marathon coming up and I wasn’t about to give in now!
In January, I had my PT friend tape up my foot before the Disney Marathon. I experienced severe sharp knee pain on the other leg during the race that I’d never had before. Two weeks later, I was limping around work with sharp stabbing pains in my heel. There was no doubt about it- PF was back with a vengeance!
Having learned from my previous mistakes with dealing with this last year, I finally gave in and put up the Brooks for a while. I set up the bike trainer, found some semi-entertaining youtube videos to ride to, and re-connected with my spin instructor friends. I had to bail on group runs and the ultramarathon I had ambitiously signed up for. My dog is mopey because his mom doesn’t take him running or on as frequent walks anymore. I’ve contemplated borrowing crutches from work to use around the house. My poor husband (bless his heart) gets the brunt end of my crankiness from not being able to do the sport I love so much. To sum things up, it’s been kinda sucky lately!!
Fortunately, things are starting to look up. I can walk without pain now, and deep pressure on the site doesn’t hurt like it did. I even woke up today without pain for the first time in two weeks! I’ve been able to maintain at least some of my cardiovascular fitness by riding the bike trainer or spin class 2-3 x week. I’ve also been keeping up with my rehab exercises and incorporating more soft tissue/fascial mobilization work (think foam rolling and lacrosse ball). Oddly enough, rock climbing and boldering has also helped keep me somewhat sane the last two weeks!
For anyone that’s dealing with a nagging injury such as PF or Achilles tendinitis, here are some tips on what I have found works for me. In a future post I will discuss more about good running form and how it can prevent running-related overuse injuries. For now, I just want to share what I have found to be beneficial and why.
- Leukotape seems to work best for me. I tape in such a way to provide a bit of arch support and off-loading of the arch during normal gait and allowing normal foot mechanics
- Activity modification– spin/biking, swimming, Arc Trainer work best.
- Careful with elpitical- many people let their heels come up and down off the pedals when going at it. This puts stress on the PF and Achilles tendon. Even though the activity is low/non-impact, the constant DF/PF of the ankle stresses the PF and Achilles tendon. If you choose to use the eliptical, take care to keep your foot flat on the pedals and maintain a level stride- avoid using an incline feature.
- Avoid high-intensity exercises; anything that inovloves jumping, lunges, sprinting, burpees, etc is a no-go.
- Stay off your foot
- Rest! The absolute best way to let the structures heal is to avoid placing stress on them. This means no walking, which is obviously unrealistic for most people. Try to take time off your feet as much as possible. You could even use crutches if you wanted!
- Dorsiflexion boot at night
- By far one of the best tools around. The sock did not work for me, and, after some research, I learned why. The boot I use came from an ankle/foot doctor, and it’s pretty comfortable to sleep in. It keeps my foot in a neutral, DF position which allows the PF to heal in a neutral position (as opposed to a PF postion that will only stretch out and be irritated again upon standing/walking)
- Well cushioned shoe
- Pretty common sense here. A worn out shoe makes your muscles, tendons, and ligaments work harder to stabilize and absorb the forces exerted on them from walking/running/standing. A shoe with good cushion helps to offset some of those forces, allowing for less work from the tendons/ligaments and thus allowing them to have time to heal.
- Wear something on your feet at all times, including a supportive flip flop or slipper around the house (Vionic Flip Flops, Oofos are two great examples)
- Rehab exercises- focus on glute med, external rotators, hip extensors; calf strengthening; balance/core work; foot strengthening
- Endurance is key- research supports the fact that strength doesn’t affect one’s running mechanics, but muscular endurance does
- Soft tissue work
- I got the most results out of going to a PT who performed IASTM work on my PF. It really helped to work out the “gunk” in the fascia. Currently, I’m in the process of obtaining an IASTM tool that I can use on my own issues as well as on future clients. It’s amazing!!
- Go easy with the tennis ball/bumpy ball rolling under the foot. 30s max 2x day!
- Regular massages from a massage therapist (preferably someone with sports medicine emphasis) can help to keep muscles, tendons, and fascia loose and healthy
I plan to continue taking another week or two off from hitting the trails and pavement. Next week my hubby and I will be in Colorado to ski, and I’m hoping my foot can handle the stress of that. By the time we get back, I hope to be able to start working on some run/walk sessions and build up my endurance again.
To those of you healthy and running happily, enjoy it! Be sure to be including regular soft-tissue work and all-around strength training in your regimen. To those of you who may be injured, have no fear- you can get better! Feel free to email me with questions and I’d be happy to offer you PT-guided advice and point you in the right direction.