plantar fasciitis: when does it go away?

Tell me about it. I've battled it off and on for 14 years.

It has never fully gone away and I'm currently in the middle of a 6-week NO RUN phase. I'm getting PT and ultrasound and was stretching, but managed to aggravate my achilles by OVERstretching. Yes, you can do that.

It's a b*stard bitch...that's all I can say.

I'm looking at bicycles, it may be time to hang up the running shoes. If this doesn't work I'm going with a cortisone shot...if all else fails.

At least I had ten decent years.

1) resting does no good- but use ice, ultrasound,

2) get a cortisone shot

3) get to a recommended sports podiatrist who can custom make some soft orthotics for you.

I wasted 3 of my 5 years in college trying all sorts of crap to deal with p.f. I rested an entire month and it did no good.

Ice and ultrasound are good treatments to 'help', but won't make it go away. I had a very promising career in college, (14:27 5k and 3:51 1500m- freshman year), pretty much wiped out by pf. By the time I got it under control for good I was almost out of school. The good news is, that I ran competitively for almost 10 years after college and the pf never came back. I wore my orthotics for all running and racing; but not in street shoes. I made one US team for a 10k road race, too, that went overseas to race, so I wasn't just jogging, post college.

you can beat pf and get it under control but you can't fall for every half-assed idea that people will tell you is a sure cure. NOT.

I had PF for years until I developed knee pain that forced me to cut my training enough for the PF to resolve itself. Luckily, when my back pain got bad enough to need surgery, the knee pain went away.

But I've felt pretty good the last couple weeks.

I haven't yet been to an orthopedist (podiatrist or orthopedist? Not sure yet which to go to).

Is there a chance that I don't have pf but rather have a bad bruise or something else? I just don't understand what I did wrong.

What do you mean by " get it under control"? Is your pf gone or is it just tolerable?

I'm currently dealing with PF also. Writing the alphabet a few times a day with my foot, heating, icing, ib prof when needed, sleeping with a stretching boot on, lots of calf stretching... any other suggestions? Already have orthotics that are wonderful. I am on the mend from foot (navicular) surgery. If you have any advice, please share!

learn to cope? wrote:

I haven't yet been to an orthopedist (podiatrist or orthopedist? Not sure yet which to go to).

Is there a chance that I don't have pf but rather have a bad bruise or something else? I just don't understand what I did wrong.

What do you mean by " get it under control"? Is your pf gone or is it just tolerable?

1- podiatrist- but not just any- do some research

2-wishful thinking; I thought that I must have had a stone bruise too; rested over a month and the pf came right back.

3- the pf didn't go away 100% right away, but was greatly diminished and then did go away, 100% within a year of getting the orthotics and having them adjusted a couple of times.

I consider this a more appropriate way to strengthen the foot intrinsics.

http://www.aptei.com/articles/pdf/IntrinsicMuscles.pdf

Some cases of chronic PF may be plantar nerve entrapment as well. They're actually fun problems to work on from my standpoint. I don't bother with the ultrasound (so much of a waste, really). To get a good clinical result, I've found that I have to do the following:

1. initial inflammation (if not a chronic problem, > 4-6 weeks) control - Plantar taping for two weeks, retaped at each treatment session

2. Biomechanical foot analysis and gait analysis, determine if orthotics are appropriate - Orthotics are often issued as a "shotgun" approach with anyone with plantar fasciitis, which is probably why the literature has shown such poor outcomes when used to treat PF.

3. Train the patient in initial weightbearing activities (slow foot circles and gradually working towards full weightbearing over a few minutes before standing/walking each morning until the symptoms come under control).

4. night sleeve - Strassburg sock - forget the plastic boots, they're impossible to sleep in.

5. Strength/endurance/balance training - the article above explains the foot end of it, but you have to work "up the chain" so to speak - hip abductor/ER training, for example - some of these cases that just don't get better aren't getting better because of poor postural/rotary control at the hip - over-pronation or prolonged pronation isn't just driven by the foot.

6. Shoes- I'm not a total minimalist freak, but I do think that the majority of trainers offer too much cushioning. The goofy thing that some do is use an orthotic device in a motion control shoe. For casual walking, I have patients wear hard-soled shoes - sounds stupid, but too much cushioning causes the foot to swim too much.

7. deep friction massage in chronic cases - trying to remodel the tissue - I use instrument assist (graston technique).

And that's about it, in a nutshell.

[quote]RunningPT12 wrote:

I consider this a more appropriate way to strengthen the foot intrinsics....

or, you can get a good, old fashioned cortisone shot, rest a week to let it work and the pain and inflamation will be gone. Of course, that just treats the painful symptom and you will need to do further preventative treatments as others have described, to keep it from coming back.

does it 'just go away'? No, not unless you want to stop running.

should you take a month off? No, it won't do any good.

does each run prevent it from healing? Not really, cause it will not just heal, once the plantar ligament is torn. It is a very tough area to heal naturally, as the blood flow through the plantar ligament is unlike other parts of the body. A cortisone shot will usually clear up the inflamation and get the healing process going and wash out the debris in the torn ligament.

warm it up before you run, ice it after you run

Had Plantar Fascitis in January 2003. Cortisone shot took care of it.

I have it right now in my left foot. 6 weeks light running did not help me much at all. I've almost gotten completely over it, but only after incorporating the following:

1) Ice - Freeze a water bottle and roll it along your plantar fascia and heel several times a day and after you run. If you feel any bumps in there (probably scar tissue), work those areas good and try to break them up. This might be painful but work through it.

2) Stretch - LIGHTLY stretch your calves throughout the day and get them good after you run or warm up. Also, I found this on a barefoot running forum and it has helped me. Buy two soft, compression softballs (can be found in a sporting goods store, wal-mart, etc.). Before bed, stand on the softballs and roll them along your platar fascias for 2-3 minutes. It will be painful at first but after a few days of this it will get better and won't hurt much anymore.

3) Walk around barefoot as much as possible and don't wear high heeled shoes if possible. This will keep your calves and plantar fascias stretched (which high heels prevent). Your feet and lower legs might ache at first but eventually it will get better as they strengthen. Eventually incorporate short barefoot runs at least once a week.

Number three is the worst PF advice I have ever heard. Barefeet is part of the problem. Have something with arch support on your feet at all times.

Rest will do no good. You must correct the problem. Orthodics will usually do the trick if you stick with them.

that's exactly what the Podiatrist I'm seeing said

"NO MORE RACING FLATS"

two other people in my club were treated by this fellow and swear by him

Bad Advice wrote:

Number three is the worst PF advice I have ever heard. Barefeet is part of the problem. Have something with arch support on your feet at all times.

You are treating the immediate symptoms, not the cause of the problem. As a long term solution, you should strengthen your feet and ankles, along with keeping your plantar fascia stretched. You don't see many Kenyans with P.F.- they all grew up running around barefoot and have very strong lower legs. Same goes with runners in the 60s and 70s who all ran in low heeled, flat shoes. No PF until shoe companies started shoving these high heeled overly cushioned shoes down our throats.

Also, for any fatties out there, try losing some weight.

Thx for all the comments. Nonetheless, this thread leaves me very down. I have been injury-free til now and this is so demotivating. My mpw has dropped by 50 %.

The rosiest scenario painted here was that if I get orthodics then perhaps in a year I'll feel better. That's not good news! I want instant gratification!

The general consensus here seems to be that running is not going to make it worse. So I can race and just push thru the discomfort. If so, somehow I suspect though that I will not put in maximum effort due to worrying about foot.

Try ART, find someone (a chiropracter or massage therapist) that uses this technique. It's really helpful when combined with a lot of stretching and strenghtening.

strassburg sock

www.thesock.com

[quote]learn to cope? wrote:

Thx for all the comments. Nonetheless, this thread leaves me very down. I have been injury-free til now and this is so demotivating. My mpw has dropped by 50 %.

The rosiest scenario painted here was that if I get orthodics then perhaps in a year I'll feel better. That's not good news!

I want instant gratification!

then get a cortisone shot, rest another week and the pain should be gone.

PF is a terrible, insidious injury that can rob you of your very soul.

I've had to deal with it over the past year and PF took a way a lot of good racing. I was in good shape and then went to $hit. Not only that, it made running a terribly un-fun event.

I've finally started to shake it, but now I am gun shy. I'm so worried about moving up my mileage, when to do track work etc.. that I'm scared to get back into real "training."

PF sucks