Whats the best management for persistent plantar fasciitis?! Help.

Zero drop shoes.

It's better then necrotizing fasciitis. It is one of the worst things you can get if you don't treat it straight away.

Plantar issues are persistent by nature. It seems as though they typically take 4-6 months to resolve completely. In severe cases, reducing the training load may not be enough. Sometimes the only solution is to cease running and load lightly in other ways.

If you have access to a PT or doc that does shockwave treatment, that will help speed healing. It can be costly and doesn’t feel good but it works.

Icing and anti-inflammatories do not promote healing at all. May relieve symptoms but nothing more.

The only way to keep plantar from recurring is to strengthen your feet and relearn proper mechanics. Odds are you have changed your footstrike and gait to compensate. If you like taking an active role in the healing and corrective processes you would probably enjoy Jay Dicharry’s book Running Rewired.

You need to approach this injury in two stages: Recovery/rehab and Prevention/Strengthening. Runners overwhelmingly try to jump to the second stage when they need to spend some time in the first stage before moving to strengthening.

In the first stage, you need a "crutch" and possibly medical intervention. The crutch is a NOT a crutch, per se. It's something to take the pressure off the plantar while it is healing. For this, I'd suggest switching to a Hoka shoe, like the Bondi. The unique heel of the Hoka moved the impact point slightly forward of the heel, which reduces the pressure on your heel. I switched to Hokas when I had severe heel PF and they helped a lot.

I also found a guy that does dry needling for PF. It took three treatments to reduce the pain by about 80%. Thereafter, the Bondis were enough to get me the rest of the way.

Once you are healed... i.e., no pain when running... you can move on to strengthening. Lots of info on this online. You might also be able to go back to a more traditional shoe. I stuck with Hokas, but I use a different low heel to toe drop shoe for tempo and intervals.

I feel for you, I had it for 8 months and nothing helped finally went to see a doctor and he gave me Power Step insoles for my shoes, they are not custom orthotics , anyways 10 days later my pain went away and has not come back.

Something different will work for everyone. Some fix it by going zero drop, others by going full support.

I tried many solutions including the famous Strassburg sock. The only thing that ever worked for me was rolling out my foot after runs with a frozen water bottle. Just icing or rolling alone did nothing. Neither did icing after rolling. But for some reason doing them at the same time managed to fix it for me. Now I keep a frozen water bottle in my freezer at all times in case I ever feel it coming back.

It's the worst feeling to not know if your PF will prevent you from doing a run on any given day. As well as the paranoia that any little tightness in the foot could be it coming back in full force. Still thankful that I found a solution that works for me so I never have to worry about it again.

I taped my foot every day. Not just during running, but every day. It went away during that period... but who knows if the tape actually helped. It could have been a fluke. The best thing would probably be to get into some type of spin or cycling class to maintain cardio and wait it out. It could be a year or more, but at least you can stay in shape.

mr turrrtlte wrote:

I taped my foot every day.

I forgot to mention this in my previous post. After switching to Hokas and the dry needling, I would tape my arches and heel anytime PF would flare up again. After a while... around 2015... I starting taping before EVERY interval workout. I buy coaches tape by the carton!

Once you get well... i.e., into the prevention/strengthening phase... you can go minimal or support. Minimal works for some runners; support works for others. I think if you're older, support is the way to go.

As far as icing is concerned, if you HAVE to ice, you're reinjuring the plantar. Thus, the healing process is constantly having to start over from day one. I think icing should only be done in the first 24 hours to prevent swelling UNLESS your doctor or PT has given you instructions to do it more often.

All you need is TLC (tender loving care) for your feet.

https://imgur.com/a/2EeykUM#j4FG2ke