Need help with plantar fasciitis and possible heel fat pad atrophy!

If you believe in homopathic medicines, do you believe in the evil eye? Eyeliner? Spirits?

Never heard of evil eye or eyeliner before. Ive never seen or felt the presence of a spirit before either so I dont have belief in them yet. I'll try anything to help with PF.

On another note, I started taking kal magnesium glycinate and I do feel a slight positive difference but I still have the issues. I now use a dough roller to put pressure by my calves which are tight twice a day and im not seeing much improvements either. I still wear the night splint every night with not much improvement either. I heard of a person taking ultra potent c with pf with success. Will try that next. Didnt take the rhus tox like someone suggested so will try that too. Thats poison ivy though. Isnt that stuff poisonous? All in all ive had a little improvement but not enough where I can start running again. Anybody else with something thats helped?

Bump

Bumpity bump.

Update Ive been doing so many things that can attribute to my PF going WAY down. I took some of the advice about magnesium and rhus tox and I started doing a new calf stretch I learned from Athlean X here...

https://www.youtube.com/watch?v=72p58Iy6u7M&t=536s

.

And i'm seeing progress. I had severe PF. I mean whenever I would get really active my left leg would feel like stabbing pain in my foot and the pain would travel up to my calf and I would start to limp. Man thats pain. I can now move around way better. Ill keep updating hopefully this helps someone!

All us old multiday guys have had every injury. A long, slow race irons out any injury in a week (mainly by stimulating various survival, self-healing feedback mechanisms).

Otherwise, go back to basics. Long barefoot walks on a gentle surface. Walking seems easy until you do it for hours. Also resets over-stimulated nerves and pain centers to a “natural” pace. Sort of like hunting & gathering pace.

Pain in foot can be ingrown warts (from wearing cushioned, sweaty shoes). Barefoot will dry them out & build callouses. Rehab running be done barefoot on soccer fields.

fisky wrote:

Switch from the Nike Free to one of the Hoka models. Hokas have a soft, thick heel and more important, they change the impact point from the end of the heel to more under the heel almost to the midfoot.

Next, you could try removing the existing insert and replacing it with a Superfeet green, blue, or black insert. The difference is that each color has a decreasing amount of cushion. They mostly support the arch and prevent pronation, which can exacerbate PF.

I strongly recommend against the Strasbourg sock. It can hyperextend the big toe if you keep it on all night.

This is a follow up to my post shown above.

It seems that you have tried a lot of stuff with no success. In my book and here on LetsRun, I write about how runners often use the wrong approach to an injury by not understanding the stages of injury recovery. In short, they try to recover too fast and reinjure the muscle/ligament.

Injury recovery goes through 4 (sometimes 5) stages. If you skip a stage or move into it too fast, you can reinjure the tissue so recovery must start over from day 1.

Stage 1 Acute: In this stage, your goal is to prevent the injury from getting worse. This involves stopping running, using ice to prevent swelling, compression, taping, and so on. It might involve use of a crutch or boot in severe cases.

Stage 1a (OPTIONAL SURGERY): In some cases, surgery might be needed. If so, after the surgery, healing begins in stage 1 again. In PF, one option that was very successful for me was dry needling to break up the scar tissue of the old injury and to speed blood flow to the area. It took three treatments.

Stage 2 Restricted Movement: For healing to occur, range of motion must be restricted so you aren't retearing the tissue. Range of motion must be restricted long enough for scar tissue to form AND get strong enough to support the running movement. Scar tissue starts to form in two weeks and is as strong as surrounding tissue in about 6 weeks. In the case of PF, restricting movement would be arch supports in ALL shoes at ALL times... not just your running shoes. It might involve a boot or arch taping. This does NOT mean you have to take 6 weeks off or even two weeks IF YOU RESTRICT RANGE OF MOTION WHILE IN STAGE TWO. It might require changing running shoes to get more support in the arch or more cushion in the heel while staying in a low heel to toe drop shoe. It will most likely require taping the arch for extra support for 4-6 weeks. If you don't do this and you feel a sharp pain, you have reinjured the tisse and recovery must start over for that strand of tissue from Day 1.

Stage 3 Rehab: Now that scar tissue has formed, it will not be as flexible as regular tissue so it will take a while to regain full range of motion. For severe injuries and older runners, you may never regain a healthy full range of motion. This step is very hard for runners because of their mindset of "working through the pain." Instead, rehab involves LIGHT stretching, not hard stretching. How light? I can't tell you. I would suggest slowly and dynamically stretching to the point of tightness and then immediately release. IF YOU STRETCH TO THE POINT OF SHARP PAIN, YOU HAVE RETORN THE DAMAGED TISSUE AND HEALING MUST START OVER AT STEP 1. I put this in bold because PF, calf, hamstring, and Achilles injuries have ended the careers of professional runners because they tried to "run through" injuries and continually reinjured the area.

Stage 4 Prevention/Strengthening: Runners routinely jump right to strengthening exercises. As a result, they continue to reinjure the tissue and healing is constantly having to start over from Day 1. Generically, strengthening involves putting the muscle/ligament into a full range of motion while under stress. You can't do this too soon. If you're young and get through this stage successfully, you might be able to return to running in the shoes you were running in before.

My story: I have had PF off and on for decades. About 4 years ago, it flared up so bad, I had to use a crutch in the morning until it loosened up enough to walk. I decided to try everything. What worked was dry needling. However, when I healed enough to run, I switched to Hokas and made my own orthotics by added crafts felt under the arch. I routinely taped my arches when wearing spikes, interval shoes, and racing shoes. Taping is an art, not a science, but you can figure it out with patience. Good luck.

Thank you very much for the advice! I will look into dry needling. My feet only tend to hurt by the arches if I stay standing for too long now. I was going to try running on the treadmill but now that I read your post I will start slow.

2 years of PF off and on for me. Switched to running in an XC flat without arch support and it instantly went away for me. Sounds too good to be true but that’s what did it in my case. I’ve even tried to rotate an old cushion shoe with arch support in on easy days and like clock work my pf flairs back up. Give it a shot. Since the Spring I’ve run in nothing but xc flats including long runs and my Fall Marathon. Zero injuries and a lot of flats are only 40 bucks!

Hi PFsucks. Could you please tell me why you thought you had fat pad atrophy? Was it diagnosed and is it better now with the exercises? I believe I have problems with my fat pad but no PF, at least ultrasound didn't confirm it. Thanks

I thought I had fat pad atrophy because the middle of the back of my foot was always hurting. I too had an ultrasound, I had xrays taken on the bottom of my foot and no heelspurs or the foot specialist telling me I had fat pad atrophy. Well my pf got better but now its come back to the point it bugs me but not like I used to have it where I was limping. I even do the stretches in the video on a daily basis every hour almost. This pf is really annoying me. Ive had it for a year straight.

Im also having back problems which may be contributing to my pf, said a chiropracter. Ill keep trying different things but I may have to accept the fact it may be a chronic condition for me. I wont lose hope yet.

NEVER lose hope and admit that you have a chronic condition.

PF, from my own research and personal experience, is an confounding injury. This thread is a testament to that. When I struggled with PF I approached a running mentor of mine and he basically told me he could not help. He said there was dozens of approaches to solving the issue and to just do what I thought would work best for me.

So I applaud you for trying every technique in order to fix this. With that being said, her is what worked for me

• Rest. There is no point, in my opinion, in doing any serious rehab if there is a great deal of pain. If you got a concussion no doctor would give you crossword and sudoku puzzles to solve as rehab.

• Once pain has subsided stretch. I stretched my calves and Achilles to the point that they began to feel like wet noodles.

• Roll out foot. This is certainly treating the symptoms, but nonetheless, get a lacrosse ball and just roll out that foot to the point that it's barely tolerable.

• Fix your mechanics. Cmon man, don't buy into the hokas, orthopedics and surgery. Those things can all be beneficial, but there is still underlying issues. My calves were my issue. It may be your hips. Or you mentioned your back? Do some supermans stretches to strengthen your back.

You've got this! Keep your head up, and if you find something that even slightly works, run with that!!! You know your body better than anyone else

Hi Fisky, would love to learn more about the dry needling and what worked for you. What is your book? I’m considering dry needling for PF. Thanks!

I had PF on and off for around 2 years. Tried everything possible. Eventually went to a sports rehab chiropractor and she uses Grafton and soft tissue therapy to loosen the foot, Achilles, and calf up. She also worked on my hamstrings and glutes. Here is what I do now for maintenance:

1. Wear a night splint - get a hard one that is comfortable, they are like 30 on Amazon. This is the best thing you can do, because it keeps your calf stretched all night.

2. Stretch your calves every chance you get. The athlean x works well.

3. Get a Chinese foot reflexology massage. Seriously amazing, it mostly targets the foot and calf, and it is way less expensive than a chiropractor.

I haven't seen a good correlation with shoes, but I mainly run in altras and topos, and hokas are good too.

Good luck.

Mollyrun wrote:

Hi Fisky, would love to learn more about the dry needling and what worked for you. What is your book? I’m considering dry needling for PF. Thanks!

Dry needling is taking very thin needles, finding the scar tissue spot by poking around until it hurts, and then pulling the needle partway out (maybe a quarter inch) and rotating it and poking it back in again several times quickly. The needle flexes so this makes a circle of holes in the scar tissue, which lets fluid/blood flow in that area to speed up healing and break down the scar tissue.

It hurts, but the pain amazingly quick and then over. My PT said it usually took 5 sessions. I was 25% better after one session, 70% better after two sessions, and 80% better after three. I decided to stop at that point since the sessions were $100 each. I was able to run/walk almost normally after the 3rd session. My PT was surprised that it healed so fast because in his experience, it took 5 sessions to get the results I had in three sessions.

I also switched to Hokas, which helped with both the PF in the arch and in the heel. If I feel any twinge in the arch when doing intervals, I stop and tape the arch. When I race in spikes or flats, I tape the arch before the race/workout.

My book is 200 Tips Every Runner Should Know: How to Train Smarter, Avoid Injuries, and Become a Better Runner, available on Amazon.

The biggest problem with most runners is that they skip important steps in the healing process by going straight to strengthening before going through the earlier stages of injury recovery. (See my post on Dec 18, 2018, in this thread.) When runners skip stages of recovery, they often re-tear the same tissue again so the healing process must start over from day one. And unless they're under a PT's supervision, runners ALMOST ALWAYS (in my first hand observations) stretch the wrong way. They stretch way too hard, too static, and before warming up the muscles.