Pain in the Planter fasciitis

Injury

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20/08/2002 at 12:55
Help

My Doctor says I've got Plantar Fasciitis. He's refered me to a podologist and suggested a seroid injection if it gets really bad.

I'd rather try to get rid of it without taking too much medication.

I've had to stop running and it's driving me nuts. I'm supposed to be training for the GNR.

Anybody got any tips for getting rid of this thing?

Thanks
Jo
Guy
20/08/2002 at 16:31
If you want to read a very long (and slightly depressing) article explaining what plantar fasciitis is, and exercises designed to avoid/cure it, have a look at http://www.pponline.co.uk/encyc/0180.htm.

Other than that, I can't really help you with getting rid of it. My only experience of it is that for the past few weeks I have had discomfort in my foot that seems to match the symptons of plantar fasciitis, although it isn't bad enough to stop me running or affect my pace. It seems to have been caused by doing a fast 5k in thin racing shoes. I have found that it virtually disappears if I don't run for a day, and is only brought back by doing a long run. It seems to come back at about 10 miles as a discomfort which doesn't get any worse, but causes pain after the run. My plan (not entirely consistent with the advice given in the article) is to run as much as I can for the next few weeks without making it worse, and then give it a rest for a few weeks after the New Forest Marathon (22nd September).

Personally, I would be very cautious about having injections, unless someone could persuade me: (i) it was absolutely necessary; and (ii) it was going to do more good than rest or exercises.

If you have not done so, you also need to give some thought to what is causing it. Otherwise you might cure it, and have it come back as soon as you start upping your mileage again.
21/08/2002 at 08:41
Joanne

I had quite a bad case of PF about 18 months ago and it really is depressing. I was training for London at the time and had to take about 8 weeks out COMPLETELY!. If you haven't done so already you must change your shoes, make sure you get them fitted properly at a specialist sports shop. I took Ibuprofen which helped but the thing that really helped was a foot massager. It was just a piece of wood shaped like a rolling pin but with grooves cut into it, its easy to use and you can even use it whilst watching the telly!!

Is it painful even to walk on? I know its depressing but you really need to get off your feet for a while. I didn't completely get rid of it before I started to train again but with the new shoes it just seemed to finally go away of its own accord after running again for a few weeks. Try to keep your fitness up by Cycling and or swimming.

Hope this helps - keep smiling!!
21/08/2002 at 09:37
Thanks fellas

I did keep running on it for a while after visiting my GP. I decided to stop when the pain after each runs was getting progressively worse. Now it hurts even when I walk.

I recently purchased some new shoes, Brooks GTS, from Northern Runner, they said I was over-pronating. At first I thought it was the shoes as I'd had no problems with my old shoes, so I went back to my old Nikes, but that made no difference

I've tried stretching, ice, heat and massage, but from what you say it's just going to be a matter time and a bit of trial and error.

I'm either swimming or cycling everyday but its just not the same as running.

Thanks again, it's encouraging to hear that it does go eventually.

Jo
28/08/2002 at 01:10
Hello Joanne,

I got Plantar Fasciitis earlier this year. I visited a sports injury clinic and had some physo including ultra-sound. The physiotherapist said I was over-pronating and sold me some shoe inserts (for my ordinary shoes) to correct my gait. This, along with stretching and ice helped to cure it in a couple of months. I started training again in June and have just done a 6k race today! No problems.

If you haven't seen one yet visit a physiotherapist - BUPA or a sports injury clinic usually charge around £30 for half an hour.

Good luck
28/08/2002 at 09:27
Thanks Percy

I'm off on holiday next week so I'm hoping some aggressive chilling-out and sunshine will help! I'm going to see a podologist when I get back so I'll let you know how I get on.

How did you know it was safe to start training again?

I'm not running at all and it's after a run that it's most painful, so it's hard to tell what's going on. There is a dull ache with each step I take and after a periods of inactivity it's sore but I can walk it off in a couple of minutes.

I did a circuit training class last week, but didn't run much, and it was OK afterwards, not perfect, but OK.

I have resigned myself to the fact that I might have to miss the GNR and I feel better about taking the time out, but I still get a little pang of jealousy when I see folk out enjoying their running!
28/08/2002 at 11:01
Extracorporeal Shockwave Therapy (ESWT)
- like what they use for kidney stones and gallstones.
Not that widely available I'm afraid but you might be lucky depending on where you live
28/08/2002 at 23:06
Joanne,

After 3 visits to the physio the pain had started to ease so she suggested I start gently jogging 1k on grass every other day for a week to see how it reacted. It seemed OK so I gradually increased.

At the same time I was doing 3 types of calf stretching twice a day because, believe it or not, tight calf muscles pull the fascii (that's why it often hurts 1st thing in the morning). I was also putting ice on it for 5 minutes after a run and last thing at night and rolling a golf ball over the sole of my feet midway through each day for 10 minutes.

It took about 2 months for the pain to gradually decrease, but at times I thought it would never go.

Hope this helps.

By the way there is info about Plantar Fascii on this site.

Percy
12/08/2003 at 13:19
I've had plantar fasciitis now since March and haven't run since and am getting very pessimistic about getting rid of this condition. I've seen several physios and have recently been to see a podiatrist. I have had ultra sound and have been told to do at least 25 mins of calf stretching each day. I'm also rolling a frozen tin of beans under my foot each night to stretch and reduce inflammation of the plantar. The podiatrist has also just prescribed night splints to stretch the plantar overnight. Does anyone have any experience of this working? I have also been told I overpronate too and have changed my running shoes. And the podiatrist also suggested undergoing a course of rehabilatative physio to help address my gait. Is this something anyone else has experience of ? Any advice gratefully received. Is it normal for it to go on so long?
12/08/2003 at 13:32
Hi Vicky

After visiting a podiatrist, getting physio and ultra sound treatment I eventually gave in and had a steroid injection at my GPs.

I had the injection in March and I've had no bother since then...touch wood.

I'm not training as heavily....it's just good to be back out there!

Good luck with the treatments, they didn't work for me but they seem to work for plenty of other folk.
12/08/2003 at 14:29
Thanks Joanne. Out of interest, how long had you had PF for before having the injection?
12/08/2003 at 14:41
It started end of June 2002, went to see podiatrist September, physio January thru February 2003 and I had the injection March...9 month.

My GP said the condition had become chronic because I didn't rest it when he'd told me to...ooopps!

It got to the point where it hurt just walking. I haven't had any pain since the injection...but I am expecting it to come back at any time!

It's not fun, I really feel for you.
16/08/2003 at 22:34
Try strapping it up - you can get instructions how to do it on the internet somewhere.
17/08/2003 at 08:35
2 PF strapping links
one in the Best of the forum
and this one from another magazine
18/08/2003 at 10:31
Thanks for the links to the PF strapping sites. I have been taping my feet following a visit to a podiatrist and it does seem to help a bit. But, I find that this condition is so variable. Some weeks I think I'm really making progress and then my feet will get really sore again.

What I'm wondering is whether I need to do even less on my feet than I am currently. I have stopped running completely, since April, but find I can only be on my feet for about 4 hours max doing shoppping, chores, cooking etc. before they get bad. Do I really need to take to the sofa? Does anyone have any experience of this condition clearing up by literally keeping off their feet for a period of time?
19/08/2003 at 21:31
I've also been suffereing from the dreaded PF for some months now and \i'm in my eighth week without any running whatsoever. After two months of physio (useless) and a steroid injection two weeks ago (more painful than child birth!)I visited a podiatrist today and was told my PF was caused by an extremely tight "gastocnemius" muscle. He said he had performed surgery on less severe cases (hes also a surgeon) and that stretching was all I needed to do (I had gone armed with cheque book for a set of orthotics)The stretch in question can be found on the RW website article "The RW Complete Guide to Stretching" Whether this works for me remains to be seen but it may be worth considering. Having looked it up in my anatomy and physiology books it appears to make sense.

12/09/2003 at 14:05
My previous (abortive) attempt at taking up running in 2001 was stopped due to PF (and laziness) but it got worse even when walking. I had a series of ultrasound treatments during last summer and, combined with rest of true couch potato proportions it seemed to go away.

Anyway, it's now September 2003, I'm 3 1/2 stone lighter than I was earlier this year and I've been running at least 9 miles a week since July.

The problem is that the twinges in the heel are starting to reappear and my worst fears are coming true - the ultrasound (as has been suggested) only helped ease the symptoms. The difference this time is that I don't want to stop running - I love it and have set myself the goal of doing a half marathon next year.

So I want to try and get to the bottom of the problem, which the doctor/hospital/NHS physio weren't too great at last time. If it's my gait, would a well-equipped specialist running shop help? (There's a Sweatshop locally with various fancy bits of analytical equipment). Yes, of course they'd want to sell me running shoes, but I'd be happy to pay if it addressed the problem.

So, to summarise, will staff in a specialist running shop be able to help or am I going to have to find a decent private physio?

Any answers welcomed...
30/09/2003 at 09:11
I had PF a couple of years ago. Not knowing what it was I tried resting it for a few weeks, but this didn't work. Went to the doctor who diagnosed an inflamed Achilles tendon!!!! and prescribed a course of anti-imflammatries. These didn't work, so he followed this up with an injection, which also didn't work (but hurt like hell). Went back to see another doctor who diagnosed PF and referred me to a physio.
The physio strapped my foot up as a short term measure, and got me to do a series of calf stretches. My over-pronation and tight calf muscles wer causing the PF. I also did a series of exercises to strengthen the calf muscles. I also used the physio's advice to buy a new pair of trainers.
Eventually the pain just faded away over time, I occasionally get twinges, but this is usually if I don't warm up and stretch the calf muscle correctly. As the doctor said the plantar muscle gets very little blood flow and because it is used constantly when walking, running etc it takes a long time to heal, it can take a year.
My advice is to see a sports physio and give it time.
01/10/2003 at 19:44
Well, similar story to Darren. I had my gait analysed at Sweatshop, got some stability shoes to replace my cheap cushioned ones and have done plenty of calf-stretching and foot-massaging since.

And the pain does seem to have faded away.

There is hope!
02/10/2003 at 07:58
Since recovering from PF late year I have taken some preventative action. The large Boots in my town (the chemist not footwear!) have a footcare department which gave me a biomechanical assessment. They found I had one leg shorter than the other by 1cm. This was causing the overpronation which had caused the PF. They took a cast of my feet and made orthotics (£150). I have had no problems at all since then. It's an expensive option, but I think it's worth it.
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