RW's BIG Q+A Index

Is there someone who can please give me some sound advice. I have been running for 16 years and have never been injured before. I have not altered my training.
I have developed a pain on the instep of my left foot. Apparently all the signs point towards the Plantar Muscle on the underside of my food.
It is very painful in the morning when I get out of bed. I have still managed to run and once warmed up it is fine. My left knee has also been a bit painful as i have been conteracting the pain. Can you please help with the following;
1) Is there some sort of strech exercise that I can do to contribute to the healing process?
2) How long will it take to heal?
3) If I am to rest how long will I need to rest for?
Posted: 20/09/2002 at 12:27

Hi Ben

I have recently been diagnosed as having Plantar Fasciitis and your symptoms seem similar. My GP has referred me to a podologist. My appointment is a week on Monday so I can't give you any expert advice but...

...my GP told me that if I kept running on it it would only get worse and become chronic, possibly leading to the formation of a heel spur.

Did I listen? Did I chuff!!

Because it mainly hurt on a morning and I could walk the pain off in a few minutes and it only hurt after running not before or during, I thought I could just keep going. It got to the stage where it hurt walking after sitting for a short time. Now it hurts all the time.

I stopped running about 5 weeks ago, I was training for the GNR and I've had to pull out. My GP recommended RICE, stretching and massage. It does help and I've been keeping active. Swimming and cycling don't seem to bother it but it's not the same as running and I miss it.

I started a thread about this a couple of weeks ago and did get some promising responses, one chap said that he had it and managed to shift it in 8 weeks with the help of some new shoes.

I would say get yourself to the doctors and if you are going to have a break do it sooner rather than later. Plenty of stretching too.

Good luck, let me know how you get on and I'll let you know what the podologist had to say.

Jo
Posted: 20/09/2002 at 13:00

Hi,

This may or may not be useful because what I had was definitely not plantar fasciitis. It was apparently micro tears in the plantar fascia, but not classic PF because it wasn't at the point of insertion and I didn't have more pain in the morning than the rest of the day.

Anyway, the point is I had it for a heartbreaking 10 months, trying absolutely everything including physio and many visits to a sports doctor. What finally cured me was a custom orthotic. I had my feet cast, got the orthotic and two months later ran a totally pain-free marathon. The doctor had avoided suggesting the casting for an orthotic in case it could be cured without it, but in retrospect it could have got me up and about so much quicker had I done it earlier.

It really is worth considering getting a custom orthotic. It holds the foot exactly in place so avoids any strain at all (the way I understand it).

Val.
Posted: 20/09/2002 at 13:32

Hi Val

Do you use the orthotic in all of your shoes or just your running shoes?

Where do you go to get one?

Jo
Posted: 20/09/2002 at 13:51

Jo,

I only use them in my running shoes. I did have some off-the-shelf ones early in the injury and I wore these in all shoes. This did initially give me a lot of relief from the pain as I was walking around, but the injury itself wasn't improving. Once I got the custom orthotics I kept the others in the pair of non-training shoes but I suspect I could have got rid of them quite soon because the injury started healing as soon as I had the others.

I got mine from the podiatrist at Bupa Wellness at Barbican in London (previously Barbican Health - I highly recommend their sports section) but I imagine any podiatrist would be able to do it. She cast my feet and made various measurements but the orthotics themselves are made somewhere else. Even though I was only injured in one foot I have orthotics for both - apparently it is to ensure the exact correct posture when running.

Good luck, I hope you get sorted out.

Val.
Posted: 20/09/2002 at 17:27

Hi all
This sounds like a painful fora
Well the best treatment for PF is to treat the injury by cooling when its in its painful phase. Take the weight off the injured foot??? Tape up to unload the area or apply a heat sock or insole
You need to check that your shoes are not too stiff or too soft
Do plenty of stretching-mainly calf stretch over the edge of a step to lengthen achilles
Take plenty of ibuprofen unless you are asthmatic. You can have orthotics made that have bits cut out around the inflammed area
Hope ive been of some help
LT x
Posted: 20/09/2002 at 17:44

Dear All

A big thank you to you all for such a quick and positive responce.
To update you;
I went for three physio sessions, have been running every second day and things are looking up. Have not run for 4 days but could be a blessing in disguise.
Things are looking up & have entered for London.

Thanks once again to you all. It has been a real blessing knowing there are folk like yourself out there willing to be so helpful.

All success and maybe chat again.
Posted: 15/10/2002 at 14:47

Has anyone any ideas as to how to prevent sore patches on my face due to running in wind and rain (combined with sweat!)? I've tried expensive creams which don't work. Vaseline has worked but recent weather has been too much even for that.
Tks,
Kate
Posted: 19/11/2002 at 15:37

Your symptoms are classis PF. I was diagnosed with the same a couple of years ago, the give away is the pain in the morning. Stretching the calf muscle for 20 minutes, spread throughout the day, will fix it. Speed work or hill sessions will aggravate the condition until you are right.

Jim
Posted: 20/11/2002 at 22:22

ben

Classic PF I'm afraid.

Get your gait checked (if you don't already know) and buy shoes to suit. Check your workaday shoes as well - chuck 'em away and buy some new if they're worn. (Sorry this sounds expensive)

Stick your feet in a bowl of iced water for five minutes on rising and retiring - and stretch. All the other advice here is sound stuff.

I got clear of it in about 10 weeks.

Posted: 21/11/2002 at 08:10

Hi all
I run to keep fit for my main sport which is mountaineering, fell walking, etc. I tend to run about 3 lots of 30 minute sessions a week either over fields or along the canal tow path. On my last run I had a sudden pain in my left hamstring approx midway between hip and knee. This stopped my leg walking properly for about a day - it didn't seem to want to go forwards! That subsided but the occasional 'twinging' has continued. I haven't run now for 3 months as I'm afraid of injuring myself further. But, I don't seem to be getting better as there is still a definite ache in the thigh, particular when I'm walking the dogs in wellies over muddy fields - when the hamstrings have to work harder to extricate feet from the mud! I'm afraid of stretching in case this makes it worse. However, after 3 months I would have thought all traces of the injury should be gone. So,
1 Should I try gently running again and
see what happens?
2 Does it simply need more time?
3 Should I try some stretching?
4 Could it have been stretching before running that caused it in the first place?

Posted: 28/12/2002 at 20:04

I've suffered from PF recently, but I cleared it in about 10 weeks (it's almost completely gone now). The key is anti-inflammatory measures - whether that be RICE or ibuprofen; mixed with an effective stretching regime for the calves and if you know how, the plantar fascia itself. The key is also REST. I didn't run for a clear six weeks, which helped immensely. Good luck! :)
Posted: 28/12/2002 at 23:51

I worry about losing lean muscle!
I am a woman of 52 who started running last December. I weigh 109lb at 5'4" tall and feel fit and healthy. At the moment I only run up to 15 miles three times a week but am inceasingly becoming an enthusiast. However, I worry about the effects of having low body fat and whether I will lose lean muscle if I run every day. Should I cross train instead?
Posted: 22/04/2003 at 23:00

It may be that your injury in neither Plantar Faciitis nor Heel Spur.
I had exactly the same symptoms and after
an X-ray discounted Heel Spur and a cortisone injection made no difference I finally was seen by a Professor os Sports Medicine who arrange for an Ultra-sound scan.
The diagnosis was "Fat Pad Syndrome" which is apperently damage to the fatty pad below the heel - hence the name.
I was told that the only cure is time and patience - not much use when you're heading for 62!.
It is now 6 months since I did any running.
Posted: 30/04/2003 at 22:46

hi there,have been having some problems with my knees lately,just below the kneecaps which is worst on climbs,do you think i need to see the doc or is it a case of buying some knee supports.
Posted: 18/05/2003 at 18:54

I have been passing blood after running which I am getting checked out, but my doctor says it could be because of the long distances I am doing, has anybody heard of this before ?
Posted: 05/06/2003 at 22:15

Hi, the pain and symptoms you have mentioned are clasical in presentation, they can however be caused by a number of factors. The term plantar fascia is a blanket term used to describe pain on the bottom of your feet. It is general and gives no specific aetiology or pathology, docs and the such use it before refering cases on etc.
The medial longitudinal arch as you mention has muscles within, both internal muscles of the first layer that insert into the medial tuberosity of the calcaneus (heel)as does the medial (inside) slip of the plantar aponeurosis which is connective tissue. There are other structure around but without palpation it is difficult to say for sure. But it is proberbly these insertion points that are strained. if you are pronating a bit to much or your calf is tight this can be the main cause of the pain as can older trainers. Ice and compression three times per day plus nsaid's such as brufen if you are not contraindicated and wish to take them are good. although running for ages there are other problems, if nothing else has changed but the majority will require a very simmilar treatment. so stretch calf and the ice and stuff. But it sounds like trainers or an irritation caused by abnormal foot function. the achilles tendon is continued to become the plantar aponeurosis which is the reason the two may be linked. A few other things do exist, but there is too much to go into here. I recomend a podiatrist as they are foot experts, this may do away with the steroid injections and x-rays and stuff that makes no long term benifit in the majority of cases but stops symptoms for a few months. Heel spurs aint going to be where you described, even so between 50 and 80% of the population have them. It isent the spurs but when operated on the access through layers of connective tissue and the rest after releives the torsional strain.
A good state registered pod will make a big difference by finding the problem, with him the prognosis is good. If you bend your foot towards you and stretch the plantar surface tight and rub up and down is there any bumps in the ligament?
regards steve
Posted: 05/06/2003 at 22:51

As for time scale to healing it depends, visit a pod now and it may be 10 days to 4 weeks, a custom device isent always needed.

Posted: 05/06/2003 at 22:53

Hi, I was after some advice;

I have been actively training for 4 years with a mixture of excercise's i.e. Boxing, running, circuit training, football etc..

But recently due to time constraints I have concentrated on running just as I felt I was getting somewhere in terms of distance and times my knee seems to have given way.

My inner side of the Knee feels tight and I suffer sharp pains after excercise. I have left out the training for 5 days and the pain has disappeared but as soon as I go out again it comes back. If anybody can offer andy advice I would be grateful.
Posted: 14/06/2003 at 12:53

5, Ashleigh Gardens
Barwell
Leicester
Leicestershire
LE9 8LE
01455 445836

Hi I have a number of problems and don't know a lot of the answers and was looking for advice. For a long time I felt very sorry for myself. I had a 35:38 10K PB behind me and a 28:50, 5 miles. However I always trained like a madman; didn’t listen to advice and people avoided “training” with me.” My times should have been faster but I kept piling on the agony. I did up to 75 miles per week. Every mile of which was “solo.” On Sunday I did a 20 mile road run. On Tuesday’s I did 12 x 70 seconds virtually flat out with 70 seconds recovery and on Thursdays I did 12 x 90 seconds virtually flat out with 90 seconds. I did a race pace run on a Saturday when I could, but instead of getting faster I got slower and slower.

Eventually the injuries stacked up one upon the other and I started to get very ill. With one thing and another in my life I had put immense pressure on my immune system and I started to get chest infections and they won’t go away. I have been diagnosed with two lung diseases called aspergillosis and bronchiectasis. I spent most of 2001-2003 ill and feeling very sorry for myself. My life as I saw it was over. Neither could I compete in my other sport of karate.

Runners World has been brilliant for me but I am never going to be free of the infections that I have pickled up and will be on medication for life. I have managed to claw my way back into jogging with the advice of my Doctor and managed a 10K training run on Sunday.

A lot of the advice in RW seems to be aimed at the wealthy. I am unemployed, cannot afford to go to gyms; cannot cross-train because of lack of venues; cannot afford a bicycle; must train on roads and I will get ill and injured again. So how do I prevent myself from getting injured when I seem to be doing a lot of the stuff that is going to make me injured?

Are there places out there where you can but reliable 2nd hand treadmills etc.

Thanks everyone
Tommy Campbell

Posted: 02/12/2003 at 18:01

Hi I have a number of problems and don't know a lot of the answers and was looking for advice. For a long time I felt very sorry for myself. I had a 35:38 10K PB behind me and a 28:50, 5 miles. However I always trained like a madman; didn’t listen to advice and people avoided “training” with me.” My times should have been faster but I kept piling on the agony. I did up to 75 miles per week. Every mile of which was “solo.” On Sunday I did a 20 mile road run. On Tuesday’s I did 12 x 70 seconds virtually flat out with 70 seconds recovery and on Thursdays I did 12 x 90 seconds virtually flat out with 90 seconds. I did a race pace run on a Saturday when I could, but instead of getting faster I got slower and slower.

Eventually the injuries stacked up one upon the other and I started to get very ill. With one thing and another in my life I had put immense pressure on my immune system and I started to get chest infections and they won’t go away. I have been diagnosed with two lung diseases called aspergillosis and bronchiectasis. I spent most of 2001-2003 ill and feeling very sorry for myself. My life as I saw it was over. Neither could I compete in my other sport of karate.

Runners World has been brilliant for me but I am never going to be free of the infections that I have pickled up and will be on medication for life. I have managed to claw my way back into jogging with the advice of my Doctor and managed a 10K training run on Sunday.

A lot of the advice in RW seems to be aimed at the wealthy. I am unemployed, cannot afford to go to gyms; cannot cross-train because of lack of venues; cannot afford a bicycle; must train on roads and I will get ill and injured again. So how do I prevent myself from getting injured when I seem to be doing a lot of the stuff that is going to make me injured?

Are there places out there where you can but reliable 2nd hand treadmills etc.

Thanks everyone
Tommy Campbell

Posted: 02/12/2003 at 18:06

Have just been diagnosed with pf (my left foot) and this thread has been really helpful. I think it has helped pinpoint my problem, whenever I do a lot of hills especially xctry races I get tight calves followed by numb feet or foot. I think this has been the cause of my probs. I tended in the past to run on with numb feet.
I did a race at Upminster on sunday and had to keep stopping and stretching calves.
My left foot came alive in the last mile!
What I have picked up now is that I have to stretch those calf muscles before
these sort of races.
Thanks everyone!
Posted: 09/12/2003 at 09:39

I've been running for 25 years and used to get the same problem.Often.I discovered that really it was my day shoes... which gave me little support. I simply bought a pair of self moulding insoles from Boots (guaranteed to ease this pain and that pain!)which cost £20. Since then ...no problems!
Posted: 14/08/2004 at 08:54

Treacle legs, what did you mean when you said to check for bumps on the ligament of the flexed foot? two weeks ago I had a lump the side of a pea there, and now I have very uncomfortable forefoot pain. The lump is gone, though.
Posted: 15/08/2004 at 23:26

I have found a tremendous cure for all biomechanical ailments including PF.

It's rather gender specific...sorry fellas...get pregnant....stop exercising completely....feel fantastic!


Posted: 16/08/2004 at 09:05

Ben,

It sounds like you've got plantar fasciitis, which is the thick fascia (or tissue) on the sole of your foot.

Its pretty tough to get rid of and is often a reoccuring problem. The best thing to do is to go to a physio, if you want an NHS physio (the best of course) you'll need a refurral from your doctor and it'll probably be a 6wk wait.

In the mean time www.blackburnfeet.com has lots of good info on plantar fasciitis. You could also try standard 3 x 30 calf stretches as long as it doesn't irritate you. There is a way to stretch the plantar fascia but opinion is split as to whether this is helpful or harmful.

You do have to rest though, I wouldn't want to stop running either, but think about it this way - the longer you don't rest and irritate it for, the longer the problem will persist.
Posted: 27/08/2004 at 17:21

I had Plantar Faciitis after running the London Marathon last year. I didn't rest it properly and and was then pretty let down by the medical profession when I sought help and advice. I am subsequently still suffering. Recently though, I went to see a clinical massage therapist who really alleviated the pain and I am now under a podiatrist looking to get custom orthotics. I have finally started to creep the mileage up again after a very depressing year and feel I have the right professionals looking after me. My advice to you would be get this sorted out properly and immediately - it sounds like your doctor is giving you the right advice at this stage and rest is crucial. I went back to training far too hard and way to soon and didn't have half as much fun watching other people run the marathon this year as I had running it last year. It will get better but I cannot stress enough how important it is to do as your told!
Posted: 18/04/2005 at 16:45

Hi Ben

I had a tight pull in the arch of my right foot (the lead leg I run with). I suspected plantar fascilitis but went to a sports physio just to check and she diagnosed it. Now I have stretches that concentrate on the calf, ibuleve gel, ice, massage and ultrasound. It pulled twice during the FLM but is much better.

If you're not getting aches in the heel or arch last thing at night/first thing in the morning then I would get it seen to now whilst it is still "mild" and before it gets worse!

Let me know how you get on.
Posted: 18/04/2005 at 18:20

Hi hope someone can help.....
I was involved in some mudbath of a race, after i felt pain in my heel behind the achillies tendon have looked all diagnosis but can't find anything that apply's to my injury.It hurts when i push off on a stride either side of the tendon it takes about ten days to recover, but as soon as i run again it re-occurs
Please help, so i can carry on with the right course of action
Cheers!
Posted: 16/02/2007 at 20:52

Tommy,
How to make yourself sick and injured indeed. People have written books on how to avoid overtraining etc. Rather than go into the principles I would suggest a trip to the local library and ask for the sports section. There should be tons of advice there and all for free. You do, of course, then have to follow the advice!!
john@physiocalling
Posted: 16/02/2007 at 23:27

Hi Tommy. I know what you mean about what's affordable. If you're not working at present you should be allowed to use your local leisure centres for free? In my area all the local leisure centres which are run by the local authority had real face lifts and refurbs and are now realy nice and full of good machines. The gyms are really well equipped and there is a wide choice of classes. In my area people who claim particular beenfits are eligible to use the facilities for free. Also if you don't want to road run, there may be a track in your area? Hope you'll get better soon. :-)
Posted: 17/02/2007 at 14:25