The "P" in Coach P is for Plantar...the F is for...well, nevermind...
I am 99% sure I have early onset Plantar Fasciitis. I haven't changed shoes but about 6 weeks ago I did pick up the mileage with an eye towards Boston. I was wearing my boot, but in retrospect my day-to-day shoes and slippers have provided zero support...and continuing to run during the rally with my peeps instead of resting it was not a good idea. So I am 3 weeks out from Boston and I am not running...I am however:
- wearing a night splint
- massaging & stretching before getting out of bed
- rolling foot on frozen can of artichoke hearts 5-6x a day
- rolling/stretching my calf / achilles (yes, tight)
- wearing better improved shoes during the day.
If I am missing anything (Tylenol?), let me know. I am thinking of changing from a 4mm Heel-to-Toe drop shoe to an 8mm one...just curious what you smaht people think.
In the meantime I am riding the bike and trying to stay sane....let me know, thanks!!!
~ P
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I just healed up from PF that I had for over a year. The best thing that worked for me was stretching the foot by bending my toes back as far as possible. If will pull on the fascia and hurt - it should feel like your toes will snap off. I did that religiously and showed the greatest improvement with that stretch. Good luck!
Often foot pain can be coming from muscles higher up the leg so good idea in digging out the calves. Posterior tibialis, deep toe flexors. Stretch your big toe into flexion. Do what you can to release the areas around the pain. What about more proximal issues. What is happening up closer to your core to cause increased pronation at the foot? If low back arched and abs not holding pelvis in neutral your hips roll in and increase the pronation at the foot.
You are doing all kind of good treatment.
So add: 1. higher heel or heel lifts in shoes. 2. Pool running 3. Planks front and side and single leg bridging, hip flexor stretch. I would add single leg squats( will help to increase calf ROM and strength)
Total bummer P. I hate Plantar Fascitis. It does not like it when we run on it. Nope- not at all. It will fight back.
Coach P, I have been fighting it for a couple of years now and feel like I am finally able to manage it. I have done all the things you listed even the night splint and strassburg sock when travelling. For me turns out the bike was aggravating it more than running. Orthotics in the bike shoe have really helped. I now wear orthotics in EVERY pair of shoes - After spending a fortune on the first pair, now use ebay and order the custom ones (they send you a mold and custom make it for 20% of the price). Also if you are a flip flop or sandal wearer recommend ordering those with arch support (also available via ebay). By doing the stretching, orthotics and icing after long rides I now seldom have to use the night splint and am 95% pain free. Good Luck!
Agree with what Kelly said above. I picked this up from Leigh Boyle's site. Put a Trigger Point ball under your foot and then stretch your toes back. It's like doing ART on your foot. You've probably already been on her site, but if not, that's what really helped (and continues to) help me...
The big question is, if you recover enough to run Boston hard, will you end up trashing the rest of your season?
Where are your priorities and how much are you willing to give? Not a position any of us wants to be in.
Rest well and recover, your injury is your Coach now.
I have an Elgin Archxerciser that I'm willing to give if you think it might be useful at some point. Basically it's used for strengthening your feet, and it's really easy to use. I don't really use it anymore, so you're welcome to have it if you want. Shoot me a PM if you're interested.
Hi coachP. Been struggling with a bit of PF myself for awhile. This is what made a difference for me:
1) Using a frozen golf ball and really trying to deep massage the area of the heel where the most pain is, usually in the evening before bed and through the day when I can 1-3x- put the ball between your foot and a hard surface floor and really dig it in. Thumbs also work well. When you find the spot rub across the tight band like playing a guitar string.
2) Following this up with stretches of the plantar fascia. Sit with affected foot crossed over the other knee so the knee is bent. Bend back the toes the of the affected foot (i.e. dorsiflex them) until you feel a stretch in the tight band at the bottom of your foot.
3) i ditched my 4mm drop shoes and went back to 8-12mm drop shoes in a rotation. I walk in my vibram five fingers sparingly.
4) check out this blog. Good write up. http://runningwritings.blogspot.ca/2013/02/injury-series-plantar-fasciitis-in.html
In the end, it's not rocket science (see video at 1:50 here:
Just out of curiosity, were you running in your Newtons or Hokas? Newtons have given me PF in the past.... please tell me it wasn't the Hokas!
everything else you mentioned helps, also, tho I'm not a big believer in the splints.
nothing wrong with Tylenol or Ibuprofen as long as your not going overboard with it.
Also, find yourself a short half-round foam roller. Place it flat side down and prop your forefeet on it. Standing tall, cross both arms over your chest and gently twist left then right. You'll feel the stretch not only in your calves but all the way up the back of your legs and lower back. You can also use the half-round for static calf stretching. I have one at work and one at home. I stretch my calves multiple times a day. I think that was a huge contributor to getting past PF for me. (FWIW, that little prop is a very useful thing. Flip it over, stand on one leg and do balancing squats - great for core and single leg ability for running.)
In regards to switching back to a higher-drop shoe, I'm in 100% agreement. I have limited dorsa-flexion in my ankles (a structural thing produced from YEARS of gymnastics abuse), so wearing a low- (or zero-) drop shoe is a really really bad idea for me. I got off the no-drop bandwagon. Besides, I think we all know now that the "drop" of the shoe isn't as important as where you're landing on your foot in relation to your center of mass while running.
I remember you were running in the Hokas at camp. Are those a recent change for you? Maybe consider going back to whatever worked prior. As a wise man once told me in regards to purchasing a new/different running shoe: "If it ain't broke......" :-)
Heal up, coach. And next time, make us run by ourselves!!!! If one of us told you that we had PF, would you have encouraged us to lace up and head out? When you fly on an airplane, the flight attendant instructs you to put your oxygen mask on first, before helping others.....there's a good reason behind that. :-)
http://www.ezultrasound.com/ultracu...chine.aspx
I really thought the P in Coach P was for "2X on the bike"!
In the article, the author points out that everyone’s PF is different and anyone who has it just wants it to heal. But as athletes, we have to “get serious” about its treatment. “Serious” is described in the paper – trust me, most of us are not serious in our actions. Following the guidelines in the paper, I recovered in less than 1 month (once I got serious) and I was back running pain-free. Contrast that with the first time I had PF was back in 2010 where it took almost 8 months before it finally heal. And understand that I’m in my 60’s now and generally heal slower.
Based on the article, here is what I did:
1. Never go barefoot (I had to stop)
2. Never wear flip flops (I had to stop)
3. Spend 3-5 days seriously icing (serious = 20 to 30 times a day!) with ice directly on the arch/heel – Ice for only 3-5 min; re-do when the foot reaches room temp; Icing this much might seem a bit counter-intuitive but it is the key. Seems that swelling is the big inhibitor to healing in the foot where blood flow is limited. I did this for 4 days.
4. Sleep with a soft splint – this holds the foot in a somewhat toes-up position. Helps it to heal and not get re-injured in the morning. Purchased at most drug stores
5. Always wear a hard arc support insole. I bought mine at a Running Store – it’s designed for PF. I wore them everywhere, inserted into every shoe I wore (running, biking, dress, casual, etc.).
6. Once the pain subsides, begin doing the two key foot-tendon stretches as described in the article and easy running (w/ supports). This was day 4 for me.
I know this is a “Serious” approach but so is having a chronic problem with your foot. There is a lot of data about PF in the article that did not apply to me but it may apply to others. Good luck.
http://saveyourself.ca/tutorials/plantar-fasciitis.php
Also, if my calves and feet feel tight I do 3 or 4 "downward dog" ( from yoga ) stretches for 30s or so each. I'm not sure exactly why these do the trick but I have a couple of ideas. They seem to give the whole kinetic chain a stretch from the low back/pelvis to the toes.
Seriously though, I hope you are able to get past it. My husband had some PF issues and has been using Superfeet inserts in his running as well as dress shoes. The later is crucial since he is in dress shoes most of the day.
I feel your pain as I think I am in the same boat as you! Thanks for posting as it saved me the trouble of having to post something. You are being remarkably calm considering Boston is 3 weeks away. I am trying not to stress out since Ironman Texas is 7 weeks away.
@Jim: X2 for posting the link to the article! And you are so right about not wearing flip flops. I bruised my my fascia when I spent 10 days in Hawaii wearing nothing but flip flops.
Thanks,
Joanna
Coach P,
Did your PF resolve? How long did it take?
I have been doing all the recommended treatments... calf,hamstring stretching, night splint, icing, rolling, foam rolling calf, hamstring, physical therapy with astym and ultrasound, orthotics, and most recently a cortisone injection. I had only 2 days of relief following the injection. FRUSTRATED! This has been with me for several months now and I can't seem to shake it.
I am seeing the physical therapist daily for Astym and ultrasound for the next 2 weeks. I have a follow-up with the podiatrist next week.
I have heard this can linger for months/years.
I am curious as to how long others in the group have battled this injury???
Did Vegas 70.3 in Sept, ignored the initial minor signs, then decided to take Oct OFF...no running, so it could "heal". What did I know? Never had PF before. Well, that was a waste of time.
Began seeing a fabulous PT in my area and she immediately began me with foot exercises (all of which have been described below) and instead of Graston, which can be hard to do on the area my PF is in, she has been doing Cross Friction Massage with her knuckles. Much easier to get in the exact area and massage ACROSS the affected area, instead on up and down the foot. This helps to break up the scar tissue that has been laid down in a criss cross pattern in the foot. The PF muscle runs up and down the foot, so the idea is to break up the scar tissue that is laid down diagonally and across the foot causing tightness and pain. Followed up with Ultrasound and tape. I have seen huge improvements.
I ice after running, and do a variety of stretches. Mine was caused by a tight left hip/glute from old injuries which was throwing off my gait. Result? Too much pressure on bottom of right foot. Hmmmm....so she does ART on hip and all sorts of stretches.
It is absolutely frustrating! Especially with a full IM looming, but I am committed to full healing and doing what I can to get to the start line healthy.
I have discovered that I can get a near similar effect of Cross Friction, by lying on the couch and placing the affected PF area on the inside ankle bone of the opposite foot and rub it back and forth across the bottom of my foot. It almost immediately improves.
Good luck!