Training recommendations

david ware

I am looking for some cumulative wisdom from the gang.  As some of you may know, I have been dealing with foot injuries almost all year.  Started with Plantar Fasciitis which has gotten a little better, but has now also become an issue with the muscle adjacent to the Plantar tendon, and also some nueritis at the 5th metatarsal and some sort of problem at the tendon insertion to the sesamoid(?).  Since I was not getting better from the treatment I was recieveing, last night I went to my podiatrist (probably should have gone a long time ago but was treating with a sports medicine MD and a chiropractor that I trust.)  Podiatrist says I have a condition that he sees a lot in gymnasts and ballet dancers.  I apparently I have high arches and with the workouts, and compensating for the PF I have developed these other conditions.  He is going to put me in a cast for 3 weeks, starting Nov 30.  If that works, great, if not he has suggested a minor surgical procedure.

In any event, I am in the NOSA.  I have been only biking per the plan and doing deep water running.  First question:  Any recommendation for training while in a cast, or should I even attempt to do so.  The doc said I could "probably" ride but may need to do a recumbent, not sure?  Obviously no running, and I am not clear if he will let me do the deep water running.  Obviously we are trying to let the injured area rest and heal, so I do not want to overdo it.  Also, thoughts on whether in light of all of this I should push back to the Jan OS and start over.  I am planning on St. Anthony's at the end of April, and my thought was that if I am able I might be a late sign up for Kansas 70.3.  I lost about $750 in entries this year because I could not race and don't want to waste the money if I am not sure what I can do.

I know we have some docs in the group and some WSM's.  Please, any help would be greatly appreciated.

Dave

Paul Stone

Has anyone diagnosed what caused the original injury? Just plain overtraining or an imbalance causing overcompensation?  

david ware

Unfortunately not. In May, I had completed a training run, per the ENTraining plan. It was essentially the same run I had done the previous week. No pain or problem during the run. About 2-3 hours later I started getting the heel pain. No one has really advised why. I have been working for the last year with a coach learning the Pose method which did change my normal heel strike to a mid foot strike, but that is supposed to help prevent PF. The docs all seem to agree that the new problems stemmed from the PF but no one has indicated why the PF came on. I would usually run about 25 -30 miles per week and rarely two days in a row to, again, try to prevent injury. I do have a chronic history of gastroc and soleus problems so I make an extra effort to try and avoid problems. Thanks for your help. Dave

Chris G

no clue how you can train in a cast, you will have to wait and see on that one. I would be very interested in finding out how the injury came about before getting a cast. What is that supposed to fix? If you have a long history of the issues won't they just come back after the cast unless you find the cause?

hollern

David;  I am a chiropractor and have had experience working with people's foot problems.  I would like to make a suggestion.  A few things, have your chiropractor look at your gait ( walk ). The foot can be adjusted as well as the toes.  It needs to be done repeatedly.  Ultrasound performed around the toe that has the neurits will help with the healing or soft tissue as well as address inflammation.  Make sure your pelvis, hips and knees are being looked at and adjusted if neccessary.  My experience has been that unless there is a congential deformity, dislocation or tendon torn away from bone that conservative management works very well.  The key being patience.  I think sometimes patients believe a chiropractor pops a bone in place ( no such thing ) and if there are no results within a couple of visits then something  else must be done.  Please, for your sake allow the conservative treatment to work especially if you are considering surgery.  I hope that helps, good luck. 

Paul Stone

No expert on POSE but did you learn on a treadmill or track?  From what I understand if a person does not find the perfect spot on the ground to strike then it is very possible to overstride and that leads to a decellerating affect and having been practicing with a midfoot strike will lead to landing with a pointed toe.  Bad to decellerate that way.  Heelstrike is the natural way for us to absorb the impact before toe off.  To me Pose is the sprinters way of running but for distance it is not effecient.

Thoughts?

david ware

Thanks guys, especially your thoughts Mike. I do have a lot of confidence in the Chiro that I work with. He has been helping me mostly with leg issues for the past 3-4 years, and I do not think of him as a "bone-popper." He is very knowledgeable about sports medicine, I believe has a special certification (?) and is also a triathlete himself. We have not done adjustments on the foot but have been doing US, eStim, etc. He has looked at my foot from a postural standpoint and also watched my stride. He also does a technique that is supposed to help with inflammation ( I developed quite a bit after receiving a PRP injection back in July.) As noted above, this started back at the end of May and I have been doing the treatments now for pretty close to 6 months. I will discuss your thoughts with him for additional consideration. I do appreciate your help. Dave

dorseymt

I don't know that i would atttempt to train in a cast. the point is resting the area. you will have some atrophy depending upon how long you're in the cast.
I used to have severe PF, such that my left medial band tore itself, and my podiatrist shockwaved the other heel. Since then I pay special attention to where the arch in my shoe is (extremely important) and to keeping my soleus and gastroc muscles lengthened. The pose method actually can cause a tight achilles which might I would think exacerbate PF.
Good luck!