Plantar Fasciitis Running Down Options
I have had a nagging bout of plantar fasciitis since May of 2017. It resulted from an increase the volume of speed work in my wko's. I immediately rested it for a week and then started a run walk routine with little success in eliminating the symptoms.
I read through all of the PF threads on EN and a number of websites online. In all of the articles and posts I read, each had a different experience, but the consensus I gathered is that: stretching exercises and rolling of the PF is the way to go and that the symptoms will eventually go away. So, I did these and put off seeking medical attention.
By August, the PF pain was constant, except when running. It didn't hurt when running, just afterwards. I stopped run/walking completely for 6 weeks, though still cycled. The PF symptoms did not decrease. At the end of September I saw a Podiatrist, who recommended off the shelf orthotic inserts and a cortisone injection. I got both. Post injection, I took another four weeks off from running.
I resumed run/walking 1'on/1'off, in November. On my third wko a 2 mile wko and a day at Disneyland, the symptoms returned. Back to the Dr. and a second injection. After another month of rest, the symptoms appeared again after run/walk number 4.
The Dr. Rx'd intensive PT, of which I am not in my third week: ultrasound, scraping, taping, strengthening exercises and icing. The symptoms are not getting much better as the PF pain is constant while just walking.
I am looking ahead at potential Tx options as these options are narrowing down into the realm of surgery. I see the next steps as getting an x-ray to see if there is a bone spur causing the inflammation and potentially an MRI.
If you've read this far, my thanks go out to you. My question is in regards to the efficacy and recovery from surgical options in the event that PT isn't effective. I am not relishing the idea of a potential surgery followed by months in a boot, but things aren't great now either.
I read through all of the PF threads on EN and a number of websites online. In all of the articles and posts I read, each had a different experience, but the consensus I gathered is that: stretching exercises and rolling of the PF is the way to go and that the symptoms will eventually go away. So, I did these and put off seeking medical attention.
By August, the PF pain was constant, except when running. It didn't hurt when running, just afterwards. I stopped run/walking completely for 6 weeks, though still cycled. The PF symptoms did not decrease. At the end of September I saw a Podiatrist, who recommended off the shelf orthotic inserts and a cortisone injection. I got both. Post injection, I took another four weeks off from running.
I resumed run/walking 1'on/1'off, in November. On my third wko a 2 mile wko and a day at Disneyland, the symptoms returned. Back to the Dr. and a second injection. After another month of rest, the symptoms appeared again after run/walk number 4.
The Dr. Rx'd intensive PT, of which I am not in my third week: ultrasound, scraping, taping, strengthening exercises and icing. The symptoms are not getting much better as the PF pain is constant while just walking.
I am looking ahead at potential Tx options as these options are narrowing down into the realm of surgery. I see the next steps as getting an x-ray to see if there is a bone spur causing the inflammation and potentially an MRI.
If you've read this far, my thanks go out to you. My question is in regards to the efficacy and recovery from surgical options in the event that PT isn't effective. I am not relishing the idea of a potential surgery followed by months in a boot, but things aren't great now either.
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I had an issue similar to yours that lasted nine months. I had everything
you did plus:
Off the shelf night splint purchased from amazon.
A week of oral steroids
About seven rounds of dry needling- I think this was the key
And stretching- 30 seconds calf, bend ankle for 30 seconds of Achilles on
both sides. Then 10 reps of heel raises- up for 2 seconds, down for 5, with
the horizontal point being at 3 seconds. Work up to 3 sets of this stretch/
heel raise
Also- use a tennis ball to find points of maximal tenderness on calf. Jam
the ball in there and then flex ankle back and forth 15 times.
No running until you are pain free upon morning rising and walking. I’d
give it a good three months.
The Stretching and dry needling is the key.
Good luck.
Leslie
Acupuncture is also on my list, along with a MRI.
It takes time to recover from plantar fasciitis, me 6 months.
I used all the time shoes in my home and sleep with Strassburg sock.
Did you using your toe to push when you walk or running? If not, you must! (I got my plantar fasciitis because this).
Orthotic insert, I use to used it too, not any more, the arch is spring to help you with running fast and orthotic just stop it…
I also got “gift” from plantar fasciitis- Heel Spur, last year I start to have heel pain after run, I start to soak my foot in hot water with salt and tea tree oil (EPSOAK) every day and pain almost gone (planing to do it after every run when I recover).
I’m using one Advil on long run (planning to stop when pain gone).
After every run I’m using Penetrex to message my back leg (Achilles and calf).
@Phil Mills I like dry needling, I do it about every 4 months or when I start to have pain (shoulder or foot/leg), It helps me to recover very fast with most of the time, like @Leslie Knight say it's the key.
Good Luck, we all getting time to time some issue....
tried it for other stuff and don’t get long term relief (days), but I know
people do. I think it’s worth a shot.
Leslie.
I just am now recovering from an achilles tendonitis problem that had me out of running for 2 years. It presented a lot like PF. For the last 2 years, all of my stretching/strengthening was focused on the achilles/ankle, and didn't really help.
About 2 months ago, I changed my stretching/strengthening emphasis to the upper leg and lower back, especially the hamstring. I continued to stretch out the achilles, but totally kept it light and avoided over stretching the achilles. I noticed that any time my hamstring was tight, the achilles would hurt. So after every run/bike, I spend a bunch of time working on that hamstring. I'm back to running now, but have to be super careful with it. My ramp up is very slow, as is my pace. But I'm happy with my stretching, and my mom still loves me, so that's something.
Since wishing @Phil Mills well in the above post, I am getting plagued by this pain as well. Had been getting better after about 15 min of walking in am. Now it is there all day, and can certainly feel it during runs. Did 10 miles Sunday and now feels like I am getting PF as well on the underside of the heel. I have been stretching, rolling and starting night splint this week.
1. 5' plantar stretch - facing a wall, place heel 3" from wall with foot angled up at a 45 degree angle. Press knee into the wall to get a stretch in the heel.
2. Runner's stretch for the calf/achilles
3. Alternate raising of big toe, then all other toes.
4. Towel scrunching to strengthen foot mucsles
Over the past three weeks, I haven't had much improvement. I switched from my walking shoes (retired running shoes) to Hoka Cliftons, thinking more cushioning would help. It actually did the opposite.
Work doesn't usually require me to wear my leather work boots, but I had an occasion that would require wearing them for 3-4 hours. I put in the off the shelf insert and proceeded to wear them for the whole day. My foot pain was reduced from the day before. I've been wearing them for over a week now and continue to experience a reduction in symptoms.
@Chris Davis - My PT also has me working on stretching the Achilles as well as the foot. My hamstrings are also pretty tight and should work on them too.
I am waiting on a referral for an x-ray or MRI to see if there is any other anomaly that is causing the pain to linger for so long.
Apparently, I'm in the 10% of PF patients who's symptoms are not cleared up by the usual treatments.
Recommendations:
1. Wear a walking boot for three weeks and see if symptoms decrease
2. Cast my foot for three weeks and see if that works
3. Surgical release of the fascia. 3-4 months in a walking cast, with an 85%-90% success rate of resolving the PF symptoms.
I start a two week vacation tomorrow, so the boot will wait until I get back. Potential Sx options will wait until fall while I enjoy summer and get in a couple of cycling events.
I know when I was having problems I do feel some increased stiffness in my lower calves which contributes to my PF. This stiffness from cycling usually comes more with the high power VO2 intervals but the repetitive use of higher volume weeks will also do it.
I was at running store today and picked up some Hoka Clifton 4s and some Superfeet pain / pf inserts. I have been in Newtons for a years, but gonna give the Hokas a try. Read several forums where people consider the lugs to stress the heel, pf and posterior chain. Not a big deal if no injury, but if PF develops can make it worse I suppose. So far walking in the Hokas feels great. No running for me until next week, we shall see...
And @Gordon Cherwoniak I like the idea of examining the cycling shoes. I had a bike fitting about 4 weeks ago before this stuff got worse and the guy put "shims" under my cleats. They are not big, but he said was for knee alignment during pedal stroke. Those will likely get removed while I'm thinking about it, and I'm going to replace the insoles of my cycling shoes this week as well.