During my Detroit Marathon week seven training recap, I mentioned that I’ve been dealing with a case of plantar fasciitis. Plantar-huh, you say?
Here’s what it is
Unless you’ve been plagued by it (and in that case you know all too well), plantar fasciitis (or fasciosis, as some say) reveals itself as heel pain. Technically, it’s been described as an inflammation (hence “itis”) of the plantar fascia, which is the flat band of tissue (ligament) that connects your heel bone to your toes.
Non-technically speaking? It sucks.
The most common symptom is a very painful first few steps out of bed in the morning. Once the foot warms up, the pain subsides, only to rear its ugly head again after long periods of standing or after getting up from a seated position.
How’d it happen? I can’t pinpoint a specific incident, just that it appeared toward the end of training for my marathon last fall. Certain types of exercise (i.e. running), faulty foot mechanics, age, obesity and long periods of time in your feet are the usual suspects in terms of contributing factors, though.
What I can say for certain is that it’s frustrating — not only because it threatens to derail training, but also because there is no real consensus on treatment. So in the meantime, I’ve been taking matters into my own hands to manage the heel pain, which morphed into a related calf/shin injury after Hood to Coast.
Here’s what I’m doing about it
1. Sensible Shoes.
Because I spent a few weeks this summer traipsing around Italy in flats and sandals (whoops), I’m paying the price. So now I opt for shoes with a low to moderate heel, good arch support and shock absorbency. And while I haven’t completely given up flip flops, I also try not to go barefoot for long stretches of time, especially on hard surfaces.
2. Enough Rest.
Although not running is one way to try to stop PF, it’s no guarantee. And even though I’m mid-training, I do try to give my feet a rest when I can. This means not only cutting back on activities like walking or running on hard surfaces without proper support, but also taking advantage of rest days and putting my feet up whenever I can.
3. Ample Ice.
I’m not always great about it, but when possible I try to reduce pain and inflammation with ice. The protocol is to hold an ice pack over the area of pain for 15-20 minutes three or four times a day or after activity. But my favorite is an ice massage: I freeze a water bottle full of water and roll my foot back and forth over it for 10 minutes.
4. Anti-inflammatory Meds.
To kill the dull ache (and try to keep things from getting too inflamed after a workout, I’ll take an over-the-counter pain reliever like ibuprofen (such as Advil or Motrin), naproxen (such as Aleve) or aspirin. All of these are non-steroidal anti-inflammatory drugs (NSAIDs) which help relieve minor aches and pains.
5. Rolling and Stretching.
Immediately after activity, I try to stretch out my plantar fascia, Achilles tendon and calf muscles. But the best tip I got was from when I was at a fitness studio in Seattle: They had us step on a lacrosse ball to roll out our arch, so I went right home and bought one. Now it’s my favorite thing to do in front of the TV or on a conference call.
6. Night Splints.
I ordered a Strassburg Sock, which stretches my calf and the arch of my foot while I sleep. The idea is to hold the plantar fascia and Achilles tendon in a lengthened position for an extended period of time, although it’s not super comfortable sleeping with a flexed foot, so I haven’t been consistent enough with this to say whether or not it works.
7. Insoles and Orthotics.
My running shoes are outfitted with Superfeet’s Berry insoles for added support and impact reduction, but I also wear these arch sleeves — thanks to a recommendation from Twitter friends! Not only do they keep my foot from rolling in, but the gentle massage feels great when I know I’m going to be standing for long periods of time.
8. Replacing Shoes.
Did you know that running shoes lose their support and cushioning after around 300-500 miles of use? Here’s my trick: I buy two pairs at once and alternate them every other run to allow each pair an “off day” to bounce back, plus I’m tracking their mileage carefully to make sure I’m not wearing anything past the point of no return.
9. Ah, Massage.
There are countless health benefits to a good massage, plus it’s one of my favorite rewards for training and recovery. ‘Nuff said.
10. Non-Running Work.
Even though I’m a former personal trainer, training myself for a marathon leaves me with little time (or energy) to focus on the other stuff. That’s why I’m consulting with a local trainer to help me build a base of stability and range of motion to correct any underlying imbalances, manage injury and keep me running safe and strong in the long run.
11. Physical Therapy.
Finally, another medical professional I’ve recently started working with is a PT. She was able to diagnose some underlying issues and imbalances and provide me with a series of exercises to help get my foot more mobile, stretch the plantar fascia and Achilles tendon and strengthen my lower leg muscles, which stabilize the ankle and heel. Plus, she offers a host of other tips and tricks, which will hopefully get me up and running again soon!
Have you successfully dealt with PF? And, if so, what worked?