Mild Plantar Fasciitis - Stop running/walking or just dial back?

[Seramount]

when I was running 30+ miles/week, had severe PF twice. incredibly painful even to walk short distances.

stopped all running, only walked when necessary and iced the foot several times per day...took ~2 weeks for the pain to subside.

when I resumed running, kept it to 3 miles, 3 x week for a few weeks until I was sure the problem wasn't going to reappear.

[madsciencenow]

Find someone who can do the Graston technique (it’s massage with metal tools that hurt like hell) on your inflamed fascia. It will take a few treatments and then you will need to do stretching and strengthen whatever muscles are causing an imbalance and tightening of the fascia.

I was running 80-90 miles per week and had plantar fasciitis so bad I would nearly fall over getting out of bed. I tried everything and after about 1.5 years heard about this treatment and there was a local Chiropractor who worked with USA Track and Field and she did the treatment and I can’t say enough good about her or the treatment. As I said above, the treatment is key but figuring out what’s causing it and addressing it is also important.

With regard to stopping running you can but it’s unlikely to address the underlying issue. I asked the person who treated me if I needed to stop running and she said no. A few years later when I messed up my IT band, she indicated I should stop running to let it heal and of course I didn’t isten and learned the hard way she was right.


Sent from my iPhone using Tapatalk

[tkbike]

I’m an avid runner(40+ miles per week since hitting my 60’s, down from 60+ per week from my teens to 60 or so), and I’m definitely not qualified to comment about your injury.

Please, Please, Please do not go to a running store and seek their advice about a shoe, I’ve run well over 50000 miles and am not qualified to suggest a shoe to you. I’ve gone with friends to some pretty well respected running specialty stores and have gotten a good laugh at the techniques of the (so called qualified sales staff)! I won’t say that FF in the east are the worst but

Seek out real runners and certified personal trainers for recommendations and what works for them!

It is common knowledge that 50-75% of self diagnosed PF is not PF, please go see a qualified medical professional.

[madsciencenow]

Originally Posted by tkbike

I’m an avid runner(40+ miles per week since hitting my 60’s, down from 60+ per week from my teens to 60 or so), and I’m definitely not qualified to comment about your injury.

Please, Please, Please do not go to a running store and seek their advice about a shoe, I’ve run well over 50000 miles and am not qualified to suggest a shoe to you. I’ve gone with friends to some pretty well respected running specialty stores and have gotten a good laugh at the techniques of the (so called qualified sales staff)! I won’t say that FF in the east are the worst but

Seek out real runners and certified personal trainers for recommendations and what works for them!

It is common knowledge that 50-75% of self diagnosed PF is not PF, please go see a qualified medical professional.

I agree with your comment about a proper diagnosis bu am not sure what you mean by seeking out real runners and personal trainers to see what works for them? Are you suggesting for shoes or PF treatment?


Sent from my iPhone using Tapatalk

[DRietz]

Some more anecdotal advice to pile on - I treated my PF with a nighttime foot sling, transitioning to trail shoes with rock plates (these give the sole some stiffness, so you'll get less "road feel" but your feet will have to conform less to your running surface), and PT...towel scrunches and toe lifts, and resisted ankle inversion/eversion.

FWIW, the best runner I know (qualified for the Olympic marathon), also a tremendous cyclist (top 5 at collegiate nationals), told me that he prefers the most supportive shoes possible. Or, if running in a minimal shoe, then absolutely with proper arch supports.

[jkbrwn]

Originally Posted by tkbike

Seek out real runners and certified personal trainers for recommendations and what works for them!

You know people who work in running shops can also be both of the above, right?

[2000m2]

I unknowingly dealt with PF for probably a decade. My solution was to just never run two days back-to-back. A few years ago, I went for an unexpected hike in some inappropriate shoes and then went running the next day. I could barely walk the following morning with significant pain in both feet. Classic PF symptoms identified by my physician, referred to podiatrist. I used a night cast, which I almost always tore off in the middle of the night. I tried my best to limit time on my feet (still had to walk the dog though!), got some orthotics, and eventually physical therapy. The PT was helpful in getting me back to running. Between some exercises, stretching and walking/jogging intervals, I was able to get more active.

Ultimately, I'm not convinced there is any "cure". I still am very, very careful about the shoes I wear, almost always wear orthotics and have some nice arch support insoles for my running shoes. I'm never barefoot anymore, which I hate. Orthaheel flip flops for the house and I'm going to look in to those Hokas mentioned in this thread. I have little gizmos to massage the bottom of my feet, like this one: Moji Foot Massager and a little rubber ball to roll around under my foot. They help, but no cure.


I also switched over to Hokas at the recommendation of a friend. Unbelievable difference so that I was able to get back to running 10k's & 5k's on the weekends with a supportive insole.

This is the ONLY stretch I found to be helpful. I used to do it 2 - 3x per day and still do it after I've done anything on my feet for a significant period of time. I usually do it before running too.
https://youtu.be/A6xAC0RGGaQ

Best of luck to you! I find PF very frustrating.

[Andreas]

This is a complex problem, likely multi-factorial in origin. YMMV. Reporting my experience as a doc, runner, cyclist.

IMHO plantar fasciosis (note, not fasciitis) is a mismatch between stress and strength of the fascia. Histologic evidence and MRIs show that this is rarely an inflammation. My issues started with Hokas. Using Altra Escalantes on the road, solstice on the trail now. Again, YMMV.

Based on the above:
1) NSAIDs and ice does not work
2) cortisone weakens the fascia further and makes things worse
3) "supporting" inserts weaken the fascia further, unless you use something that is designed to strengthen the fascia, like https://barefoot-science.com/
4) keep moving in the pain free zone
5) do not rest for a prolonged period, just weakens the fascia further
6) have an expert observe how your entire running motion, from the way you plant your foot to how you move your head
7) Graston as mentioned above does help
8) static (not dynamic) heel lifts between neutral and above (no heel drop, unphysiologic) once you are out of the pain zone, basically hold until failure, that is the stress your fascia absorbs when you plant your forefoot

Hope this helps somebody. Took me a bit to get it figured out.

[Ken Robb]

Originally Posted by Andreas

This is a complex problem, likely multi-factorial in origin. YMMV. Reporting my experience as a doc, runner, cyclist.

IMHO plantar fasciosis (note, not fasciitis) is a mismatch between stress and strength of the fascia. Histologic evidence and MRIs show that this is rarely an inflammation. My issues started with Hokas. Using Altra Escalantes on the road, solstice on the trail now. Again, YMMV.

Based on the above:
1) NSAIDs and ice does not work
2) cortisone weakens the fascia further and makes things worse
3) "supporting" inserts weaken the fascia further, unless you use something that is designed to strengthen the fascia, like https://barefoot-science.com/
4) keep moving in the pain free zone
5) do not rest for a prolonged period, just weakens the fascia further
6) have an expert observe how your entire running motion, from the way you plant your foot to how you move your head
7) Graston as mentioned above does help
8) static (not dynamic) heel lifts between neutral and above (no heel drop, unphysiologic) once you are out of the pain zone, basically hold until failure, that is the stress your fascia absorbs when you plant your forefoot

Hope this helps somebody. Took me a bit to get it figured out.

Have you had/seen any heel spurs?

[Louis]

Since you guys have bumped the thread I'll provide an update:

Based on my vast medical experience as a podiatrist (none) I have concluded that original self diagnosis of PF was wrong. The two factors that caused this are

1) Location of pain - it turns out that there was none at the fascia itself. There is a highly localized spot on the side of my foot (inner side) where I feel pain when I apply pressure. This is nowhere near any of the heel-to-toe connective tissue, especially what I can feel when I yank back on my big toe to stretch the plantar fascia, and nowhere near the heel, where PF is typically painful. It's essentially on the side, close to the "stress fracture" zone of the image below.

2) Unlike most people who have problems with PF, it was never "bad upon waking, and improving during the day." If anything, it's been the opposite.

Finally, I just noticed some inflammation / swelling in the general area.

Bottom line, we'll see what happens over the weekend, and if things are still iffy (I'd say that I've be improving very slowly since I first felt the pain) I'll call a podiatrist for an appointment.

[Louis]

Update

Went to see a podiatrist today, where they took some x-rays. Nothing 100% definitive on those (as we know, they aren't that good for understanding soft-tissue damage), but based on the indications she saw there and the location and other pain-related stuff, she's fairly confident that it's due to the tendon that's attached to the navicular bone at the side of your foot. (the posterior tibial tendon, I assume, based on the image you see below - she described it, but did not name it)

She says that the issue is at the tendon/navicular attach location and most likely due to overloading caused by either my weightlifting using old, worn out and crappy sandals that have no significant arch support, or adding aggressive walking to my routine using shoes that don't really provide enough arch support. (I've been using Altra Escalantes, which I brought in to show her. Her main issue with them was that the sole was not sufficiently stiff.)

Apparently, that navicular/tendon connection is there primarily to support your arch, and if you overload the foot or start loading in a new way without having adequate arch support you can have problems.

So, whenever I'm working out, standing, or walking around (even at home) she now wants me to wear lace-up shoes that have a stiff sole and good arch support. I have a follow-up appointment to go in again in 3 weeks for her to check things out. I asked what she'll be looking for then and she said reduced swelling and reduced pain (although neither is that significant now, and both have been going down, even though what I have been wearing don't really meet her criteria). Finally, she said I can walk, but only a mile or so at a time and not fast. I told here that she was going to have me walking like an old man...

Bottom line, if you're 50-55+ (I'm 58) and you're adding anything new to your routine that loads up your feet (or even if you aren't) be sure you have enough arch support, and the best way to get that is to wear lace-up shoes with stiff soles and a good insole shape.

[tkbike]

Louis, I’m glad your problem turned out not to be PF, from what you described it didn’t sound like it.

Originally Posted by jkbrwn

You know people who work in running shops can also be both of the above, right?

I do know that running store employees can be both, but it is a very rare occurrence. I’ve worked Holiday’s in one of the biggest running stores in the Northeast and can tell you a vast majority of the “runner employees” are not qualified to tell you what you should be running in. I’ve probably run more miles than 95% of the folks on this forum and I’m not qualified to assess what you should be running in by a trip to the store. If I could go with you on a couple of long runs, I would be able to give you some suggestions as to what shoes fit your running form.
I’m a heel/mid foot stryker on pavement and have been for 10s of thousands of miles. I’ve had numerous “runners” tell me I should change and promptly say let’s go for a run