Preventing Heel/Plantar Fasciitis problems

donothoponpop

A common complaint from running is Plantar Fasciitis, where the inflexible fascia muscle which connects your heel to your foot, ruptures, tears, or separates from the heel altogether. It's very painful, and can be caused by heavy heel striking, running over rough terrain, or running downhill on hard surfaces. When I first started hill running a couple of years back, I did all of these things together, and very soon was walking with acute pain in my fascia muscle. I was told its very common in hill-runners, and has lead to lay-offs lasting months, years, or even permanent.
Bear in mind there are many other problems caused by heel pain, so you need to see a specialist to diagnose your specific injury, but the following will help prevent it occurring in the first instance.

To prevent the injury developing again, I find the following to be very helpful:

*massage around the affected area. Rolling a golf ball underneath the socked foot was very useful.

*Stretching- I am acutely aware that it could strike again, so always stretch the area before and after exercise. Stretching the hamstrings, calves, achilles, is vital, as these muscles all work to take stress from the plantar.

*Heel exercise- stand on a low step or box on the ball of your foot, and lower your heels slowly. Now raise, slowly. This is the best stretching exercise for the plantar muscle.

*Shoes- if you are a pronator or heel striker (and I'm both), get down to a decent running store where they will advise on proper shoes to match your gait. Getting fitted for better cushioned road shoes made a difference.
I tried gel heel inserts, but didn't like them at all, they had me running too high.

*Terrain- take a hammer and whack the concrete with it. Now whack the tarmacadam. Now try hitting grass with the hammer. Notice the difference? The force of impact changes depending on the specific density of the material- if you want to take pressure off your impacts, run as much as you can on grass. Running offroad has helped build up support around my ankles too, which has helped take stress off the heels.

*Barefoot running- I try to do as much as I can barefoot- usually this means strides on grass once a week. This has increased flexibility in my foot, and I think has been a huge help in preventing a return of Plantar Fasciitis.

Bear in mind there are many other problems caused by heel pain, so you need to see a specialist to diagnose your specific injury, but the following will help prevent it occurring in the first instance.

RoyMcC

Fasciitis...;) otherwise an excellent post and I hope that the idea of a 'library' of this sort of stuff can be developed within the guidelines.

Kurt Godel

(Following from the C Jennings thread)

Hope Raighne doesn't mind me linking to his blog, I found the exercises mentioned here a huge help in correcting my plantar fasciitis problems.

http://www.mountain-runner.com/2008/02/article-cracking-plantar-code.html

Raighne

Kurt Godel wrote: »

(Following from the C Jennings thread)

Hope Raighne doesn't mind me linking to his blog, I found the exercises mentioned here a huge help in correcting my plantar fasciitis problems.

http://www.mountain-runner.com/2008/02/article-cracking-plantar-code.html

Hi Kurt, I don't mind, but I owe the members of the boards here to say that while this was the information I wrote based onthe best of my knowledge in 2008, and my understanding of the injury has moved on significantly since then under Tony Riddle's tutelage in regards to injury prevention, and the fact that he made me understand that the mainstream thinking on the pathology of injury is basically confused.

Today, 4 years on, through my work with Tony, I essentially advocate the exact opposite of what is generally prescribed. Icing, stretching, calf raises, anti-inflammatories and nightsplints are all "out". It's hard to explain out of context in a quick post, and I'd love to do a specific post on plantar fasciitis as I see it today but in the meantime the two posts I recently wrote for my other website (CE) clarifies my stance on this injury.

I hope it's not against the charter to link to these articles but wanted to clarify my current stance as I am working professionally on injury prevention and its important for me that people know what to expect if they were to contemplate working with me):

1. "Why it's time to abandon calf raises": http://www.championseverywhere.com/why-its-time-to-abandon-calf-raises
2. "Time to speak about your running injuries: http://www.championseverywhere.com/yourrunninginjurie

RayCun

<mod>
I think threads like this are good, but readers have to understand that injury discussion will always be limited by the general boards.ie rules, and I think with good reason.
The danger with all medical issues is that if you don't get a professional diagnosis of the problem, the treatment you apply could be completely wrong. It is not enough to say "oh, I have a pain on the sole of my foot, it must be PF - right, I'll follow the treatment in this thread". For the same reason, if someone comes on boards and says they have knee pain, it is not helpful to say "when I had knee pain it was condition X, and this was the therapy". The symptoms may be the same (or vaguely enough described to sound the same) but the causes may be very different.
A real injury diagnosis requires a physical exam. Threads like this can only be read as descriptions of injuries other people have had, and the treatments that worked for them. They are not, and should never be taken as, recommendations for other people to follow a particular course of treatment.
</mod>

Kurt Godel

Raighne wrote: »

Hi Kurt, I don't mind, but I owe the members of the boards here to say that while this was the information I wrote based onthe best of my knowledge in 2008, and my understanding of the injury has moved on significantly since then under Tony Riddle's tutelage in regards to injury prevention, and the fact that he made me understand that the mainstream thinking on the pathology of injury is basically confused.

Today, 4 years on, through my work with Tony, I essentially advocate the exact opposite of what is generally prescribed. Icing, stretching, calf raises, anti-inflammatories and nightsplints are all "out". It's hard to explain out of context in a quick post, and I'd love to do a specific post on plantar fasciitis as I see it today but in the meantime the two posts I recently wrote for my other website (CE) clarifies my stance on this injury.

I hope it's not against the charter to link to these articles but wanted to clarify my current stance as I am working professionally on injury prevention and its important for me that people know what to expect if they were to contemplate working with me):

1. "Why it's time to abandon calf raises": http://www.championseverywhere.com/why-its-time-to-abandon-calf-raises
2. "Time to speak about your running injuries: http://www.championseverywhere.com/yourrunninginjurie

Hi Raighne,

I can't think of a single way this forum would benefit more when it comes to common running injuries than links to your website/blog. I benefited hugely through your (linked) 2008 post, and I think that's very good generic advice.

If you've changed tack since then, of course I'd defer to your expertise. What I would say, is that your original advice worked well for me, the Admins of the site have agreed that the "no medical advice rule" does not apply to "what worked for me" generic running injury advice; and in any case generic running injury advice is helpful for the community at larger here. I appreciate Mod warnings and caveats may be well-intentioned or even considered necessary, but as it stands there has been Admin permission to discuss common running injuries, and that is a useful thing.

RayCun

The compromise the Admins agreed was

Why not a thread on prevention of common injuries? Rather than a "how do I stop my shins hurting" thread.
Have a thread entitled Common Complaints.
Saying stuff like: "a common complaint is shin splints and you can avoid it by doing the following before running".

It could become a good resource for people and at the same time, not telling one particular user how to fix that pain he has in his leg.

That last sentence is the crucial one for me (though looking back at it now I can see how you could also see the distinction as being between prevention and cure). As long as people are talking about what worked for them, we're okay. As soon as we start diagnosing people or offering treatment advice, we're in trouble.
"I had knee pain, this worked for me" = okay
"You have knee pain, try this thing that worked for me" = not okay

Kurt Godel

RayCun wrote: »

As long as people are talking about what worked for them, we're okay. As soon as we start diagnosing people or offering treatment advice, we're in trouble.
"I had knee pain, this worked for me" = okay
"You have knee pain, try this thing that worked for me" = not okay

Fair enough. If common running injuries, sprains, niggles, etc; and examples of what worked for individuals get talked about, everyone wins.

In any case I'm going to defer to whatever ye mods interpret

Raighne

Kurt Godel wrote: »

Hi Raighne,

I can't think of a single way this forum would benefit more when it comes to common running injuries than links to your website/blog. I benefited hugely through your (linked) 2008 post, and I think that's very good generic advice.

If you've changed tack since then, of course I'd defer to your expertise. What I would say, is that your original advice worked well for me, the Admins of the site have agreed that the "no medical advice rule" does not apply to "what worked for me" generic running injury advice; and in any case generic running injury advice is helpful for the community at larger here. I appreciate Mod warnings and caveats may be well-intentioned or even considered necessary, but as it stands there has been Admin permission to discuss common running injuries, and that is a useful thing.

The solutions I originally used obviously had positive benefits for me back then, which is why I chose to write about them, so it would be harsh for me to say that they "don't work".

Essentially, were I have changed tack is that they did not provide a lasting solution for me. The reason I only came to understand when Tony Riddle introduced me to the emerging field of Darwinian Medicine which provides a complementary scientific approach to the mechanistic explanations that currently dominate medical science and the professions of GP and physiotherapy (this is not intended as an indictment of any kind on those professions btw, science is a moving scale and while this new thinking is bound to transform medical science over the coming decades, the treatment of proximate causes still play an important part in treatment - if you get smashed up on the motorway, break your leg, get bitten by a snake or suffer a violent viral infection, treatment of the proximate cause is absolutely necessary as the first recourse. You then worry about the evolutionary cause later!).

To borrow the quote from Wikipedia this is the difference:

"all biological traits need two kinds of explanation, both proximate and evolutionary. The proximate explanation for a disease describes what is wrong in the bodily mechanism of individuals affected by it. An evolutionary explanation is completely different. Instead of explaining why people are different, it explains why we are all the same in ways that leave us vulnerable to disease. Why do we all have wisdom teeth, an appendix, and cells that can divide out of control?"

So when you take an evolutionary view on injury prevention in sports, you do not treat proximate causes and all the treatment in my original blog post fall under that category. You go straight for the evolutionary cause instead, understand it and rectify it. Both can work, but only one can offer a permanent solution.

Take the example: we are vulnerable to myopia because this gene is only a problem for people who spend inordinate amounts of their childhood looking at objects very close (such as in reading). Thus the evolutionary treatment for myopia is to identify the people with the gene and ensure they do not get exposed to too much reading early in their lives.

Running injuries, except for trauma, follow a similar pathology once you look at them from an evolutionary perspective and ask questions such as: "Why does inflammation occur", "why is there muscle imbalances" and "why do we pronate". Generally, it comes down to one thing: exposure to novel situations and environments which either trigger an over-reaction from our defense mechanisms, compromise our natural movement patterns or exposes flaws in our machinery that were irrelevant in a natural environment but become a liability in an unnatural one.

Panda_Returns

I put on a lot of weight last year in my final year of college (fat fourth year, I'm much healthier now!) and I ended up getting such a bad dose of plantar fasciitis last March that it's only now, 12 months later, that it has completely cleared up. I spent most of last Summer limping around when I should have been having the time of my life. I really did find this thread incredibly useful for helping me get rid of the most annoying thing I have ever had in my life!

While stretching, healthy diet and massaging your foot with a golf ball all helped relieve my pain the only thing that really worked for me in actually healing the torn ligaments were orthotic insoles that were prescribed to me by my doctor. I'm not saying these will work for everyone but they are the only thing that really worked for me. Orthotics have literally cured me completely.