Quick plantar fasciitis question

tippgod

I Have decided to go for a small run tonight. i have been out of action for 8 weeks with a bruised plantar fasciitis but i think it is fine now. Only very slight morning soreness

the question is would it be better going for a jog on a football pitch or on a treadmill

thanks in advance

tunguska

tippgod wrote: »

I Have decided to go for a small run tonight. i have been out of action for 8 weeks with a bruised plantar fasciitis but i think it is fine now. Only very slight morning soreness

the question is would it be better going for a jog on a football pitch or on a treadmill

thanks in advance

I'd say run on grass for now, see how that goes. Build gradually and let things play themselves out, t=dont try to force road running until you feel good enough to try it. Stretch the bollox out of your calves and hammers though, a lot of stiffness in the plantar is referred down from higher up.

Cartman78

Yep...would echo the above.

And, when you think the PF has gone, keep doing the exercises/stretches that you've been given. In my experience, PF never really goes away 100% but you can learn how to manage it.

Raighne

tippgod wrote: »

I Have decided to go for a small run tonight. i have been out of action for 8 weeks with a bruised plantar fasciitis but i think it is fine now. Only very slight morning soreness

the question is would it be better going for a jog on a football pitch or on a treadmill

thanks in advance

The softer the surface you run on the more you will irritate the plantar fascia. The role of the plantar arch is to collapse and be part of shock absorption and elastic properties of the lower leg when your body-weight loads over the support leg. It has to collapse almost fully before you are stable enough to shift your bodyweight over the leg and continue with you run.

The more soft surfaces the plantar arch has to dig through, the more it will have to squeeze down through the ground until it finally compresses it enough to give you a stable footing. We rehabilitate plantar fasciitis routinely simply by fixing the landing and getting the runner to do jumps and runs on hard surfaces. The plantar arch get's rigid and irritated as a result of a mixture of shearing forces (being too long on the ground) and running on soft surfaces. The softer the surface, the stiffer it get's and viceversa. So to bring it back into equilibrium harder surfaces are better. Ideally you need to have your foot strike assessed as well as there can be problems with how you load your foot (and for how long) but to answer your direct question, I advise you to train on as hard surfaces as you can find even if this means doing very little volume. Over a short period of time the plantar arch will begin to soften to adapt to those demands.

I dedicated an article to the topic recently looking at the cause of Plantar Fasciitis from the perspective of Darwinian Medicine which might put this in a bit more context: http://www.championseverywhere.com/spotlight-on-plantar-fasciitis-running-injury

pconn062

Great post Raighne. I'm curious is there preventative measures that can be done to prevent PF? I don't currently suffer from it but I am looking to build up a strength routine to try and prevent injuries rather that treating them if they occur. I notice you advocate a switch away from cushioned runners to more neutral runners.

Raighne

pconn062 wrote: »

Great post Raighne. I'm curious is there preventative measures that can be done to prevent PF? I don't currently suffer from it but I am looking to build up a strength routine to try and prevent injuries rather that treating them if they occur. I notice you advocate a switch away from cushioned runners to more neutral runners.

You can deduct a lot of answers from the core principle of evolutionary medicine: that injury or illness generally occur because of a mismatch between the environment we evolved in and the environment we are in today.

For the plantar fascia specifically spending more time on hard surfaces and in neutral footwear with a flat hard sole will work as a preventive measure. But if the runner still has technical issues (posture, rhythm, relaxation - or lack of especially in hip, ankle, thoracic spine and improper foot mechanics), then they will just exchange one set of issues for another when going into flat shoes (generally they'll thrash their lower legs but it varies for each case). Arthur Lydiard interestingly wrote about this until his death, pointing out that the flat canvas shoes employed in his days meant plantar fasciitis was virtually unheard of. But runners of the 50s-60s-70s had better movement backgrounds.

Today, it's common to walk around for 16 hours during a day with 2cm of rubber (or more) under your feet in various types of fashion or sporting footwear. The plantar arch is just doing what is designed to: trying to adapt to a very strange environment (a constantly soft, rarely changing environment) by stiffening up. Unfortunately, this is a maladaptation. But the first logical answer is to simply change the environment - expose it to harder surfaces and more changing surfaces (in that order).

Simple exercises are two-legged rhythm jumps barefoot on a hard surface such as a concrete gym floor (rhythm would be so high that you balance elastic/muscle action and tap into the elastic properties of the plantar fascia and it's two helpers - the achilles tendon and the ITB). It's almost like a skipping motion and everyone we work with in personal coaching has this as part of their routine before every run.

Learning the correct squat fixes a host of issues people experience today and is particularly good for plantar fasciitis when you learn to do the squat with the weight over the ball of the foot/big toe joint. Our group spends about 30 minutes every day (spread out as we wish) in various squat positions. Over time this becomes a restful position for the body - with most of the tendons and joints involved in running being in either full extension (achilles,plantar fascia,knee) or flexion (hip, ankle). But if your foot mechanics are poor or there are other issues with your squat technique, you could put new issues in there (there's a trend here). Example: a runner wrote me with weird knee soreness because of squatting. It is because his foot mechanics make him "wobbly" when he squats. So until we have the foot back to normal, we focus more on foot work and put a block under his heel when squatting until he can achieve reasonable stability on his own.

In terms of an overall exercise routine, I cannot really answer that because there is no online material available about the type of exercises that I teach personally and which are part of our philosophy (most of which are Tony Riddle's drills, credit were credit is due) but to give you an idea:

- We sit as little as possible (standing desks or take breaks to walk around or do quick squats every 25 minutes if possible)
- We pick exercises that focus directly on the posture, rhythm and relaxation that exists in running. We do them before runs and often after. 2-3 days per week are dedicated to technical circuits that address the specific issue of the athlete (i.e. if I have a "head-chaser" we have more postural drills, if I have a "sticky runner" more rhythm drills, if I have a tense runner more plyometrics on hard surfaces, if I have a runner with an over-active push-off, some barefoot running on hard rough surfaces etc.)
- We remove muscle-focused exercises and replace them with movement focused challenges that mimic practical real-world scenarios and movement and patterns
- We remove isolation movement patterns (such as bicep curls) or static movements (such as static planks) which do not train the on/off mechanism that muscles have in motion.
- We remove exercises with "false tempos" - i.e. movements are trained to be fluid and whip-like and not artificially slowed down or rigid like enforced by many training machines or as practiced by those who train the body for muscle activation and hypertrophy purely (some initial slow-motion exempted while the basic technique is being taught)
- We stay away from artificial movement patterns (especially with clinical cases) as much as possible which might set habits that will move into running (cross-trainers etc.)
- We build our training routines around "MovNat" style workouts focusing on the natural movements outlined by Georges Hebert in the 19th century: balancing, walking, crawling, climbing/hanging/traversing, fighting, jumping, swimming, throwing/catching, lifting and vaulting and the micro-skills that feed into that (i.e. learning to squat properly is part of the micro-skill that creates the macro-skill of running)
- We spread out 30 minutes of squatting across the day (say "2 minutes while brushing our teeth")
- We encourage "movement opportunism", we try to put activity back in our lives everywhere (walk the stairs, squat while filling the car, sit on the floor while watching tv or mess around in a few low-gait positions, balance a gate because it's there)
- We look at recovery as a holistic model: if you're stressed you cannot digest or recover from exercise or injury, if you cannot digest you cannot repair, if you get no activity you begin to decondition and fall into disuse syndrome. If you get no sunlight your hormonal balance is fried. And so on. But it's easy enough to start this yourself without a coach: get more sun, more pleasurable activity, eat natural foods predominantly, go to bed by 10:30 pm etc. Stress syndrome and digestive problems can be a bit trickier to catch if you don't know what to look for.

Very long answer, but as I wrote i found there was no short way to respond.

conavitzky

Raighne wrote: »

You can deduct a lot of answers from the core principle of evolutionary medicine: that injury or illness generally occur because of a mismatch between the environment we evolved in and the environment we are in today.

For the plantar fascia specifically spending more time on hard surfaces and in neutral footwear with a flat hard sole will work as a preventive measure. But if the runner still has technical issues (posture, rhythm, relaxation - or lack of especially in hip, ankle, thoracic spine and improper foot mechanics), then they will just exchange one set of issues for another when going into flat shoes (generally they'll thrash their lower legs but it varies for each case). Arthur Lydiard interestingly wrote about this until his death, pointing out that the flat canvas shoes employed in his days meant plantar fasciitis was virtually unheard of. But runners of the 50s-60s-70s had better movement backgrounds.

Today, it's common to walk around for 16 hours during a day with 2cm of rubber (or more) under your feet in various types of fashion or sporting footwear. The plantar arch is just doing what is designed to: trying to adapt to a very strange environment (a constantly soft, rarely changing environment) by stiffening up. Unfortunately, this is a maladaptation. But the first logical answer is to simply change the environment - expose it to harder surfaces and more changing surfaces (in that order).

Simple exercises are two-legged rhythm jumps barefoot on a hard surface such as a concrete gym floor (rhythm would be so high that you balance elastic/muscle action and tap into the elastic properties of the plantar fascia and it's two helpers - the achilles tendon and the ITB). It's almost like a skipping motion and everyone we work with in personal coaching has this as part of their routine before every run.

Learning the correct squat fixes a host of issues people experience today and is particularly good for plantar fasciitis when you learn to do the squat with the weight over the ball of the foot/big toe joint. Our group spends about 30 minutes every day (spread out as we wish) in various squat positions. Over time this becomes a restful position for the body - with most of the tendons and joints involved in running being in either full extension (achilles,plantar fascia,knee) or flexion (hip, ankle). But if your foot mechanics are poor or there are other issues with your squat technique, you could put new issues in there (there's a trend here). Example: a runner wrote me with weird knee soreness because of squatting. It is because his foot mechanics make him "wobbly" when he squats. So until we have the foot back to normal, we focus more on foot work and put a block under his heel when squatting until he can achieve reasonable stability on his own.

In terms of an overall exercise routine, I cannot really answer that because there is no online material available about the type of exercises that I teach personally and which are part of our philosophy (most of which are Tony Riddle's drills, credit were credit is due) but to give you an idea:

- We sit as little as possible (standing desks or take breaks to walk around or do quick squats every 25 minutes if possible)
- We pick exercises that focus directly on the posture, rhythm and relaxation that exists in running. We do them before runs and often after. 2-3 days per week are dedicated to technical circuits that address the specific issue of the athlete (i.e. if I have a "head-chaser" we have more postural drills, if I have a "sticky runner" more rhythm drills, if I have a tense runner more plyometrics on hard surfaces, if I have a runner with an over-active push-off, some barefoot running on hard rough surfaces etc.)
- We remove muscle-focused exercises and replace them with movement focused challenges that mimic practical real-world scenarios and movement and patterns
- We remove isolation movement patterns (such as bicep curls) or static movements (such as static planks) which do not train the on/off mechanism that muscles have in motion.
- We remove exercises with "false tempos" - i.e. movements are trained to be fluid and whip-like and not artificially slowed down or rigid like enforced by many training machines or as practiced by those who train the body for muscle activation and hypertrophy purely (some initial slow-motion exempted while the basic technique is being taught)
- We stay away from artificial movement patterns (especially with clinical cases) as much as possible which might set habits that will move into running (cross-trainers etc.)
- We build our training routines around "MovNat" style workouts focusing on the natural movements outlined by Georges Hebert in the 19th century: balancing, walking, crawling, climbing/hanging/traversing, fighting, jumping, swimming, throwing/catching, lifting and vaulting and the micro-skills that feed into that (i.e. learning to squat properly is part of the micro-skill that creates the macro-skill of running)
- We spread out 30 minutes of squatting across the day (say "2 minutes while brushing our teeth")
- We encourage "movement opportunism", we try to put activity back in our lives everywhere (walk the stairs, squat while filling the car, sit on the floor while watching tv or mess around in a few low-gait positions, balance a gate because it's there)
- We look at recovery as a holistic model: if you're stressed you cannot digest or recover from exercise or injury, if you cannot digest you cannot repair, if you get no activity you begin to decondition and fall into disuse syndrome. If you get no sunlight your hormonal balance is fried. And so on. But it's easy enough to start this yourself without a coach: get more sun, more pleasurable activity, eat natural foods predominantly, go to bed by 10:30 pm etc. Stress syndrome and digestive problems can be a bit trickier to catch if you don't know what to look for.

Very long answer, but as I wrote i found there was no short way to respond.

post of the day shoe in.

martyoo

I dedicated an article to the topic recently looking at the cause of Plantar Fasciitis from the perspective of Darwinian Medicine which might put this in a bit more context: http://www.championseverywhere.com/s...running-injury

Very interesting article and it makes a lot of sense. I was told that in my case of plantar fasciitis that it was caused by an uneven foot strike. Is that true and what can be done about it?

Dying to get back running again!

Raighne

martyoo wrote: »

Very interesting article and it makes a lot of sense. I was told that in my case of plantar fasciitis that it was caused by an uneven foot strike. Is that true and what can be done about it?

Dying to get back running again!

Foot strike is very important but generally the cause is mistaken for the effect when the discussion comes down to "foot strike". Here's how we see it by way of a "10 pin bowling analogy": if you analyse a "pin-strike" by only looking at how the ball strikes the pins you don't really have much information. Rather you need to look at the throw - which involves lots of elements such as the stance, the approach, stability during the throw, throw itself, the spin of the hand etc. etc.

What is called an "uneven" foot strike whether it is excessive supination (rolling outward) or pronation (rolling inwards) or other issues it is just a symptom of more fundamental issues with either your "software" (i.e. aspects of your movement controlled mainly by your mind) such as posture (segments of the body out alignment), rhythm (too rapid/too sticky getting on/off the ground) or relaxation (too much tension in muscles at inappropriate times during movement) or your "hardware"* (actual physical changes such as bunions and a "squashed big toe").

The foot strike does set in motion a chain of events that can lead to injury but it is not the root cause so not the best place to intercede. If I was working with you I would look at you running - work out how your posture, rhythm, relaxation and other important aspects are acting while running and then I'd begin to take correct them - starting with the most important ones.

Example: If your head is ahead of your body when you move you have to land ahead of yourself (or you would fall over) - this causes an uneven foot strike by default - so that would be the first thing to take out. One of our runners did this test recently as a bit of a bit of a prank - he went for traditional gait analysis and was told he supinated (he stuck his head ahead of his body to achieve this). He asked for a second analysis, corrected his posture (aligned all his segments) and was told "oh, now it's gone, how did you do that?". So foot strike is just an effect - correct the causes and it changes.

One of the most effective cues that we advise people to adopt is to forget about their feet - because the landing of the foot is too complex a movement to control with your conscious mind (which can only deal with about 40 bits of information). Your subconscious mind however can process millions of bits which is why movements are rigid and robotic when you first learn them (until you can do them as "second nature" - which means the subconscious just execute them super-quick). So we tell people to "pretend you have no foot, but just an ankle" as a way to get them to focus away from the foot strike. The moment you start to think about your landing we generally find people are in trouble - because it puts all sorts of tension into the system. That's not enough if posture etc. are still not fixed as your landing will still be a problem in those cases.

*The line is blurry between hardware and software btw because a lot of the lack of range of motion in joints is actually not a problem with the tissue - it's just the mind is tensing up the muscles. You can test this by going under a full anesthetic. When you do this most people are like contortionists (foot behind the ears flexible!). Essentially the brain tenses up muscles when it senses a range of motion it considers a threat that will injure you - whether imagined or real.


It takes a good bit of education and experience to intercede at the root cause than to treat the symptom, however, so it is not yet as common. The coach needs to be very skilled at observing human movement and needs at least a rudimentary understanding of anatomy, posture and biomechanics (more if dealing with clinical issues) as well as possessing knowledge and experience of the art of coaching movement. You can learn for life in this field, it is so intricate but it also makes it interesting.

TommyLAD

500 ml coke bottle , fill it with water and stick it in the freezer , Roll the arch straight after your run .. helped me a lot

kineiso Tape also .. amazing stuff for Planter Fascitis

DMcGSR

Plantar fasciitis is entirely to do with the speed of pronation in the foot. The rear and mid foot oppose each other, one dorsiflexes everts and internally rotates while the other plantar flexes, abduct and externally rotates to create length along the medial arch of the foot. Foot mechanics get very very complex so I won't go into it here as it would bore you to death but essentially what is happening in plantarfasciitis is that the foot lengthens and spreads too quickly. The ability of your foot to properly pronate DIRECTLY relates to you ability to load up your extensor chain muscles (calves, quads, hamstrings, gluteals, lats etc.). If for some reason you are not pronating well it decreases the neurological stimulus to the brain and your recruitment of the extensor chain muscles is much poorer than it should be and as such they don't support the transfer of your bodyweight as well as they should when walking or running. If this occurs, you can bet you sleepy ass muscles that the plantar fascia or the achilles will take the strain every time and the overload caused by poor pronation becomes tissue irritation, which becomes "plantar fasciitis".

I am an Anatomy in Motion Practitioner and a Neurokinetic Therapy practitioner, I treat these all the time. If you improve pronation, you can eliminate plantarfasciitis or tendiniitis in a couple of sessions. I have done many times in the past! And NO, orthotics are definitely NOT the answer before anyone mentions them! :-)