Plantar Fasciitis
My pain in the heel!
I’ve now joined the millions of runners who have experience with Plantar Fasciitis. Besides being hard to say and as hard to spell as a Hawaiian surname it is a, to use a technical term, ‘sucky’ injury. But, as I always strive to do when confronted by the unfortunate twists and turns of this running life, I ask the important question, “What can I learn from this?” and “What good can I get out of the experience?”
I’m not Mother Teresa. I’m just too old and I really don’t have the attention span to worry about stuff I can’t change! Also, I’m not a Doctor, just runner so your contents may vary.
What is Plantar Fasciitis?
I’m glad you asked. It is an inflammation of the ligaments that connect your metatarsals (toes) to your heel. It is a lot like Tendonitis, but it’s a ligament so they use the term Fasciitis or basically inflammation of the Fascia. The ligament is like a big bundle of tough rubber bands. There are five strands of these that stretch back along the bottom of your foot and all attach at the same point on the front of your heel.
What happens typically is that this attach-point gets somehow injured and inflamed. This is what has happened to me. It manifests as heel pain and feels like a bruise. As the condition worsens the pain will often start to radiate up the ligaments towards the toes.
What makes this injury a stinker is that there is very little blood flow to this area. This makes it hard for the injury to heal. If you keep running on it, it becomes chronic and two bad things happen. First, the swelling cuts off what little blood flow there is and second, hard scar tissue forms. The scar tissue also cuts off the blood flow and is easily reinjured because it is not flexible like the healthy ligament.
All of these things combined with the fact that it’s hard to live without using your feet, even if you stop running, make Plantar Fasciitis hard to get rid of.
How did I get it?
I can’t be sure but I will repeat advice I’ve given in the past. When you get an unexpected injury it is typically because you are doing something differently. Also, it’s typically a combination of things, not just one causal factor.
This injury manifested when I cut over from road running to trail running and mountain biking in May and June. Ironically trail running and mountain biking is what I like to think of as my recovery time from road racing in the summer season.
I don’t think the trail running volume or the mountain bike volume was directly to blame. However I think the combination of this volume and the shoes I was wearing are probably the culprits. You heard me complaining that I needed new shoes in May and June. I was running these long 2-3 hour trail runs in either my old Brooks Launch or my old NB MT101’s.
The Brooks Launch, besides being pretty worn out, don’t have a lot of support in them, especially for running technical trails. They are not designed for that action and I can definitely see where I could have stretched these ligaments by landing on a root or rock wrong in the dark.
The MT101’s are fairly minimal as well and have a very stiff sole, or outer, with minimal cushion. They are ok on the trails, but once my foot was injured they did nothing to protect it, especially on the road segments that I run in between trails.
The punch line is that I have a new pair of Brooks Cascadia that have the cushion and support I need to do long technical trail runs. But the damage has been done and I need to get this healed up.
I thought I was resting it over the last 3 weeks. I wasn’t running, sure, but like a dope I was doing all those squats and calf raises and riding my mountain bike up giant hills standing in the pedals. It aint gonna heal unless I stay off it.
How will I cure it?
I went to see my guy, Dr. Hester, who has pulled my bacon out of the fire many times before and he explained it all to me. First, I have to stop running. I can ride, but only if I stay in the seat and don’t stand up in the pegs.
He prescribed me some strong anti-inflammatories and told me to ice and stretch it several times a day. I am also wearing the night splint boot to keep my foot in the flexed position while I’m sleeping. I already own one from previous bouts of Achilles Tendonitis. (but that’s another story).
He also recommended some PT, but I don’t really believe in PT unless I can do it myself – the time/cost benefit doesn’t work for me.
If things go very badly he said they sometimes do cortisone injections to break up the scar tissue but this is the nuclear option and can damage healthy tissue as well.
To summarize, I’m learning how to heal this and will let you know what works and what doesn’t, but I take the long view. It’s ok with me if it takes 6 months to heal, but I’d much rather it took 2 weeks.