Plantar Fasciitis

Plantar Fasciitis is a pain in the arch of the foot, and is different to Sore Feet. Plantar Fasciitis is a common problem with runners and is often difficult to fix.

1 Causes

My short bout with Plantar Fasciitis was caused by a modification to one of my shoes. After Umstead 100 I had a large blister on the inside of my left heel, so I removed a large part of the shoe in that area. The modification allowed me to train, but put some extra stress on the foot. If I'd treated the problem when I first noticed the symptom, things would probably have been fine. Unfortunately, I ignored it, thinking it would go away once I moved back to my usual shoes. That did not happen and the pain flared up early in a 26 mile run. I completed the run, but this aggravated the problem, which then required more extensive treatment. Lesson #1 - treat the symptom before it becomes a problem.

2 Background

If you are not familiar with Plantar Fasciitis, I would recommend reading one of the many articles on the web, such as http://en.wikipedia.org/wiki/Plantar_fasciitis or https://health.google.com/health/ref/Plantar+fasciitis

3 Symptoms

The pain I experienced included the Plantar Fascia, but also involved pain and swelling of the muscles of the arch of the foot ([abductor halluces], [flexor digitorum brevis]). Stretching the arch and toes upward caused pain in the Plantar Fascia; the push up position became problematic as it involves that stretch. Flexing my toes caused pain under the arch, and the exercise of scrunching up a towel with your toes was difficult. The toes also lacked flexing strength when compared with my right foot.

4 Treatment

I tried a number of treatment approaches, with varying success

I reduced my running dramatically for 5 days
I checked my running shoes for any arch support. Due to the collapse of the foam under the ball of the foot, I found that there was some pressure under the arch. I removed a little more material just behind the ball of the foot, which prevented any support. (Some authorities believe that Plantar Fascia should be treated with additional arch support. I believe that the arch is a self supporting structure, and pushing up under an arch will weaken it.)
Icing the arch relieved the pain, but did not resolve the problem.
Alternate icing and heating worked slightly better than icing alone.
Using the trigger wheel was very painful, but produced significant relief. I was surprised how much pressure was needed.
Massaging the flexor hallucis longus, which is deep below the other calf muscles was almost impossible. Some deep massage in this area did return some of the strength in the flexing of the toes.
Wearing the 'Strasbourg sock' at night helped but was quite painful and interfered with sleep quality.
Icing the lower calf in an attempt to reach the flexor hallucis longus seemed to resolve the problem. This was performed after most of the other treatments and when healing was well underway, so this could be coincidence. I used a gallon Zip Loc bag filled with ice on the lower part of the calf for about 3 hours each evening for 4 days. Many authorities warn that applying ice for more than a few minutes can cause skin or nerve damage; follow my example at your own risk!

5 Caveats

My symptoms may differ from yours, and my treatment may be inappropriate. It is possible that some of the approaches I tried hindered rather than helped with the healing process. However, after 5 days I was able to run 26 miles again without any running pain, though I did have some swelling after the run. It took a couple of weeks to fully recover, at which point I was able to run 100+ MPW.