Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

advise needed

Posted by Dave on 1/21/04 at 05:04 (142513)

Hi. I've been suffering from plantar fasciitis for about 4 months now. My background is I'm a runner and I think it came on as a result of a poor pair of shoes, as I already have arch support insoles. I have a night splint and I stretch my calves and hamstrings regularly. I am at the point now where I can train again quite hard, and some days I feel no pain at all, and some days only a dull ache in the base of my heel (but I must ware the night splint, otherwise the mornings are still very painful). At no point is it an acute pain, but I am conscious that the pain is not getting any better. Does anyone have any advise whether it will just gradually disappear or is it best to totally get rid of all pain and use of the night splint before commencing training?

Re: advise needed

sandy h. on 1/21/04 at 06:18 (142514)

I think you should take this opportunity to take a break from running and try some other exercise like swimming or cycling (make sure to use low gears for the terrain). When you go back to running, do it gradually. I made the mistake of taking a break and then going headlong back into a race and that's what did me in. Don't underestimate this injury's ability to get worse if it doesn't heal totally.

Re: advise needed

BrianJ on 1/21/04 at 09:00 (142531)

Dave --

Sandy is absolutely right. PF is a strange and dangerous condition. It may not feel like a big deal now, but it will become chronic if you don't give it a LOT of rest now. I tried to 'train through the pain' -- and have now had PF for six years.

Re: advise needed

Rick R on 1/21/04 at 11:01 (142539)

Dave,

Sandy and Brian gave you sound advise. I also was a runner when this hit me 20 years ago. It's so easy for people to give the advise to just quit and find some other exercise, so it becomes as easy for us to blow it off. Any serious runner over time has run through countless episodes injury, pain and discomfort. PF has the potential to shut you down for good, do not let it. Do not expect your garden variety doctor to have a solid understanding of this particular condition or understand that he may be in over his head. You need someone that has experience with this be he/she a podiatrist or orthopedic. Come back here for feedback.

The fact that you are still susceptable to morning pain without that night long stretch, to me is an indicator to give it a rest and seek help. Rest is the proverbial double edged sword. I can't begin to caution you enough on the potential harm you might do by underestimating how gradual your return to running needs to be.

If I were in your shoes I'd stop running, stop the aggressive stretching (foot on the floor hands on the wall). I'd continue the gentle night splint, and light stretching and Julie's yoga stretches (you'll find her here) and massage. I'd take Ibuprofen at night before bed(Your Dr might tell you how much). Do the whole routine at night and don't put the foot/feet down until morning. Stop going barefoot. Keep running shoes at your bedside wear them as slippers. If that means you need to buy another pair or drag a retired pair out of the closet so be it.

I'd want the symptoms to be gone for a month prior to resuming more aggressive stretching let alone running. Gradualy resume stretching for several weeks prior to that grand running attempt. If you can get back to stretching without a problem over that time, then it's time to give it a try. I'd tape up before running. I think anyone that has ever had this to any extent shouldn't ever try to run without tape. Even if you have only had symptoms on one foot tape both. The rest makes you more susceptable so that your good foot may not be to good anymore (oh yea happened to me). My normal run prior to PF was 5 - 7 miles and double on one day of the week. I'd start with nothing over one mile. Ice for 10 min after you get back. Take a day off. Go one mile the next day ice. Keep a days rest and ice routine while you increase the mileage as long as all goes well. I'd try a plan that takes 2 months for a return to normal mileage. The last thing to attempt is running on consecutive days.

I have come to understand that I am a bit of an extreeme case and I did make it back to running 5 miles a day. I'm in a down time now, oddly enough caused by not running and spending roughly 15 hour days on my feet(no way can I do both even without the time factor). I must confess it's easier to give this advise than it is to follow it.

Rick

Re: advise needed

Dave on 1/22/04 at 03:23 (142610)

Thanks for taking the time to reply. very kind. you have all scared me into action!!! all running and stretching has totally ceased, and i have joined a guy to try to keep some sort of CV fitness. I have got a doctors appointment tomorrow so fingers crossed i get a bit of NHS treatment! thanks agaign

Re: advise needed

Julie on 1/22/04 at 08:28 (142616)

Dave, ask your doctor for a referral to a podiatrist. You need someone who has knowledge of the foot and its problems, and the equipment to properly evaluate and diagnose you, and the expertise to put a treatment programme in place. If you're in London, or anywhere near, I can recommend my podiatrist. You'd have to see him privately, but I'd advise that if you can afford it: it may take you quite a long time to get an NHS referral to podiatrist. Your GP is very unlikely to have the specialist knowledge you need.

Ron McCulloch's website is http://www.londonpodiatry.com .
.

Re: advise needed

Julie on 1/22/04 at 08:30 (142617)

I've just realised that 'guy' probably meant gym, and that CV is cardiovascular. Be careful: avoid the treadmill. Rowing machine is fine, recumbent bike may be all right as long as you watch your technique and as long as using it doesn't cause pain. With PF the simple rule is 'if it hurt's, it's causing re-injury, so stop'.
.

Re: apology for unnecessary apostrophe -nm

Julie on 1/22/04 at 08:38 (142619)

.