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Am I ready to play again ?

Posted by Alan M on 8/18/04 at 07:34 (158310)

Hi everybody,

I have been dealing with PF for about 10 months now and have made great strides but I'm not sure how far to push the comeback.
I have attached a history of the problem below.
As I say at the end of the history my focus is on how my foot is and whether I am in a position to play competitive sports.
I am hoping that you will be able to help me in determining this.
I have been out for quite a while and obviously I am anxious to return to playing but at the same time I don't
want to rush it and cause myself more problems in the long run.


Problem History
First noticed while away travelling in Australia in October last year. Was running on a treadmill one day and woke up the next with pain in my foot.
Didn't take too much notice and as I was travelling didn't think much about going to see a doctor.
Got worse and worse over next few months. Went to hospital in December in Sydney.
X-ray taken and showed up nothing of concern. Went to GP as was diagnosed with PF.
Told me to rest and take anti-inflammatory drugs for a week and should be fine. Drugs helped but when they wore off it was just as bad.
Every morning would wake up in great pain.

Returned to Ireland in January and went to see GP who specialises in Sports Injuries. He gave me steroid injection and refered my to Physical Therapist.
Injection didn't do much. Therapist worked on stretching the foot and this seemed to help.
I bought a night splint to sleep in from here http://www.docortho.com/Orthopedic_Supports/Product/Plantar_Fasciitis_Resting_Comfort_Slipper_HealWell_330224.html

This had a great effect. Within 2 weeks I went from having trouble walking everyday to being able to walk fine most of the time.
Continued to get therapy and wear splint. I started wearing the splint in mid Aprill and I still wear the splint every night to this day.
I also saw a physio who worked on loosening up hip as she though this might have contributed to the pain I experienced when kicking a ball.

Then I went back in to training. I started off at jogging 2 laps of a football field and did this 3 times a week with a
rest day in between. I increased by a lap a week until I reached 8 laps.
Initially I experienced usually at most mild discomfort while running. I iced afterwards and the next day my foot ranged anywhere from fine to fairly sore.
Over time the discomfort subsided and the next day was generally good so that by the time I was at 8 laps I had little or no problems either
running or the next day.

Then I began to do a little speed work and over the space of a couple of weeks I was back able to sprint full out and not feel any illl effects
either at the time of the day after.

The next step was to go back kicking a ball. I eased my way into it and at first experienced some discomfort while kicking.
Over the next few sessions this lessened somewhat and what pain i did feel was usually in the centre of my foot as opposed to the heel area.
And the next day any discomfort felt was very mild.

Then last week I played a game for an hour. I played in football boots too which lack the support of the runners I usually wear.
I experienced some discomfort but not too much and the next day was a little uncomfortable but again not too bad.
I then tried to play again 2 days later and experienced a good level of discomfort but running and kicking.
I think that perhaps I didn't give myself enough time to recover from the hour of football 2 days previous.
The following day it was quite sore but by the day after that it was fine again.

I possibly have a football match within a week and I need to know is if I am in danger of doing damage by playing.
I have no problem playing through the pain as long as I know I'm not making it worse and that it is just a normal by-product of my foot
readjusting to kicking and running again.

Re: Am I ready to play again ?

Julie on 8/19/04 at 02:13 (158386)


I'm sure you will get a response from one of the doctors. Meanwhile...

You've been pacing your recovery and gradual return to normal (for you) activity intelligently, and it's possible you might be able to play a match without a real setback. I would wait, though. Through all the activities you've described, you've gone carefully, monitored your pain levels, stopped in time to avoid further injury, and taken time to rest and heal in between. In a match situation you might not be able to be so sensible: the excitement and the pressure you'd be under to perform, and to not let the team down, could override good sense. Under those sorts of conditions, we don't always notice when we're hurting, and you could injure yourself without realising you'd done so until it was too late.

So for that reason, I would be inclined to forego competitive sport for a while longer. You are on the way to recovery, and it would be a great pity to backtrack now.

Also, it sounds from your history that you don't really know what caused your PF. You haven't seen a foot specialist and been thoroughly evaluated. Anti-inflammatories, a steroid injection and physiotherapy don't constitute comprehensive treatment. Possibly you have biomechanical issues and these should be identified and addressed. This is important for everyone, but especially for someone whose feet take the pounding yours take. If you need orthotics to correct, for example, overpronation, you ought to have them before you return to competitive football.

If you do decide to play next week I'd suggest that you at the very least you tape your feet for additional support. You can find instructions and illustrations in part 2 of the heel pain book, which you should read in any case for a better understanding of PF.

Also, as a general rule (I'm sure you know this) make sure that you stretch religiously before and after any impact activity, whether running or football. The fact that the night splint has been helpful indicates that your gastroc/soleus/achilles complex is in need of stretching.

(Note for Americans who read this thread, Alan lives in Ireland, so for 'football' read 'soccer'. Around here, what you call football we call rugby.)

Re: Am I ready to play again ?

Alan M on 8/19/04 at 04:07 (158388)


Thanks for the helpful comments.
You are of course correct in what you say.
I have a appointment to have a Biomechanical analysis tomorrow to see if I need orthotics.
So I guess the 'soccer' will just have to wait.
Its already waited 10 months so another while won't hurt.
It just gets very frustrating as I'm sure everyone who reads this site will echo.
On the up side though 4 months ago I couldn't walk to the shop without help and now I can run and sprint again so there is light at the end of the tunnel.


Re: Am I ready to play again ?

Julie on 8/19/04 at 05:20 (158389)


You're doing terribly well and are nearly out of the tunnel! The intelligent way you've handled and are handling your situation, and your steady improvement, will inspire others here.

Let us know what the biomechanical analysis reveals. If you do need orthotics, and if they're correctly casted, prescribed and made, they should help you a lot. You might find it useful to read through past posts on the Shoes/Orthotics board (you can use the search facility too) to get an idea of what's involved, what to look for, questions to ask, etc. Our resident pedorthist, Richard, is always very helpful.