Thursday, August 6, 2009

Dealing with Plantar Faciitis, review of article about barefoot running & less is more running shoes

"Barefoot Running: Not just for bums and hippies", is a well-researched blog article found at It's an excellent source of news about the new discourse in the running community about the benefits of running barefoot or with "less is more" minimal running shoes.

The trend seems to be inspired by the book Born to Run by Christopher McDougal that came out earlier this year. The book documents the author's search for a cure for his nagging running injuries including the dreaded plantar faciitis (PF) that has ended running for many. The "Barefoot Running..." article's author Clynton expounds on the McDougal's findings about barefoot running, the running shoe industry marketing shoes known to be bad for running efficiency, and current articles. He also, very nicely and responsibly, cites his sources. (I love that!)

According to Clynton the benefits of running barefoot are these:
1. Shock absorption: Barefoot running makes you run using the body's natural shock absorption system by landing mid-foot while conventional running shoes force you to land on your heals which is damaging [my paraphrase]
2. Lighter Strike: Landing more lightly on your feet happens naturally barefoot [my paraphrase]
3. Muscle Strength: Your feet become stronger and more resilient to injury when running barefoot [my paraphrase]

What I also found useful were his several reviews of minimalist running shoes such as the Nike Free racing flats and Vibram Five Fingers shoes.

I used to run barefoot on the beach in my twenties as an undergrad at SDSU. I felt better, more free, and lighter running barefoot than plodding along on the concrete bike along the beach in my big running shoes. I had sore calves after my barefoot runs, but that was it.

Flash forward 20 years with 2 kids, 2 great careers (one in sales, other in web design) and current grad student & PT web designer ...

Bare with me on this, but I believe that our occupation, which effect the movements we do every day habitually, is directly connected to our fitness. My occupation, unfortunately, requires me to sit on my butt for hours--all day sometimes--and that is not conducive to being physically fit.

I'm not running now because of a nagging case of the dreaded plantar faciitis injury. The facia, a tendon that acts as a shock absorbing and flexible band runs from my heal to my forefoot, is badly strained and inflamed. (See drawing at the left of the Plantar Fascia from the American Academy of Orthopedic Surgeons helpful web site.) This is the the same injury that prompted author Christopher McDougal to write his book Born to Run.

To figure out how to recover from this cursed injury, my research included the above mentioned web site, several other web sites I found via Google, and two peer-reviewed articles written by physicians (that I found online via CSUN's library with my student access), and this very helpful little book that I found on Injury Afoot: 30 things You Can Do to Relieve Heel Pain and Speed Healing of Plantar Faciitis by Patrick Hafner. It seems that my case of plantar faciitis comes from a combination of variables:

1. Weak feet. At the time of injury I was sitting all day and doing short "maintenance" jogs 3-4x week--no more than 45 minutes long each.
2. Wearing heavily structured and cushioned running shoes; In my case it was the NB 1223) during my sleep-deprived grad school semesters (sleep deprivation inhibits tissue repair, etc)
2. Tight calves from inadequate stretching (because I was always in a hurry to get my run in),
3. Weak abdominal muscles (probably from sitting hunched over a compooper all day (miss-spelling of "computer" is intentional!)
4. Walking around in stiff/arch-free flipflops all day (we live at the beach) which further caused my foot muscles to atrophy
5. A dramatic increase in my weekend long runs in a couple of weeks (from 5 miles to 14 miles--more than double) when I joined our local running club in November 2008.
6. Ignoring the nagging pain in my left foot PF for months, favoring my right foot which did two things: (1) made my injury worse and (2) gave me another injury: hip bursitis on my right side. This was probably caused by subtly shifting my weight off my left injured foot to my right foot. So, I came down with two injuries by December 2008 and by May 2009 I could not walk without extreme pain, on both sides of my body and suffered from lower back pain. How dumb is that? See where ignoring the obvious gets you? Don't do what I did!

So, unlike Clynton's article implies, my case of PF is due to more than atrophied foot muscles and tendons caused by over-structured expensive running shoes, it was my lifestyle too. However, I believe those shoes contributed my weaker arches in general and, eventually, plantar faciitis. But not by themselves.

I thought my years of racing and "muscle memory" could carry me through the jump in miles. I've done 20 marathons and used to train mostly on hilly trails. As an out of shape and older grad student, road runner and web developer, my "old school" attitude that training intelligently was for beginners, got a rude smack down by the reality of my current state of fitness. I had forgotten the miles and months it used to take me to get in good running shape when I was younger.

Right now I'm walking (not running) around in a new pair of NB 1224s with Superfeet insoles for high arches nearly all my waking hours. Even with dresses. Not very flattering but I figure it's my version of foot cast. It allows the plantar facia to heal and, unfortunately, atrophy. I'm no longer in pain with I walk but the tenderness is there and I have to be very careful and slow with my feet strengthening exercises and walking barefoot right now--or I'm back to square one.

(1) My Everything-but-the-kitchen sink Plantar Faciitis Treatment Plan:

• Ice pack treatment 2x/day (no longer than 10 minutes each per my doctor friend)
• Ibuprofen when there's arch/heel pain/inflammation (per my retired PT friend)
• Wearing shoes with archsupports such as SuperFeet all the time--even at the beach (this really was not fun at the Hurley US Open Surf Championship two weeks ago!)--per my graduate adviser at CSUN who suffered from PF
• Heal rises: positive 3 sets of 20 and negative (off a step) to exhaustion, every other day
• Stretching my calves, hamstrings, glutes--everything every day
• Cross-training once or twice (if I'm lucky) a day by swimming, cycling, core workouts, elliptical workout, or weight training
• Survive a pain and straight-talk session once a month with my gifted and no-nonsense Rolfer who keeps repeating "Don't run for two months!" (I just repeat his words over and over again when I'm tempted to skip..errr... I really mean run... down the beach a bit after an open water swim or when I'm with the kids).
Wearing a night splint (which keeps my arch stretched while sleeping), etc.

If you suffer from Plantar Faciitis, the book Injury Afoot: 30 things You Can Do to Relieve Heel Pain and Speed Healing of Plantar Faciitis may help you with it's plan to get rid of it. So far, when I follow that little book's steps for healing and strengthening exercises, my foot is pain-free.

(2) As soon as my PF is healed, the plan is for me to return to barefoot running on the beach to strengthen my feet. Gradually--just mile or two at first. I've come to realize, during this injury, that my body needs more than muscle memory to get conditioned, especially at my age.

That being said, my footwear plan:

(1) I will get a pair of Vibram FFs. They fit my feet fine and the weird factor is kinda cool in my book. I like them. They crack me up! Also, I think Barefoot Ted (from book Born to Run) is on to something.

(2) For road running I also have a pair of Brooks Cascadia 4 trail running shoes that I got just before my PF injury got too painful to run. I like them, too, and I feel that my foot can flex more naturally while wearing them. I heard that Scott Jurek designed them. Maybe he added some magical running powers to their design. I need it.

(3) I don't think I will go back to wearing conventional running shoes. But, then when marathon training on concrete and asfault I'm not sure if the Vibrams and trail running shoes will adequately protect my feet from injury. I'm waiting to hear more and may purchase a pair of racing flats for this reason in the future. I was considering the Nike Free or a NB racing flat (if they have one) but I'm kinda pissed off at Nike and coventional running shoe companies right now for inventing and marketing the over-structured/padded running shoes that contributed to my running injury in the first place. I still don't know what to get.

Please comment and keep me updated on your own barefoot running or "less is more" running experiences! And, feel free to offer any "less is more" running shoe tips.



  1. I started having some Achilles tendon issues after jumping up my mileage too quickly (what? I have to do it gradually?)

    I made two big changes, one was making a concerted effort to strike gently on my midfoot not my heel.

    The other was lacing my shoes more loosely allowing my foot more movement. I got elastic laces when I started triathlons and discovered they were more comfortable. I had a new set that I hasn't adjusted properly, so I just loosened them nearly all the way. I think the looser shoes don't force the feet as much.

    Of course, I need to watch how quickly I jump up my mileage (I'm almost 47 not 20) and have been better about stretching.

    last weekend's half marathon was the first one that I didn't have that crackling noise in my Achilles for a day or two afterward.

  2. Thanks for posting this! I don't have PF but my good friend does and she has tried many things. I am going to forward your blog to her. I have been wearing the VFF at work, not for running yet though. I don't have the patience to only run a mile or so at a time yet since you can't jump right into a long run. :-) But I do enjoy being barefoot during the day and it feels better, more correct. I admire your dedication, patience and perseverance in dealing with this and have no doubt you will be back racing and running the distances you want very soon!

  3. Thanks for this - very well put! I have the book (Born to Run) ready and waiting to be read this week. I don't have any injuries but am fascinated by the idea of running barefoot/more free.

  4. I wish people would write more about this as you have done. This is something that is very important and has been largely overlooked by the paraphrase website .


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