Saturday, October 3, 2009

Dealing with Plantar Faciitis: Trying a cast to heal the cursed thing

I have had more kind words of advice to help me recover from plantar faciitis these past few months than I can count from friends, family, Twitter, Facebook and blog followers and even complete strangers.

I've been battling this affliction off and on since 1995 when it first reared it's evil head after I finished the Santa Barbara Chardonnay 10 mile race and got micro-tears in my Achilles tendon. (I still remember that awful popping sensation in my right Achilles tendon just above my heal in the last mile of the race.) I PR'd that day but I paid a terrible price. After limping into the finishers area my running would never be the same. The Achilles tendinitis forced me to drop out of Canadian Ironman and eventually, I developed a case of plantar faciitis on my left foot--my "good" foot--while trying to recover from it. The Achilles tendinitis healed completely after a few months or so of no running. However, the plantar faciitis wouldn't go away until I got pregnant with my first child and stopped running completely for about 5 months.

But then the plantar faciitis came back again after I did the Catalina Marathon in March 2000. To combat it I wore my own homemade arch supports, eschewed wearing flip-flops, got deep tissue sports massage and cross-trained for a few months. It really didn't go away for another year. Later, I was able to train for and completed several more marathons, including the heinously fun Big Sur Trail Marathon in 2003, and later qualified for Boston. My last long, 15+ miles, run was the Boston Marathon in 2004.

To date, my current case of plantar faciitis began after I increased my running mileage too quickly in Dec'08 after joining a local running club. I was working, being mom and juggling writing a difficult research paper then, so I had very little time to train. I was doing the long running club road runs on the weekends (10-14 miles) while only running 2-3x during the week (5 miles). In hindsight this was stupid and I knew better. The pain got worse and by six months later I couldn't run a step without pain. I also had two secondary injuries: hip bursitis (right side) and lower back pain. I tried changing running shoes: first buying a new pair of my usual cushioned and structured New Balance running shoes, the NB 1224, then when my heal still hurt, I went for less structure and switched to Brooks Cascadia trail shoes. I also bought a running video of a running technique developed by Ken Mierke called Evolution Running that was mentioned by Christopher McDougal as one of the curatives for his own case of chronic plantar faciitis and Achilles tendonitis in the recent published best selling book, Born to Run. Nothing worked.

What I have tried

This past summer, to treat my plantar faciitis, I've did just about "everything but the kitchen sink". Beginning in June:
  • I stopped running
  • Cross-trained in swimming, bicycling and weight training.
  • I bought a pair of last year's racing flats on sale, Brooks T5s, and used those to walk around in with Superfeet orthotics (the green high arch model) most of the time and as soon as I got out of bed in the morning.
  • I got the book Injury Afoot by Patrick Hafner on how to treat my plantar faciitis iinjury and tried everything in the book. (Sponsorship disclosure: After I reviewed Injury Afoot, the author kindly sent me a free copy as well as some advise on good stretches for plantar faciitis sufferers on his blog "Heal Your Heel Pain".) In hindsight, I was was doing some of the stretching exercises too early, re-injuring the facia. I also wasn't diligent in obeying the book's advise to never walk barefoot. I was re-injuring the facia as soon as I got out of bed in the morning when I walked barefoot into the bathroom and three times a week when I walked barefoot from my car to the beach for my open water swims or from the locker room to the pool at our local fitness club.
  • I actively treated the the plantar faciitis stiffness and pain in my left foot with monthly Rolfing sessions (if you try this, bring a piece of wood to chew on, it's deep tissue work and can get uncomfortable)
  • Iced my heal and arch 1-2x/day (10-15 min each time)
  • Took Advil (2-4x/day, 400mg each time, as needed for pain
  • Slept with a night splint (so sexy...not!)
  • My husband administered deep tissue work on the injured foot once a week during the last month
  • I saw an orthopedic surgeon foot specialist finally
  • After the doctors visit, I wore Superfeet orthotics or the over-priced ($58 but $8 to me with insurance) heal lift given to me by my orthopedic surgeon in my shoes
During my summer of plantar faciitis, at about every 3 or 4 weeks, I would do something stupid and re-injure it. In desperation, one beautiful dawn morning while visiting Leucadia, a north county San Diego Meca for old school triathletes, I tried jogging barefoot on the hard packed sand of Moonlight beach for 30 minutes while my husband coached me on my gait for less heal striking. Another morning, I tried jogging in my socks on a treadmill (only 1 mile) after being inspired by the barefoot running tweets and articles I have been reading. Both times had disappointing and painful results. (At least the beach run was pretty.)

Nothing I have done has worked for longer than a day or so. Even the deep tissue massage and Rolfing didn't work for longer than two days. Sure, my foot felt great afterward (my whole body felt great), but the classic symptoms of tendon tightness in my arch, a hard swelling from the adhesion at the front of my heal and sharp pain (like an ice pick jabbing violently in my heal) returned after a day or so of tentative painfree bliss.

What I have not tried

I had not tried aqua-jogging, acupuncture, cortisone shots, surgery, seeing a shaman, praying to the Virgin Mary, taking supplements, meditation or wearing a cast. For now, I am trying the cast method. And, to I'm eating mostly fruits and vegetables to boost my antioxidant intake and to maintain my weight. I hope that by immobilizing my foot in a cast for 4 weeks and keeping all pressure off my plantar facia, it will be able to finally get better.

Someday I hope to be able walk and eventually run long distances again without that ice-pick-stabbing-in-the-heal debilitating pain.

If those Tarahumara that Chris McDougal wrote about in his book Born to Run can kick ass in their forties, fifties and sixties running twenty, fifty or hundred miles on mountainous trails wearing nothing but homemade tire sandals, there must be some way to recover from this affliction. I'm open to just about any suggestions people may have who have recovered from plantar faciitis.

For now, I just hope the cast and the diet of mostly fruits and veggies work.


  1. I too have had nagging, but not nearly as bad as yours! PF. I have been fortunate enough to keep it at bay via the Strausburg Sock, icing and stretching. I will be looking forward to seeing how yours progresses!

  2. Thx! So far, completely immobilizing my left foot w/PF in a cast seems to be working. I spoke with an athletic trainer this morning who had PF for about 15 months. She and I have the same doctor and he helped her. Here is what she told me on how she got rid of it finally:
    1. Kept her foot elevated on a chair most of the day (I guess she had a desk job)
    2. Used a heating pad on it constantly (no ice)
    3. Never let her PF foot touch the ground
    4. Deep tissue self-massage in arch/heel area several times a day and before get out of bed
    5. Stretched the soleus muscle/Achilles tendon/foot facia "about 50 times a day" she said (Stretch form: Stand with both hands on wall, weight on back foot bending it at the knee with toes pointing straight at the wall; keep back straight/bottom tucked in & lower torso to stretch)

    :) A

    She told me that it went away in "two days".

  3. Finally, she (the athletic trainer who had PF) said it took two days of this routine to get rid of her Plantar Faciitis. She couldn't believe it a first.

    Several people who had PF have told me that after staying off of the foot and stretching it, the pain seems to mysteriously disappear all at once.

    I'm still waiting for the PF disappearing act...

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Thank you for sharing your thoughts.
:) A